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Monday, September 15, 2014

Ebola Claims The Life Of Another Doctor In Sierra Leone

14 Sep 2014

Ebola Claims The Life Of Another Doctor In Sierra Leone

A fourth doctor, Dr Olivet Buck has died of Ebola in Sierra Leone after a failed bid to transfer her abroad for treatment. The doctor passed away last night after the World Health Organization, WHO said it couldn’t help to move her to Germany.
Sierra Leone had requested funds from the organisation to transfer her for treatment saying it could not afford to lose another doctor.
However, Chief Medical Officer Dr Brima Kargbo confirmed today September 14 that the Sierra Leone national had died on Saturday night. WHO had said it could not meet the request but instead would work to give Dr Buck 'the best care possible' in Sierra Leone, including access to experimental drugs.

This will come as a huge setback for the impoverished country that is battling the virulent disease amid a shortage of health care workers.
A total of 301 health workers had become infected with the disease as of September 7 in Guinea, Liberia and Sierra Leone, according to WHO. Of that number, which included suspected and probable cases in addition to confirmed ones, 144 had died.
Due to the fact that the virus is only transmitted through contact with the bodily fluids of people showing symptoms or from dead bodies of Ebola victims, health workers have been especially vulnerable as they respond to the worst outbreak in history.
In Nigeria, the virus has claimed the lives of two doctors.  http://real9jagists.blogspot.com/2014/09/ebola-claims-life-of-another-doctor-in.html

Ebola crisis: Australian doctor at frontline of outbreak says time is running out to contain disease

Ebola crisis: Australian doctor at frontline of outbreak says time is running out to contain disease

Updated
The Ebola outbreak in west Africa is already a crisis; it could very easily become a catastrophe.
Dr Ian Norton, chief of foreign medical teams with the World Health Organisation (WHO), is a contributor to ABC News coverage of the Ebola crisis. He says it is a race against time to build a number of massive field hospitals in Monrovia, Liberia, as the death toll nears 3,000.

We have only a narrow window of opportunity in which to contain this outbreak.
If we ignore it, we will find the disease much more difficult to control and can expect infection rates to escalate.
Not to put too fine a point on it: we have a closing window of perhaps weeks now before we will not be able to manage all the cases on the ground in the way that we normally would.
Already the WHO and the ministries of health of the three most affected countries are thinking of other ways to contain and manage the large numbers infected.

This is new for everybody. The only team that has built a field hospital for Ebola treatment before has been from Medecins Sans Frontieres (MSF), and their standard operations are for only 40 people.

We are building five 100-bed field hospitals in Monrovia, in addition to the 200-bed facility which already exists there and which will soon be expanded to at least 300, perhaps 400, beds.

Profile: Dr Ian Norton

  • Currently chief of foreign medical teams with the World Health Organisation in west Africa
  • Previously Director of Disaster Preparedness and Response at the National Critical Care and Trauma Response Centre in Darwin
  • Involved in the emergency medical response when 44 asylum seekers were badly burnt in a boat explosion at Ashmore Reef in 2009
  • Team leader of the Australian civilian medical response to the Pakistan floods in 2010
  • Has worked in India, Indonesia, Europe and East Timor

We are calling for foreign medical teams across the world to come and assist us.
We are not looking for huge numbers of foreign doctors and nurses and logistics staff but at least a core group of 30 to 40 who would help manage these large centres and then work alongside national medical staff and nurses.
Tragically, Liberia - which already ranks fourth-last in the world for numbers of doctors per population - has lost almost 20 doctors to Ebola. They only produce 10 doctors per year in a medical class.

They have also lost a large number of nurses, and Ebola care is all about the nursing care. There are only a couple of thousand nurses in the country and we know that at least 90 have died from the infection and another 50 or 60 have survived.
The nurses and doctors are actually willing to come back to work, with measures in place to assist them including protecting equipment, training and a payment scheme which reflects the danger of the work.
Without medical care, the mortality rate of this Ebola outbreak is about 90 per cent. While it is a devastating disease, it is not universally fatal, even with minimal care.
But with better care, and certainly with the new Ebola treatment centres and with the right number of staff treating them, we can gradually escalate the level of care and have better outcomes.
For example, we have seen in Guinea for several months that with good supportive care we can bring the mortality rate down to 30 to 50 per cent at most.
So we can see a several-fold improvement in survival if we can just get the teams in here and get these Ebola treatment centres up and running.
We have to stop this spreading beyond the point of no return.
This interview with Dr Ian Norton first aired on the ABC's PM program.
 

CDC issues Ebola checklist: 'Now is the time to prepare'

CDC issues Ebola checklist: 'Now is the time to prepare'

By |
The Centers for Disease Control and Prevention, warning hospitals and doctors that “now is the time to prepare,” has issued a six-page Ebola “checklist” to help healthcare workers quickly determine if patients are infected.
While the CDC does not believe that there are new cases of Ebola in the United States, the assumption in the checklist is that it is only a matter of time before the virus hits home.
For example, one part reads: “Encourage healthcare personnel to use a ‘buddy system’ when caring for patients.” Another recommends a process to report cases to top officials:
Plan for regular situational briefs for decision-makers, including:
-- Suspected and confirmed EVD patients who have been identified and reported to public health authorities.
-- Isolation, quarantine and exposure reports.
-- Supplies and logistical challenges.
-- Personnel status, and policy decisions on contingency plans and staffing.
The checklist has been distributed to major hospitals and even little ones, including an urgent center in Leesburg, Va.
“Every hospital should ensure that it can detect a patient with Ebola, protect healthcare workers so they can safely care for the patient, and respond in a coordinated fashion,” warns the CDC.
“While we are not aware of any domestic Ebola Virus Disease cases (other than two American citizens who were medically evacuated to the United States), now is the time to prepare, as it is possible that individuals with EVD in West Africa may travel to the United States, exhibit signs and symptoms of EVD, and present to facilities,” it adds.
Several hospital and medical websites have just begun to post the checklist online.

Ebola: Expatriates flee Port Harcourt


As a result of the deadly Ebola virus disease, which a Nigerian diplomat, Olu-Ibukun Koye took to Port Harcourt from Lagos, expatriates are leaving the country.
Investigations reveal that foreigners, especially those from Asia countries, who work in multinational companies located in Port Harcourt, are leaving the city in droves for fear of contacting the dreaded virus.
Many foreigners, mostly of India extraction, were seen at the Port Harcourt International Airport with their families making efforts to board international flight back to their countries.

Some of the expatriates, who spoke to reporters, said they were afraid of contacting the dreaded virus and decided to go back to their countries. One of them who spoke under the condition of anonymity said, “We are very scared because Ebola has no cure. So we want to go back to India. We don’t want to take chances; hence the reason why we want to go back to our country. I am here with my kids and wife. We want to leave Nigeria for our country.’’
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Since the Ebola outbreak in Port Harcourt, the Garden City has lost its peace. Residents now live in fear. Body contact, backslapping and the traditional handshake have become a taboo in the city. Nightlife, which the Rivers State capital is noted for, has become a nightmare. In churches, the spiritual laying of hands by clergies has stopped. In various hospitals, mere symptoms of fever and diarrhea have become a dangerous venture medics don’t want to trade on. Hospitals in Port Harcourt and its environs now reject patients with symptoms of malaria and diarrhea.
The prices of hand-gloves and sanitisers have increased tremendously.
 Addressing traditional rulers and religious leaders in Port Harcourt on the Ebola disease, Governor Chibuike Amaechi of Rivers State enjoined them to sensitise the people in their different domains and partner with his administration in its rescue efforts.
The state government is also getting assistance from multinational companies in Port Harcourt in its fight against the virus.

Coalition Of Inaction: Outrage On The Ebola Front Line In Liberia

Coalition Of Inaction: Outrage On The Ebola Front Line In Liberia

In Monrovia(John Moore/MSF)
MONROVIA— "Welcome to hell." There is no cynicism and no irony in the voice of the young French volunteer from Médecins sans frontières (Doctors without Borders). The deep rings of fatigue under his eyes tell the same tale.
This "hell" is Elwa in Monrovia, the capital of Liberia. Elwa is the largest treatment center ever set up by the French NGO to fight an epidemic, a camp of big white tents where its staff is trying desperately to fight Ebola, the terribly contagious virus that causes often fatal hemorrhagic fevers and has already killed more than 2,000 people in west Africa, over half of them in Liberia.
Dealing with death is not even the hardest part for the young volunteer. What haunts him is that for three days through the chain link and padlocks of Elwa’s high gate he has been sending infected people to die elsewhere, because the center is too crowded. 
"There is nothing worse for us, both humanly and hygienically, because we don’t cut the chain of contamination," says a discouraged Laurence Sailly, emergency coordinator of Doctors without Borders Belgium, the branch of the French NGO with the most expertise in the fight against Ebola. "We are swamped but we have to keep the center under control for both the people who work there and the patients. So we refuse people. It’s awful."
When it opened on August 18, Elwa had 120 beds. That number was soon increased to 160, then 400. This is a first for Doctors without Borders, which took over the treatment center after the departure of the evangelical American NGO Samaritan's Purse at the beginning of August. Elsewhere in town there are 80 other places managed by the Liberian Ministry of Health, in this country still ravaged by the last civil war that ended in 2003. Local doctors and nurses are paying a heavy cost in the fight against Ebola: 152 health professionals have been infected in Liberia, 79 of whom have died, according to the World Health Organization.
But all of this is not enough for Monrovia and its population of some one million people, many of them crammed into squalid slums transformed into viral powder kegs. "We would need 1,000 beds now to fight against this epidemic, the like of which has never been seen before, and Liberian authorities would have to call for help from the outside," says Sailly.
In Elwa’s muddy alleys indignation is mounting. "Where are the other big NGOs so ready to show up when there are humanitarian disasters? They’re afraid of the epidemic and are hiding behind their lack of expertise," says one volunteer, adding that the larger UN agencies move very slowly.
"It’s a coalition of inaction, it’s shocking," says Christopher Stokes, director general of Doctors without Borders Belgium.
A family story
The situation has become so critical that Doctors without Borders has called on American military health services and its logistics. Washington, which sent aircraft carriers, GIs and helicopters to the rescue in Haiti when it was ravaged by earthquake in 2010, is looking into the matter. 
"International organizations and various countries have promised tens of millions of dollars as well as equipment to implement the World Health Organization’s emergency plan, but who’s going to coordinate all this?" Stokes says angrily.

Kitchen staff provide food to Ebola patients in Sierra Leone.(Photo - P.K. Lee, MSF)
Meanwhile, Doctors without Borders has stretched to the point of importing a crematorium that can burn over 100 bodies a day. "Normally that’s not out job," Stokes adds.
Still, time is short. On Monday, under sweltering sun in this muggy rain season the frail silhouette of a woman delirious with fever is curled up on the cinderblocks in the shade of the fence surrounding Elwa. Passersby eye her with looks ranging from disquiet to indifference. Indeed in Monrovia lately, a dead body or a person in agony are not such a rare sight. From the other side of the fence the sick woman’s daughter has received a sanitary protection kit: a little white plastic box that contains chlorine, gloves, an apron and a mask to limit contamination. The girl is gathering water bottles discarded by other contaminated people.
How many other contaminated people lie in agony in family compounds, ostracized by their neighbors? How many Ebola orphans are wandering the streets? Nobody can say with certitude. 
"The figures have been underestimated so we can’t make projections," says Pierre Rollin, a specialist in hemorrhagic fevers at the American Center for Disease Control and Prevention.
The figures put forth: 10,000 dead, 20,000 by the end of the year"We’re not seeing the light at the end of the tunnel," Rollin, an Ebola specialist admits. "Previous Ebola epidemics were on a human scale. This is a real natural catastrophe. We cannot explain why there are so many new cases being registered in such a short period of time."
And the meter is running. "On average every case is in contact with ten people and generates 2.4 new cases," Rollin explains. The result is that none of Liberia’s 15 counties — including those bordering on Ivory Coast — has been spared by the epidemic, which probably began in December with one case in neighboring Guinea.
In this region people and hence the virus weave in and out of forested frontiers where the state is nonexistent. Funeral rites are as much a transmitter of the disease as are bodily fluids.
In Monrovia, the authorities have plastered the city with posters that read "Ebola is real." For those who are not illiterate, the message is on every street corner. "Ebola exists," concedes Abdu Aziz Kromah, a student met in one of the muddy alleys of West Point, a slum in Monrovia where a quarantine has just been lifted.
Finda Fallah can bear witness to the reality, which now also includes some hope. On Saturday this young woman of 30 emerged healed from the Elwa center with two of her children, aged three and six, and her young sister of 15. They are now immune to Ebola. But the virus killed her mother, husband, one of her children, a sister, and nephews and nieces, eight people in all with whom they shared a single sordid room in West Point transformed into an Ebola incubator dirtied by blood diarrhea and vomit.
When we saw her the next day, Fallah managed a smile. But she’ll sleep outdoors this night. The roof she used to sleep under is already occupied by others following a visit from the disinfection service. "People don’t come near us, the pharmacist refused to serve me," she says. 
"Cured, you say?" says another local, Abdu Aziz Kromah, keeping a skeptical distance. Fallah responds: "That’s what Doctors without Borders said? Well, maybe. But we don’t believe the government."  http://www.worldcrunch.com/mobile/#a:16989

Bracing for Worse: WHO Scaling up 120-bed Ebola Facility

Monrovia - The deadly Ebola virus continues to claim more lives in Liberia as health centers become completely overwhelmed to continue receiving new patients daily. On Friday, September 12, 2014, a high powered delegation led by Dr. David Nabarro, Senior United Nations System Coordinator for Ebola and DrKeiji Fukuda, WHO Assistant Director-General, Health Security and Liberian health officials took a tour of the facility.


The World Health Organization in collaboration with the Liberian government is working to complete the 120-bed facility at the former Island Clinic located on the Bushrod Island in Monrovia to meet the demand for more hospital beds for Ebola patients.

Friday construction works were ongoing as contractors were seen busy putting together what will be the second Ebola Treatment largest facility after the medical humanitarian group, Medecin San Frontier, MSF. Workers at the hospital told FrontPageAfrica that they are already seeing an influx of sick people from the disease and that they have to turn them away because the center was not ready.

“People are coming here every day, thinking the center is ready because of the information that is out there,” said Stephen Chea, Deputy Chief of Security at the hospital now renamed the Oniyama Specialist Hospital. “There are a lot of things that we’ve been doing here. It is just that the government wants to use this place so urgently, but the work that needs to be done here could take another 30 days.”

Men at work said they had been given an ultimatum to finish the center in two days and that they (worker) were under a lot of pressure to deliver. During a tour of the facility, Dr. Fukuda seemed impressed by the level of work that was ongoing and said he hopes the facility will help meet the needs of Ebola patients and break the chain of transmission of the deadly disease.

“This example here, we have had contractors working overnight for ten days, to really achieve a miracle in putting together a wonderful facility,” he said. “It really shows you that the international community, both within Africa and outside have been working with the countries in order to turn around this fight and as Dr. Nabarro said, it is still a difficult fight, but this is really how it is going to turn around.”


The opening of treatment centers across the country is urgently needed as available Ebola treatment facilities around the country are turning patients away because they have run out of beds. Suspected Ebola patients who turned themselves into various treatment centers last week were seen lying around in front of the gates, many of them too weak to walk.

But the government said late last week that it is working around the clock to provide the needed resources to open treatment centers where patients could go to receive treatment. The government said it has expended close to five million United States Dollars to fight the deadly Ebola Virus.

GoL Funding to health sector

The government said to date, it has mobilized a total of US$5.7 million dollars consisting of US$5.6 million and LD$9.4 million paid into the Ebola Trust Fund at the Central Bank of Liberia as donations from the government, private individuals and organizations for the fight against the deadly Ebola virus.

Speaking Thursday at a news conference, Finance minister Amara Konneh said after one month of implementation, the government through the finance ministry has disbursed approximately US$4.7 Million to the various implementing agencies, leaving an undisbursed balance of approximately US$1.1 million.

“The Ministry of Health has received US$2.8 million, constituting 61.7% of the initial funding, as part of the government’s initial support to the health sector in dealing with the crisis,” he said. “Of this amount, US$1. 4 million disbursed for the payment of per diems for deploying health workers; US$600,000 to procure 12 ambulances.”

Konneh said the government disbursed US$300,000.00 as an advance on the construction of various treatment facilities across the country, including ElWA II Liberian-run Ebola Treatment Unit, Foya Treat Unit, and Gbarnga Treatment Unit; bringing the Island Clinic online and the Congo Town Ebola Treatment Unit online. He said as part of the government’s effort to fight Ebola Virus Disease (EVD), it has prioritized key activities within the Health and Security Sectors through the National Budget for Fiscal Year 2014/2015.

“We have to date disbursed US$6.2 million over the period July to August to the Health Sector, targeting the Ministry of Health, John F. Kennedy Hospital, Jackson F. Doe Hospital, Phebe Hospital, Tellewoyan Hospital, C.H. Renney Hospital and other county health centers and systems across the country through the Ministry of Health and Social Welfare,” he said.

“Separately, we have disbursed through the budget a total of US$1,276,339.00 to the Security Sector for their regular operations based on the one-twelfth provision of the PFM Law in the absence of an approved budget.”

Konneh said the government has disbursed a total of US$556,150.00 to counties to assist county health teams in their effort to fight Ebola: Mon
tserrado US$276,500; Gbarpolu US$127,650; Margibi US$77,000; Bong County US$50,000 and Grand Gedeh US$25,000. WHO, has predicted an increase in the number of Ebola virus infections in Liberia in September. About 60 percent of Liberia's cases and deaths occurred within the last three weeks, WHO data shows.

Liberia’s Infrastructure was devastated by a 14-year civil war, which killed about 250,000 in the conflict that ended in 2003. The country is estimated to have one doctor to treat nearly 100,000 people before Ebola outbreak, which began in March this year. There have been 2,046 cases since the outbreak with 1,224. In a country of 4.4 Million people it is not good news at all.

EU mechanism to coordinate evacuation Ebola

It will create EU mechanism to coordinate evacuation Ebola PDF Print out E-Mail
Active Image Brussels, Oct 15 (Prensa Latina) The European Union (EU) today announced the creation of a mechanism to coordinate the evacuation of active physicians and workers in West African countries affected by the epidemic of Ebola .
The proposal was made for a high-level meeting devoted to analyzing the EU response to the advance of the disease.

In the same among the European commissioners development and health, along with representatives of EU states, the World Health Organization and the United Nations coordinator attention to Ebola.

"We agree on the crucial importance of reliable medical staff in countries affected systems for medical evacuation and humanitarian workers, in order to maintain an effective international response on the ground," said a statement released here.

In the document, Kristalina Georgieva, EU responsible for Humanitarian Aid and Crisis Response, said that those attending the meeting endorsed a proposal by France that "could form the basis for further discussions on this mechanism."

He also reiterated that the risk of Ebola virus circulating in Europe is low, but warned the need to continue the work of preparation and coordination of risk management to be ready for any eventuality.

He also stressed that the EU is committed to help African countries not only in fighting disease but also in its development in the medium and long term.

"It is very important to strengthen health systems and health in those countries. Try to also provide transportation to and from the region," he said.

For its part, the Italian Minister of Public Health, Beatrice Lorenzin, noted that the Ebola epidemic is a "great tragedy" that must be stopped with coordinated international action.

"This is an emergency that must be addressed throughout Europe with a common and coordinated commitment, both in Africa and here, with new media and new resources, seen so far were insufficient efforts," said Lorenzin.   https://translate.google.com/translate?sl=auto&tl=en&js=y&prev=_t&hl=en&ie=UTF-8&u=http%3A%2F%2Fwww.prensa-latina.cu%2Findex.php%3Foption%3Dcom_content%26task%3Dview%26id%3D3081651%26Itemid%3D1&edit-text=

Thursday, September 11, 2014

What We’re Afraid to Say About Ebola


Photo
Credit Jonathon Rosen
MINNEAPOLIS — THE Ebola epidemic in West Africa has the potential to alter history as much as any plague has ever done.
There have been more than 4,300 cases and 2,300 deaths over the past six months. Last week, the World Health Organization warned that, by early October, there may be thousands of new cases per week in Liberia, Sierra Leone, Guinea and Nigeria. What is not getting said publicly, despite briefings and discussions in the inner circles of the world’s public health agencies, is that we are in totally uncharted waters and that Mother Nature is the only force in charge of the crisis at this time.
There are two possible future chapters to this story that should keep us up at night.

The first possibility is that the Ebola virus spreads from West Africa to megacities in other regions of the developing world. This outbreak is very different from the 19 that have occurred in Africa over the past 40 years. It is much easier to control Ebola infections in isolated villages. But there has been a 300 percent increase in Africa’s population over the last four decades, much of it in large city slums. What happens when an infected person yet to become ill travels by plane to Lagos, Nairobi, Kinshasa or Mogadishu — or even Karachi, Jakarta, Mexico City or Dhaka?
The second possibility is one that virologists are loath to discuss openly but are definitely considering in private: that an Ebola virus could mutate to become transmissible through the air. 

 You can now get Ebola only through direct contact with bodily fluids. But viruses like Ebola are notoriously sloppy in replicating, meaning the virus entering one person may be genetically different from the virus entering the next. The current Ebola virus’s hyper-evolution is unprecedented; there has been more human-to-human transmission in the past four months than most likely occurred in the last 500 to 1,000 years. Each new infection represents trillions of throws of the genetic dice.
If certain mutations occurred, it would mean that just breathing would put one at risk of contracting Ebola. Infections could spread quickly to every part of the globe, as the H1N1 influenza virus did in 2009, after its birth in Mexico.
Why are public officials afraid to discuss this? They don’t want to be accused of screaming “Fire!” in a crowded theater — as I’m sure some will accuse me of doing. But the risk is real, and until we consider it, the world will not be prepared to do what is necessary to end the epidemic.

In 2012, a team of Canadian researchers proved that Ebola Zaire, the same virus that is causing the West Africa outbreak, could be transmitted by the respiratory route from pigs to monkeys, both of whose lungs are very similar to those of humans. Richard Preston’s 1994 best seller “The Hot Zone” chronicled a 1989 outbreak of a different strain, Ebola Reston virus, among monkeys at a quarantine station near Washington. The virus was transmitted through breathing, and the outbreak ended only when all the monkeys were euthanized. We must consider that such transmissions could happen between humans, if the virus mutates.

So what must we do that we are not doing?
First, we need someone to take over the position of “command and control.” The United Nations is the only international organization that can direct the immense amount of medical, public health and humanitarian aid that must come from many different countries and nongovernmental groups to smother this epidemic. Thus far it has played at best a collaborating role, and with everyone in charge, no one is in charge.
A Security Council resolution could give the United Nations total responsibility for controlling the outbreak, while respecting West African nations’ sovereignty as much as possible. The United Nations could, for instance, secure aircraft and landing rights. Many private airlines are refusing to fly into the affected countries, making it very difficult to deploy critical supplies and personnel. The Group of 7 countries’ military air and ground support must be brought in to ensure supply chains for medical and infection-control products, as well as food and water for quarantined areas.
The United Nations should provide whatever number of beds are needed; the World Health Organization has recommended 1,500, but we may need thousands more. It should also coordinate the recruitment and training around the world of medical and nursing staff, in particular by bringing in local residents who have survived Ebola, and are no longer at risk of infection. Many countries are pledging medical resources, but donations will not result in an effective treatment system if no single group is responsible for coordinating them.
Finally, we have to remember that Ebola isn’t West Africa’s only problem. Tens of thousands die there each year from diseases like AIDS, malaria and tuberculosis. Liberia, Sierra Leone and Guinea have among the highest maternal mortality rates in the world. Because people are now too afraid of contracting Ebola to go to the hospital, very few are getting basic medical care. In addition, many health care workers have been infected with Ebola, and more than 120 have died. Liberia has only 250 doctors left, for a population of four million.

This is about humanitarianism and self-interest. If we wait for vaccines and new drugs to arrive to end the Ebola epidemic, instead of taking major action now, we risk the disease’s reaching from West Africa to our own backyards.

Dying of Ebola at the Hospital Door

Dying of Ebola at the Hospital Door

BY Ben C. Solomon | Sep. 11, 2014 | 3:47
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. .. http://www.nytimes.com/video/world/africa/100000003107917/dying-of-ebola-at-the-hospital-door.html?playlistId=100000003105684

Fear of Ebola infection Dutch physicians



Two Dutch tropenartsen in Sierra Leone want as quickly as possible back to the Netherlands as possibly the Ebola virus contamination.

The Press reports that a doctor from Reeuwijk and a doctor from Apeldoorn go. They work for Lion Heart Medical Centre by Ebola stricken Sierra Leone.




The doctors have had contact with an Ebola patient confirms the RIVM to RTL News. They were at that time not being adequately protected against disease because they did not know that the patient had acquired Ebola.

no symptoms
The Dutch show no symptoms of the disease. But since three weeks may take longer clear whether someone is infected hit, it's even more not to say that the doctors have acquired Ebola.

The doctors want as quickly as possible back to the Netherlands, said the father-in-law of one of the two to the Press.

The problem is that the two because of the risk of spreading the disease is not a regular flight back to the Netherlands can.


The Lion Heart Foundation, a foundation that Rotterdam hospital in Sierra Leone supports a private flight not pay and insurance would according to the press service, the charges may not be willing to pay at the moment it appears that the physicians actually ill.

Protocols are provided
How and when the Dutch could return at this time so is not clear. The Director of the Lion Heart Foundation performs 'day and night' agreement to return possible. A spokesman said the RIVM also at this time not to know whether and when the two come back.

RIVM said that the Netherlands are well prepared for the arrival of the physicians. "There are protocols that provide complete isolation and safe medical treatment., The roadmaps were first used in 2008, when a patient with Marburg virus came back," a spokesperson let know http://www.rtlnieuws.nl/nieuws/binnenland/angst-voor-ebola-besmetting-nederlandse-artsen?utm_source=twitterfeed&utm_medium=twitter

CHRONOLOGY-Worst Ebola outbreak on record tests global response

CHRONOLOGY-Worst Ebola outbreak on record tests global response

Thu Sep 11, 2014 5:54pm EDT

(Updates with Thursday developments)
    Sept 11 (Reuters) - International agencies and governments
are struggling to contain the world's worst epidemic of Ebola
since the disease was discovered in 1976. The hemorrhagic virus
has killed at least 2,296 people in West Africa. 
 Here is a timeline of the main developments in the outbreak.
        
    March 22: Guinea confirms that a previously unidentified
hemorrhagic fever, which killed over 50 people in its southeast
Forest Region, is Ebola. One study traces the suspected original
source to a 2-year-old boy in the town of Gueckedou. Cases are
also reported in the capital, Conakry.
    March 30: Liberia reports two Ebola cases; suspected cases
are reported in Sierra Leone.
    April 1: Noting the spread, medical charity Medecins Sans
Frontieres (MSF) warns it is "unprecedented," but a World Health
Organization (WHO) spokesman calls it "relatively small still."
    April 4: A mob attacks an Ebola treatment center in
southeast Guinea. Health care workers in Guinea, Sierra Leone
and Liberia face increasing hostility from fearful and
suspicious local people, many of whom refuse to believe the
disease exists.
    May 26: WHO confirms the first deaths in Sierra Leone.
    June 17: Liberia says Ebola reached its capital, Monrovia.
    June 23: With deaths above 350, making the West African
outbreak the worst Ebola epidemic ever recorded, MSF says the
outbreak is "out of control" and calls for massive resources.
    July 25: Nigeria, Africa's biggest economy, confirms its
first Ebola case, a Liberian-American man who died in the 
commercial hub, Lagos, after traveling from Monrovia.
    July 29: Dr. Sheik Umar Khan, who was leading Sierra Leone's
fight against the epidemic, dies of the virus.
    July 30: Liberia shuts schools and orders the quarantining
of the worst-affected communities, using troops to enforce it.
    July 31: The U.S. Peace Corps withdraws all volunteers from
Liberia, Sierra Leone and Guinea, citing Ebola risks.
    Aug 2: An American missionary aid worker infected with Ebola
in Liberia, Dr. Kent Brantly, is flown to Atlanta in the United
States for treatment at Emory University Hospital.
    Aug 4: The World Bank announces up to $200 million in
emergency assistance for Liberia, Sierra Leone and Guinea.
    Aug 5: A second U.S. missionary infected with Ebola, Nancy
Writebol, is flown from Liberia to the Atlanta hospital.
    Aug 8: WHO declares Ebola an "international public health
emergency" but stops short of calling for a ban on international
trade or travel.
    Aug 12: WHO says death toll from outbreak rises above 1,000,
approves use of unproven drugs or vaccines.
    Spanish priest infected with Ebola dies in Madrid hospital.
    Aug 14: WHO says reports of Ebola deaths and cases from the
field "vastly underestimate" the scale of the outbreak.
    Aug 15: MSF compares the Ebola outbreak to "wartime," says
it will take about six months to control.
    Aug 20: Liberian security forces in Monrovia fire live
rounds and tear gas to disperse crowd trying to break out of
Ebola quarantine. One teenager dies of gunshot wounds. 
    Aug 21: The two American missionary aid workers treated in
Atlanta are released from the hospital free of the virus. They
received an experimental therapy called ZMapp.
    Aug 24: Democratic Republic of Congo declares an Ebola
outbreak in its northern Equateur province, apparently separate
from the larger West African outbreak.
    Infected British medical worker is flown home from Sierra
Leone for treatment.
    Aug 28: WHO says death toll is above 1,550, warns outbreak
could infect more than 20,000 people. The U.N. health agency
announces a strategic plan to fight the epidemic, says $490
million will be needed over the next six months.
    Aug 29: Senegal reports its first confirmed Ebola case.
    Aug 30: World Food Program says it needs $70 million to feed
1.3 million people at risk in Ebola-quarantined areas.
    Sept 2: MSF President Joanne Liu tells U.N. members the
world is "losing the battle" to contain the Ebola outbreak and
slams "a global coalition of inaction."
    Sept 3: Pace of epidemic accelerates; deaths top 1,900.
Officials say there were close to 400 deaths in the past week.
    A third U.S. missionary infected with Ebola, Dr. Rick Sacra
of Boston, is flown out of Liberia for treatment at the Nebraska
Medical Center in Omaha.
    Sept. 5: WHO puts Ebola deaths in West Africa at more than
2,100 out of about 4,000 people thought to have been infected.
    Sierra Leone announces a four-day, countrywide "lockdown" to
halt the virus's spread, starting Sept. 18.
     U.N. Secretary-General Ban-ki Moon says the world body
plans a center to coordinate the response to the epidemic.
    European Union pledges 140 million euros (US$180 million)
toward the fight against the outbreak.
    Sept. 6: Scientists publish a map of places most at risk of
an Ebola outbreak, saying regions likely to be home to animals
harboring the virus are more widespread than previously feared,
particularly in West Africa. (To see the map, click on bit.ly/WOtGCc)
    Sept. 7: President Barack Obama says in an interview the
United States needs to do more to help control Ebola to prevent
it from becoming a global crisis that could threaten Americans.
    Sept. 8: WHO says Liberia, the country worst hit by the
epidemic, should see thousands of new cases in coming weeks as
the virus spreads exponentially.
    Britain says it will send military and humanitarian experts
to Sierra Leone to set up an Ebola treatment center, while the
United States says it will send a 25-bed military field hospital
to Liberia to help provide care for health workers.
    A fourth Ebola patient will be flown to the United States
for treatment, says Atlanta's Emory University Hospital.
    Sept. 9: WHO says the death toll jumped by almost 200 in a
single day to at least 2,296 and is already likely to be higher.
The agency says it has recorded 4,293 cases in five West African
countries, but it did not have new figures for Liberia.
    Liberia's defense minister tells U.N. Security Council his
country's national existence is seriously threatened by Ebola.
    Sept. 10: Bill & Melinda Gates Foundation pledges $50
million to support emergency efforts to contain the disease. 
    Sept. 11: International Monetary Fund says economic growth
in Liberia and Sierra Leone could decline by as much as 3.5
percentage points due to Ebola, which has crippled their mining,
agriculture and services sectors.
    Doctors treating Sacra at University of Nebraska Medical
Center say he is showing "remarkable improvement" after
receiving an infusion of plasma from U.S. Ebola survivor Brantly
and an undisclosed experimental drug.
    Microsoft co-founder Paul Allen's charitable foundation says
it will give the U.S. Centers for Disease Control and
Prevention$9 million to establish emergency operations centers
in Guinea, Liberia and Sierra Leone.

 (Writing by Pascal Fletcher and Jonathan Oatis; Editing by Toni
Reinhold)   http://www.reuters.com/article/2014/09/11/health-ebola-idUSL1N0RC2NH20140911?rpc=401

Spain again-Entered a minor in Murcia for a possible case of Ebola

Entered a minor in Murcia for a possible case of Ebola

     This is a thirteen year old boy who traveled to Spain from Lagos, Nigeria, on 25 August

     EFE | MURCIA

September 11 201423: 54



A thirteen year old boy who traveled to Spain from Lagos, Nigeria, on 25 August was admitted to the hospital Virgen de la Arrixaca Murcia suspected it could be a case of illness from Ebola virus.

A spokesman for the Ministry of Health has reported that the child has been treated in the emergency department of the town of Sewell and paid to the said hospital, because some of the symptoms had set for these cases, prevention protocol compliance established with suspected Ebola. They have made ​​the necessary analytical determinations and were sent to the national reference center Majadahonda (Madrid), which will take 48 hours to deliver.

According to a statement of Health, the whole operation was developed normally and the patient has been admitted to the specific rooms for infectious diseases at the Hospital Virgen de la Arrixaca.
The child says counseling, is controlled by the Department of Internal Medicine and Infectious hospital and you have made the necessary analysis to determine if it is affected by the Ebola virus (EVE).

In the statement, Dr. José Antonio Herrero, practitioner of Internal Medicine and Infectious Diseases, which is coordinating the implementation of the protocol and patient management says they have sent the samples and the reference laboratory and in two days they will reach the results.

Smith stresses that "this protocol is mainly to prevent, and everything worked perfectly.'s Worth remembering that this is a suspect, if only," adding that "the patient is stable right now, with good clinical condition" .

Health works with the Coordinating Center Alerts and Health Emergencies, the Ministry of Health, Social Services and Equality and to this end, a specific protocol is now enabled due to the assistance of a person with suspected was created presenting this pathology. Herrero destaha also stressed that "the risk to citizens living in Spain is considered very low, but our obligation is to be ready for the early detection of potential patients with Ebola and immediately to apply appropriate prevention and care efforts."
http://www.elcomercio.es/sociedad/salud/201409/11/ingresado-menor-murcia-posible-20140911235033-rc.html