2014-10-30

We begin with root causes, starting with this from the Guardian:

Ebola is a product of a destructive and exploitative global economic system

Deforestation and increasing demands on habitats to produce food don’t just wreck the environment, they are increasing the risk of global pandemics like Ebola

Like a sleepwalker roused from his dream, the world is slowly waking up to the full nightmare of the Ebola outbreak decimating west Africa. With small numbers of cases turning up in western countries, governments here are belatedly pledging action to fight the disease, which has already claimed almost 5,000 lives.

Liberia, Sierra Leone and Guinea – all countries struggling to recover from wars still fresh in the memory – have buckled under the onslaught of this horrific virus. Inadequate, creaking health services have been no match for a ruthless killer. But while the shocking poverty of these countries provides the fertile ground for the disease to spread, there are bigger issues at play that ought to cause us to think about the macroeconomic conditions that brought us to this point.

Ebola – like HIV, anthrax, Sars, avian flu and other pandemics of recent years – is a zoonotic virus, one that has crossed from animals to humans. It was first identified in 1976 during near-simultaneous outbreaks in Sudan and what is now the Democratic Republic of the Congo (DRC).

The strain of Ebola implicated in the current outbreak is thought to have originated from a mutant pathogen found in fruit bats. This is where we see a direct connection with economic development. The conflicts which have done so much damage to the affected countries have also attracted a range of activities – both legal and illicit – including logging and extractive industries like bauxite mining, which have deforested large swathes of the region.

More from The Ecologist:

Oil palm explosion driving West Africa’s Ebola outbreak

The medical response to the Ebola outbreak in West Africa has been monstrously inadequate, writes Richard Kock. But so has been recognition of the underlying causes – in particular the explosive spread of industrial oil palm, which disrupts the ecology of forests and farms, and undermines local economy and traditional governance, leading to a ‘perfect storm’ of disease.

It is poverty that drives villagers to encroach further into the forest, where they become infected with the virus when hunting and butchering wildlife, or through contact with body fluids from bats – this has been seen with Nipah, another dangerous virus associated with bats.

The likelihood of infection in this manner is compounded by inadequate rural health facilities and poor village infrastructure, compounded by the disorganised urban sprawl at the fringes of cities.

The virus then spreads in a wave of fear and panic, ill-conceived intervention and logistical failures – including even insufficient food or beds for the severely ill.

Take for example the global palm oil industry, where a similar trend of deep-cutting into forests for agricultural development has breached natural barriers to the evolution and spread of specific pathogens.

The effects of land grabs and the focus on certain fruit crop species leads to an Allee effect, where sudden changes in one ecological element causes the mechanisms for keeping populations – bats in this case – and viruses in equilibrium to shift, increasing the probability of spill over to alternative hosts.

Next, some possibly good news from the Guardian:

Ebola may have reached turning point, says Wellcome Trust director

Dr Jeremy Farrar says international community is belatedly taking the actions necessary to stem the tide of the disease

Writing in the Guardian, Dr Jeremy Farrar says that although there are several bleak months ahead, “it is finally becoming possible to see some light. In the past 10 days, the international community has belatedly begun to take the actions necessary to start turning Ebola’s tide.

“The progress made is preliminary and uncertain; even if ultimately successful it will not reduce mortality or stop transmission for some time. We are not close to seeing the beginning of the end of the epidemic but [several] developments offer hope that we may have reached the end of the beginning.”

Farrar’s comments come as the World Health Organisation confirmed that the number of Ebola cases in Liberia has started to decline, with fewer burials and some empty hospital beds. But the WHO warned against any assumption that the outbreak there was ending.

“I’m terrified that the information will be misinterpreted,” said Dr Bruce Aylward, assistant director-general in charge of the Ebola operational response. “This is like saying your pet tiger is under control. This is a very, very dangerous disease. Any transmission change could result in many, many more deaths.”

Science qualifies the optimism:

Liberia’s Ebola progress real, but epidemic far from under control

The apparent decline in cases could mean that  families are hiding patients and secretly burying the dead, but it is more likely that a combination of factors has reduced the spread of the disease, said Aylward. “There was a rapid scale up in safe burial practices in the month of September,” he said, adding that many people were isolated in Ebola treatment units, further curbing spread. There also has been intensive education of communities about the disease, including how it is spread, the value of seeking care, and self-protection strategies.

The situations in Guinea and Sierra Leone, the other two hard-hit countries, have not changed as dramatically.

In a disconnect with the drop of cases in Liberia, Aylward noted that WHO has tallied 13,703 cases—a jump of more than 3000 from the figures released 25 October. He said the steep increase reflects reporting on a backlog of cases “With the huge surge in cases in certain countries, particularly in September and October, people got behind on their data,” he said. “They ended up with huge piles of paper and we knew we were going to see jumps in cases at certain times that are going to be associated with more new data coming in that are actually old cases.” He said about 2000 of the latest cases came from old data collected in Liberia, where reporting of cases continues to be a problem. “Data for Liberia are missing for 19, 20, 21, 26 and 27 October,” the latest update from WHO notes.

And from Liberia itself, another caution via The NewDawn:

Ellen warns against early excitement – Chinese military team arrives

President Ellen Johnson-Sirleaf has warned against early jubilation over news of reduction in the infection across the country with news of less than 400 cases nationwide.

The Liberian leader is cautioned citizens and residents against a repeat of a scenario in March this year when people got “too happy too soon” over decline in Ebola infection, thereby giving room for the virus to resurface by June when preventive measures were largely downplayed.

“Yes we feel good, but we want to be cautious. We don’t want people to get happy too soon; we got to continue this fight, and we got to continue it with everything that we got,” President Sirleaf said Tuesday in Monrovia when she received an advance Chinese military delegation of 15 personnel to build ETUs here.

Judging from previous scenario, she warned, “This time we want to be careful, we’ll not be satisfied until we are declared that the last Ebola victim has been cured and is freed of this disease.” President Sirleaf’s warning comes as government prepares to conduct a mid-term election for 15 senators in December.

A video report from euronews:

Ebola: WHO announces ‘slowing rate of new cases’

Program notes:

Liberia may be experiencing a slowdown in the rate of new cases of the deadly Ebola virus according to the World Health Organization.

“We are seeing a slowing rate of new cases, very definitely,” WHO Assistant Director General Bruce Aylward announced.

The African country has reportedly seen a drop in burials and new hospital admissions, while the number of laboratory-confirmed cases has levelled out.

While the Associated Press adds more nuance:

Top UN Ebola official: new cases poorly tracked

Authorities are having trouble figuring out how many more people are getting Ebola in Liberia and Sierra Leone and where the hot spots are in those countries, harming efforts to get control of the raging, deadly outbreak, the U.N.’s top Ebola official in West Africa said Tuesday.

“The challenge is good information, because information helps tell us where the disease is, how it’s spreading and where we need to target our resources,” Anthony Banbury told The Associated Press by phone from the Ghanaian capital of Accra, where the U.N. Mission for Ebola Emergency Response, or UNMEER, is based.

Health experts say the key to stopping Ebola is breaking the chain of transmission by tracing and isolating those who have had contact with Ebola patients or victims. Health care workers can’t do that if they don’t know where new cases are emerging.

“And unfortunately, we don’t have good data from a lot of areas. We don’t know exactly what is happening,” said Banbury, the chief of UNMEER.

Meanwhile, the crisis remains both critical and costly. From Sky News:

Ebola: DEC Launches ‘Unprecedented’ Appeal

The charity group asks the public for money to halt the “explosive” virus – the first time it has done so for a disease outbreak.

The Disasters Emergency Committee is to launch a major television appeal over the Ebola crisis, the first time it has called for donations in response to a disease.

The committee, which is made up of 13 of the UK’s major aid charities, said it took the decision because the killer virus threatens to become a “catastrophe”.

The DEC described the spread of the virus as “explosive”, and said it was devastating communities, health services and people’s ability to support themselves.

Next, California joins the list of states with Ebola quarantine policies, via the San Jose Mercury News:

Ebola: California is latest state to impose 21-day quarantine for those exposed to Ebola

California on Wednesday became the latest state to order a 21-day quarantine for travelers who have been in close contact with Ebola patients.

In an attempt to avoid the criticism lodged against New York, New Jersey and Maine that had blanket quarantine orders, however, California will allow county health agencies to impose the quarantine on a case-by-case basis.

By working with county health departments to assess the individual risks, the California Department of Public Health said it “respects the individual circumstances of each traveler while protecting and preserving the public health.”

And a case at hand, via KCBS in San Francisco:

Stanford Surgeon Under ‘Modified Quarantine’ In San Mateo County After Returning From Liberia

A Stanford surgeon has been put on modified quarantine in San Mateo County after treating Ebola patients in Liberia for the past month.

Dr. Colin Bucks returned to the Bay Area on Friday, but no state or federal quarantine orders were in place at the time. Dr. Bucks is not experiencing any symptoms of Ebola, but he is the first Californian to be quarantined under the new guidelines. Bucks is considered by health officials to be at “some risk.”

The doctor contacted San Mateo County health officials. After consultation with the U.S. Centers for Disease Control and the California Dept. of Public Health, Dr. Bucks was told to stay away from work and to stay away from others for 21 days. However, he can leave his house to go jogging by himself. He is taking his temperature every day and has not developed any symptoms.

Politics of pain, via the Los Angeles Times:

Obama urges Americans to honor aid workers fighting Ebola in Africa

President Obama on Tuesday urged Americans to set aside their fears of the Ebola virus and make sure U.S. healthcare workers who go to West Africa are “applauded, thanked and supported” when they return home.

If those workers are successful in fighting the virus at the source of the outbreak, he said, “we don’t have to worry about it here.”

“They are doing God’s work over there,” Obama said, “and they are doing that to keep us safe.”

And a fundamental lack from the Associated Press:

Funding to tame an Ebola outbreak has fallen short

“We don’t really have a pharmaceutical response for Ebola,” said retired Air Force Col. Randall Larsen, the former executive director of the Congressional Commission on the Prevention of Weapons of Mass Destruction. “But could you imagine if there were 20,000 sick people in 10 cities and we did not have a pharmaceutical response? We would be completely overwhelmed.”

Emergency preparedness programs ramped up significantly in the U.S. after the Sept. 11 attacks and the 2001 anthrax scare, said Dr. Gerald Parker, a former principal deputy assistant secretary in the U.S. Health and Human Services preparedness office. Those efforts included research and development of vaccines and anti-viral drugs.

“It was recognized that there would be a dual benefit from research on vaccines, therapeutics and diagnostics to counter bioterror threats and emerging infectious diseases,” said Parker, now a vice president at Texas A&M Health Science Center.

But a combination of budgetary constraints and politics has delayed many of those plans.

Other quarantine news from the New York Times:

New York State Ebola Policy Allows for In-Home Quarantine

Offering the first detailed account of how New York State’s quarantine order for health care workers returning from West Africa will be put into effect, the Cuomo administration has issued guidelines that go beyond federal recommendations but seek to allow individuals to spend their enforced isolation in a location of their choosing.

The state documents, copies of which were obtained by The New York Times, show an effort by Gov. Andrew M. Cuomo’s administration to portray the quarantine in a humane manner.

The protocols are meant to ensure “a respectful and supportive approach” to arriving travelers, who are supposed to be “treated with the utmost respect and concern,” according to a document prepared by the State Health Department that outlines the screening procedures.

While the Guardian covers a controversy:

Ebola: Maine deploys state police to quarantined nurse’s home

Kaci Hickox, who was held for days in an isolation tent in New Jersey, says she doesn’t plan on obeying home quarantine in her home state

A nurse freed from an Ebola isolation tent in a New Jersey hospital declared on Wednesday the she will not comply with a quarantine request imposed by state officials, saying the policy is not based on science and infringes on her civil liberties.

“I don’t plan on sticking to the guidelines,” nurse Kaci Hickox told the Today show from her home in Maine. “I remain appalled by these home quarantine policies that have been forced upon me, even though I am in perfectly good health and feeling strong and have been this entire time completely symptom-free.”

The governor’s office said in a statement that Maine state police would monitor Kickox’s home “for both her protection and the health of the community”. A TV reporter with the local WLBZ news channel said as of 1pm ET on Wednesday at least two police cars were parked out front of the home.

More from the Washington Post:

Maine Gov. Paul LePage is seeking legal authority to enforce Ebola quarantine on nurse

Maine Gov. Paul LePage (R) is looking for ways to force a nurse released from mandatory Ebola isolation in New Jersey to abide by a similar 21-day quarantine in Maine.

“The Office of the Governor has been working collaboratively with the State health officials within the Department of Health and Human Services to seek legal authority to enforce the quarantine,” LePage’s office said in a statement Wednesday. “We hoped that the health-care worker would voluntarily comply with these protocols, but this individual has stated publicly she will not abide by the protocols.”

Still more from the Guardian:

Maine prepared to go to court to enforce nurse’s Ebola quarantine order

Officials plead with Kaci Hickox to abide by 21-day order

‘I have been this entire time completely symptom-free’

Maine’s top public health official has said the state will if necessary seek a court order to ensure a nurse stays quarantined in her home after returning from treating Ebola patients in Sierra Leone.

Mary Mayhew, the commissioner of the state department of health and human services, pleaded with Hickox to abide by the state’s 21-day at-home quarantine order.

“We do not want to legally enforce an in-home quarantine unless absolutely necessary,” Mayhew said on Wednesday afternoon.

More quarantine politics from Reuters:

Obama sees different Ebola rules for U.S. military than for civilians

President Barack Obama on Tuesday appeared to back more rigorous procedures for dealing with soldiers returning from missions to Ebola-hit West African countries, even as he criticized moves by some U.S. states to quarantine returning civilian health workers.

Obama said that American military personnel were in a “different situation” compared with healthcare workers. While civilians may be discouraged from volunteering to help fight the Ebola if they are facing quarantine on their return, troops were sent as part of their mission and could expect such inconveniences.

“They are already by definition if they are in the military under more circumscribed conditions,” Obama told reporters at the White House. “We don’t expect to have similar rules for our military as we do for civilians.”

More from USA Today:

Quarantine ordered for troops returning from W. Africa

U.S. troops returning from Ebola-stricken nations will be isolated for 21 days, Defense Secretary Chuck Hagel announced Wednesday, a day after the White House raised concerns about states imposing strict quarantines of health care workers returning from West Africa.

Top commanders for the Navy, Air Force and Marine Corps made the recommendation to Hagel on Tuesday. The Army instituted an isolation requirement for 21 days — the incubation period for the deadly virus — on Monday.

Hagel directed the isolation policy be reviewed in 45 days to see whether it was necessary to continue with it, said Rear Adm. John Kirby, Pentagon press secretary.

Still more from the Guardian:

Conflicting Ebola guidelines put US defense secretary in a tough spot

Hagel’s choice on quarantining troops returning from west Africa involves rebuking either government scientists or military leaders

The Ebola outbreak has placed the US secretary of defense on the horns of a dilemma: whether to back the military service chiefs about a quarantine for troops or to support the Centers for Disease Control and Prevention (CDC), which recommends no such thing.

Defense chief Chuck Hagel has received a recommendation for a “quarantine-like program” for all US servicemembers returning from Liberia and Senegal, where they are supporting civilian efforts to contain the disease, Rear Admiral John Kirby, the Pentagon spokesman, said on Tuesday.

The recommendation, made by the heads of the military services, would expand across the military a directive made on Monday from the army chief, General Raymond Odierno, to keep soldiers returning from Operation United Assistance in Liberia and Senegal under a 21-day period of “controlled monitoring”.

Kirby said Hagel has yet to make a decision, having received the quarantine recommendation earlier on Tuesday. But imposing a broader military quarantine for returning servicemembers goes beyond new guidance set on Monday by the CDC, which urged a home quarantine only for high-risk individuals, such as those whose body fluids have been directly exposed to Ebola. US troops have not been involved in treating Ebola patients.

And yet more from Reuters:

US isolates troops

The U.S. military has started isolating soldiers returning from an Ebola response mission in West Africa and Australia became the first rich nation to impose a visa ban on the affected countries amid global anxiety about the spread of the virus.

The latest measures, along with decisions by some U.S. states to impose mandatory quarantines on health workers returning home from treating Ebola victims in West Africa, have been condemned by health authorities and the United Nations as extreme.

The top health official in charge of dealing with Washington’s response to Ebola warned against turning doctors and nurses who travel to West Africa to tackle Ebola into “pariahs”.

From Reuters, intranational man of mystery:

In Ebola response, Obama’s ‘czar’ stays behind the curtain

It’s not often that a White House official gets mocked on both Saturday Night Live and a major daily newspaper before he makes his first public appearance.

But Ron Klain’s low-profile first week as President Barack Obama’s behind-the-scenes Ebola “czar” has become another attack point for a White House struggling to show it’s on top of the crisis.

Since starting last Wednesday, Klain has been seen only once, in a photo op on his first day, leaving health officials from the Centers for Disease Control and Prevention and National Institutes of Health – and Obama himself – to be the public “face” of the response.

The White House has declined to give details about his activities, especially what role he played as governors Andrew Cuomo of New York and Chris Christie of New Jersey undermined the White House’s attempt to keep the nation calm about the risk posed by healthcare workers returning from Ebola-stricken West Africa.

More predictable politics from the Associated Press:

Jeb Bush: Obama handling of Ebola ‘incompetent’

Former Florida Gov. Jeb Bush on Tuesday criticized President Barack Obama’s initial handling of the Ebola crisis as “incompetent,” saying it gave rise to unneeded fears among the American public about the virus.

Bush, who is the latest potential Republican presidential candidate to attack the president over Ebola, also said in a wide-ranging discussion at Vanderbilt University that he supports travel restrictions for people who have been to the most severely affected countries in Africa.

Bush said Obama should have been more “clear and concise” about his plans, and lent more credibility to health officials leading the response.

“It looked very incompetent to begin with, and that fueled fears that may not be justified,” Bush said. “And now you have states that are legitimately acting on their concerns, creating a lot more confusion than is necessary.”

Meanwhile, the Obama administration made a notable symbolic move sure to piss off some of Bush’s former Florida constituents, via the Associated Press:

US sends health official to Cuban Ebola meeting

The United States has sent a health official to a Cuban meeting on coordinating Latin America’s response to Ebola. The participation of the Centers for Disease Control’s Central America director is the most concrete sign to date of the two nations’ expressed desire to cooperate against the disease.

The two-day meeting that began Tuesday in Havana is sponsored by ALBA, a forum of left-leaning Latin countries founded by Cuba and Venezuela as a counterweight to U.S. influence in the region.

Cuba is sending at least 256 medical workers to West Africa to treat and prevent Ebola. The World Health Organization says it’s the largest contribution by a single government, although there may be more doctors of other nationalities who are sent by non-governmental organizations.

The U.S. has welcomed Cuba’s response.

Ebolaphobia from the New York Times:

Connecticut Child Barred From School After Trip to Africa; Father Sues

The father of a Connecticut third grader filed a federal lawsuit on Tuesday, saying his daughter has been unfairly barred from school amid fears she may have been exposed to the Ebola virus while in Africa.

The daughter, Ikeoluwa Opayemi, and her family, who live in Milford, visited Nigeria for a wedding from Oct. 2 to 13, according to the lawsuit, which was filed in Federal District Court in New Haven.

When the girl tried to return to the Meadowside Elementary School, she was told by the school district’s health director that she would have to stay home until Nov. 3 “due to concern from certain parents and teachers that she could transmit Ebola to other children,” according to the lawsuit.

More from Ebolaphobics from Science:

Been to an Ebola-affected country? Stay away from tropical medicine meeting, Louisiana says

Ebola fears are interfering with the world’s premier scientific meeting on tropical diseases. Today, Louisiana state health officials asked anyone who has traveled to Liberia, Sierra Leone, or Guinea in the past 21 days, or has treated Ebola patients elsewhere, to stay away from the annual meeting of the American Society for Tropical Medicine and Hygiene (ASTMH), which begins on Sunday in New Orleans.

ASTMH doesn’t know exactly how many scientists will be affected, but there are several, says incoming president Christopher Plowe, including representatives from the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC). “They are quite disappointed,” says Plowe, a malaria researcher at the University of Maryland. ASTMH sent all meeting registrants an email today containing a letter from Kathy Kliebert, secretary of Louisiana’s Department of Health & Hospitals, and Kevin Davis, director of the Governor’s Office of Homeland Security & Emergency Preparedness, that outlines the state’s position. ASTMH referred registrants to the state’s health department for further information.

“Given that conference participants with a travel and exposure history for [Ebola] are recommended not to participate in large group settings (such as this conference) or to utilize public transport, we see no utility in you traveling to New Orleans to simply be confined to your room,” the letter says.

After the jump, an infectious lie, a sole supplier, North Korean Ebolaphobia, Hong Kong preparedness, fast-tracking a vaccine, anger at Aussie exclusion, Japanese angst leads to a task force, then on to Africa and vigilance in the newest addition to the ranks of the stricken while a border remains open, a study of who survive in Sierra Leone, Tokyo lends mobile assistance, Brits train “Ebola warriors,” missing funds, and survivors are shunned, then on to Liberia and the crisis personified, the healthcare worker’s painful conundrum, another blow to overstretched police resources, long overdue pay for healthcare workers, a cultural belief hampering prevention efforts with specific voices heard, Christian leaders call a three-day fast, a Christian tradition invoked, a change in command of American boots on the ground, and a presidential birthday is deferred, thence to Nigeria and an unanticipated arrival, followed by a precipitous tourism decline in Kenya. . .

FrontPageAfrica covers an infectious lie:

Duncan Lies Before Death: Reveal He Buried Daughter in Liberia

When nurses treating Thomas Eric Duncan asked him whether he came in contact with any sick person before traveling to the U.S. he said yes, according to nurses who were treating him at the hospital in Texas

Nurse Sidia Rose told American broadcaster CBS 60 Minutes Sunday that because U.S. State and federal health officials wanted to know if Duncan had been with anyone who had died in Liberia she asked him the question and he revealed a secret. “And that’s when he said to me his family had suffered a loss. That he had buried his daughter who had died in childbirth,” she said.

But nurse Rose said Duncan told her it was not Ebola that killed his daughter. Rose told us that she reported this to the Texas Department of Health, but then, Duncan denied his own story when he spoke to those officials. Duncan then lied about his travels and about him burying his pregnant daughter who had died in childbirth.

Duncan’s story to his US caregivers contradicts the real story in his community in Liberia a little because in the 72nd community, where he lived before traveling to to the US, many saw him as this humanitarian who went to give help to a neighbor whose daughter was pregnant and sick. Mathaline Williams was six months pregnant and her parents were Duncan’s neighbors who owned the apartment that Duncan lived in.

From the Washington Post, a sole supplier:

The whole world relies on this one U.S. company to fly Ebola patients

When it comes to transporting Ebola victims by air, the world relies on just one U.S. company.

Phoenix Air, a jet-charter service based in Cartersville, Ga., has flown 15 infected patients, including Europeans who worked in West Africa and five individuals who were treated in the United States — doctor Kent Brantly, photojournalist Ashoka Mukpo, missionary Nancy Writebol, and nurses Nina Pham and Amber Vinson.

Now the Defense Department is stepping up. The Pentagon this week said it is developing its own portable isolation units for use on military planes, as thousands of U.S. troops head to West Africa. The agency expects to test the systems next month and deploy them in C-17 and C-130 transport planes by January.

Korean Ebolaphobia from TheLocal.es:

N. Korea bans Spanish man over Ebola fears

North Korea has refused a Spanish cameraman entry using for a rare press visit due to Ebola fears, the trip’s Dutch organizer said on Monday.

Marc Martínez Sarrado was turned down because he is from Spain, which is considered by Pyongyang “to be a risk country,” businessman Paul Tjia told the Dutch NOS public broadcaster.

Sarrado is an NOS cameraman based in Beijing and has not been in Spain since July, or before Spain saw its first Ebola case.

“As a Spanish passport holder I’ve been rejected to get in #DPRK. #Spain considered country of risk,” he wrote on Twitter.

Hong Kong preparedness from South China Morning Post:

Hong Kong has ‘highest level’ of Ebola prevention control at airport, says health secretary

Hong Kong has adopted the highest possible level of preventive measures at the border to block the fatal Ebola virus that has spread out of West Africa, the health minister says.

Secretary for Food and Health Dr Ko Wing-man did not see any need yet to keep travellers from infected countries from entering Hong Kong, as the World Health Organisation had not deemed it necessary.

“We have raised the preventive measures at the border to the highest possible level we can,” Ko said yesterday on the sidelines of the sixth Global Conference of the Alliance for Healthy Cities in Tseung Kwan O.

Fast-tracking a vaccine from the Guardian:

Third possible Ebola vaccine to be sped through human safety trials

Vaccine has so far been tested only in monkeys, but human trials set to start in Germany, Switzerland, Gabon and Kenya

A third potential Ebola vaccine could be tested on healthworkers in west Africa in December following the announcement of funding to speed it through its first-ever human safety trials.

The vaccine, called rVSV-EBOV, was developed by the Public Health Agency of Canada. So far it has been tested only in monkeys, but in the hope that it could prove effective, 800 vials have been donated by the Canadian government. The safety trials – in which people at no risk of catching Ebola are vaccinated to ensure there are no serious side-effects – will start imminently in Germany, Switzerland, Gabon and Kenya.

The Wellcome Trust is donating £3.1m to enable the collection of safety data, overseen by the World Health Organisation.

Anger at Aussie exclusion from BBC News:

Ebola outbreak: Sierra Leone angry at Australia visa ban

Sierra Leone has condemned Australia’s decision to suspend entry visas for people from Ebola-affected countries in West Africa as “counterproductive” and “discriminatory”.

The move has also been criticised by Amnesty International. And UN Secretary General Ban Ki-moon has said travel restrictions will severely curtail efforts to beat Ebola.

The Australian government announced on Monday that it was cancelling non-permanent or temporary visas held by people from the affected countries who were not yet travelling, and that new visa applications would not be processed.

Japanese anxiety from the Japan Times:

Questions remain over how Japan would handle actual Ebola cases

Health experts have said authorities were correct to intercept a Canadian journalist who subsequently tested negative for the Ebola virus and remains under observation.

But the structure of Japan’s health system remains a cause for concern. There are questions over its ability to respond quickly and effectively to other suspected Ebola cases, and worries persist over the expertise of personnel.

While the Health, Labor, and Welfare Ministry beefed up detection measures last week, the logistics of handling a suspected Ebola victim are not as clear as they need to be, experts say.

One result from NHK WORLD:

Japan to set up Ebola response task force

Japan’s health ministry plans to launch a task force to prepare for possible cases of Ebola infection in the country.

The ministry task force will be launched on Tuesday. It is expected to establish a system to provide protective equipment to designated hospitals across the country.

The team will also discuss ways to transport possible Ebola patients to designated hospitals.

Health Minister Yasuhisa Shiozaki said the ministry will do all it can to prevent the virus from entering the country, and contain it if it does.

On to Africa and vigilance in the newest addition to the ranks of the stricken from Agência Angola Press:

WHO says 82 being monitored for Ebola in Mali

Health workers are monitoring 82 people who had contact with a toddler who died of Ebola in Mali last week, but no new cases of the disease have yet been reported, World Health Organization spokesman Tarik Jasarevic said on Tuesday.

Three WHO officials are already in the country, having travelled to Mali a week ago to test its Ebola preparedness, and five more are arriving, Jasarevic said.

Mali became the sixth West African country to report a case of the disease, and health officials want to try to contain the virus before it can spread out of control.

Keeping the gate open, via StarAfrica:

Ebola: Senegal will not close border with Mali

The Senegalese government said it has no intention of closing its border with Mali which recently recorded its first confirmed Ebola case, a two-year-old girl who later died of the disease.Health minister Eva Marie Coll Seck was quoted by the Senegalese press agency on Tuesday as saying that the decision to leave the borders open was informed by the fact that “there is no out-and-out Ebola epidemic in Mali although the city of Kayes where the infected child died is located near the border with Senegal.�

She added: “Even if the closure of the border with Mali is not planned unlike Guinea where the epidemic has been raging for several months, preventive measures will be reinforced. A medical team will soon be dispatched to the cities near the common border to gauge the temperatures of suspected people with thermo equipment”.

Professor Seck pointed out that the health services in the eastern region of Tambacounda will also be strengthened as part of efforts to forestall the entry of the virus into Senegal again.

On to Sierra Leone and a study of who survives from Reuters:

Why do some survive Ebola? Sierra Leone study offers clues

“This is the first time anybody has had this much data collected on any Ebola patients,” said Dr. John Schieffelin of Tulane University in New Orleans, an author of the study published in the New England Journal of Medicine.

He said the findings help confirm some of the observations seen by doctors treating patients with Ebola.

It shows, for example, that 57 percent of people under age 21 who were treated for Ebola died from their infections, compared with 94 percent of those over the age of 45.

In the cases studied, the virus took six to 12 days to incubate before patients developed symptoms, and 74 percent of the patients in the study died, similar to what has been seen in prior outbreaks.

Tokyo lends mobile assistance from the Japan Times:

Old ambulances, firetrucks on the way to Ebola-hit West Africa

Retired emergency vehicles, including ambulances, donated by prefectural governments were readied Tuesday for a new mission — helping two West African countries fight the deadly Ebola outbreak.

The 13 vehicles will be airlifted Wednesday night from Narita International Airport to Liberia and Sierra Leone.

The five ambulances and eight command vehicles were provided by fire departments in 10 prefectures, including Tokyo, Tochigi, Aichi and Shimane.

They were given to the Society for Promotion of Japanese Diplomacy, which donates used emergency vehicles to developing countries.

The two African nations asked for the vehicles.

British training from Reuters:

Ebola “warriors” step forward for training in Sierra Leone

In a stifling room in a sports stadium in Freetown, a dozen young people watch intently as three British soldiers show them how to put on several layers of protective clothing needed to enter an Ebola treatment centre “red zone”.

They are training to be hygienists to help treat victims of the hemorrhagic fever that has gripped Sierra Leone, as well as neighbouring Liberia and Guinea. The outbreak has killed some 5,000 people and threatens to infect tens of thousands more in the coming weeks.

It is a lesson that could save their lives. Ebola is spread through contact with bodily fluids of infected people, who suffer from diarrhoea, vomiting and bleeding in the final stages of the deadly disease, making treating them a dangerous job.

Some 250 healthcare workers have already died in the three worst-hit countries.

From StarAfrica, curious:

S/Leone: MPs demand more Ebola ‘sensitization’ funds

Another showdown between Sierra Leone`s lawmakers and the public looks imminent as some MPs Wednesday demand for further funding of their anti-Ebola sensitization around the country.Back in September, a heated national debate erupted when the government allocated billions of leones to MPs to sensitize their constituencies.

Each MP at the time got 63 million leones ($15000). Many of them were later drawn in disputes with their constituents over their spending of the funds.

The ensuing debate, particularly fuelled by strong media coverage, prompted Parliament to warn journalists off the issue, and even threatened drastic actions.

From the World Health Organization, the doubly stricken:

Sierra Leone: for Ebola survivors the pain goes on

As the Ebola outbreak grows and spreads, a small but significant group of people is also growing – the Ebola survivors. Emerging shell-shocked from what one described as a “glimpse of hell”, the survivors have not found life easy on the other side of the Ebola ward.

Some in the community brand them as “witches” for surviving. For many, the faces they longed to see again while lying in the Ebola ward are no longer there. Husbands, wives, children, brothers, sisters, mothers and fathers have all been carried off to unmarked graves by Ebola virus disease.

“I am learning to live a new life in the home without my husband and my 2 children. Now there is so much emptiness in the house especially at night,” said Fatimata Gaima who clung to life in the hospital desperate to get home to care for her three year old.

However, as she recovered, her worst fears came true. Her last child was brought to the hospital ward, tested positive for Ebola, and died a few days later.

Ms Gaima told her story to others in a small focus group at the first Ebola survivors conference organized by UNICEF and GOAL, humanitarian agency, in Kenema, one of the areas where the Ebola outbreak first exploded in Sierra Leone. The meeting aimed to identify the needs of survivors – physical, mental, social and economic – and help them to consider how they might contribute to battling the Ebola virus outbreak in Sierra Leone.

On to Liberia and the crisis personified from the Washington Post:

In a Liberian slum swarming with Ebola, a race against time to save two little girls

The two girls had nursed their mother as she died, cleaning up her vomit and curling up against her feverish body on the family’s only mattress. They braided her hair until a truck came for the corpse.

Now, as Ebola leapt from house to house in this sprawling slum, it seemed inevitable that Princess, 13, and Georgina, 12, would soon come down with the disease themselves. Unless someone intervened, they would be the next links in an endless chain of transmission that was destroying New Kru Town.

It was Bobby Pomney’s job to intervene.

Pomney is a “contact tracer” for the Liberian government. When he arrived on a sweltering morning earlier this month, Mary Nyanford’s body was being driven away. Princess was screaming for her mother. Tears were running down Georgina’s cheeks.

The healthcare worker’s painful conundrum, via the New York Times:

Wish to Do More in Ebola Fight Meets Reality in Liberia

What level of care is possible for a disease with no cure being treated in wooden huts in the middle of a forest? How do medical workers prioritize which patients and tasks to focus on when they cannot do everything they were trained to do? Will their decisions determine who lives and who dies? And how would they even know?

“You always want to do more, but it has to be balanced with what’s possible, with what makes sense for the context you’re working in,” said Dr. Pranav Shetty, the medical director at the center operated here by International Medical Corps.

Because of the limited time they can spend in the sick wards in their stifling protective suits, the risks of certain procedures and even the amount of medicines available, health workers here and elsewhere in West Africa ration care, operating under constraints they often find frustrating. The mainstays of fighting the Ebola epidemic — isolation and basic treatment — have resulted in more dead than survivors among those infected.

Another blow to overstretched police resources from the NewDawn:

Ebola kills police commander, 8 officers quarantined

Report from Nimba County says a deputy police commander has died of the Ebola Virus Disease, while eight other officers are being quarantined in Saclepea, central Nimba. The eight police officers are said to have come in contact with the late Deputy Commander Charles Scott, who was assigned in Saclepea.

The NewDawn Nimba correspondent says the late Charles Scott was deputy commander for the Women and Children department of the Liberia National Police in Saclepea. Prior to his death, Commander Charles Scott had visited Ganta, according to report. The head of the Nimba County Health Team, Dr. Collins Bowah, said the late Commander Charles Scott died of a very high fever and was thus suspected to have contracted the Ebola virus.

The Ebola epidemic has affected other security agencies here besides the police. In Monrovia, a segment of the police barracks on Camp Johnson Road was quarantined few months ago after several police officers reportedly got infected.

Long overdue pay for healthcare workers, via the Liberian Observer:

Margibi Authorities Begin Health Workers’ Encouragement Package Scheme

US$10,000 for October 2014

Authorities of Margibi County have begun distributing what they termed motivational benefits to health workers at C.H. Rennie, government’s only referral hospital in Kakata City.

Addressing several government and volunteer health workers, Margibi Supt. John Zubah Buway said the county administration, including the Legislative Caucus thought it prudent to allocate some money from the county development funds to give  to health workers as an encouragement package.

According to Supt. Buway, not all health workers in the county would benefit from the health workers’ motivational package due to what he described as some financial disparity.

A cultural belief hampering prevention efforts, via BuzzFeed:

What Will The Ancestors Think If You Burn A Body In Liberia?

Ebola has turned dead bodies into public health threats in Liberia. But dealing with death is also about grief, loss and long-held beliefs about the spiritual afterlife.

James Dorbor Jallah knows as well as anyone that one part of Liberia’s Ebola response raises ire among his fellow Liberians.

Jallah is the deputy incident manager of the response, and the man who runs day-to-day operations at the National Ebola Command Center in Monrovia, the capital. He knows how crucial safely dealing with dead bodies is for controlling the disease. A human body that Ebola has killed can literally crackle with virus, and the dead are the most contagious bodies in the country.

Collecting them safely is probably Liberia’s number-one public health concern, and in Montserrado County, where the capital sits, the government policy is that safe collection means cremation. There are too few cemeteries, and too few communities willing to allow mass Ebola graves in their backyards, health officials say, to have given them any other option in the city that became the epicenter of the Ebola outbreak in August and September.

But Jallah also understands, intimately, why Liberians long for something else.

And specific voices are heard, via the Liberian Observer:

“We Prefer Burial, not Cremation”

-Say Traditional Leaders in Bong

Traditional leaders in Bong County have denounced the cremation of Ebola dead on ground that it is conflicting to the cultural norms and traditional practices of the country.

In an interview with the Daily Observer over the weekend, the Chief Elder of Bong County Moses Suakollie said incinerating the lifeless does not demonstrate love for the dead.

Mr. Suakollie told this reporter that their posture to censure the cremation is largely due to their tradition and customs as people of the Kpelle tribe.

“The ancestors will not accept their souls because they were burnt by fire and furthermore, it is not our teaching as Kpelle people” Mr. Suakollie stressed.

A Christian tradition invoked from the NewDawn:

Christian Task Force declares fast and prayer

The chairperson for the National Christian Task Force, Rev. David G. Benitoe, says the Lord has spoken to him and some other members of the clergy that Liberia should observe three-day fast and prayer, beginning 29 October to 31 October to seek God’s healing for the Nation.  He said that the Task Force has visited several counties, educating citizens about the deadly Ebola virus, while calling on all Liberians to join the fast and prayer.

Rev. Benitoe said everyone will start the fast and prayer the first two days and then gather on the Providence Island to climax. He also said that all Liberians should take along bread, which represents the body of Jesus Christ and Vimto or juice, representing the blood of Jesus. He said the spiritual exercise is in conformity with the book of Deuteronomy Chapter 32, adding that the Lord spoke to him in July, saying, “Liberia Return to God and Live.”

According to him, God is angry with Liberians because they have left from under his shadow and are involved in all kinds of demonic activities, adding, the three days fast and prayer is intended for healing and restoration.

A change in command of American boots on the ground from the Monrovia Inquirer:

US Troops Challenged…As US Africa Command Transfer Authority To 101st Airborne Division

‘Operation United Assistance Joint Force Command’ laid out by Major General Darryl Williams of the U.S. Africa Command has successfully transferred authority to Major General Gary Volesky of the U.S. 101st Airborne Division (Air Assault) in Liberia.

At the turning over occasion on Saturday at the Barclay Training Center, outgoing Commander Williams expressed gratitude to those he had worked with in strengthening the Military-to-Military operations especially Defense Minister Brownie Samukai, U.S Ambassador Deborah Malac, Liberia’s Chief of Staff Daniel Ziankahn, the US-CDC and USAID.

Major General Williams as he turned over responsibility in the mission, he said that he understands that there is still much to be done and believes that there is no other better unit to carry on the task beside the 101stAirborne Division led by Volesky which is leading one of the highly decorated units in the United States of America.

And a presidential birthday is deferred StarAfrica:

Liberia: Sirleaf suspends birthday fête over Ebola crisis

The Ministry of Information in Liberia has announced that due to the current Ebola epidemic in the country, President Ellen Johnson Sirleaf will not officially celebrate her 76th birthday.Making the disclosure at the Ministry of Information daily Ebola press conference in Monrovia Tuesday, deputy Information Minister for Public Affairs, Isaac Jackson, said President Sirleaf is concerned about the current health crisis, and will continue her normal work to contain the outbreak which has killed over 2000 people since March.

Jackson observed that the Liberian leader remains incredibly strong even at the age of 76, saying her mental alertness has enabled her to provide astute leadership for the people of Liberia during these trying times.

President Sirleaf who was born on October 29, 1938, was elected in 2005 as the 24th president of Liberia.

An unanticipated arrival in Lagos from Punch Nigeria:

Suspected Ebola patient causes panic at Lagos airport

Passengers and other users of the Murtala Muhammed International Airport, Lagos were on Wednesday thrown into panic as a suspected Ebola patient was flown into the country by Royal Air Maroc in the early hours of the day.

The Moroccan airline arrived Lagos from Casablanca at 6am. The victim, one Theophilus Onnakhinon, a Nigerian, was said to have been flown into the country by the airline, while his younger brother, Chinedu Eroka, absconded from Sierra Leonean authorities.

As at the time of filing this report, it was not clear why Eroka absconded from the Sierra Leone.

A source close to the Port Health Services at the airport, who spoke on condition of anonymity, explained that the passenger had already been treated for the Ebola Virus Disease and declared cured.

The source said the passenger was assisted into the country by a Nigerian consular official, Mrs. T. Mohammed.

According to the source, the consular officer accompanied  Onnakhinon into the country in order to avoid stigmatisation by Nigerian health officials and others at the airport.

And to close, a precipitous tourism decline in Kenya from AllAfrica:

Kenya: Ebola Spread Hurts Kenya’s Tourism, Say Hoteliers

The spread of Ebola in West Africa has affected tourism in Kenya.

Tourism players said there have been 70 per cent cancellation of bookings from European countries.

Kenya Hotelkeepers and Caterers Association, North Coast vice chairman Phillemon Mwavala said tourists fear contracting Ebola.

He was speaking during an interview in Watamu yesterday.

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