An Ebola scare at the Dominase SDA Hospital in the Ashanti Regional has created panic in the area. A man believed to be in his late twenties died in the hospital with the symptoms of Ebola Tuesday. He
was left unattended to by frightened hospital staff who did not have
basic protective equipment with which to handle the patient. According
to the Medical Superintendent of the hospital, Prince Kwakye Afriyie,
the deceased reported to the hospital three days ago with fever.
He was treated and discharged. But the Pusiga native returned to the hospital, this time with blood oozing out of his orifices, Dr Afriyie said.
Frightened
hospital, suspecting the victim to be suffering from the deadly Ebola
which has killed over 2000 across West Africa, called the District
health authorities for Personal Protective Equipment.
There was none there. More soon.http://www.modernghana.com/news/570792/1/ebola-scare-hits-dominase-1-dead-2-hospital-staff-.html
Medical team dressed in Ebola apparel conveying the body
Fear and panic has gripped residents of
Kintampo in the Brong-Ahafo Region following the bizarre death of a
young man suspected to have been infected with the deadly Ebola virus. The
man, who was on board a Kumasi-Bolga bound mini bus with registration
number GT 9982 E, allegedly complained of some ailment and started
having running stomach and vomiting blood when the vehicle got to
Kintampo Sunday morning. He died some few minutes later.
Eyewitnesses
told DAILY GUIDE that the development created panic among both the
passengers and the residents around the lorry park where he passed on,
as medical personnel, dressed in their full Ebola apparel, stormed the
scene to convey the body to prevent people from contacting it.
The
Disease Officer of the Kintampo Municipality, Kofi Adams, confirmed the
death of the man to this paper when contacted on telephone. He said the
body had since been buried, whilst the blood sample had been taken to
the Noguchi Medical Research Centre in Accra for testing.
Mr Adams
therefore appealed to residents of the area and the general public not
to be scared by the incident since it was not anything serious as
earlier speculated, whiles waiting for the full result to ascertain the
actual cause of death. He disclosed to DAILY GUIDE that the
deceased was among a group of students from the Upper East Region who
went to the Wassa area in the Western Region to embark on galamsey
(illegal mining) activities during the holidays to earn some money to
pay their fees. And, on their way back to the region, the deceased
suddenly fell sick and died. According to Mr Adams, the cause of
death could be mercury poison. Mr Adams indicated that a similar
incident happened recently at the Goaso area where a Galamseyer died
vomiting blood as a result of mercury poison. http://www.modernghana.com/news/570653/1/suspected-ebola-man-dies-at-kintampo.html
MONROVIA, Liberia — Looking for a new approach to blunt the Ebola epidemic sweeping West Africa, the Liberian government, the World Health Organization and their nonprofit partners here are launching an ambitious but controversial program to move infected people out of their homes and into ad hoc centers that will provide rudimentary care, officials said Monday.
The
effort, which is expected to begin in the next few weeks, is an
intermediate step, officials said. The goal is to reduce the chances
that Ebola patients will infect their own families and others while
ensuring that they receive basic care — such as food, water and pain
medicine — at a time when many hospitals and treatment centers are closed.
The initiative
also is a tacit acknowledgment that it could be weeks, even months,
before new treatment facilities promised by the United States and others
are operational. Continued reliance on home-based care doesn’t do much
good, officials said, in taming a devastating epidemic in a country
where large groups of people live in crowded, urban settings. The
proposed community care centers, as they are dubbed by officials, would
have between 15 to 30 beds. Ultimately, as many 70 centers could be set
up across Liberia, if the strategy proves successful. Such a program
has never been tried on such a large scale.
A similar effort is being discussed for Sierra Leone.
The
10 Ebola treatment centers in West Africa are based on a design of
three wards, which help separate patients suspected of having the
disease from patients with a certain diagnosis. Ebola care units would
have two wards (one each for both suspected and confirmed cases), with a
few beds per ward and a triage zone.
The total number
of cases of Ebola in West Africa is doubling every three weeks, with
each person with the virus infecting as many as two other people, health
officials say. That high rate of transmission is making it impossible
to contain the worst Ebola outbreak on record.
The new treatment
beds promised by Washington and others “are not coming fast enough,”
Peter Graaf, the WHO’s country representative in Liberia said Monday.
“We have to get to the point where every Ebola patient infects less than
one [other person]. You have to get out of your house.”
The community care centers are supposed to complement the recently announced U.S. military effort to build facilities for 1,700 Ebola patients across
Liberia, as well as ongoing efforts by other groups to provide several
hundred beds. There are now slightly more than 380 beds in Monrovia,
which has a population of 1.5 million people. One of the main
organizations involved in fighting the outbreak, Doctors Without
Borders, is dubious about the new effort and has decided not to take
part. Brice de le Vigne, the group’s director of operations, warned that
the proposed community care centers could worsen the situation. “This
is not going to work,” he said. “To move people in an epidemic is a big
responsibility, and it requires huge logistical capabilities” that the
affected countries simply don’t have. To be effective, he said,
these care centers need to have strict infection control, adequate
supplies, trained staff, regular supervision, the ability to diagnose
and refer patients, and proper burial methods. Otherwise, they could
turn into “contamination centers,” he said.
De le Vigne said the
top priority should be deploying more trained staff to run the
higher-level treatment centers in hospitals and clinics.
Nigeria, Senegal are halting its spread, the World Health Organization said, although the overall death toll rose.
Sept. 22, 2014Doctors
transport Manuel Garcia Viejo, who is infected with Ebola, upon arrival
at the hospital in Madrid. Viejo worked as a doctor at St. John of God
Missionary Hospital in Sierra Leone, where he treated people diagnosed
with Ebola.Hospital La Paz-Carlos III via European Pressphoto Agency
Nearly
6,000 people in West Africa have been infected with the virus, and
2,833 have died, the WHO says. Liberia, the hardest-hit nation, has had
more than 3,000 infections and 1,578 deaths, according to the latest WHO data.
But
this laboratory-confirmed case count is well below the actual number of
people infected, according to the WHO and global health experts.
Doctors Without Borders, for example, has said that number represents
only 20 percent of the current caseload, meaning the true number of
cases could be in the tens of thousands. “I
think the message is that this outbreak isn’t going to turn around
until we get people out of their homes and into safe places,” said Frank
Mahoney, who is leading the team from the U.S. Centers for Disease
Control and Prevention here. No one would be relocated to the
community care centers against his or her will. A draft report by the
WHO stresses the need to work cooperatively with communities that want
to isolate individuals who are infected or suspected of being infected.
The project is aimed at people who are showing symptoms of the disease
but are not in the later stages of the illness. Patients would get food,
water, sanitation, analgesics and other necessities.
The care
centers would be located in former health clinics or other medical
facilities, many of which have closed, according to the WHO’s Graaf.
In
contrast to the basic-care community centers, the medical facilities
that provide special Ebola treatment — including the ones the United
States and others will be setting up — provide a higher level of care
and a better-trained staff.
Because many people with Ebola are
being cared for at home, efforts are underway to distribute as much
chlorine and as many rubber gloves, buckets and other hygiene items as
possible. But officials say such steps don’t go far enough.
In a
few locations here, residents already have started a version of the
community-care program on their own, moving infected people into, for
example, a shuttered school and attempting to feed and care for them
without becoming infected themselves. As
envisioned, the new plan would be a somewhat more sophisticated
alternative to that, including testing to determine whether a person has
Ebola, anti-malarial drugs, infection control and body removal and
cremation or burial. Each person moved into the center would be
accompanied by a family member or friend charged with taking care of him
or her; that relative would be supplied with protective gowns and
gloves and taught their proper use.
Graaf said setting up the
facilities, supervising them and getting the word out will be
labor-intensive. He declined to say how much the plan would cost, saying
those figures have not been finalized. De le Vigne of Doctors
Without Borders said the hardest-hit countries don’t have the
infrastructure to put in place the logistics, discipline and clear chain
of command needed for the community centers to work properly,
especially when patients become sicker and need the higher level of
medical care available at treatment centers. “Once you start to
vomit blood or have bloody diarrhea, you need to have properly trained
medical staff and sanitation to be able to handle these super-infected
cases,” he said... http://www.washingtonpost.com/national/health-science/new-effort-to-fight-ebola-in-liberia-would-move-infected-patients-out-of-their-homes/2014/09/22/f869dc08-4281-11e4-b47c-f5889e061e5f_story.html
Health workers in Liberia haul away the body of a person suspected of dying of EbolaAbbas Dulleh/AP
As of this week, the Ebola outbreak in West Africa is known to have infected
more than 5,700 people and taken more than 2,700 lives. Yet those
figures could be dwarfed in the coming months if the virus is left
unchecked. On Tuesday, the Centers for Disease Control and Prevention reported
that the total number of infections could reach 1.4 million in Liberia
and Sierra Leone by January 2015. Though cases have been reported in
five countries, nowhere has been harder hit than Liberia, where more
than half of the Ebola-related deaths have occurred.
More MoJo coverage of the Ebola crisis.
The outbreak has crippled Liberia's economy. Its neighbors have
sealed their borders and shipping has all but ceased, causing food and
gas prices to skyrocket. Schools and businesses have closed down, and
the country's already meager health care system has been taxed to the
breaking point. Meanwhile, as panic grips the country, crime has risen
steadily and some reports suggest that Liberia's security forces are
among the perpetrators. To get a picture of how dire the situation is on
the ground, we got in touch with Abel Welwean, a journalist and
researcher who lives outside of Monrovia. He conducted a handful of
interviews with Liberians in his neighborhood in the second week of
September and also provided his own harrowing story of what life is like
in the country. The outbreak has forced many Liberians to stay indoors and avoid
interacting with other people. Since the virus can be caught merely by
touching the sweat of an infected person, once-common forms of physical contact, like handshakes, have become rarer. Frances (a university student): Football has been
suspended in our country. We are sitting at home just doing nothing—all
in the name of protecting ourselves. It is hurting us, but we have to
play the safe rules, because we value our own lives.
Abel:
I don't wear short sleeve shirts to step outside my house. I keep my
children in my yard throughout the day. I make sure we wash our hands
periodically. We do not shake hands with anybody outside of our house.
We do not entertain visitors in our house… These behaviors are very
strange amongst Liberians… Shaking hands is our one of the cultural
values that we have. Liberia may be poor and not willing to be
developed, but we are friendly people who believe in shaking hands in a
special way, and eating together from the same bowl. Frances: Schools are closed for time indefinite. We
don't know when schools will open. We are sitting at home, watching and
praying that school will open sooner. Rumors are coming that schools
will open next year— we don't know. What I think the youth can do now is
to get on our feet and educate the common man, those that are still in
the denial stage, to sensitize them, give them the actual information
about this Ebola virus, let the youth get on their feet from house to
house, door to door, and try to inform the populace about the deadly
Ebola virus, and how it can be prevented. Abel: I worry a lot about the future of our
children's education. I was at the verge of paying my children's tuition
when the government announced the closure of all schools in the
country. For now, I am my children's tutor at home.
"We are urging the international community
to come to our rescue, for the downtrodden, because pretty soon there
will be another war, and that will be the hunger war."
When the epidemic struck Liberia, a number of hospitals closed,
often because their staffs had fled in fear. Adding to the problem,
Ebola's symptoms mimic other, still common diseases, but treating
anything that resembles Ebola necessitates protective gear that's not
always available outside the quarantine centers. That means that many
people who are suffering non-Ebola illnesses are going untreated. Esther (a nurse and midwife): Before, August,
September were months we had diarrhea cases in Liberia. But right now,
the symptoms of Ebola and malaria are all the same. It's very, very
difficult to know an Ebola patient from malaria, so it's very, very
difficult to treat any patient in that direction. Frances: Many were afraid that if you have malaria,
you have common cold, you have fever, you go to the hospital, they would
diagnose you as an Ebola patient... I even got sick during the
outbreak. I was afraid to go to the hospital. I had to do my own
medication, but God looked out for me. I'm well. But these were the
messages that were going around, that once you have this, they will
confine you to a place, they will quarantine you for 21 days, they will
inject you. So many Liberians were afraid to go to hospitals. But now
the message has spread out. We now know people are surviving of Ebola.
Even if it is not Ebola, you just have malaria, you go there, you are
treated. They get you tested; they release you on time. Brooks (an American who was working at the
Accountability Lab, an anti-corruption NGO, in Monrovia and has since
left the country): Even in July, you heard stories of pregnant women
going into labor, bleeding profusely, and not being tended do because
people were afraid of Ebola. Esther: As a midwife, most of the time I have to do
deliveries. But right now, as we sit here, this clinic is closed. These
are cases that could be treated, but since we don't have the proper
equipment, the proper outfits to wear and treat our patients and do
tests [for Ebola], we decided to stay away from treating patients,
because you don't know who you are touching. Obviously, it's a kind of
embarrassment, but we have to go through with it for now. Before it spread to Monrovia, Ebola struck in Lofa County,
Liberia's rice-producing center. Many farmers avoided their fields,
severely hurting domestic food production. Food imports (the country
imports about two-thirds
of its grain supply) have also been hampered because of the crisis.
Borders with neighboring countries have been closed, and shipping
companies have avoided
the nation's ports. All of that has led to the biggest increases in
food prices since the nation's civil war, which ended in 2003. In a
country where 84 percent of everyone lived on less than $1.25 per day in 2011, this shock has become its own crisis. Esther: There were times, we were paying, for a
25-kilo [55 pound] bag of rice, we were paying something like
1,150-1,250 [Liberian dollars, or $14 to $15], but right now it's like
1,500 [$18]. John (a Liberian employee of the International
Committee of the Red Cross): I see so many people, sometimes they are
walking to town [about six miles]. Even if they have money, they prefer
walking a distance and saving the money to buy food so they will eat for
the day. We tend to be afraid to assist someone from the vehicle, even
to tell them the distance they are going, because we don't know who is
carrying the virus. Lawrence (the Liberia country director for
Accountability Lab): Hunger is really hitting the country… If the ships
are not coming, [farmers] are not making rice, the stockpiles are
depleted…the animals are eating the crops, what happens then? The
production will decrease, the price will increase, and if you don't have
money, what is going to happen? Hunger is going to strike… This is a
serious war, without bullets. It's not just a rise in food prices that Liberians are struggling
with; transit costs have increased as well, partly because the
government has forbidden commercial vehicles from carrying large numbers
of people. Markets have been shut down; NGOs and companies are asking
employees to stay at home; schools are closed so teachers are not
working. On September 17, the World Bank warned that Ebola could cut
Liberia's GDP by 3.4 percentage points, costing $228 million by 2015. Esther: In my own clinic, I have a staff of twelve.
But right now, everybody has to be home until otherwise. Since we don't
have protective gear, we don't have anything to work with, we cannot
risk our own lives, because if you are not able to protect yourself, you
will not able to work with other people. It will be difficult for their
families. Frances: It is better for us to stay at home, but we
need, also, to have our daily bread. The international community,
international donors, need to come to our rescue, because hunger is
taking over Liberia, gradually. Abel: I have gone out of job because of the Ebola
outbreak. Before the outbreak, I had contracts with Princeton, PBS
Frontline, Nursing For All, and the Gender Ministry. All of my contracts
are on hold until the crisis is over. The statistics are unreliable, but many report that violent crime is rising since the outbreak began. Even more troubling: some
of these crimes have reportedly been at the hands of police and
soldiers in uniform. Some Liberian's blame the government's curfew for
the problem. John: Armed robbery is increasing because the
government placed this curfew from 9 [p.m.] to 6 AM. Before, there used
to be community watch teams. At that time, there was no curfew. Abel: Our lives were relatively peaceful before the
deadly outbreak of the Ebola virus. We could go out any hour and return
any hour. There were robberies once in a while, but not compared to the
recent ones… I do not know if the proliferation of robberies was
political or some criminals just decided to take advantage of the
situation.
There have been numerous cases of armed robberies since the curfew
was announced… There was one in my community and my neighbors were badly
affected. I was really afraid that night when I heard the bullet sound.
At that time my family and I were watching movie in the living room. We
got scared so much that we couldn't continue the movie. We turned the
video off, turned all the lights in the rooms off and went to bed.
Fortunately for me, those police officers that came to rescue my
neighbors were my friends. They came to my house that night to see how
my family and I were doing. [Later, I learned] the robbers wore police
uniforms and were fully armed. Esther: I was a victim about four days ago. I just
left my back door open to hang clothes in the front. By the time I was
back in, someone had snuck in and took the two phones I had charging.
Because the children are not in school, most of the young ones are
turning to crime—and not just the young ones, even people who were
working and they are not able to work now, some of them are thinking,
how do they maintain their families? They are collaborating with some of
these criminals to get their way through. Frances: Liberia is declining, the economy is
declining, and things are just getting difficult on a daily basis. We
are not free to move around, we are not free in our own country because
of this deadly Ebola virus. We are urging the international community to
come to our rescue, for the downtrodden, because pretty soon there will
be another war, and that will be the hunger war. http://www.motherjones.com/politics/2014/09/ebola-crisis-liberia-way-worse-you-think
Yet
another set of ominous projections about the Ebola epidemic in West
Africa was released Tuesday, in a report from the Centers for Disease
Control and Prevention that gave worst- and best-case estimates for
Liberia and Sierra Leone based on computer modeling.
In the
worst-case scenario, the two countries could have a total of 21,000
cases of Ebola by Sept. 30 and 1.4 million cases by Jan. 20 if the
disease keeps spreading without effective methods to contain it. These
figures take into account the fact that many cases go undetected, and
estimate that there are actually 2.5 times as many as reported.
In
the best-case model, the epidemic in both countries would be “almost
ended” by Jan. 20, the report said. Success would require conducting
safe funerals at which no one touches the bodies, and treating 70
percent of patients in settings that reduce the risk of transmission.
The report said the proportion of patients now in such settings was
about 18 percent in Liberia and 40 percent in Sierra Leone.
The
caseload projections are based on data from August, but Dr. Thomas R.
Frieden, the C.D.C. director, said the situation appeared to have
improved since then because more aid had begun to reach the region.
“My
gut feeling is, the actions we’re taking now are going to make that
worst-case scenario not come to pass,” Dr. Frieden said in a telephone
interview. “But it’s important to understand that it could happen.”
Outside experts said the modeling figures were in line with estimates by others in the field.
“It’s
a nice job,” said Ira Longini, a professor of biostatistics at the
University of Florida who has also done computer modeling of the
epidemic. “It summarizes the extent of the problem and what has to
happen to deal with it.”
Bryan Lewis, an epidemiologist at the
Virginia Bioinformatics Institute at Virginia Tech, agreed that the
estimates were reasonable, perhaps even a bit low compared with those
generated by other models. He said that if some of the latest data from
the World Health Organization is plugged into the C.D.C. model, “the
very large numbers of estimated cases are, unfortunately, even larger.”
The current official case count is 5,843, including 2,803 deaths, according to the W.H.O.
The C.D.C. estimates omit Guinea, which has been hit hard, because the epidemic struck in waves that could not be modeled.
The
W.H.O. published its own revised estimates of the outbreak on Monday,
predicting more than 20,000 cases by Nov. 2 if control does not improve.
That figure is more conservative than the one from the C.D.C., but the
W.H.O. report also noted that many cases were unreported and said that
without effective help, the three most affected countries would soon be
reporting thousands of cases and deaths per week. It said its
projections were similar to those from the C.D.C.
The W.H.O.
report also raised, for the first time, the possibility that the disease
would not be stopped but could become endemic in West Africa, meaning
that it could become a constant presence there.
President Obama’s
promise last week to send 3,000 military personnel to Liberia and to
build 17 hospitals there, each with 100 beds, was part of the solution,
Dr. Frieden said. But it was not clear when those hospitals would be
ready, or who would staff them.
Dr. Frieden said the Defense
Department had already delivered parts of a 25-bed unit that would soon
be set up to treat health workers who become infected, a safety measure
he said was important to help encourage health professionals to
volunteer. He said that more aid groups were also arriving in the region
to set up treatment centers, and that a “surge” of help would “break
the back of the epidemic.”
Monrovia, the Liberian capital, is
facing a widespread Ebola epidemic, and as the number of infected grows
faster than hospital capacity, some patients wait outside near death.
Dr.
Jack Chow, a professor of global health at Carnegie Mellon University
and a former W.H.O. official, said, “The surge only becomes realized
when those beds are up and operating and the workers are delivering
care.”
He added, “If even the medium case comes to pass, with,
say, 700,000 cases by January, the epidemic will quickly overwhelm the
capabilities that the U.S. plans to send.”
The W.H.O. reported
that a new center had just opened in Monrovia, the Liberian capital,
with 120 beds for treatment and 30 for triage. Patients were already
lined up at the door.
The report from the C.D.C. acknowledged
that case counts were rising faster than hospital beds could be
provided. It said that in the meantime, different types of treatment
would be used, based in homes or community centers, with relatives and
others being given protective gear to help prevent the disease from
spreading.
The United States government is also sending 400,000
kits containing gloves and disinfectant to Liberia to help families take
care of patients at home.
At least one aid group in Liberia is
already shifting its focus to teaching people about home care and
providing materials to help because there are not enough hospital beds
for the sick. Ken Isaacs, a vice president of the group, Samaritan’s
Purse, said, “I believe inevitably this is going to move into people’s
houses, and the notion of home-based care has to play a more prominent
role.”
“Where are they going to go?” he said.
Though
providing home-care kits may seem like a pragmatic approach, some public
health authorities said they were no substitute for beds in isolation
or containment wards.
But Dr. Frieden said that home care had
been used to help stamp out smallpox in Africa in the 1960s. The
caregivers were often people who had survived smallpox themselves and
were immune to it. Some experts have suggested that Ebola survivors
might also be employed to care for the sick.
Dr. D. A. Henderson,
who led the W.H.O.’s smallpox eradication program, said that local
people had been paid to help in the campaign.
“We recruited a lot
of people to stand guard at huts with smallpox,” said Dr. Henderson, a
professor at the Johns Hopkins Bloomberg School of Public Health and the
University of Pittsburgh. “The important thing was to know they got
paid.”
He added: “We gave money and food to families who had
smallpox so they didn’t have to go out and beg, and they didn’t have to
go to the market and potentially infect people. What can you do? If you
don’t have food, you’ve got to leave the house and go out. Money can
play a useful role.”
News 12 at 6 o' clock/ September 23, 2014
AUGUSTA, Ga. (WRDW) -- The head of the CDC says
the Ebola epidemic is spiraling out of control in Africa. Now, the
organization is asking US hospitals to prepare in the event of an Ebola
outbreak where you live. Georgia Regents Medical Center is waiting for a
shipment of protective goggles, boot covers, and hoods. It's one of the
precautions they're taking in case the CDC's fears become reality. "It's spiraling out of control. It's bad now,
it's going to get worse in the very near future," Dr. Thomas Frieden,
the CDC director, said.
That's why they're urging hospitals around the country to prepare in case Ebola spreads to our borders.
"Before we actually had our plan in place, we
were seeing patients who had spent time in Africa, including West
Africa, who had returned with symptoms, just not fever," Dr. Peter
Rissing, the Epidemiologist at Georgia Regents Medical Center, said.
So far, there have not been any confirmed cases of Ebola at GRU, but Dr. Rissing says, their team now has a plan in place. "It was actually put together in conjunction with
the same emergency room physicians who had to deal with the first
couple of patients without a plan," Dr. Rissing said. And, after treating Ebola patients in a trial by fire style, the doctors at Emory had a few suggestions. "Additional insight from folks inside that system
would suggest it wasn't all quite as well organized as it might have
seemed," Dr. Rissing said.
GRU's plan begins with identifying patients with
Ebola symptoms quickly, and getting those patients isolated as soon as
possible. It also covers everything from containing blood samples, to
training staff how to handle contaminated gear.
GRU is sharing the plan with first responders, like Gold Cross, all to be prepared, no matter what comes our way.
GRU says they've shared their plan with several
other area hospitals who have asked for it. Dr. Rissing also says some
local doctors have been asked to head to Africa to help fight the
outbreak. http://www.wrdw.com/home/headlines/Local-hospital-puts-Ebola-action-plan-in-place-276838511.html
Last Tuesday, the White House announced
plans to send 3,000 US troops to the country to coordinate medical care
and deliver humanitarian aid. Their command center, and much of their
work, will be in Monrovia. But as the maps below show, controlling the
disease in and around the sprawling city will not be an easy task. This
first map shows the spread of the disease in the capital region as of
September 11 (areas colored in darker shades of blue have reported more
Ebola infections):
Liberian Ministry of Health and Social Welfare
This second map shows the spread of the disease in the capital region
as of September 20—just nine days later. Note the spread of the dark
blue:
Liberian Ministry of Health and Social Welfare
When the current outbreak of Ebola first reached Liberia, there were only two known
cases of the disease anywhere in the country. Both infections were far
from the West African nation's capital, Monrovia. But the virus spread
rapidly. In mid-June,
health workers discovered the first evidence the disease had spread to
the capital: the bodies of seven people, including a nurse and four of
her family members. As of Sunday, 1,232 people are believed to have been infected in
Monrovia's Montserrado County— more than a third of Liberia's total
cases to date, according to
Liberia's health ministry. The disease is believed to have killed 758
people in the county, including 33 health workers. Conditions will
almost certainly get worse. On Tuesday, the US Centers for Disease
Control and Prevention issued a report stating
that a worst-case scenario for the disease could bring the number of
infected in Liberia and Sierra Leone to 1.4 million by January 2015. http://www.motherjones.com/mojo/2014/09/these-maps-show-ebolas-spread-in-around-liberias-capital
Minister
Kabange Numbi and his delegation visited the General Referral Hospital
Wangata Mbandaka to talk with health professionals | Photo: WHO / Eugene
Kabambi.
Twenty-seven people with Ebola virus Djera (Ecuador) are cured, said
Tuesday, Sept. 23 medical advisor to the Minister of Health, Dr Roland
Shodu Lomani Radio Okapi. "In 68 cases, if you subtract 41, we have 27 cases were treated by us and heal," said he said.
Medical adviser to the Minister of Health explained that the problem
[the epidemic] is not as strong in the DRC "because the country has the mastery of the situation. The government has put substantial resources to start the response, he said.
Dr. Roland Shodu Lomani also regretted "the lack of interest in the
international community about the epidemic [Ebola] raging in the DRC."
He still hopes that the international community "will change his mind
to return to the Congo" to support the efforts of the government. Dr. Roland Shodu Lomani recognizes, however, that some donors have helped to combat Ebola outbreak. The Ebola outbreak was declared last August. 68 cases have been recorded since the beginning of the disease, including 41 deaths including 8 health workers. https://translate.googleusercontent.com/translate_c?depth=1&hl=en&ie=UTF8&prev=_t&rurl=translate.google.com&sl=auto&tl=en&u=http://radiookapi.net/actualite/2014/09/24/rdc-27-malades-debola-gueris/&usg=ALkJrhhFiOjEUJV3qajvWQubWefyhZd57w#more-191560
In
a study published by the "New England Journal of Medicine", the World
Health Organization (WHO) warned on September 23 that over 20,000 people
will be infected with Ebola virus in early November if the control
measures the epidemic are not reinforced in West Africa. "Assuming there is no change in measures of controlling the epidemic",
there will be 9,939 cases in Liberia, Guinea in 5925 and 5063 in Sierra
Leone, experts say the WHO.
"Without a drastic improvement measures", there will be in the coming
months, not "hundreds" of cases and deaths each week, but "thousands"
they added, noting that the fatality rate of people with virus stands at
70.8%. If nothing is done, Ebola likely to settle in the area for many years and become "endemic", according to experts.
Last week, the UN said 20,000 people rely on infected end of 2014 but
the rate of exponential growth of the epidemic has worsened the forecast
Scientists Call for More "quick" control measures, especially at
funerals and to enhance early detection of cases. Towards a "catastrophe" if nothing changes
"We are in a third phase of growth of the epidemic" that is
"explosive," said Dr. Christopher Dye, one of the co-authors of the
study and director of strategy at WHO, during a press conference in
Geneva.
"If we do not stop the epidemic quickly, it will not be a disaster but a
disaster," he said, adding that if the situation remains the same,
Ebola could reach "hundreds of thousands" in the coming months.
He stressed that this epidemic, the worst in the history of this
hemorrhagic fever identified in 1976, is "quite similar" to other
epidemics have affected other African countries in recent years, such as
the DRC and Sudan.
"What is different, it is not the characteristics of the virus, but the
nature of the affected people," he argued, pointing in particular as a
factor in the contamination highly mobile populations.
>> Access our interactive map of 40 years of Ebola outbreaks in Africa by clicking on the video below:
The rapid transmission rate is also due to the slow response to Ebola
early in the epidemic that the poor state of the health systems of the
three main affected countries, he has acknowledged.
"In Nigeria, where the health system is stronger, the number of cases
has been limited to date," said Christl Donnelly, a professor at
Imperial College London and co-author of the study. Dr. Christopher Dye also explained that it was difficult for the moment
to take stock of the epidemic, since it appears to be stabilizing in
some areas but has appeared in other districts that were spared far.
The experts also noted that the virus does not seem to know of mutation
that could facilitate its spread by air, but Christopher Dye said it
was "possible that this type of change can happen."https://translate.google.com/translate?sl=auto&tl=en&js=y&prev=_t&hl=en&ie=UTF-8&u=http%3A%2F%2Fwww.jeuneafrique.com%2FArticle%2FJA2802p014.xml0%2Fsante-oms-virus-epidemie-sante-ebola-chronique-d-une-panique.html&edit-text=
Monrovia – Two more relatives of the late Miss Liberia 2009/2010 Shu-rina Rose Wiah have succumbed to death just a week after she died of circumstances related to the deadly Ebola virus. Shu-rina died just few days after her sister, Sieanyene TooseYuoh- Katty, lost her life to what family sources say, was complications from an appendix surgery.
The deaths are heightening calls for authorities to do speedy tests of corpses prior to cremating
bodies amid growing fears that corpses from several suspected cases of
Ebola are being cremated without actual confirmation that they died of
the deadly Ebola virus.
The issue is poised for even more
complications after Toose’s son, Kelvin Kels Toure, who has been
quarantined along with his brother at the ELWA 3 MSF Ebola treatment
facility, was reported dead Sunday. Oxford Wiah, a brother of Shu-rina
who was quarantined along with Kels and Toose’s second son, also died
Monday. Both deaths have not yet been confirmed to be Ebola by authorities and it is unclear whether the corpses would be or have already been cremated.
Toose
died on Sunday, August 31, 2014 at about 5:28 PM and her remains
deposited at the Samuel A. Stryker Funeral Home in Monrovia. A funeral
was held on Thursday, September 11, 2014 at 10:00 am and she was buried
at the 1st Baptist Church cemetery, oldest Congo Town Back Road.
Although
there have been fears that her death was related to Ebola, that has not
been proven as there has not been any incident at the Stryker Funeral
Home which processed Toose’s body.
Her Sister, Shurina shockingly died on Tuesday, September 15, 2014. Shurina’smother Rev.
Mother Rosie Dillon-Wiah told FrontPageAfrica Tuesday that her daughter
had not died from Ebola as was widely speculated on the social media
Facebook and in Monrovia. “She did not die from Ebola.”
‘This is Depressing’
The
mother explained that "Shurina had not eaten for a week, that’s why she
was weak and she died. When they came for the body, they asked whether
she had sore mouth, I said no. She was not vomiting, not bleeding. Then
they told us that we had called the wrong rescue team and they took the
body away, but there was no sign of Ebola on Shurina, I swear. They
collected the body and never tested the body. They said we called the
wrong team, the burial team when we should have called the testing team
first,” Mother Rosie lamented.
A relative citing one of the nurses, posted on Facebook Monday that Kelvin, whose aunt, is the late Shu-rina,
was not responding to treatment at ELWA and kept saying he was getting
ready for his mom’s funeral. “This is depressing. RIP Family!”
Some family members have suggested that Kelvin was depressed over his mother’s loss and are ruling out Ebola as a cause of death. Others are not so sure. “They (authorities
are not communicating with the families. So they do not know whether
they died from Ebola or whether their bodies have been cremated already.
We don’t know.”
But even if Kelvin did die of Ebola,
family members continue to scramble for answers as to where he may have
gotten infected amid uncertainty over how Shu-rina died as no tests were done prior to her cremation and her mother’s insistence that she did not die of the deadly virus.
">Another sister of Shu-rina has since been discharged from JFK treatment facility after showing no signs of Ebola. Rev. Mother Rose Wiah, Shu-rina’s mom and several other family members, including Toose’s second son, are still under quarantined.
Several dignitaries, family and friends who attended Toose’s funeral have been concerned amid fears that family members were quarantined after Shu-rina’s death.
The deaths of a further two family members are triggering more fears. Associate Justice Sieanyene G. Yuoh, Toose’s aunt is still in good spirits and said she is showing no signs of the Ebola virus as is being widely speculated in Monrovia.
Speaking to
FrontPageAfrica Friday from Nashville, Tennessee, the United States of
America, Associate Justice Yuoh, who was among several dignitaries who
attended Toose’s funeral, said she reported herself to the hospital as soon as she learned of Shurina’s death.
"I
reported myself when I got here and I have no symptoms for ten days.
I’m running no fever, my life is not at risk, and my children’s lives
are not at risk. I have been walking every hour by the grace of God, I am fine."
James Hamilton said of burying Ebola victims in Sierra Leone, “We will need much more space.”Credit
Samuel Aranda for The New York Times
FREETOWN,
Sierra Leone — The gravedigger hacked at the cemetery’s dense
undergrowth, clearing space for the day’s Ebola victims. A burial team,
in protective suits torn with gaping holes, arrived with fresh bodies.
The
backs of the battered secondhand vans carrying the dead were closed
with twisted, rusting wire. Bodies were dumped in new graves, and a
worker in a short-sleeve shirt carried away the stretcher, wearing only
plastic bags over his hands as protection. The outlook for the day at
King Tom Cemetery was busy.
“We
will need much more space,” said James C. O. Hamilton, the chief
gravedigger, as a colleague cleared the bush with his machete.
The
Ebola epidemic is spreading rapidly in Sierra Leone’s densely packed
capital — and it may already be far worse than the authorities
acknowledge.
Since
the beginning of the outbreak more than six months ago, the Sierra
Leone Health Ministry reported only 10 confirmed Ebola deaths here in
Freetown, the capital of more than one million people, and its suburbs
as of Sunday — a hopeful sign that this city, unlike the capital of
neighboring Liberia, had been relatively spared the ravages of the
outbreak.
Video
Play Video|4:51
Burial Boys of Ebola
Burial Boys of Ebola
In Sierra Leone, a group of young men take on the dirtiest work of the Ebola outbreak: finding and burying the dead.
Video Credit By Ben C. Solomon on
Publish Date August 23, 2014.
But
the bodies pouring in to the graveyard tell a different story. In the
last eight days alone, 110 Ebola victims have been buried at King Tom
Cemetery, according to the supervisor, Abdul Rahman Parker, suggesting
an outbreak that is much more deadly than either the government or
international health officials have announced.
“I’m
working with the burial team, and the first question I ask them is,
‘Are they Ebola-positive?’ ” said Mr. Parker, adding that the figures
were based on medical certificates that he had seen himself. The deaths
are carefully recorded by name and date in a notebook headed “Ebola
Burials.”
A
burial team supervisor who drove up with fresh bodies echoed Mr.
Parker’s assertion. “Any body we collect is a positive case,” said Sorie
Kessebeh. “All the bodies that we are bringing in are positive.”
Beyond
the many worrisome trends in the Ebola epidemic seizing parts of West
Africa — the overflowing hospitals, the presence of the disease in
crowded cities, the deaths of scores of health workers trying to help —
another basic problem has stymied attempts to contain the disease: No
one seems to know how bad the outbreak really is.
The World Health Organization acknowledged
weeks ago that despite its efforts to tally the thousands of cases in
the region, the official statistics probably “vastly underestimate the
magnitude of the outbreak.”
Photo
The grave of Marion Seisay at
King Tom Cemetery in Freetown, Sierra Leone. Area residents say animals
dig near the graves, creating dangers for the living.Credit
Samuel Aranda for The New York Times
Here in Sierra Leone, the government just finished an aggressive national lockdown
to get a handle on the epidemic, ordering the entire country to stay
indoors for three days as an army of volunteers went door to door,
explaining the dangers of the virus and trying to root out hidden
pockets of illness.
Still, the Health Ministry spokesman insisted that the epidemic was not as bad as the flow of bodies at the cemetery suggested.
“It
is not possible that all of them are Ebola-related deaths,” said Sidie
Yahya Tunis, the Health Ministry spokesman, saying the corpses included
people who died of other causes.
But as the cemetery records show, the challenge facing the government might be of a different magnitude than previously thought.
The
majority of the recent deaths recorded at the cemetery were young
people — young adults, people in early middle age, or children — with
very few elderly people on the list. Several of the deaths also occurred
in a concentrated area, sometimes in the same house, suggesting that a
virulent infection had struck.
King Tom Cemetery
1 Mile
Kolleh Town
Kroo Bay
SIERRA
LEONE
Freetown
Atlantic
Ocean
Freetown
At
the house of Marion Seisay — the third name on the list — her son
acknowledged she was a secretary at Wilberforce Hospital, had died of
Ebola and was buried on Sept. 14. The house was now under quarantine,
with some of its eight residents lingering on the cinder-block porch.
“The
way my Mummy died was pathetic,” said the son, Michael Foday, clearly
frustrated by the quarantine. “How do you expect us to get food?”
Other
houses in Wilberforce Barracks, the village-like compound surrounding
the hospital, were on the list of the dead and placed under quarantine,
marked off from the surrounding jumble of shacks and cinder-block houses
by a thin line of red or blue string.
In
one of them, the house of Momoh Lomeh, the residents said that a total
of five people who lived there had died of Ebola — yet four of them did
not even appear on the cemetery list. At another, the house of Andrew
Mansoray, a family member said that the disease had been ruthless and
unrelenting.
“It
wouldn’t stop,” Abdul R. Kallon said of the diarrhea that Mr. Mansoray,
his brother-in-law, had endured before dying. “They took him to the
hospital, and they wouldn’t let him out.”
Photo
A burial team removed the body of a man in Freetown believed to have died from Ebola.Credit
Samuel Aranda for The New York Times
At
another six households on the cemetery supervisor’s list of the dead,
residents gave similar accounts. One family said the victim had
definitely died of Ebola, while five others described Ebola-like
symptoms — vomiting, diarrhea, fever — though none had been given an
official cause of death.
International
health experts here had no explanation for the striking discrepancy
between the government’s tally of the dead in the capital and the
cemetery crew’s statistics. Several of them noted the general confusion
surrounding official statistics here from the beginning, with one
leading international health official saying: “We don’t know exactly
what is going on.”
But
nobody disputed that things appear to be getting worse. The W.H.O. has
shown a sharp increase in new cases in Freetown in recent weeks, rising
from almost none early in the summer to more than 50 during the week of
Sept. 14.
Various
models of the growth of the epidemic here “all show an exponential
increase,” said Peter H. Kilmarx, the head of the Centers for Disease
Control and Prevention team in Sierra Leone. “The conditions are
amenable to Ebola spread.”
The
goal of the government’s national lockdown was to reach every household
in the country, and officials claimed success in doing so on Monday,
saying that progress had been made in the fight against the disease.
But
the exhaustion of the Ebola gravediggers at King Tom Cemetery, who dig
as many as 16 graves a day, indicated that the disease was far from
being contained.
“It’s a herculean task,” said Mr. Hamilton, the chief gravedigger. “It’s only out of patriotism that we are doing it.”
The
Ebola victims were buried in an expanding stretch of fresh muddy graves
under a giant cotton tree, and the makeshift arrangements are seen as a
looming threat by the residents of the slum next to it. No barrier
stops the pigs rooting in the adjoining trash field from digging in the
fresh Ebola graves, which residents say they often do.
“We
have creatures in the community, and they dig in the graves,” said
Henry S. Momoh, who lives in the adjoining slum, which residents call
Kolleh Town. “They are burying the Ebola patients in there, but not in
the proper manner.”
Five
yards from where the new graves begin, a well-used path connects the
slum to the main road. Residents all use it, passing close to the
freshly dug graves, and are frightened by the intensifying activity in
the cemetery.
“Since
last month, it’s every day, any minute and hour, and often, they are
coming” to bury the Ebola dead, said Desmond Kamara, a police officer.
A cloudy stream drains from the area of the new graves into the slum, further frightening the residents.
“We are at risk, big risk,” said Ousman Kamara, a resident. “We have made many complaints.”
But the bodies, he said, keep coming.
“Even at night,” he said. “You stand here, and you see them coming.”
Correction: September 22, 2014
An earlier version of a picture caption with this article
referred incorrectly to a possible victim of Ebola whose body is shown
being removed from a house in Freetown, Sierra Leone. The body is that
of a man, not a woman. http://www.nytimes.com/2014/09/23/world/africa/23ebola.html?_r=1
A man fromEindhovenwasrecentlyhit byEbolaSierraLeone.A man fromBrabantEindhovenmay havethe Ebolavirusincurred.He volunteeredMondaywith the symptomswith a doctor inhis hometown.
The man, according tothe Eindhoven Dagbladbeenin SierraLeonerecently.Thatcountry hasoftento do with thevirus.The doctorfound that thesymptomsof the manpointed tothe infectious disease.
MONROVIA, Liberia (AP) — Liberia's largest Ebola treatment center
is already handling 112 patients, a day after it opened, though not all
of are confirmed to have the dreaded disease. Health officials
said Monday that 46 people admitted to the Island Clinic Treatment
Center have tested positive for Ebola. The remaining patients are being
held for further observation and are being treated for other diseases,
like malaria.
The 150-bed center opened Sunday, and ambulances
rushed to its doors immediately. Liberia has been hardest hit by the
Ebola outbreak sweeping West Africa.
According to new figures
released Monday, the U.N. health agency says Ebola is believed to have
sickened more than 5,800 people in Liberia, Sierra Leone, Guinea,
Nigeria and Senegal. It is blamed for more than 2,800 deaths. http://www.miningjournal.net/page/content.detail/id/611359/Dozens-flock-to-new-Liberia-Ebola-treatment-center.html?isap=1&nav=5016
Health
workers push an Ebola patient who escaped from quarantine from
Monrovia's ELWA Hospital into an ambulance in the center of Paynesville,
Liberia, on Sept. 1, 2014. The patient, who wore a tag showing he had
tested positive for Ebola, held a stick and tried to get away from
doctors when they arrived on the scene attempting to catch him.
Photo by Reuters
It’s nine months into the biggest
Ebola outbreak in history, and the situation is only going from bad to
worse. The outbreak simmered slowly in West Africa from December 2013, when the first case was retrospectively documented,
through March, when it was first recognized by international
authorities. It began gaining momentum in June and throughout July. Now,
terms like “exponential spread” are being thrown around as the epidemic continues to expand more and more rapidly. Just last week, an increase of 700 new cases was reported, and the case count is now doubling in size approximately every three weeks.
Already, the number of cases (approximately 5,300 as of Sept. 18)
and deaths (2,630) has dwarfed the total number of cases and deaths
from every reported Ebola outbreak in history—and those are only the
cases that we know about. Here’s where we stand with Ebola right now.
The situation on the ground
By all accounts, it’s understandably miserable everywhere Ebola has
hit, but even experienced international disaster responders have been
shocked at how bad it has gotten. A Doctors Without Borders worker in
Monrovia, Liberia, named Jackson Naimah describes the situation in his home country,
noting that patients are literally dying at the front door of his
treatment center because it lacks patient beds and assistance; the
sufferers are left to die a “horrible, undignified death” and
potentially infect others as they do so:
One day this week, I sat outside the treatment center eating
my lunch. I saw a boy approach the gate. A week ago his father died
from Ebola. I could see that his mouth was red with blood. We had no
space for him. When he turned away to walk into town, I thought to
myself that this boy is going to take a taxi, and he is going to go home
to his family, and he will infect them.
When health care workers aren’t available, or when patients are too
fearful to take loved ones to a clinic, it falls to those closest to the
ill to nurse them. This has wiped out entire families, “prey[ing] on care and love, piggybacking on the deepest, most distinctly human virtues,” turning caregivers into victims as the virus passes among siblings and parents, from one generation to the next.
Health care workers who are treating the sick are dying because they also lack basic protective equipment,
or because they have been so overwhelmed by taking care of the ill and
dying that they begin to make potentially fatal errors. They have gone on strike
in Liberia because they are not being adequately protected or even paid
for their risky service. Hearses have been commandeered as ambulances; motorcycles are used to transport patients long distances, putting drivers at risk of becoming the next victim.
So far, other West African countries have been largely spared. Senegal experienced one imported case in late August, but to date other contacts have tested negative for the virus. Ivory Coast is watching closely
and working to keep the virus out of the country. Perhaps the most
extreme measures are currently being taken in Sierra Leone, where the
country has been under a lockdown for three days
to track cases of infection and minimize transmission. The country’s 6
million residents were ordered to stay indoors while volunteers went
door-to-door to educate citizens, document new cases, and remove bodies.
As of today, MSF has sent more than 420 tonnes of supplies
to the affected countries. We have 2,000 staff on the ground. We manage
more than 530 beds in five different Ebola care centres. Yet we are
overwhelmed. We are honestly at a loss as to how a single, private NGO
is providing the bulk of isolation units and beds.
The plea has fallen on sympathetic ears, but the response has been
slow and insufficient. The United States has answered the call to some
extent, promising 3,000 military personnel and up to $750 million in aid. Even this massive amount is less than what the World Health Organization has called for: a minimum of $1 billion, and even that will only keep infections contained to the “tens of thousands.”
No one has sounded the alarm more clearly or critically than journalist Laurie Garrett, who wrote about Ebola in her 1995 book The Coming Plague. Writing for Foreign Policy,
she has denounced the international response and lack of coordination,
criticizing individual countries as well as the United Nations, World
Health Organization, and the World Bank, noting that the world “just doesn’t get it” when it comes to Ebola.
The virus
If there can be a faint silver lining to this outbreak, it’s that
researchers have been able to study the evolution of the virus in a way
no previous Ebola epidemic has allowed. With thousands of cases
documented to date, investigators have been able to track mutations in the virus’ RNA genome—and they found hundreds of mutations just in viruses examined before the publication of a paper in Science in August. In a tragic footnote, five of the authors of this paper died of Ebola during this outbreak.
While we do know that the virus is mutating, what remains murky is
what those mutations are actually doing in patients. Genomic data itself
is really only as good as the epidemiologic information that goes along
with it, such as patient location, outcome of infection, symptoms
exhibited, familial transmission patterns so it can be traced back
between family members or members of the same geographic area, etc.
Given that the outbreak has been so explosive and understaffed, much of
this data may be lost, and it’s estimated that almost half of all those infected probably aren’t even reporting to hospitals—unfortunately limiting the conclusions of some of these genetic studies.
However, we do know that the risk that this outbreak may spawn an
airborne Ebola virus is still incredibly tiny. Virologist Vincent
Racaniello sums up the history of viruses mutating to a novel route of transmission,
noting, “There is no reason to believe that Ebola virus is any
different from any of the viruses that infect humans and have not
changed the way that they are spread,” and that “the likelihood that
Ebola virus will go airborne is so remote that we should not use it to
frighten people.”
The big concerns
Even without an airborne form of Zaire Ebolavirus, we still have
plenty to be concerned about. Models have suggested that this outbreak
could go on for several more months at a minimum. The worst-case
situation suggests that half a million cases are possible before the outbreak is finally brought under control. New research proposes that the current outbreak is so different from past Ebola epidemics that modeling is simply not informative, and “as a result, we are not in a position to provide an accurate prediction of the current outbreak.”
Besides the incredible potential number of lives lost, a huge concern
is the destabilization of the affected countries—and even of those
around them that have not shown any cases of Ebola. WHO Director-General
Margaret Chan noted that this outbreak “is
a social crisis, a humanitarian crisis, an economic crisis, and a
threat to national security well beyond the outbreak zones.” Partly in
response to the testimony of Chan and others, the United Nations announced the establishment of an emergency mission to fight Ebola.
Countries were also asked to lift travel bans to the affected
countries, which have made it more difficult to move supplies in and out
of the area.
While 5,300 cases may not be a lot in the grand scheme of things,
hospitals and clinics have been crippled, and mortality rates in these
countries may be affected beyond just the Ebola virus. Patients who have
other ailments, pregnant women looking to enter hospitals
and clinics to give birth or to bring in ill children with
non-Ebola-related diseases have been turned away. Crops are not being
harvested or transported, making hunger an issue equal or greater to Ebola in many areas.
Finally, all of this is only examining the West African Ebola
outbreak. Ebola also re-emerged in the Democratic Republic of the Congo
in August; to date, there have been at least 60 cases in that country
and 35 deaths. With all of the concern about West Africa, much less
attention and aid has been given to the DRC, which has a much more extensive history of Ebola epidemics, mainly in rural areas. It is hoped that history and experience will more quickly bring the outbreak there under control.
The coming months
Even with massive international intervention, the situation will
still worsen before it improves. The influx of funds and assistance from
the United States and other countries is certainly welcome news, but it
remains to be seen exactly how that will be allocated, who will be in
charge, and how coordination will be established. This will be a
long-term effort, and even after this Ebola outbreak has been
extinguished, additional doctors and nurses will need to be trained to
replace those that have been tragically lost in this epidemic. Some of
Ebola’s victims will survive, but they and their families may face harsh stigma in their hometowns. It may take a year, but this fire from the pit of hell will eventually be extinguished. At what cost to human life, we do not know yet. http://www.slate.com/articles/health_and_science/medical_examiner/2014/09/ebola_outbreak_status_and_predictions_the_virus_the_response_the_biggest.single.html
