Worst Ebola outbreak ever gets worse: top Ebola doctor now infected

[QuotaMan]

http://www.vox.com/2014/7/23/5930311/ebola-virus-disease-outbreak-africa-facts-guinea

 

http://theconversation.com/what-happens-to-your-body-when-you-get-ebola-28116

 

The deadliest Ebola outbreak in recorded history is happening right now. And Reuters reports that the head Ebola doctor in Sierra Leone has contracted Ebola and is receiving medical care.

 

That doesn't necessarily mean he will die, though. The death rate during this outbreak has been roughly 60 percent. And it's an unfortunate blow in a long battle that doesn't look like it's slowing down.

THE CURRENT OUTBREAK HAS KILLED 632 PEOPLE AND INFECTED ABOUT 1,000

 

Sierra Leone is one of several countries battling the current outbreak, which is unprecedented both in the number of cases and in its geographic scope. It's now hit three countries: Sierra Leone, Guinea, and Liberia.

 

And the virus — which starts off with flu-like symptoms and often ends with horrific hemorrhaging — has infected about 1,048 people and killed an estimated 632 since this winter, according to the numbers on July 17 from the World Health Organization.

 

Ebola is both rare and very deadly. Since the first outbreak in 1976, Ebola viruses have infected thousands of people and killed about one-third of them. Symptoms can come on very quickly and kill fast:

This data is what the CDC has on record. Not every case or death always gets officially recorded, so there is always some wiggle room in numbers like these. 2014 is estimate of the current outbreak as of June 24, 2014 from the WHO.

 

 

Journalist David Quammen put it well in a recent New York Times op-ed: "Ebola is more inimical to humans than perhaps any known virus on Earth, except rabies and HIV-1. And it does its damage much faster than either."

 

So why is Ebola doing so much damage right now? Here's a primer on what's going on.

  Why is Ebola back in the news?

 

Ebola tends to come and go over time.

The viruses are constantly circulating in animals, most likely bats. Every once in a while, the disease spills over into humans, often when someone handles or eats undercooked or raw meat from a diseased ape, monkey, or bat. An outbreak can then happen for several months. And then it becomes quiet again.

Ebola can completely disappear from humans for years at a time. For example, there were zero recorded cases of Ebola in 2005 or 2006.

  Where is the current Ebola outbreak?

This map is up to date as of June 20, 2014. CDC/VSPB

 

The current outbreak started in Guinea sometime in late 2013 or early 2014. It has since spread to Sierra Leone and Liberia, including some major capital cities. It's the first time Ebola has ever reached a state capital.

  Why is this particular outbreak so deadly?

 

First, this outbreak concerns the most deadly of the five Ebola viruses, Zaire ebolavirus, which has killed 79 percent of the people it has infected. (The virus is called that after the formerly named Zaire, which, along with Sudan, experienced the first Ebola outbreak back in 1976.)

These death rates were calculated by adding up the records of cases and deaths from all known outbreaks. Individual outbreaks can vary, and Zaire ebolavirus is often cited as having death rates up to 90 percent. Data in this chart doesn't include the most recent 2013-2014 outbreak.

 

There are also social and political factors contributing to the current disaster. Because this is the first major Ebola outbreak in West Africa, many of the region's health workers didn't have experience or training in how to protect themselves or care for patients with this disease.

 

What's more, an NPR story suggests that people in these countries tend to travel more than those in Central Africa (where outbreaks usually occur). That may have helped the virus disperse geographically, and it made it difficult to track down people who might be infected.

 

MANY OF WEST AFRICA'S HEALTH WORKERS DIDN'T HAVE TRAINING DEALING WITH EBOLA

 

Meanwhile, as an editorial in the medical journal Lancet noted, social stigmas and a lack of awareness may lead people to not seek medical care (or even avoid it). Another often-cited problem is that some people have had direct contact with victims' dead bodies during funerals and preparations for burial, which can spread the disease.

 

A World Health Organization assessment in Liberia noted problems with tracing patients' contacts with other people, "persisting denial and resistance in the community," and issues with "inadequate" measures used to prevent and control infections, weak data management, and "weak leadership and coordination," according to a statement released on July 19.

 

On June 23, the humanitarian group Doctors Without Borders sent out a distress call. As the only aid organization treating people with Ebola, the group said it was "overwhelmed," that the epidemic was out of control, and that it couldn't send workers to new outbreak sites without getting more resources.

 

In many ways, how well a country can deal with an Ebola outbreak comes down to basic health-care practices and public education. With enough resources poured into the effort, people should be able to contain this outbreak. So far, however, these countries are struggling.

 

Does Ebola really make people bleed from their eyes?

 

 

Yes. Bleeding from orifices is one of the more unusual and memorable symptoms of viral hemorrhagic fevers like Ebola. In later stages of the disease, some people bleed from the eyes, nose, ears, mouth, and rectum. They may also bleed from puncture sites if they've had an IV.

 

External bleeding can be one of the main symptoms that can help people realize they're dealing with a case of Ebola, since other signs — first fevers and headache, then vomiting and diarrhea — can be caused by any number of illnesses. Internal bleeding can happen, as well.

 

But it doesn't always happen. For example, this study of a 1995 outbreak in found external bleeding in 41 percent of cases. And bleeding didn't correlate with who survived and who didn't.

 

What actually kills people is shock from multiple organ failure, including problems with the liver, kidneys, and central nervous system.

 

Symptoms come on abruptly after an incubation period of 2 to 21 days. And people generally die between day 6 and 16 of the illness.

 

Why is Ebola so deadly?

 

One of the main things that seems to make Ebola viruses especially deadly is that they seem to be able to evade much of the human immune system. Among other problems, white blood cells from the immune system are often seen to die off in patients. And if the body can't fight fully back, the virus can just keep taking over.

 

Scientists are still figuring out exactly how this happens, and they have several promising leads. One is that the virus is making proteins that act as decoys, interfering with the body's ability to fight back.

 

How hard is it to catch Ebola?

 

Ebola is relatively hard to catch. Unlike measles or the flu, it's not spreadable over the air through casual contact.

 

In order to get Ebola, someone must touch the blood or bodily fluids (including sweat, urine, and semen) of a person or animal who's infected (alive or dead). People can also catch it through indirect contact with victims' fluids, such as via bedding or medical equipment.

 

People generally aren't infectious until they get sick.

 

This limited transmission ability is one of the main reasons why Ebola outbreaks can often be stopped within weeks or months. What it takes is public education and good health-care hygiene like patient isolation, sterilization procedures, and the use of gloves and masks.

 

A view of gloves and boots used by medical staff, drying in the sun, at a center for victims of the Ebola virus in Guinea. AFP/Getty Images

  What are the chances of Ebola spreading to the US?

 

 

The Ebola viruses known today don't spread from person-to-person well enough to have much risk of causing a wide pandemic across several continents. The risk of Ebola coming to the US is very low.

  How do you treat Ebola?

 

 

Patients are treated for symptoms, including IV fluids for dehydration. It's important to remember that some people do survive an Ebola infection.

 

Hopefully, in the future there will be more options. For example, researchers are working to find drugs, including a recent $50 million push at the National Institutes of Health. And scientists are working on vaccines, including looking into ones that might be able to help wild chimpanzees, which are also susceptible to the disease.

 

[jocky king]

Very scary , someday it may spread to the world , if that does , we are fucked .

[Cosmic36]

Read the book "the Hot Zone". Will leave you with a warm and fuzzy feeling inside.

[QuotaMan]

http://news.yahoo.com/official-ebola-kills-senior-doctor-liberia-094351470.html

 

 

MONROVIA, Liberia (AP) — One of Liberia's most high-profile doctors has died of Ebola, officials said Sunday, and an American physician was being treated for the deadly virus, highlighting the risks facing health workers trying to combat an outbreak that has killed more than 670 people in West Africa — the largest ever recorded.

 

 

A second American, a missionary working in the Liberian capital, was also taken ill and was being treated in isolation there, said the pastor of a North Carolina church that sponsored her work.

 

Dr. Samuel Brisbane, a top Liberian health official, was treating Ebola patients at the country's largest hospital, the John F. Kennedy Memorial Medical Center in Monrovia, when he fell ill. He died Saturday, said Tolbert Nyenswah, an assistant health minister. A Ugandan doctor died earlier this month.

 

The American physician, 33-year-old Dr. Kent Brantly, was in Liberia helping to respond to the outbreak that has killed 129 people nationwide when he fell ill, according to the North Carolina-based medical charity, Samaritan's Purse.

 

He was receiving intensive medical care in a Monrovia hospital and was in stable condition, according to a spokeswoman for the aid group, Melissa Strickland.

 

"We are hopeful, but he is certainly not out of the woods yet," she said.Early treatment improves a patient's chances of survival, and Brantly recognized his own symptoms and began receiving care immediately, Strickland said.

 

The American missionary, Nancy Writebol, was gravely ill and in isolation in Monrovia, her husband, David, told a church elder via Skype, according to the Rev. John Munro, pastor of Calvary Church in Charlotte, N.C.

 

Munro said the couple, who had been in Liberia for about a year, insisted on staying there despite the Ebola threat. "These are real heroes — people who do things quietly behind the scenes, people with a very strong vocation and very strong faith," Munro said.

 

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A man reads a newspaper on a Lagos street with the headline Ebola Virus kills Liberian in Lagos, Sat …

There is no known cure for the highly contagious virus, which is one of the deadliest in the world. At least 1,201 people have been infected in Liberia, Sierra Leone and Guinea, according to the World Health Organization, and 672 have died. Besides the Liberian fatalities, 319 people have died in Guinea and 224 in Sierra Leone.

 

Ominously, Nigerian authorities said Friday that a Liberian man died of Ebola after flying from Monrovia to Lagos via Lome, Togo. The case underscored the difficulty of preventing Ebola victims from traveling given weak screening systems and the fact that the initial symptoms of the disease — including fever and sore throat — resemble many other illnesses.

 

Health workers are among those at greatest risk of contracting the disease, which spreads through contact with bodily fluids.

 

Photos of Brantly working in Liberia show him swathed head-to-toe in white protective coveralls, gloves and a head-and-face mask that he wore for hours a day while treating Ebola patients.

 

Earlier this year, the American was quoted in a posting about the dangers facing health workers trying to contain the disease. "In past Ebola outbreaks, many of the casualties have been health care workers who contracted the disease through their work caring for infected individuals," he said.

 

There is no known cure for Ebola, which begins with symptoms including fever and sore throat and escalates to vomiting, diarrhea and internal and external bleeding.

 

The WHO says the disease is not contagious until a person begins to show symptoms. Brantly's wife and children had been living with him in Liberia but flew home to the U.S. about a week ago, before the doctor started showing any signs of illness, Strickland said.

 

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Men read newspapers on a street with headlines about Ebola Virus killing a Liberian in Lagos, Nigeri …

"They have absolutely shown no symptoms," she said.

 

A woman who identified herself as Brantly's mother said the family was declining immediate comment when reached by phone in Indiana.

 

Besides Brantly and the two doctors in Liberia, Sierra Leone's top Ebola doctor and a doctor in Liberia's central Bong County have also fallen ill.

 

The situation "is getting more and more scary," said Nyenswah, the country's assistant health minister.

 

Meanwhile, the fact that a sick Liberian could board a flight to Nigeria raised new fears that other passengers could take the disease beyond Africa.

 

Nigeria's international airports were screening passengers arriving from foreign countries, and health officials were also working with ports and land borders to raise awareness of the disease. Togo's government also said it was on high alert.

 

Security analysts were skeptical about the usefulness of these measures.

 

"In Nigeria's case, the security set-up is currently bad, so I doubt it will help or have the minimum effectiveness they are hoping for," said Yan St. Pierre, CEO of the Berlin-based security consulting firm MOSECON.

 

An outbreak in Lagos, a megacity where many lived in cramped conditions, could be a major public health disaster.

 

The West Africa outbreak is believed to have begun as far back as January in southeast Guinea, though the first cases weren't confirmed until March.

 

Since then, officials have tried to contain the disease by isolating victims and educating populations on how to avoid transmission, though porous borders and widespread distrust of health workers have made the outbreak difficult to bring under control.

 

News of Brisbane's death first began circulating on Saturday, a national holiday marking Liberia's independence in 1847.

 

President Ellen Johnson Sirleaf used her Independence Day address to discuss a new taskforce to combat Ebola. Information Minister Lewis Brown said the taskforce would go "from community to community, from village to village, from town to town" to try to increase awareness.

 

In Sierra Leone, which has recorded the highest number of new cases in recent days, the first case originating in Freetown, the capital, came when a hairdresser, Saudata Koroma, fell ill. She was forcibly removed from a government hospital by her family, sparking a frantic search that ended Friday. Kargbo, the chief medical officer, said Sunday that Koroma died while being transported to a treatment center in the east of the country.

 

 

[QuotaMan]

Fears rose Friday that the Ebola virus may have spread as Nigerian authorities said they have quarantined two people who may have the disease and have another 69 under observation.

 

With fears the disease may get a toehold in Nigeria’s most populous city, Lagos, the head of the World Health Organization warned that the virus in West Africa was outstripping efforts to control it.

 

Dr. Margaret Chan was speaking at a meeting of the leaders of four West African countries in Conakry, the capital of Guinea, to discuss measures to bring the disease under control. The WHO said it planned to release $100 million to deploy hundreds of medical staff to fight the disease.

"This outbreak is moving faster than our efforts to control it. If the situation continues to deteriorate, the consequences can be catastrophic in terms of lost lives but also severe socioeconomic disruption and a high risk of spread to other countries," Chan said. “This meeting must mark a turning point in the outbreak response.”In recent weeks the epicenter of the outbreak has shifted from Guinea to Sierra Leone.

 

In Nigeria, authorities insisted they had the situation under control after a Liberian, Patrick Sawyer, 40, became ill with Ebola while flying into the commercial capital, Lagos, and later died there in a hospital. The spread of the disease to Lagos has raised fears that cases may emerge farther afield in other parts of Africa, Europe, the United States or elsewhere.

 

 

The immediate worst-case scenario would be for the disease to take hold in Lagos – crowded, poverty-stricken in many areas, and at times chaotic, posing the risk it could spread throughout Africa’s most populous country.

 

“It would be foolish for us to think it couldn’t spread. I think this is a potential worldwide threat,” said Ebola expert G. Richard Olds, dean of the School of Medicine at UC Riverside, noting that in past outbreaks of highly infectious diseases, including SARS, AIDS and monkey pox, the diseases eventually reached the U.S.

 

“If it takes hold in Nigeria, we have a real problem on our hands. I’d be very concerned about that because Lagos would be the most concerning situation: It’s a very densely populated area and is in a situation where the healthcare infrastructure is probably ill prepared to deal with this type of virus.”

 

The chief medical officer of the Lagos Teaching Hospital, Akin Osibogun, said the hospital had tested 20 blood samples for possible Ebola cases, all of which tested negative, Nigerian media reported Friday.

 

However, there were signs of panic and chaos. A man’s corpse was brought into Anambra state in recent days as cargo from Liberia, underscoring doubts about whether adequate measures are in place to control the disease. The cause of the man’s death wasn’t known.

 

Authorities on Thursday cordoned off the morgue where the body was being held.

 

“We are surprised how the corpse came into Nigeria and Anambra state. It is shocking to us,” a local health official, Josephat Akabike, told Vanguard newspaper. “We have directed the police to cordon off the area. Ebola is a very big threat and that is why we are taking all the measures.”

 

Uganda, Kenya and South Africa all said Friday they had no suspected cases of the disease.

 

South African authorities warned they would not allow anyone into the country who knowingly arrived with the Ebola virus -- but said they would admit and treat anyone who arrived with symptoms if they were not aware they had the disease. The country has thermal scanners at airports capable of detecting people with elevated temperatures.

 

South Africa has had two reports of Ebola-like symptoms, both which turned out not to be Ebola, according to South Africa's National Institute of Communicable Diseases.

 

Ebola initially presents with common, flu-like symptoms -- fever, headache and body aches. The disease, while highly contagious, is not airborne and is transmitted through contact with bodily fluids, including sweat and blood.

 

The terror in West Africa has hampered efforts to control it, with people running away rather than going into isolation wards, which are associated with death.

In her remarks, Chan said it was important to combat the popular view that Ebola was a certain death sentence, which impeded efforts to get people to seek help in hospitals and treatment facilities. People instead keep their loved ones hidden at home or turn to traditional healers, causing the virus to spread.

 

She warned that “public attitudes can create a security threat to response teams when fear and misunderstanding turn to anger, hostility, or violence."

 

Chan also said it was also important to change cultural attitudes around burial.

 

For relatives of victims, washing and burying the body is culturally important, but also highly dangerous and one way in which the disease has spun out of control.

 

Olds said that while the disease has a high fatality rate – more than 50% - and was highly contagious, it is not as contagious as SARS, because it is not an airborne virus.

 

Previous outbreaks had occurred in remote areas of Africa, where the population wasn’t mobile, making it easier to contain, but this outbreak occurred in a more densely populated region with a highly mobile population, accounting for the rapid spread of the disease and difficulties containing it.

 

“It’s particularly dangerous when it gets into areas that are densely populated and have weak health infrastructure,” he said.

 

 

http://www.latimes.com/world/africa/la-fg-guinea-ebola--20140801-story.html