H5N1

ECDC: CDTR for week 44

ECDC has published Communicable disease threats report, 26 October-1 November 2014, week 44. Click through to download the PDF, as always one of the best overviews available. The abstract:

The ECDC communicable disease threats report is a weekly bulletin intended for epidemiologists and health professionals in the area of communicable disease prevention and control. 

Summarising information gathered by ECDC through its epidemic intelligence activities regarding communicable disease threats of concern to the European Union, it also provides updates on the global situation and changes in the epidemiology of communicable diseases with potential to affect Europe, including diseases that are the focus of eradication efforts.

Saudi Arabia: No new MERS cases as of noon October 31

Via the KSA MOH Command and Control Center: MOH: 'No New Corona Cases Recorded'. No new deaths or recoveries either.

The numbers are 16 cases under care, 436 recovered, 789 total, and 337 deaths.

Braving Ebola in Liberia

Via The New York Times, a feature article: Braving Ebola. Click through for the full report and photographs. Excerpt:

The patients arrive, at first fearful of the people in spacesuits whose faces they cannot see. They wait for test results, for the next medical rounds, for symptoms to appear or retreat. They watch for who recovers to sit in the courtyard shade and who does not. They pray. 

The workers offer medicine, meals, cookies and comfort. They try to make patients smile. Very, very carefully, they start IVs. They spray chlorine, over and over, and they dig graves. They pray. 

These are the people of one Ebola clinic in rural Liberia. Run by the American charity International Medical Corps, the clinic rose in September out of a tropical forest. It now employs more than 170 workers, a mix of locals and foreigners, some of them volunteers. 

There are laborers trying to make money for their families, university students helping because Ebola has shut down their schools, and American doctors who, after years of studying outbreaks, are seeing Ebola’s ravages in person for the first time. A mobile laboratory operated by the United States Navy has set up shop at a shuttered university. Now, test results come back in a matter of hours instead of several days. 

Some of the workers will stay a few more weeks, or until the end of the year. Many of the Liberians vow to remain until the disease is gone, when they can go back to their old jobs or resume their former lives. They work toward a time after Ebola.

Indonesia: Two suspected MERS cases in Jambi

Via The Jakarta Post: Jambi reports pilgrims infected with MERS. Excerpt:

Two Jambi residents, who just returned from performing a haj pilgrimage in Saudi Arabia, are reported to have contracted Middle East Respiratory Syndrome (MERS), a viral respiratory disease caused by the MERS coronavirus (MERS-CoV). 

They are undergoing medical treatment in an isolation facility at the Pinang Minang Masak pavilion of Raden Mattaher Hospital (RSUD), Jambi. 

The pavilion’s head, Neli Wirlis, said the two pilgrims suspected of being infected with MERS-CoV were a married couple and were now undergoing intensive treatment. 

To confirm MERS-CoV infection in the two patients, RSUD Raden Mattaher, together with the Jambi administration’s health agency, conducted laboratory testing. 

“We continue to give intensive treatment to the two patients while waiting for lab test results from Jambi Health Agency,” said Neli on Thursday. 

The agency’s head of disease control and environmental health (P2PL) directorate, Kaswendi, said the married couple showed symptoms that were similar to MERS CoV infection shortly after they arrived in Jambi. 

“They developed a high fever, severe cough and are short of breath,” he said.

'We can control Ebola here, by helping Africa': Swedish health minister

Via The Local.se: 'We can control Ebola here, by helping Africa'. Click through for the full report and a video. Excerpt:

The Local meets the face of Sweden's Ebola crisis team, the country’s new 29-year-old Public Health Minister, Gabriel Wikström.  

Plunged into his first ministerial post just as one of the biggest health crises in Africa for decades spread into Europe, the man overseeing Sweden’s world-renowned healthcare system has got a lot on his plate.   

In the three weeks since he was appointed, the number of Ebola scares in Sweden has reached double figures, although as yet no cases have been confirmed.   

"We are working round-the-clock to see that we have good preparation in Sweden in case we get Ebola," says Gabriel Wikström as we sit on two yellow striped armchairs in his modest office, just across the bridge from Sweden’s parliament.

"But the best disease control we can have in Sweden is really to help the west African countries that are already affected," he adds.

Sweden’s new Social Democrat-Green coalition initially faced strong criticism from international aid agencies and charities, who accused one of Europe’s richest countries of standing on the sidelines as its Nordic neighbours sent increasing numbers of doctors to fight the crisis in west Africa and boosted their financial contributions.

Not any more. Sweden is now the fifth largest donor in the world after Gabriel Wikström revealed earlier this month that it would invest an additional 100 million kronor ($13.89 million), taking its overall spending to around 240 million kronor.   

The move led to Prime Minister Stefan Löfven getting a call from US President Barack Obama to discuss ways to combat the ongoing epidemic.   

Over the weekend the country pledged a further $15 million to the UN’s global Ebola fund. 

"We need to make a common stand," says Wikström.   

"I can't give you any details, but we are speaking to other countries - to try and co-operate with others."

Ebola in Liberia: Man loses 35 relatives, faces eviction

Via FrontPageAfrica: He Lost 35 Relatives to Ebola, Then, Landlord Gives Him Notice. Excerpt:

Morris Kromah, 40, a resident of Chicken Soup factory — one of Monrovia’s slum communities — has lost 35 members of his family to the deadly Ebola virus. Now his community refers to him as an Ebola carrier. He had to get the Police intervention for members of the community to stay off his back. 

Kromah is among the many Ebola survivors who are finding it difficult to reintegrate into their various neighborhoods. “The worst of all is the community stigmatization,” he says. “I have been taken to the Police station twice because people in the community say I have been circulating the virus.” The Police made the accuser write an apology to Kromah, but he says it is not enough. He says the government must find a way to provide Ebola survivors and their families with protection from hostile community members. 

“The most frustrating part is that personnel of the Ministry of Health told me to go sit at home to observe 21-day quarantine,” he says. “As I speak to you, I have [been] quarantined for more than four times. That’s 21 days times four. I took myself to the center, I’m aware that Ebola is deadly, that it kills. People don’t need to remind me of what I’ve suffered.” 

To make matters worse, Kromah says his landlord has given him an eviction notice. He says the owner of the house in which he lives has not been sympathetic to him. “I feel very disgusted. I have to pray to be able to withstand this, because it’s hard to take,” he says. 

“Now as I speak to you, I have no job, nowhere to get money. The landlord saw that I lost a lot of people to Ebola, yet she gives me notice to leave the apartment by November 17.”

US ambassador quarantined at JFK after Ebola visit

Via The Telegraph: US ambassador quarantined at JFK after Ebola visit. The headline is misleading; she's not confined in isolation. Excerpt:

The US ambassador to the United Nations has been held in mandatory quarantine at a New York airport after returning from Ebola-stricken West Africa. 

Samantha Power arrived at John F Kennedy airport on Thursday on a US government plane after visiting Guinea, Sierra Leone and Liberia, three countries worst affected by the virus that has killed more than 5,000 people. 

Upon leaving the plane, customs officers took Ms Power’s temperature before asking questions about her health and interaction with Ebola patients. Ms Power’s delegation is not believed to have come into contact with anyone infected. 

The ambassador was then given an information kit including a thermometer and a card to record her temperature. She must report twice daily to the New York state health department for the next 20 days. 

Several US states have imposed a mandatory quarantine on healthcare workers returning from the region who had contact with Ebola patients. 

The crackdown came after Craig Spencer, a New York doctor diagnosed with Ebola last week, traveled back to the city and went about his daily life for a week before being diagnosed. 

Speaking in Brussels on Thursday, Ms Power suggested some countries were not doing enough to fight Ebola and some restrictions on aid workers returning home from Ebola-hit nations could deter thousands from helping.

Liberia’s Ebola crisis puts president in harsh light

Via The New York Times: Liberia’s Ebola Crisis Puts President in Harsh Light. Excerpt:

Ms. Johnson Sirleaf is the first woman elected president of an African country, a Nobel Peace Prize winner and arguably the most recognized leader on the continent. Rising from a junior bureaucrat, she became one of the few top Liberian officials not executed by firing squad during the 1980 military coup. From a jailed dissident in the 1980s, she became one of Newsweek’s 10 top leaders in the world. 

But Ebola is threatening to derail that legacy. The epidemic has exposed crippling weaknesses in the public health system, decrepit infrastructure that has still not been dealt with more than a decade after the war, and endemic corruption that, despite Ms. Johnson Sirleaf’s protestations of “zero tolerance,” continue to characterize the interactions between Liberians and their government.

 “The international community has arrived and is now seeing our backyard for the first time,” said Francis Dunbar, a former deputy finance minister who now supports Benoni Urey, a Johnson Sirleaf rival who was once a close adviser of Charles Taylor, the former president convicted of crimes against humanity. “The front yard is clean but the backyard is dirty.”  

Karin Landgren, the United Nations secretary general’s special representative here, echoed a similar theme. “Ebola has shone a very harsh light on the many things that had not been done adequately. Very tangible things, like the health care system.”

Virus sleuths chip away at Ebola mysteries

Via NPR's Shots blog: Virus Sleuths Chip Away At Ebola Mysteries. Excerpt:

Vincent Racaniello, who studies viruses at Columbia University, says Ebola has recently become his obsession. 

"I find myself reading incessantly about Ebola when I should be doing other things," says Racaniello, host of the online show This Week in Virology, which has devoted several recent programs to Ebola. 

The unprecedented Ebola outbreak probably has more virologists thinking about Ebola than ever before. And while scientists have learned a lot about this virus since it was discovered almost four decades ago, there's still a lot left to wonder about.

Racaniello and his virologist buddies wish they knew some really basic things — like, how does the virus actually slip into cells? What part of the cell's surface does it latch onto to get access? Knowing that might let scientists figure out ways to block it. 

And how do outbreaks of Ebola actually start? "This is a really important question," says Racaniello,"because if we could figure out where the virus comes from we might be able to take measures to stop that." 

Scientists believe the virus circulates in fruit bats, which seem to carry Ebola without getting sick. But no one knows the details of how bats pass it to humans or other species. 

"We know for sure that gorillas and chimpanzees and some antelope have been infected with Ebola in the past," says veterinarian and epidemiologist Jonathan Epstein of EcoHealth Alliance, an organization devoted to understanding and predicting the emergence of diseases. "But the mechanism for spillover isn't totally clear, and so that's an area where more study needs to be done."

Ebola in Sierra Leone: UK aid ship docks in Freetown

Via BBC News: Ebola outbreak: UK aid ship docks in Sierra Leone. Excerpt:

A UK ship has arrived in Sierra Leone to help deal with the deadly Ebola outbreak in the West African country. 

Royal Fleet Auxiliary Argus is carrying food, medical equipment and 32 pick-up trucks, to help keep hard-pressed Ebola treatment centres going. 

Doctors, nurses and military personnel are also on board. The ship has docked in the capital, Freetown. 

Ebola has killed nearly 5,000 people and infected more than 10,000 in West Africa since March. 

RFA Argus set sail from Falmouth in Cornwall on 17 October and is also carrying three Royal Navy Merlin helicopters. 

The BBC's Africa correspondent Andrew Harding said it would act as an offshore base for the aid effort, and described it as an "important moment". 

He said there was now the "beginnings of hope" in Freetown that the giant international aid effort was beginning to get under way.