Nigeria has successfully contained Ebola, U.S. hopes to learn from their response
AFRICA’S most populous country has reason to celebrate. According to Nigeria’s health ministry, the West African country has officially claimed control over the Ebola outbreak ravaging nearby nations, USA Today reported. No new cases of the virus have been reported since Aug. 31. Nigeria’s “extensive response to a single case of Ebola shows that control is possible with rapid, focused interventions,” Tom Frieden, director of the Centers for Disease Control and Prevention (CDC), told the news source.
Students sing during an assembly in Lagos, Nigeria, on October 8, 2014. Public and private schools in at least 11 states resumed academic activities after having been closed due to the Ebola outbreak.
According to information from the CDC updated on October 7, Nigeria has been downgraded to a Level 1 watch by the organization because of the decreased risk of Ebola transmission.
Nigeria’s success has grabbed attention from U.S. officials hoping to prevent transmission of the virus in America, after Liberian Thomas Eric Duncan was diagnosed with Ebola in Dallas. On Wednesday, Duncan, 42, died at Texas Health Presbyterian Hospital. The CDC is sending researchers to Lagos, Nigeria’s largest city, to study how the country was able to control the disease.
The Guardian reported that the ongoing struggle to eradicate polio in Nigeria – recently complicated by Boko Haram’s insurgency – actually helped the country in thwarting Ebola. The Bill & Melinda Gates Foundation built an emergency command center in 2012 to survey the presence of polio in the region, and the existing system helped enable the country to proactively contain the spread of Ebola.
Utilizing emergency operations, healthcare personnel in Nigeria had confirmed 19 cases of Ebola, as well as one probable case, Reuters reported. By Sept. 24, officials had identified 894 contacts with those cases and conducted 18,500 visits with those who’d potentially been infected to check for Ebola symptoms. In the weeks since, no new cases have emerged.
But while Nigeria is sighing of relief, transmission of the virus continues in the hardest-hit West African nations of Guinea, Liberia and Sierra Leone. According to the World Health Organization’s latest report, there have been 3,865 deaths and 8,033 total cases worldwide to date.
Ebola panic is getting pretty racist
The first time a reporter asked a CDC representative whether Thomas Duncan — the first patient to receive an Ebola diagnosis in the US — was an American citizen, the question seemed pretty tame. One could excuse it as a general inquiry about the Duncan’s nationality during the first press conference announcing his diagnosis. But after the CDC declined to answer, the question kept coming. “Is he a citizen?” reporters repeatedly asked. “Is he one of us?” they meant.
“IS HE ONE OF US?” THEY MEANT.”
The current Ebola crisis has been tinged with racism and xenophobia. The disease rages in West Africa, and has therefore largely infected people of color. But somehow Americans were among the first to get a dose of Zmapp — the experimental anti-Ebola drug — this summer, despite the fact that Africans have been dying from the current Ebola epidemic since its emergence in Guinea in December. There are a lot of reasons for that, of course. The drug is potentially dangerous and only exists in short supply. It’s also extremely costly. And it originated in Canada, so it’s unsurprising that North America controls its use.
And now that Ebola has “reached” the U.S., American privilege – white privilege, especially – is floating to the surface, in even less subtle ways.
The difference in treatment for US patients and African patients is stark, beyond the use of experimental drugs. Some Ebola-stricken regions in West Africa don’t have access to fuel to power ambulances, and many health workers lack the protective gear to stave off infection. Which is why it’s so strange that Duncan’s health has been used as an excuse to voice concerns about the presence of foreigners in Dallas. Instead of asking government officials why the WHO has a much smaller budget than the CDC or why it has suffered massive cuts in the last two years, Americans have preferred to focus on themselves.
“Duncan’s Health Is An Excuse To Voice Concerns About Foreigners
” Yesterday, The Raw Story wrote about how immigrants living in the same neighborhood as Duncan’s family were facing immense discrimination. Some have been turned away from their jobs, David Edwards writes, while others have been refused service in restaurants. The color of their skin and their accents makes them a target, even though they never came into contact with Duncan, and therefore pose zero risk. It doesn’t matter: they’re dark-skinned and foreign. They’re in Dallas. They might be infectious.
Now, an ugly new hashtag has emerged: #Obola, a coinage that was popularized thanks to a tweet by conservative writer Dinesh D’Souza, and a Michael Savage radio segment. If you don’t get the reference, I don’t blame you. The President’s name doesn’t exactly resemble “Ebola.” But D’Souza, a known “birther,” has somehow managed to liken a name like Obama with a disease that’s raging in Africa — not in the US. Predictably, this has given racist xenophobic Americans a banner to rally around.
What is the Ebola virus?
Most people’s views of Ebola are probably informed by Hollywood — they think of it as a deadly and contagious virus that swirls around the world, striking everyone in its path and causing them to hemorrhage from their eyeballs, ears and mouth until there is no more blood to spill.
In reality, Ebola is something quite different. About half of the people who contract Ebola die. The others return to a normal life after a months-long recovery that can include periods of hair loss, sensory changes, weakness, fatigue, headaches, eye and liver inflammation.
About the blood: while Ebola can cause people to hemorrhage, about half of Ebola sufferers ever experience that Biblical bleeding that’s become synonymous with the virus.
More often than not, Ebola strikes like the worst and most humiliating flu you could imagine. People get the sweats, along with body aches and pains. Then they start vomiting and having uncontrollable diarrhea. These symptoms can appear anywhere between two and 21 days after exposure to the virus. Sometimes, they go into shock. Sometimes, they bleed. Again, about half of those infected with the virus die, and this usually happens fairly quickly – within a few days or a couple of weeks of getting sick.
Nor is Ebola as contagious as Hollywood would have you believe. You need to have contact with the bodily fluids — vomit or sweat or blood — of someone who is symptomatic and shedding the virus to get the disease. That’s why health-care workers and family caretakers who nurse the sick have borne the burden of Ebola.
The virus isn’t airborne, thankfully. Experts expect that it will never become airborne. As Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, told the Senate recently: “Very, very rarely does [a virus] completely change the way it’s transmitted. “
What makes Ebola scary is the fact that there is no cure or treatment yet on the market, but those who have access to hospital care — including fluids and antivirals — have a much higher chance of beating the disease. The trouble is, until now, Ebola always strikes in Africa — and among populations where few have access to that kind of advanced medical care.
13 things you need to know about Ebola
13 CARDS / EDITED BY JULIA BELLUZ UPDATED SEP 28, 2014, 6:00P
Funerals, ghost towns and haunted health workers
The roots of our Ebola fears
CNN’s John Bonifield contributed to this story.
The six biggest myths about EVD debunked
Updated by Susannah Locke
THE world is currently experiencing the worst Ebola outbreak on record. It started in Guinea in December 2013 and has since spread to four other countries in West Africa. On September 30, a patient was diagnosed in the United States for the first time. Altogether, the outbreak has infected more than 6,500 people and killed about 3,000.
Unfortunately, as Ebola spreads, there has been a surprising amount of misinformation on the subject. Here are five common myths you might have heard about Ebola, debunked:
(1) Myth: Ebola outbreaks are unstoppable
That’s not true. In fact, every previous Ebola outbreak has been controlled and stopped. It is true, however, that the current Ebola outbreak has been much tougher to contain.
There have been 33 previous outbreaks of various Ebola viruses on record, all of which have been contained and stopped with far smaller death tolls than this one.
In previous outbreaks, health officials have successfully followed these steps to stop the disease from spreading: (1) find the patients (2) isolate the patients (3) find everyone those original patients have contacted (4) keep the patients isolated until they’re no longer a threat. This approach is capable of containing an outbreak in most places around the world, including in the United States.
The massive outbreak this year in West Africa is new and unusual — and Ebola managed to spread so widely because of a combination of factors. It took several months before officials even realized that Ebola was in the region, many of those countries had impoverished health-care infrastructures, and the international response was weak and delayed. That gave the disease time to spread, making it much, much tougher to contain once people realized it was Ebola. In September, some scientists predicted that they expect the outbreak to last another 12 to 18 months.
(2) Myth: Ebola is a death sentence
In fact, about half of Ebola patients survive. And good medical care may be able to improve outcomes.
Ebola doesn’t kill everyone who catches it. The current big outbreak, which is centered in West Africa, has killed roughly half of those who have contracted the disease.
The survival rate in all previous outbreaks of the Ebola virus EBOV (formerly called Zaire ebolavirus) has been about 20 percent. Those who survive can go back to good health and rejoin their communities. (And they’ll be somewhat protected from that Ebola virus for at least the next 10 years.)
Although there is no specific cure for Ebola, good medical care can help people survive. Treatment may include IV fluids to prevent dehydration from diarrhea and vomiting, as well as antibiotics to prevent or treat other infections in the body. (Ebola seems to have a suppressive effect on the immune system, which can make people especially susceptible to additional infections by unrelated bacteria.)
Some people have also received experimental therapies, but there isn’t enough data yet to know if they’re helpful.
(3) Myth: Ebola patients always hemorrhage blood
In fact, most Ebola patients don’t bleed at all. Many earlier symptoms of Ebola look a lot like the flu.
Bleeding is one of Ebola’s more recognizable symptoms — but it doesn’t happen to everyone, and it’s rarely a huge volume of blood. For example, one study of a 1995 Ebola outbreak found external bleeding in only 41 percent of cases. And people who bled weren’t any more likely to die than those who didn’t.
One of the trickiest things about Ebola is that in its early stages it often looks like other feverish illnesses, such as malaria or the flu, making it difficult to diagnose. If bleeding does happen, it’s usually in later stages of the disease. Some people may bleed from the eyes, nose, ears, mouth, or rectum. They may also bleed from puncture sites if they’ve had an IV. Internal bleeding can happen, as well. What actually kills people isn’t hemorrhaging itself. It’s shock from multiple organ failure, including problems with the liver, kidneys, and central nervous system.
(4) Myth: Ebola is an airborne disease
The reality is that Ebola spreads through bodily fluids.
Ebola’s mode of transmission is through the bodily fluids of someone who is ill with Ebola (or has died from Ebola). It’s not an airborne disease that floats around for long distances.
If someone coughs, sneezes, or vomits close to your face, it’s possible that Ebola could be transmitted to you through those bigger liquid droplets if you get them into your eyes, nose, or mouth. However, Ebola doesn’t travel far through the air like some other viruses, such as the flu or the measles. Sitting several rows away from an infectious Ebola patient on a plane shouldn’t put you at risk. Nor would sitting across the room from someone with the disease.
In addition, Ebola is unlikely to develop the ability to become transmitted over long distances through the air. It’s exceptionally rare for a virus to change how it infects people. As Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told Congress in September: “Very, very rarely does [a virus] completely change the way it’s transmitted.”
(5) Myth: Ebola is easy to get
Ebola is much harder to catch than, say, the measles. To contract Ebola, you have to come into contact with the bodily fluids of someone who is already showing symptoms.
To catch Ebola you have to somehow touch the bodily fluids of someone who has symptoms of the disease.
People who are incubating the virus but not yet ill are not infectious. You need to touch those bodily fluids, including sweat, blood, vomit, or diarrhea, and then somehow get the virus into your body through your mouth, eyes, nose, some other mucus membrane, or an open cut. Corpses can also be infectious, and the virus can stay on surfaces for several hours if not properly decontaminated.
An epidemiologist writing in the Washington Post notes that Ebola is currently spreading from each patient to only one or two other people on average. And for comparison, he notes that before measles vaccination became standard, each case of measles transmitted to an average of 17 other people.
In a hospital using proper infection-control procedures, health-care workers should not catch Ebola. Several Americans have been treated for Ebola in the U.S. this year, and no cases have been transmitted in a U.S. hospital.
For more on this one, check out Julia Belluz’s story on how you can — and can’t — catch Ebola.
6) Myth: Ebola is the most dangerous disease on the planet
In fact, Ebola kills far fewer people than many other diseases, including malaria and HIV/AIDS.
Even though Ebola has one of the highest death rates among infectious diseases, it doesn’t kill nearly as many people in Africa as HIV/AIDS, respiratory infections, diarrhea, and malaria. That’s because far more people end up getting those other diseases.
That said, Ebola can still be deadly. The CDC currently projects a possible worst-case scenario of as many as 1.4 million total cases in Liberia and Sierra Leone by January 20, 2015. (The outbreak is thought to have started very late in 2013, so that would be roughly 1.4 million cases in one year.)
If that worst-case scenario happens, it could mean roughly 700,000 deaths, which could bump Ebola up to the third slot on this chart.
Another complication worth noting is that the Ebola outbreak has been overwhelming whatever health-care systems have been in place in many of the countries affected in West Africa, which has been leading to more deaths from non-Ebola health problems such as malaria.
“West Africa will see much more suffering and many more deaths during childbirth and from malaria, tuberculosis, HIV-AIDS, enteric and respiratory illnesses, diabetes, cancer, cardiovascular disease, and mental health during and after the Ebola epidemic,” disease researchers Jeremy Farrar, of the Wellcome Trust, and Peter Piot, of the London School of Hygiene and Tropical Medicine, said in an editorial in The New England Journal of Medicine in September.
Correction: Fixed the statement about the protective effect that being an Ebola survivor has on the risk of future Ebola infections.
The majority of Ebola deaths may not be from Ebola
Last week, the World Bank said Ebola may deal a “potentially catastrophic blow” to the West African countries reeling with the virus. Businesses are shutting down, people aren’t working, kids aren’t going to school.
The epidemic has also led to widespread food insecurity. “The fertile fields of Lofa County, once Liberia’s breadbasket, are now fallow. In that county alone, nearly 170 farmers and their family members have died from Ebola,” the WHO director warned. “In some areas, hunger has become an even greater concern than the virus.”
There’s also the fact that people are going to suffer and die more from other diseases as the scarce health resources in the region go to Ebola. Speaking at the United Nations, Dr. Joanne Liu, international president of Médecins Sans Frontières, said, “Mounting numbers are dying of other diseases, like malaria, because health systems have collapsed.”
Jimmy Whitworth, the head of population health at Britain’s Wellcome Trust, told the Independent in an interview, “People aren’t going to hospitals or clinics because they’re frightened, there aren’t any medical or nursing staff available.”
“West Africa will see much more suffering and many more deaths during childbirth and from malaria, tuberculosis, HIV-AIDS, enteric and respiratory illnesses, diabetes, cancer, cardiovascular disease, and mental health during and after the Ebola epidemic,” wrote disease researchers Jeremy Farrar, of the Wellcome Trust, and Peter Piot, of the London School of Hygiene and Tropical Medicine in an article in the New England Journal of Medicine.
So this virus has wreaked incalculable damage on not only the bodies of those infected, but on others who are not getting health care they need, and the health systems and economies of West Africa.
Dr. Ezie Patrick, with the World Medical Association who is based in Nigeria, focused on the simple and disquieting fact that Ebola has also taken the lives of health workers in places where the ratio of doctors per population is currently about 1: 6,000. “Sadly Ebola is claiming the lives of the few doctors who have decided to work in these challenging health systems thereby worsening the dearth and also increasing the brain drain leading to far fewer doctors in the region.”
The disaster could last longer than the epidemic itself. Before the Ebola outbreak, West African nations were seeing promising signs of economic growth. Sierra Leone, for example had the second highest real GDP growth rate in the world. Liberia was 11th in 2013.
Now, there’s worry that Ebola will slam the brakes on that development. “A prolonged outbreak could undercut the growth that these countries were finally starting to experience, taking away the resources that would be necessary for improving the health and education systems,” says Jeremy Youde, a professor of political science at the University of Minnesota Duluth.
“These countries are generally not starting from a great position as it is, so they don’t have much of a cushion to absorb long-term economic losses. If the international economy turns away from West Africa and brands it as diseased, that could be very problematic.”
Cynicism dies hard in Ebola-hit Liberian slum
By Marc Bastian
Monrovia (AFP) - IN the narrow, gloomy alleyways of one of West Africa’s largest slums, Liberian teenagers explain the dangers of Ebola to their neighbours but the message is falling on deaf ears.
West Point, a squalid township of 75,000 jutting from Liberia’s capital Monrovia into the Atlantic Ocean, has been awash with cynicism since being quarantined at gunpoint after riots in August.
The population density in the byzantine network of tin-roofed shanties is staggering. People live cheek-by-jowl, touching, jostling — and presenting the perfect opportunity for proliferation of a virus that many residents even refuse to believe exists.
“It’s one of the worst communities in Liberia. There are a lot of bad guys, a lot of violence and criminality,” says social worker Prezton Vaye.
A group of young girls in West Point are on the front line of the fight against an epidemic which has killed 2,000 Liberians, with an initiative they call “A-Life”, or “Adolescents Leading the Intense Fight against Ebola”.
They have received training to deliver information from UNICEF and a local charity called Think on preventing the spread of the tropical pathogen.
The girls have a shared history: A-Life is the second iteration of a community support group they formed to combat sexual violence.
They were persuaded Ebola was an even more pressing concern however when an armed mob attacked and looted an isolation centre in the slum, sparking a national panic when a group of infected patients escaped.
The government’s response to the incident was swift and brutal. On August 20 the slum’s residents were surrounded by a cordon of soldiers and heavily armed police.
A riot ensued, with the inhabitants pelting security forces with stones and provoking return fire. A teenager, Siafa Kamara, was fatally wounded.
The lockdown stayed in place for ten days and, by the time it was lifted, many residents had decided there was no Ebola in West Point at all, heightening their sense of injustice at having been penned in.
- ‘People don’t listen’ -
“I want to help my fellow citizens. There are a lot of sick people in West Point, but the people here still don’t believe Ebola is real, because they don’t see (anyone) die,” says Jessica Neufville, 16.
Twice a week, around 60 teenagers in sky blue T-shirts fan out through West Point’s alleys, going from door to door, or opening to opening where no doors have been installed.
“We tell people how they can protect themselves: no shaking hands, avoid body fluid contact. We tell them that if someone in the family is sick, one particular person should take care of the sick, in a specific room,” Jessica tells AFP.
The response, she says, is often mistrust, or blank faces at best.
“People don’t want to listen, they say it’s not true,” she tells AFP.
President Ellen Johnson Sirleaf echoed Jessica’s frustration at the launch of an international youth coalition against Ebola in Monrovia on Thursday, speaking out against Liberians failing to accept the reality of the epidemic.
“We can build Ebola treatment units across the country, establish testing centres, bring in all the medication and personal protective equipment, but if the behaviour of Liberians is not changed, the virus will continue to spread,” she said.
In a lane about 1.5 metres (five feet) wide, three mothers sit on a small wooden bench, leaning against a wall. The girls surround them, one delivering the well-rehearsed message.
One mother hides her face in her hands, embarrassed or perhaps hostile. The other two never deign to look up or speak, busying themselves instead with plaiting their hair.
The day’s canvassing passes without incident or impediment, but things don’t always go so smoothly, says Vaye, the social worker.
“People don’t want to hear about Ebola. They say the government is lying, it’s a way to take our money,” he tells AFP.
Among those least open to being educated on Ebola are the most destitute residents of a community where penury was a way of life even before the epidemic destroyed the black market economy.
The A-Life girls collar another mother on their rounds but find that health concerns are not among her priorities.
“I want work. Since Ebola, there’s nothing. I want work,” she says.
Americans stocking up in survival gear
WASHINGTON — The first patient diagnosed with Ebola on U.S. soil may have died, but health experts say Americans don’t need to stock up on survival gear.
“I really can’t see that that’s an appropriate or reasonable response,” Arthur Reingold, Head of Epidemiology at the University of California, Berkeley, told The Huffington Post. “It’s reasonable for people to be concerned, though I would argue they should be more concerned about the dreadful situation in West Africa.”
“The fact is we don’t have transmission on the Ebola virus here in the community,” Reingold said. “I just can’t see why anybody would want to spend money on those kinds of things in response to concern about Ebola.”
Nonetheless, fears about the spread of Ebola have led to a spike in sales of disease protection supplies. LifeSecure, a Chicago-based emergency preparedness company, has sold more than 100 “Extended Infection Protection” emergency supply kits since officials confirmed the first case of Ebola in the U.S. last week, according to owner David Scott. Typically, LifeSecure sells just a handful of such kits per week.
“People are being reminded that there is a chance something that’s on another continent can make it here in one flight,” Scott told HuffPost. “Sooner or later, these kinds of supplies will have to be used generally by the entire population.”
Government officials and health experts say such an outbreak is extremely unlikely. But Bloomberg News reported that LifeSecure’s infection kits, along with simpler items like preparedness books and surgical masks, have been flying off the shelves.
Survivalists or “doomsday preppers” are also selling advice. For $2.99, Kindle owners can own “Ebola: Natural Remedies + Government Conspiracies,” an e-book published Sept. 4 that accuses the U.S. and the CDC of knowingly allowing the deadly virus to come to America. (In August, two Americans infected abroad had been brought home so they could recover in American hospitals.)
There has also been an uptick in purchases of Ebola-themed merchandise such as neckties, earrings, and coffee mugs, according to Adweek. Consumers can also purchase plush toys shaped like the microscopic image of the virus. Items like these have been available for years, Adweek notes, but their sales have increased in recent months.
Ebola has infected more than 7,400 people in West Africa and more than 3,400 have died, according to the World Health Organization. On Wednesday, Thomas Eric Duncan, who contracted the illness in Liberia and became the first patient diagnosed with Ebola in the U.S., died in a Dallas hospital. Officials said yesterday they’re monitoring the several dozen people with whom Duncan had contact and so far, none have shown symptoms. To date, nobody has been infected in America.
Most Americans aren’t worried they’ll be exposed to Ebola, according to a Pew survey. Fifty-eight percent of respondents are confident the federal government can prevent an outbreak, while just 32% percent are either very or somewhat concerned.
Meanwhile, charitable organizations like the American Red Cross and UNICEF report that they’ve received less from individual donors than they’ve gotten in response to previous crises, according to CNN.
Why didn’t Texas Ebola patient receive experimental drug sooner?
Doctors were concerned about the risks the experimental drug posed to the Ebola patient, Thomas Eric Duncan. But a worsening condition appears to have changed the equation.
By Patrik Jonsson
NEWS that Thomas Eric Duncan, the dead Ebola patient in Dallas, was receiving an experimental antiviral drug is another chapter in a fast-moving geopolitical drama exploring, patient by patient, the frontiers of medicine and ethics.
As the global community scrambles to contain the virus, and as the cases outside Africa grow, questions have been raised about why Mr. Duncan, a Liberian war survivor who came to the United States to marry his son’s mother, hasn’t received the same experimental drug that doctors say may have played a role in the recovery of two American medical workers, Dr. Kent Brantly and aid worker Nancy Writebol.
The medical community, led by the Centers for Disease Control and Prevention (CDC), is scrambling to find a medicine to stave off the disease. Two potential Ebola vaccines are now being tested on humans, but even if they’re deemed successful, it will be months before they’re available.
Meanwhile, with Duncan “fighting for his life,” in the words of CDC Director Tom Frieden, a nephew of Duncan’s said: “I don’t understand why he is not getting the ZMapp [the experimental drug administered to Dr. Brantly and Ms. Writebol].” Joe Weeks made the statement to ABC News.
The maker of ZMapp says it doesn’t have any of the drug left. The doses given to the Americans were part of a small batch that took months to develop. It will take the company several months before more of the serum is available, the drugmaker said.
Dr. Frieden has also said that doctors have balked at giving Duncan experimental drugs because side effects may present a mortal threat. The fact that he’s now receiving an experimental drug suggests that his situation has gotten worse to the point where the potential benefits outweigh the potential risks.
Texas Health Presbyterian Hospital said Monday that Duncan is being given brincidofovir, a “broad spectrum” antiviral that has shown promise stopping Ebola, at least in a test tube. The drug is also judged to have fewer side effects than other experimental treatments, which probably played into the doctors’ decision to try this particular drug.
In cases where doctors want to use drugs on humans in ways that haven’t been tested, they apply directly for special permission from the Food and Drug Administration. The agency granted that permission in the Duncan case for compassionate use.
An American Ebola patient in Nebraska is also being treated with brincidofovir. Ashoka Mukpo is a freelance cameraman working for NBC who was diagnosed with the illness while on assignment.
Other Ebola patients have received other drugs. Dr. Richard Sacra, an American who was diagnosed with Ebola in Liberia and came back to the US for treatment, was given TKM-Ebola, which is also experimental.
And a French nurse has received a Japanese anti-flu drug called favipiravir, in hopes it will stave off Ebola.
In addition, Norwegian health authorities just announced that a Norwegian woman being treated for Ebola in Oslo will receive the last remaining dose of ZMapp in the world. Authorities said they were “lucky” that they were able to secure the serum from storage in Canada.
Share this post
Comments
Thank you for your post. However, remember to give credit to the website that you copied and pasted by including originating web link after the discussion or article.