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EBOLA: Health minister under quarantine in Liberia
« on: September 29, 2014, 09:06:25 AM »

The damage being done by the Ebola Virus Disease in Liberia has been underscored by the quarantine of the country?s deputy health minister. The minister, Dr. Bernice Dahn, placed herself in quarantine following the Ebola death of her assistant, health officials and humanitarian sources said on Sunday.

The minister?s assistant died of the infectious disease on Thursday.

Dahn and her assistant?s staff, whom she also quarantined, will remain under observation for 21 days for the full incubation period of the tropical fever that has killed more than 3,000 people since the end of last year.

Of the four West African nations affected by the Ebola outbreak, Liberia has been hit the hardest, with 3,458 people infected, and 1,830 of killed by the disease, according to a WHO data released Saturday.

In Monrovia, ?about 50 bodies are incinerated each day, though we estimate that 20 to 30 per cent of those did not have Ebola,? a WHO official who requested anonymity said, suggesting an Ebola toll of 35 to 40 victims each day in the Liberian capital.

?This is a slow rise, and it only includes the cases that have been officially tallied. There are still people who continue to bury their dead secretly in their gardens,? he said.

The US federal health body Centres for Disease Control and Prevention estimates that only about 40 percent of Ebola cases are being announced in Liberia and Sierra Leone, the worst-affected states.

The virus can fell its victims within days, causing rampant fever, severe muscle pain, vomiting, diarrhoea and, in many cases, unstoppable internal and external bleeding.

Liberia?s decrepit public health infrastructure, ruined by 14 years of civil war to 2003 and endemic poverty, has ?totally collapsed? under the Ebola crisis, the WHO official said.

A national crisis

With more than half of the reported cases and deaths, the Ebola Virus Disease is not slowing down in Liberia. The country of four million people is struggling under the heavy weight of an epidemic, which according to the World Health Organisation, has exploited its weak health systems. Within two days last week, more than 150 Liberians succumbed to Ebola. So far, 89 out of 211 health workers lost to the disease were also Liberians.

Meanwhile, thousands of doses of experimental Ebola vaccines should be available in the coming months and could eventually be given to health care workers and other people at high risk of the deadly disease, the WHO said on Friday.

Public health experts are however exploring experimental therapies and unconventional means of stopping the Ebola outbreak sweeping West Africa because it is picking up steam and has defied the typical methods used to stem Ebola?s spread.

The number of deaths linked to the disease has now passed 3,000, according to a published WHO toll. No vaccine has yet been proved to be safe or effective in humans, said Marie-Paule Kieny, assistant director-general at WHO, who spoke at a news conference in Geneva that was later shared by email. Testing must first be done to ensure they are not harmful to people, some of which has already begun, she said.

The Canadian government has already donated 800 vials of one vaccine, which it developed before licensing to NewLink Genetics Corporation. Kieny said the company was expected to produce several thousand more doses in the coming months. It is unclear how many doses the 800 vials hold because testing needs to be done to determine how large an effective dose is, but Kieny said it was probably about 1,500.

By the beginning of next year, there should be about 10,000 doses of another vaccine, developed by the US National Institutes of Health and GlaxoSmithKline, Kieny said.

?This will not be a mass vaccination campaign,? she said. Health workers or people known to have had contact with an infected person could be given a vaccine as early as January, as part of a bigger trial to test the shot?s effectiveness, she said.

Filled hospitals

Doctors are in short supply. So are beds for patients. Nine months after the Ebola outbreak emerged for the first time in an unprepared West Africa and eventually became the worst-ever outbreak, the gap between what has been sent by other countries and private groups and what is needed is huge.

Even as countries try to marshal more resources, those needs threaten to become much greater, and possibly even insurmountable.

Fourteen-year-old D.J. Mulbah was taken by his mother and grandmother on Saturday in desperate pursuit of a coveted bed at the Ebola clinic run by Doctors Without Borders in Monrovia, Liberia?s capital. Too weak to stand, he was put into a taxi with his backpack and a bucket for vomit.

?He?s been sick for a week with a runny stomach,? said his mother, wiping the sweat off the boy?s brow with her bare hands. ?We tried calling ambulance days ago but nobody ever came,? the desperate mother said.

Beds are filling up as fast as clinics can be built. Ambulance sirens blare through standstill traffic. Often there is nowhere to take the sick except to ?holding centres? where they await a bed at an Ebola treatment facility.

Statistics reviewed by the Associated Press and interviews with experts and those on the scene of one of the worst health disasters in modern history show how great the needs are and how little the world has done in response. Some foreign medical workers have bravely fought on, a few even contracting Ebola themselves as they cared for patients. Experts warn that the window of opportunity to snuff out the dreaded disease may close unless promises of additional assistance immediately become reality.

The existing bed capacity for Ebola patients in Liberia, Sierra Leone and Guinea and Nigeria is about 820, well short of the 2,900 beds that are currently needed, according to the WHO. Recently 737 beds were pledged by countries. Yet even after the promised treatment facilities are built, they will still be at least 2,100 beds short.

The shortage of health workers is also great. WHO has estimated that 1,000 to 2,000 international health workers are needed in West Africa. More than local 200 health workers have died of Ebola while trying to save patients, complicating recruitment efforts.

Doctors Without Borders, which has more Ebola clinics than anyone, currently has 248 foreign aid workers in the region.

President Barack Obama has ordered up to 3,000 US military personnel to West Africa to train health workers and build more than a dozen 100-bed field hospitals, including reserved sections for infected aid workers in Liberia.

The list of global helps include a pledge by the African Union to deploy 100 health workers to assist the West African countries affected by Ebola. The first batch of an AU Ebola taskforce, totalling 30 people, left for Liberia on September 18. Taskforce members are expected to arrive in Sierra Leone on October 5 and in Guinea by the end of October.

Britain and France have both pledged to build field hospitals in Sierra Leone and Guinea.
China is sending a 59-person lab team to Sierra Leone.
Cuba will send 461 health workers, who will be trained in biosecurity, and some will go to Liberia and Guinea.
Dr. Joanne Liu, international president of Doctors Without Borders, urged world leaders this week to take ?immediate action.?

?The reality on the ground today is this: The promised surge has not yet delivered,? she said.

MSF and other aid workers are distributing home-care kits with gloves and surgical gowns to try and keep those awaiting hospital beds from infecting relatives at home, though only thousands of kits are being distributed in Monrovia, a city of 1.6 million.

?We have been working furiously trying to set up treatment centers but (incoming patients) have been outpacing our ability to set them up,? said Dr. Frank Mahoney, co-lead of the US Centres for Disease Control team in Liberia.

Unless the situation is put under control, the outbreak may infect as many as 1.4 million people by the end of the year and nearly half of those people could die, the CDC estimated this week. More than 3,000 are currently believed to have died from Ebola, which is spread through direct contact with the bodily fluids of the sick.

If more people get sick than those who recover or die, the needs will grow even more pronounced.

?If this outbreak continues, the sheer caseload will make it much more difficult to contain,? said Dr. Bruce Aylward, assistant-director general in charge of emergencies at WHO. ?We will need more health workers to take care of them, more PPE (protective suits), more hospitals, more of everything.?

A top priority is sending enough protective equipment, including gloves, gowns, masks and boots. WHO is shipping about 240,000 protective suits a month in addition to supplies sent by other agencies. Under-sourced clinics are reportedly washing and reusing protective gear that is meant to be worn once and burned.