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PostPosted: Mon Oct 06, 2014 3:27 pm 
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The Washington Post

Experimental drug provided to Dallas Ebola patient

By Associated Press October 6 at 3:07 PM

WASHINGTON — A North Carolina drugmaker is providing its experimental antiviral drug to a Dallas patient being treated for Ebola,
an emergency step authorized by the Food and Drug Administration.

Officials at Texas Health Presbyterian Hospital said Monday that their patient, Thomas Eric Duncan, is in critical condition
and being treated with brincidofovir, an oral medicine developed by Chimerix Inc.

The Durham, North Carolina-based drugmaker said earlier that physicians sought FDA permission to use the company’s drug,
which is in late-stage testing for several other types of viruses.

The FDA grants emergency access to unapproved drugs on a case-by-case basis, usually when a patient faces a life-threatening condition
for which there are no alternatives. The agency has not approved any drugs or vaccines to safely and effectively treat Ebola.

Duncan was diagnosed with Ebola in Dallas last Tuesday after recently arriving from Liberia.

Brincidofovir is an antiviral drug being tested against several common viruses, including one that infects patients undergoing bone marrow transplants.
Chimerix is also developing the drug as a treatment against smallpox. Laboratory tests suggested it may also work against Ebola.

Two other experimental drugs developed specifically for Ebola have been used in American patients, though it’s unclear if they had any effect. The small supply of one drug, ZMapp, was exhausted after being used on a few patients. A second drug, TKM-Ebola from Tekmira Pharmaceuticals, has been used in at least one patient and is said to be in limited supply.

The Centers for Disease Control and Prevention has consulted with U.S. hospitals about more than 100 potentially suspicious cases in recent months.
More than a dozen were worrisome enough to merit Ebola blood tests. Only the Dallas patient had Ebola.

Federal officials say they are confident they can stay on top of any more cases that arrive.
___
AP Writer James Beltran contributed to this story from Dallas


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PostPosted: Mon Oct 06, 2014 3:55 pm 
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Dallas Ebola patient getting experimental drug
By Doug Stanglin and Liz Szabo, USA TODAY 3:42 p.m. EDT October 6, 2014

Brother of Dallas Ebola patient Thomas Duncan spoke to his son, who is one of the people quarantined, and was told that none of the other family members are experiencing any symptoms of the Ebola virus. VPC

Thomas Eric Duncan, the first person diagnosed in the United States with Ebola, remains in critical condition, but is now receiving an experimental drug, hospital officials say.

The drug is brincidofovir, a broad-spectrum antiviral that has shown promise against Ebola in test tubes and is now being tested in animals, according to a statement from Texas Health Presbyterian Hospital, where Duncan is being treated. It has not been tested against Ebola in humans.

The drug's manufacturer, North Carolina-based Chimerix, announced that it has received special permission from the Food and Drug Administration to provide the drug to Ebola patients. Requests for the special permission came from patients' doctors.

Texas Health Presbyterian Hospital released a brief statement Sunday saying the 42-year-old Liberian national — who had been listed in serious condition until Saturday — was in critical condition but stable.

Thomas Frieden, the director of the Centers for Disease Control and Prevention, said Sunday on CNN that Duncan was "fighting for his life."

"We understand that his situation has a taken a turn for the worse," he said. "We know that Ebola is a very serious disease, and we are hoping for his recovery."

There are no proven treatments or vaccines for Ebola, but several Ebola patients treated in the USA and elsewhere have received experimental, unproven drugs for compassionate use.

Ebola patients Kenty Brantly and Nancy Writebol, who both contracted Ebola while working for missionary groups in Liberia, received a drug called ZMapp, which contains man-made antibodies against Ebola. That drug's manufacturer, Mapp Bio of San Diego, says there are no more supplies of ZMapp, which was made in small quantities during its early developmental phase.

Dr. Richard Sacra, who also contracted Ebola in Liberia, received a different drug, TKM-Ebola. That drug is also experimental and made by the Canadian company Tekmira Pharmaceuticals.

Thomas Geisbert, who helped develop TKM-Ebola, said he is surprised that doctors would choose brincidofovir. To his knowledge, there is no evidence that brincidofovir works against Ebola in animals, said Geisbert, a professor at the University of Texas Medical Branch in Galveston.

"I've never heard of this drug being used for Ebola before," Geisbert said. "tt works in cell culture. That's great. Lots of things work in cell culture against Ebola," he said, but then fail to help animals.

With no proven way to fight Ebola, doctors have to weigh a number of factors when choosing an experimental drug, including its potential to cause side effects in critically ill patients, said Amesh Adalja, an infectious disease specialist at the University of Pittsburgh Medical Center.

Adalja notes that the Food and Drug Adminstration put a temporary hold on clinical trials of TKM-Ebola earlier this year in order to investigate the flu-like symptoms that some patients experienced as side effects. It's possible that Duncan's doctors considered these side effects and considered them too risky for someone on a ventilator who's already on the "edge of death," Adalja said.

While brincidofovir doesn't have a long track record against Ebola, it has been used safely for patients suffering from cytomegalovirus, an ordinary virus of childhood that can be life-threatening if contracted by patients who are immune suppressed because of an organ transplant, Adalja said. Brincidofovir is also being tested as a countermeasure against smallpox, in the event of a bioterrorist attack.

While Adalja hasn't talked to Duncan's doctors, he said, "they may want to use a drug with the cleanest safety profile. You may not want to give him a drug that will push him over the edge."

There are number of anti-Ebola drugs in the research pipeline, Adalja said, with several getting a jumpstart due to the West African outbreak. Two Ebola vaccines are now undergoing human trials, although neither will be available for months, even if preliminary human tests are positive.

Meanwhile, a French female nurse infected with the deadly Ebola virus in Liberia has received a Japanese anti-influenza drug called Favipiravir. That drug is made by Toyama Chemical Co., a group firm of Fujifilm Corp.

The latest outbreak of the Ebola virus is concentrated in West Africa where more than 3,400 have died, according to the World Health Organization.

Duncan was infected with the virus in Liberia last month after helping take a woman with Ebola to the hospital.

The CDC said that only 10 of the nearly 50 people thought to have had contact with Duncan carried even a moderate risk of contracting the disease and that none of them had shown any symptoms as of Sunday.

Like all travelers leaving Liberia, Duncan was examined at the airport and showed no signs of the virus when he flew to Dallas last month to visit his fiancée, Louise Troh, and her family in her Dallas apartment.

MADRID: Spanish nurse who treated infected priest tests positive

FOUND: Homeless man who rode in Ebola patient's ambulance

WHO'S AT RISK?: With Ebola, 'contact tracing' is critical

After becoming ill, Duncan went to the hospital on Sept. 25, but was only given antibiotics and sent home. It was only after his condition worsened and he returned to the hospital three days later that doctors diagnosed him with Ebola and admitted him.

Troh and other members of her family were subsequently quarantined in the apartment where they had lived for six days after Duncan was hospitalized. City officials later arranged to move them to another home and monitor their conditions.

In other developments:

• A Spanish nurse at a Madrid hospital who treated a Spanish missionary from Sierra Leone for Ebola has tested positive for the virus in the first reported case of the transmission of the deadly disease outside Africa.

• An American freelance cameraman who contracted Ebola in Liberia arrived Monday in Nebraska aboard a specially equipped plane for treatment at Nebraska Medical Center's specialized isolation unit. Ashoka Mukpo, 33, became ill last week while working for NBC in Liberia as a freelance journalist, most recently covering the Ebola outbreak in the region.

• A homeless Dallas panhandler who rode in the same ambulance after Duncan has been found after an extensive manhunt. The 52-year-old man — who city officials identified as Michael Lively — was admitted to Parkland Memorial Hospital Sunday afternoon after being taken into custody by Dallas police officers. County Judge Clay Jenkins said he was taken to the hospital's psychiatric ward, WFAA-TV in Dallas reports.

Contributing: Associated Press; Tanya Eiserer and Todd Unger, WFAA-TV in Dallas.

http://www.usatoday.com/story/news/nati ... /16798391/

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PostPosted: Mon Oct 06, 2014 4:16 pm 
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CNN Money

Chimerix Announces Emergency Investigational New Drug Applications for Brincidofovir
Authorized by FDA for Patients With Ebola Virus Disease


October 06, 2014: 08:01 AM ET

DURHAM, N.C., Oct. 6, 2014 (GLOBE NEWSWIRE) -- Chimerix, Inc. (Nasdaq:CMRX), a biopharmaceutical company developing novel, oral antivirals in areas of high unmet medical need, today announced that brincidofovir has been provided for potential use in patients with Ebola Virus Disease. These requests were made by treating physicians. Emergency Investigational New Drug Applications (EIND) were granted by the U.S. Food and Drug Administration (FDA).

"Chimerix is committed to working with global health organizations and government agencies in the fight against the Ebola virus outbreak," said M. Michelle Berrey, M.D., M.P.H., President and Chief Executive Officer of Chimerix. "Based on in vitro data from work conducted by the CDC and the National Institutes of Health suggesting brincidofovir's activity against Ebola, we are hopeful that brincidofovir may offer a potential treatment for Ebola Virus Disease during this outbreak. Data collected over years of clinical development of brincidofovir have allowed us to progress this compound into Phase 3 programs for cytomegalovirus and adenovirus infections, and provided information on the safety and dosing of brincidofovir to allow it to be explored as a potential therapy for Ebola Virus Disease."

Chimerix is working closely with the FDA to finalize a clinical trial protocol early this week to assess the safety, tolerability, and efficacy of brincidofovir in patients who are confirmed to have an infection with the Ebola virus. Testing at the Viral Special Pathogens Branch of the CDC and the NIH revealed in vitro (test tube) activity of brincidofovir against the Ebola virus that was similar to that seen in test tube assessments of brincidofovir against other viral diseases, such as adenovirus and smallpox. Additional tests of brincidofovir in in vivo (animal) models of Ebola virus infection are currently underway.

About Brincidofovir (CMX001)

Chimerix's lead product candidate, brincidofovir, is an oral nucleotide analog that has shown broad-spectrum in vitro antiviral activity against all five families of DNA viruses that affect humans, including viruses in the herpes virus family and adenovirus. Brincidofovir has shown no evidence of kidney or bone marrow toxicity in nearly 900 patients treated to date. Building on the positive Phase 2 results in cytomegalovirus (CMV) prevention, Chimerix initiated the Phase 3 SUPPRESS trial in 2013.

If positive, data from SUPPRESS will support Chimerix's initial regulatory submission for brincidofovir for the prevention of CMV infection in adult hematopoietic cell transplant (HCT) recipients. Chimerix recently initiated AdVise, a Phase 3 trial in adenovirus, which is an often-fatal viral infection with no approved treatment; enrollment is ongoing for the pilot portion of the trial. Chimerix is also working with the Biomedical Advanced Research and Development Authority (BARDA) to develop brincidofovir as a medical countermeasure against smallpox. Brincidofovir has received Fast Track designation from the FDA for CMV, adenovirus, and smallpox.

About Chimerix

Chimerix is a biopharmaceutical company dedicated to discovering, developing and commercializing novel, oral antivirals in areas of high unmet medical need. Chimerix's proprietary technology has given rise to brincidofovir (BCV, CMX001), a clinical-stage nucleotide analog lipid-conjugate, which has demonstrated potent antiviral activity and safety in convenient, orally administered dosing regimens. Chimerix is currently enrolling SUPPRESS, the Phase 3 study of brincidofovir for the prevention of cytomegalovirus (CMV) in hematopoietic cell transplant recipients. In addition, Chimerix is enrolling the pilot portion of the Phase 3 AdVise study of brincidofovir for treatment of adenovirus infection. Chimerix is also working with BARDA to develop brincidofovir as a medical countermeasure against smallpox. For further information, please visit Chimerix's website, http://www.chimerix.com.

Forward-Looking Statements

Statements contained in this press release regarding matters that are not historical facts are "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995. Because such statements are subject to risks and uncertainties, actual results may differ materially from those expressed or implied by such forward-looking statements. Risks are described more fully in Chimerix's filings with the Securities and Exchange Commission, including without limitation its most recent Quarterly Report on Form 10-Q, its most recently filed Current Reports on Form 8-K and other documents subsequently filed with or furnished to the Securities and Exchange Commission. All forward-looking statements contained in this press release speak only as of the date on which they were made. Chimerix undertakes no obligation to update such statements to reflect events that occur or circumstances that exist after the date on which they were made.
CONTACT: Joseph T. Schepers

Executive Director,
Investor Relations and Corporate Communications
ir@chimerix.com
919-287-4125

http://money.cnn.com/news/newsfeeds/art ... 101305.htm


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PostPosted: Mon Oct 06, 2014 8:47 pm 
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Spanish health worker contracts Ebola at Madrid hospital

Lisa Schnirring | Staff Writer | CIDRAP News | Oct 06, 2014

The US government is considering added steps for screening airline passengers.
A Spanish nurse who helped care for a sick priest who was brought back from West Africa has tested positive for Ebola, based on initial lab findings, which if confirmed would mark the first local transmission of the disease outside of West Africa.

The impact of West Africa's Ebola outbreak continued to reach across the globe to other locations, as Nebraska hospital officials announced that an American photojournalist sickened in Liberia has been airlifted to their facility, and Norway prepared to receive its first Ebola patient, a Norwegian woman who was infected with Ebola while working for Doctors without Borders (MSF) in Sierra Leone.

Meanwhile, recent events surrounding the Ebola illness of a Liberian man in Dallas have fueled calls from the public and some politicians officials for the US government to do more to screen travelers arriving in the United States from the outbreak countries.

Spain, MSF report infected health workers
The Spanish nurse helped care for a Spanish missionary who was flown to Madrid 2 weeks ago after he was sickened with Ebola while working in Sierra Leone, The Guardian, a newspaper based in London, reported today. The man died on Sep 25, 4 days after he arrived back in Spain. The nurse sought treatment at a hospital today, where initial tests were positive for Ebola, according to The Guardian. Spanish officials are waiting for the results of the second test to confirm the case.

The woman works as a "sanitary technician" and entered the sick priest's room twice: once to treat him and once after he died to retrieve his belongings, NBC News reported today. She started having symptoms on Sep 30 and sought care. She had also been part of the medical team that in early August treated another Spanish priest who was infected in West Africa and was brought back to Spain.

The case is sure to raise questions across the globe about protecting healthcare workers, even those in developed nations, and the preparedness of hospitals outside the outbreak region to handle Ebola cases.

In another development, MSF confirmed today that one of its staff members in Sierra Leone has been infected with Ebola. The worker from Norway was isolated yesterday after coming down with a fever, and tests confirmed Ebola infection. MSF said the patient will be evacuated to a treatment center in Europe and that an investigation is underway to determine how the contamination occurred. According to media reports, the worker is a woman and will be airlifted for treatment at an Oslo hospital.

MSF is known to have strict infection control protocols, and the Norwegian is the second from MSF to be infected with Ebola. The first is a French woman who recovered from her infection and was recently discharged after being treated at a Paris hospital, Agence France-Presse (AFP) reported on Oct 4, citing the French health ministry. She had received the experimental antiviral drug favipiravir (Avigan), developed by a subsidiary of Japan-based Fujifilm.

Meanwhile, Nebraska Medical Center's first Ebola patient, Rick Sacra, MD, is hospitalized with a respiratory infection at a Massachusetts hospital. Sacra recovered after contracting Ebola in Liberia and was discharged from the Omaha hospital on Sep 25.

SIM USA, the missionary group Sacra serves with, announced yesterday that Sacra went to a Boston-area emergency room on Oct 4 because of a persistent cough and low-grade fever, with concerns that he might be getting pneumonia. He was transferred to UMass Memorial Medical Center in Worcester for observation as a precaution according to Centers for Disease Control and Prevention (CDC) guidelines, according to SIM.

Sacra's doctors from Nebraska Medical Center said in the SIM statement that his immune system is compromised because of his recent battle with Ebola and that his symptoms point to a respiratory illness and not Ebola. It added that three CDC-confirmed blood tests showed that Sacra was virus-free when he left Nebraska, and that while the likelihood of an Ebola relapse is low, the medical team orders diagnostic testing to be certain.

UMass Memorial said in a statement late last night that the CDC confirmed that Sacra's lab tests were negative for Ebola and that they were removing him from isolation. It added that physicians are continuing routine care for his upper respiratory tract infection.

Sick journalist hospitalized in Nebraska
In related developments, Nebraska Medical Center in Omaha said today that it admitted a second patient infected with Ebola in West Africa, Ashoka Mukpo, a freelance photojournalist who got sick while working for an ABC News crew in Liberia.

The hospital made the announcement in its Twitter feed during a live media briefing today. Mitchell Levy, MD, the patient's father, said his son's illness is still in the early stages, and that he has fever and nausea but no diarrhea. Hospital officials said Mukpo was alert and already on intravenous fluids as he was being admitted.

Bradley Britigan, MD, dean of the College of Medicine at the University of Nebraska Medical Center, said hydration, symptom control, and blood chemistry monitoring are the main components of Mukpo's medical care and that the medical team is assessing all treatment options, including experimental ones.

Mukpo's mother, Diana Mukpo, and his father appeared at the press briefing today and said their son is in good spirits and that discussions about treatment are underway. His father said it's not clear how his son was infected, but that he had apparently helped spray-wash a car that someone had died in.

Texas contact tracing, patient developments
In media briefings over the weekend, Texas health officials and CDC Director Tom Frieden, MD, said so far no symptoms have been reported in 48 contacts of a man from Liberia who is hospitalized in critical condition with an Ebola infection at a Dallas hospital.

David Lakey, MD, commissioner of the Texas Department of State Health Services (TDSHS), said 10 of the people are considered close contacts, including 3 thought to have had direct contact with the man, along with 7 healthcare workers. An additional 38 are considered possible contacts, and will also undergo health monitoring for 21 days.

Clay Jenkins, Dallas County judge, said four members of a family who had stayed in an apartment with the patient have been relocated to a private four-bedroom home made available by a member of the Dallas faith community. He said he personally drove the family to the location to ensure that it meets their needs and that they feel safe and comfortable.

He also revealed that over the weekend health officials lost track of one of the low-risk contacts, a homeless man, and that law enforcement officials were trying to locate him. However, the authorities found him and he is now being monitored at Parkland Memorial Hospital, the Dallas Morning News reported today.

The Liberian man's condition has been downgraded to critical, and Texas Health Presbyterian Hospital in Dallas said he is receiving the experimental antiviral drug brincidofovir, made by Chimerix Inc., a pharmaceutical company based in Durham, N.C.

The company in a statement today confirmed that the drug had been provided for use in patients and that the US Food and Drug Administration (FDA) has approved an emergency investigational new drug application for it. It said in vitro studies conducted by the CDC and the National Institutes of Health (NIH) suggest that the drug may offer a potential treatment for Ebola. Phase 3 studies of the drug as a treatment for cytomegalovirus and adenovirus infections have provided safety and dosing information that has allowed the drug to be considered as a possible treatment for Ebola, Chimerix said.

In another development, Texas Health Presbyterian Hospital's parent company on Oct 3 retracted its key investigation finding regarding a communication breakdown during the Liberian patient's first visit to the emergency department on Sep 25, his recent travel to Africa was overlooked. In an earlier statement the company said the travel history was taken and appeared in the nursing workflow portion of the electronic health record (EHR), but that it wasn't visible in the physician workflow.

However, the hospital said on Oct 3 that the patient's travel history was documented and available to the full care team in the EHR. "There was no flaw in the EHR in the way the physician and nursing portions interacted related to this event," according to the clarification from Texas Health Resources.

Texas Gov Rick Perry today announced that the state has created a special task force to assist with the Ebola response and build the capacity to respond to similar threats in the future. Perry named Brett Giroir, MD, executive vice president and chief executive officer of the College of Medicine at Texas A&M Health Science Center, as director of the 16-member task force, which includes epidemiologists, public health experts, scientists, academics, and state government officials. Its first report is due Dec 1.

"Over the past several days we have learned a lot about the unique challenges of situations like this, and it's important that we continue to adapt our response to those realities," Perry said in a statement, adding that the task force will develop a long-term plan to help the state handle future outbreaks, based on an existing plan.

At a media briefing to announce the task force, aired by NBC News today, Perry urged the federal government to help Texas and other states by tightening screening procedures at entry points, such as obtaining extra information from passengers, taking their temperatures, and boosting staffing at quarantine stations.

Federal officials consider added screening steps
President Barack Obama said his administration is working on additional steps for screening airline passengers to identify people with possible Ebola infections and to make sure medical teams know what to do when they flag a suspected illness, Reuters reported today. The President's remarks came after a briefing today with CDC Director Tom Frieden, MD, MPH, and other government officials involved in the outbreak response.

Obama said that for now the administration is not considering a travel ban from West Africa, but he said other measures could be considered to help keep infected travelers from entering the United States.

At a media briefing over the weekend, Frieden said the CDC is open to suggestions on ways to step up screening, but he added that flight bans have been shown to impede the outbreak response in West Africa, and that stopping Ebola transmission in West Africa would be the best way to protect Americans.

So far, outbound traveler screening in the outbreak countries has stopped 77 people from boarding flights, including 17 in September. Though he said the CDC doesn't have follow-up information on all of the travelers, many had malaria, a common condition in the countries.

While other steps could be discussed, he told reporters it would be a mistake to take any step that would make it harder to battle the virus in West Africa.

"We're looking at all possibilities. There have been suggestions from people in Congress, from the public, from the media—we'll look at those and see what works to protect Americans and to make sure that whatever we do doesn't unintentionally actually increase our risk," Frieden said.

He also noted that the nature of Ebola infection makes it difficult to flag infected travelers, because fever and other symptoms can begin as long as 21 days after exposure to the virus.

See also:

Oct 6 Guardian story

Oct 6 Reuters story on Norwegian Ebola patient

Oct 6 MSF press release

Oct 4 AFP story

Nebraska Medical Center Twitter feed

Oct 5 SIM press release

Oct 5 UMass Memorial statement

Oct 6 Dallas Morning News story

Oct 6 Chimerix statement

Oct 3 Texas Health Resources press release

Oct 6 Texas Governor's Office press release

Oct 6 Reuters story

http://www.cidrap.umn.edu/news-perspect ... d-hospital

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PostPosted: Tue Oct 07, 2014 10:32 am 
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DALLAS — This is a crucial week in the ongoing Ebola virus investigation centered in Dallas.

Local officials are working to ease public fears and concerns over the often deadly disease. And monitoring 48 people who had contact with the one known infected man — Thomas Eric Duncan, who remains in critical condition at a Dallas hospital — will be critical this week, state health Commissioner Dr. David Lakey said.

At the Ivy Apartments in Dallas, hazardous materials cleaning crews are gone, and a quarantine notice is now taped to the door of Unit 614. Neighbors at the complex are working to get back to some sense of normalcy during the ongoing Ebola investigation, but they say it is tough.

"A lot of people are scared," Lakey conceded. "A lot of people throughout Dallas are scared right now."

Lakey is among those working to calm the public's fears after Duncan's positive diagnosis for Ebola one week ago. Texas Health Presbyterian Hospital Dallas says Duncan, remains in critical condition. They say he is stable, and since Saturday afternoon at 2:14, has been receiving an investigational medicine called brincindofovir.

"I want to let you know that we are working really hard to make sure no other Texans are exposed to this virus," Lakey said.

Dallas County and city officials say 48 people are being monitored for having had possible contact with the patient. Ten of those people are considered high-risk contacts, including Duncan's fiancée and three school age children who have been moved from Unit 614 to an undisclosed private residence offered to Dallas County.

"Remember — we take these temperatures two times a day, and we've got zero symptoms out there... zero! " Dallas Mayor Mike Rawlings said at a Monday news briefing. "That is a good sign."


In addition to the local investigation and monitoring, there is the associated stigma that neighbors in the Vickery Meadows area have been dealing with, according to City Council member Jennifer Gates.

"Unfortunately, they are feeling discriminated against," Gates said. "We still have some that have been turned away from jobs, some that have been turned away at retail locations."

The city has contacted legal aid to help those neighbors, as local leaders continue working to address misconceptions about Ebola.

They emphasize that the virus is known only to spread by transfer of bodily fluid and contact with someone who is symptomatic.

http://www.khou.com/story/news/local/te ... /16849247/

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PostPosted: Tue Oct 07, 2014 2:29 pm 
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Ebola patient in Dallas on dialysis, remains in critical condition -hospital
Tue Oct 7, 2014 6:13pm GMT

DALLAS Oct 7 (Reuters) - The patient being treated for Ebola in a Dallas hospital remains in critical condition, is on a ventilator and receiving kidney dialysis, the hospital said on Tuesday.

"His liver function, which declined over the weekend, has improved, but doctors caution that this could vary in coming days," Texas Health Presbyterian Hospital said of the patient, Thomas Eric Duncan. (Reporting by Jon Herskovitz; Editing by Sandra Maler)

http://af.reuters.com/article/liberiaNe ... PT20141007

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