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PostPosted: Thu Aug 28, 2014 7:58 am 
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Ebola Could Eventually Afflict Over 20,000, W.H.O. Says
By NICK CUMMING-BRUCE and ALAN COWELLAUG. 28, 2014
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Officials handing out food in West Point, Liberia, a region hit hard by Ebola. The death toll from the disease has risen to 1,552 in four countries: Guinea, Liberia, Sierra Leone and Nigeria. Credit Abbas Dulleh/Associated Press

GENEVA — As the tally of deaths from the worst known outbreak of the Ebola virus continued its seemingly inexorable rise, the World Health Organization said on Thursday that the epidemic was still accelerating and could afflict more than 20,000 people — almost seven times the current number of reported cases — before it could be brought under control.

The dire forecast was made as the W.H.O. reported that the number of known cases and fatalities had risen once again. The organization also acknowledged that in areas of intense transmission “the actual number of cases may be two-to-four times higher than that currently reported.”

The outbreak “continues to accelerate,” the organization said.

According to the latest figures released by the W.H.O. on Thursday, the death toll has risen by more than 100, to 1,552 out of 3,069 cases in four countries: Guinea, Liberia, Sierra Leone and Nigeria, which had previously indicated that its outbreak was under control.

While the disease was first identified in March, “more than 40 percent of the total number of cases have occurred within the past 21 days,” the W.H.O. said. “However, most cases are concentrated in only a few localities.”

The W.H.O. also published a so-called road map on Thursday to guide the response of affected countries and the efforts of the international community in trying to contain the disease.

The road map assumed that a number of countries that are not now affected by the epidemic could become so, but also said that the procedures it set out would stop any new transmissions within eight weeks of the first case being identified.

In a sign of the difficulties facing governments seeking to contain the disease, the health authorities in Nigeria reported for the first time on Thursday that the disease had spread beyond Lagos, its commercial capital, to claim another death.

Nigeria does not share a land border with the other three countries in the grip of the outbreak.

The first sign of the virus’s spread to Nigeria came when Patrick Sawyer, a Liberian-American traveling from Liberia, flew to Lagos and died of the disease in the teeming city last month. Nigeria is Africa’s most populous nation but has recorded only 15 patients infected with Ebola, six of whom have now died.

The Nigerian health minister, Onyebuchi Chukwu, told reporters on Thursday that a man who had come into contact with Mr. Sawyer had evaded surveillance and traveled to Port Harcourt, the hub of Nigeria’s lucrative oil industry in the south of the country, where he infected a doctor who later died.

The man, who was not identified by name, recovered from the disease. The wife of the dead doctor also has Ebola symptoms, Mr. Chukwu said, according to The Associated Press. Additionally, 70 people in Port Harcourt, including funeral directors who embalmed the dead doctor, are now under surveillance.

In its statement on Thursday, the W.H.O. said the countries hit hardest by the epidemic — Guinea, Liberia, and Sierra Leone — were “struggling to control the escalating outbreak against a backdrop of severely compromised health systems, significant deficits in capacity, and rampant fear.”

“Clearly, a massively scaled and coordinated international response is needed to support affected and at-risk countries in intensifying response activities and strengthening national capacities,” it added, spelling out that particular attention to stopping the virus was needed in capital cities and major ports.

The organization’s road map came as Tom Frieden, director of the United States Centers for Disease Control and Prevention, warned that the epidemic could get worse before it gets better. Mr. Frieden called for quicker international help and cooperation to control its spread.

The latest figures do not include deaths from a separate Ebola outbreak in the Democratic Republic of Congo, which the authorities say is from a different strain of the virus.

Nick Cumming-Bruce reported from Geneva and Alan Cowell from London.
http://www.nytimes.com/2014/08/29/world ... .html?_r=0

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PostPosted: Thu Aug 28, 2014 8:06 am 
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First Human Trials of Ebola Vaccine Start Next Week
BY MAGGIE FOX

The first human trials of a vaccine against the deadly Ebola virus will start next week in the U.S., officials announced Thursday, just as the World Health Organization predicted as many as 20,000 people could be infected in West Africa before the epidemic is brought under control.

The National Institutes of Health will sponsor the first trial of the vaccine, one of several being developed against Ebola. It’s fast-tracked the testing because of the outbreak of Ebola that is ravaging three West African countries.

"The early stage trial will begin initial human testing of a vaccine co-developed by NIAID and GlaxoSmithKline (GSK) and will evaluate the experimental vaccine’s safety and ability to generate an immune system response in healthy adults," the NIH said in a statement. "Testing will take place at the NIH Clinical Center in Bethesda, Maryland."

Ebola has killed more than 1,500 people out of more than 3,000 infected in Liberia, West Africa and Guinea in the ongoing outbreak, by far the worst outbreak of Ebola ever seen. And the WHO says those numbers almost certainly understate the true numbers of those infected and killed. WHO predicted on Thursday that as many as 20,000 could become infected.

"Testing will take place at the NIH Clinical Center in Bethesda, Maryland."

"In parallel, NIH has partnered with a British-based international consortium that includes the Wellcome Trust and Britain’s Medical Research Council and Department for International Development to test the NIAID/GSK vaccine candidate among healthy volunteers in the United Kingdom and in the West African countries of Gambia (after approval from the relevant authorities) and Mali," NIH said.

"Additionally, the U.S. Centers for Disease Control and Prevention has initiated discussions with Ministry of Health officials in Nigeria about the prospects for conducting a Phase 1 safety study of the vaccine among healthy adults in that country."

The National Institute of Allergy and Infectious Diseases, part of the NIH, has been working on an Ebola vaccine for years. The idea was to develop it to defend people in case Ebola or a related virus, Marburg, was ever used in a biological attack. Previous outbreaks of the virus were always too small and too easily controlled to justify developing a vaccine quickly.

NIAID was working with a small Swiss-Italian biotech company called Okairos to develop the vaccine. It’s been shown to protect monkeys against Ebola.

Glaxo bought the company last year.

The next step is to test the vaccine in people, both to see if it’s safe and to see if it stimulates the immune system in a way that would be predicted to protect people from infection.

The vaccine is made using a virus called an adenovirus that infects chimpanzees but not people. The virus is genetically engineered with a single piece of Ebola virus, a protein that the immune system can recognize, but which doesn’t make people sick.

Several other companies are working to develop Ebola vaccines, including Crucell, a small biotech called Profectus Biosciences, Iowa-based NewLink Genetics and Immunovaccine Inc, based in Nova Scotia, Canada.

Two American medical missionaries, Dr. Kent Brantly and Nancy Writebol, were treated with an experimental therapy made by California-based Mapp Biopharmaceutical. Three Liberian doctors also received the drug. One died and the other two have recovered.

WHO published what it called a road map on Thursday for fighting the outbreak.

"Clearly, a massively scaled and coordinated international response is needed to support affected and at-risk countries in intensifying response activities and strengthening national capacities," it says.

"Clearly, a massively scaled and coordinated international response is needed."

"Response activities must be adapted in areas of very intense transmission and particular attention must be given to stopping transmission in capital cities and major ports, thereby facilitating the larger response and relief effort."

This outbreak is different from other outbreaks across Africa over the past 40 years, it says.

"This Roadmap assumes that in many areas of intense transmission the actual number of cases may be 2-4 fold higher than that currently reported," it says.

None of the provisions call for vaccination -- it's far to soon for that. Instead, the plan calls for better tracking down and diagnosis of cases, a fast-track training program to get more health workers on the job, safer burials and better control of travelers.

“Today we know the best way to prevent the spread of Ebola infection is through public health measures, including good infection control practices, isolation, contact tracing, quarantine, and provision of personal protective equipment,” NIAID director Dr. Tony Fauci said in a statement. “However, a vaccine will ultimately be an important tool in the prevention effort. The launch of Phase 1 Ebola vaccine studies is the first step in a long process.”

First published August 27th 2014, 10:28 pm
http://www.nbcnews.com/storyline/ebola- ... ek-n190716

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PostPosted: Thu Aug 28, 2014 8:14 am 
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ACCRA: Ebola-hit nations met for crisis talks Thursday as the death toll topped 1,500 and the World Health Organization warned that the number of cases could exceed 20,000 before the outbreak is stemmed.

Nigeria meanwhile announced the virus had reached its oil-producing hub, dashing hopes that the country had successfully contained its spread outside its biggest city, Lagos.

British medical charity the Wellcome Trust and pharmaceuticals giant GlaxoSmithKline also said that safety trials on a possible vaccine for the haemorrhagic fever could begin as soon as next month.

Health ministers from member states of the West African regional bloc ECOWAS were meeting in the Ghanaian capital, Accra, to discuss how to strengthen its response to the devastating outbreak.

As of August 26, 1,552 people had died from the virus in four countries - Sierra Leone, Liberia, Guinea and Nigeria - while 3,062 had been infected, the WHO said in Geneva.

The global health body said it aimed to reverse the trend within three months, with the final aim of stopping "all residual transmission within 6-9 months."

But at the current rate, which experts believe is an underestimation, the number of infections "could exceed 20,000 over the course of the emergency."

In Accra, the Economic Community of West African States warned that Ebola was "a threat to regional and global public health safety as well as the economic and social security of the affected countries."

As the meeting began, Nigeria's Health Minister Onyebuchi Chukwu said the country had recorded its sixth death from the virus - a doctor in the southeastern city of Port Harcourt.

The medic died on August 22, a day after treating a patient who had contact with the Liberian-American man who brought the virus to Nigeria and who died in a Lagos hospital on July 25.

"Following the report of this death by the doctor's widow the next day, the case had been thoroughly investigated and laboratory analysis showed that this doctor died of Ebola Virus Disease," he told reporters in Abuja.

The confirmation and an announcement that the doctor's widow was also symptomatic came after Chukwu said Wednesday that Nigeria seemed to have contained the virus.

Port Harcourt, 435 kilometers east of Lagos and the capital of Rivers state, is the center of Nigeria's oil industry and home to a number of industry majors, including Anglo-Dutch giant Shell, U.S. firm Chevron and France's Total.

Chukwu said the patient, who works for ECOWAS, slipped through the surveillance net and went to the city in the last week of July, where he consulted the doctor after showing Ebola-like symptoms.

"After four days, following a manhunt for him, he returned to Lagos, by which time he was found to be without symptoms," the minister said but added that he was currently under quarantine.

"The man has antibodies showing that he has suffered it (Ebola) before but he's not ill today."

Another ECOWAS official, who picked up the index case from Lagos airport on July 20 and took him straight to hospital, later died from the disease.

The developments came after the director of the U.S. Centers for Disease Control and Prevention, Tom Frieden, said Wednesday that there was no quick fix to what the WHO has called an "unprecedented" outbreak and called for "urgent action."

Frieden told a news conference in the Liberian capital, Monrovia: "The cases are increasing. I wish I did not have to say this but it is going to get worse before it gets better."

There has been mounting concern about the effect of the most lethal outbreak of the tropical virus in history, which the WHO said Thursday could cost at least $490 million to tackle over six months.

On Wednesday, Air France became the latest carrier to announce a suspension of its services to Sierra Leone, while British Airways said it was stopping its flights to Freetown and Monrovia until next year.

Royal Air Morocco is now the only airline providing a regular service for both capitals, although the company said that flights were only about 10 percent full from Casablanca.

The United Nations' envoy on Ebola, David Nabarro, this week criticized airlines for scrapping flights, warning that Ebola-hit countries faced increased isolation and made it harder for the U.N. to carry out its work.

Liberia has been worst hit by the outbreak. Sporadic violence, including against hospitals treating Ebola patients, has been seen and some areas of the city placed under quarantine.

Elsewhere, there have been warnings of food shortages in affected countries.


Read more: http://www.dailystar.com.lb/News/World/ ... z3Bgjd5DcK
(The Daily Star :: Lebanon News :: http://www.dailystar.com.lb)

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PostPosted: Thu Aug 28, 2014 8:46 am 
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WHO says Ebola outbreak could strike 20,000 people

http://newsbcpcol.stb.s-msn.com/amnews/ ... lfalse.jpg

Medical staff take a blood sample from a suspected Ebola patient at the government hospital in Kenema, Sierra Leone. Reuters: Tommy Trenchard

Reuters 2 hr ago | By Stephanie Nebehay of Reuters

GENEVA (Reuters) - The current Ebola outbreak in West Africa could infect more than 20,000 people, the World Health Organisation (WHO) said on Thursday in a bleak assessment of the deadly disease.


The United Nations health agency issued a strategic plan to combat the outbreak in four West African nations where it said the actual number of cases could already be two to four times higher than the reported 3,069. The death toll stands at 1,552.

"This roadmap assumes that in many areas of intense transmission the actual number of cases may be 2-4 fold higher than that currently reported. It acknowledges that the aggregate case load of Ebola Virus Disease could exceed 20,000 over the course of this emergency," the WHO said.

The deadly outbreak that began in Guinea in March and has spread to neighboring Liberia and Sierra Leone as well as to Nigeria requires a massive and coordinated international response, the WHO said.

A separate outbreak of Ebola in Democratic Republic of Congo identified as a different strain, is not included in its toll.

"Response activities must be adapted in areas of very intense transmission and particular attention must be given to stopping transmission in capital cities and major ports, thereby facilitating the larger response and relief effort," the WHO said.

The virus is still being spread in a "substantial number of localities", aggravating fragile social and economic conditions and has already killed an unprecedented number of health workers, the agency said.

A wider U.N.-led plan being launched by the end of September is "expected to underpin support for the increasingly acute problems associated with food security, protection, water, sanitation and hygiene, primary and secondary health care and education, as well as the longer-term recovery effort that will be needed," the WHO said.

(Reporting by Stephanie Nebehay; Editing by Hugh Lawson)
http://news.msn.com/world/who-says-ebol ... 000-people

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PostPosted: Thu Aug 28, 2014 9:44 am 
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Ebola Cases May Surpass 20,000, WHO Says in Updated Plan
By Simeon Bennett Aug 28, 2014 7:49 AM ET
VIDEO
Aug. 28 (Bloomberg) – Bloomberg’s Scarlet Fu reports on Ebola cases may rise to twenty thousand in course of outbreak according to the World Health Organization. She speaks with Tom Keene on “Bloomberg Surveillance.” (Source: Bloomberg)

More than 20,000 people may be infected with the Ebola virus before the outbreak in West Africa is controlled and curbing the epidemic will cost at least $490 million, according to a World Health Organization plan.

The number of people falling ill is accelerating, with more than 40 percent of the infections happening in the past 21 days, the Geneva-based United Nations agency said in an e-mailed statement today. In some areas, the number of cases may be two to four times higher than reported, the WHO said in a separate document, a so-called road map that lays out the plan to deal with the situation.

“The 2014 Ebola virus disease outbreak continues to evolve in alarming ways,” the WHO said in the road map released today. Liberia, Guinea and Sierra Leone are “struggling to control the escalating outbreak against a backdrop of severely compromised health systems, significant deficits in capacity and rampant fear.”

By mobilizing international resources, the WHO is aiming to stop Ebola transmission within six to nine months, the agency said in the document. The virus has infected more than 3,000 people, making it the biggest outbreak ever, and has killed more than 1,550. It’s on a pace to cause more deaths than all previous outbreaks combined.

The WHO’s cost estimate is up from $430 million in a draft of the road map reported by Bloomberg News this week.

Cases also have been reported in Nigeria. The death toll there has risen to six after a doctor who died in the southern oil city of Port Harcourt tested positive posthumously, Health Minister Onyebuchi Chukwu said in e-mailed statement.

There’s no cure for Ebola and the outbreak, which began in Guinea in December, has jumpstarted the development of drugs against the virus.

U.S. scientists will begin enrolling patients as soon as next week in safety trials of GlaxoSmithKline Plc’s experimental vaccine, Michael Kurilla, director of the Office of Biodefense, Research Resources and Translational Research, said yesterday in a telephone interview.

The virus is spread through direct contact with bodily fluids from an infected person. It causes fever, diarrhea, muscle pain, vomiting and, as it progresses, can lead to bleeding from the eyes, ears and nose. In the past, the fatality rate has been as high as 90 percent. About 52 percent of those infected in the current outbreak have died.

Funeral Practices

Doctors treat patients by keeping them hydrated, replacing lost blood and using antibiotics to fight off opportunistic infections. The goal is for the body’s immune system to eventually beat the disease.

The WHO and aid groups have struggled to bring Ebola under control. Widespread fear of the illness and suspicion of aid workers is prompting families to hide people with the virus, and funeral practices such as the kissing of corpses have propagated Ebola’s spread. The main countries hit by Ebola are among Africa’s poorest, with rudimentary health systems, inadequate supplies and a shortage of doctors and nurses.

That shortage has been compounded by the toll Ebola has taken on health workers this year. More than 240 developed the disease in the four countries, and more than 120 have died, the WHO said on Aug. 25.

For Related News and Information: Glaxo’s Ebola Vaccine Set to Begin Tests in Humans Next Week

To contact the reporter on this story: Simeon Bennett in Geneva at sbennett9@bloomberg.net

To contact the editors responsible for this story: Phil Serafino at pserafino@bloomberg.net Robert Valpuesta

http://www.bloomberg.com/news/2014-08-2 ... -plan.html

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PostPosted: Thu Aug 28, 2014 9:42 pm 
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WHO launches road map for containing Ebola in West Africa
Filed Under: Ebola; VHF
Lisa Schnirring | Staff Writer | CIDRAP News | Aug 28, 2014

WHO's road map to containing West Africa's Ebola epidemic has a goal of stopping transmission in 6 to 9 months.
The World Health Organization (WHO) today unveiled a road map to step up the global response to West Africa's intensifying Ebola virus outbreak, at an estimated price tag of $490 million, and to limit spread to other countries, with a goal of stopping transmission in 6 to 9 months.

In a separate development, scientists today provided a blueprint of the outbreak virus's genome, which tracks its evolution and sheds new light on West Africa's epidemic.

The WHO called the need to scale up the response urgent and said the actual number of cases may be 2 to 4 times higher than the 3,069 currently reported. The agency estimated that the number of people sickened by Ebola virus disease (EVD) could reach 20,000 over the course of the outbreak.

Plan spells out priorities, tasks, troubleshooting
The 27-page WHO plan, a follow-up to an initial strategy released Jul 31 after a health minister's meeting in Accra, reflects an intensifying outbreak, with more than 40% of the cases occurring in just the past 21 days, said the group Alarms have been sounded recently about the heavy toll the outbreak is taking on health workers at the frontlines and difficulties border and flight restrictions are having on getting supplies and personnel into affected countries to battle the outbreak.

A large number of partners had input on the plan, including the affected countries, the African Union, development banks, other United Nations (UN) agencies, Doctors Without Borders (MSF), and countries that are providing direct financial support, the WHO said in a press release.

The top priorities are treatment and management centers, social mobilization, and safe burials, with plans based on site-specific data that will appear in regular situation reports starting this week that will map out hot spots and show how the outbreak is evolving, according to the WHO. The plan outlines potential bottlenecks that will require international coordination, such as the need for personal protective equipment (PPE), disinfectants, and body bags.

The group said it hopes air traffic restrictions to the affected countries will be addressed within 2 weeks, and it said by the end of September the UN will launch a complementary plan that provides a common operational platform for enhancing the response steps and addressing the outbreak's broader consequences, such as problems related to food security, water, sanitation, and healthcare infrastructure.

Today's plan spells out roles and responsibilities for different groups, from the WHO to the private sector, as well as steps for monitoring the plan's implementation, which will be evaluated twice a week.

MSF response
In response to today's WHO release, Brice de la Vinge, director of operations for MSF, said in a statement that he welcomed the plan but cautioned that it should not give a false sense of hope. He questioned who will implement the plan and who has the right training for taking on the variety of tasks that it details.

De le Vigne also said it's not clear how long it will take to train organizations to establish and run more Ebola treatment centers or how long it will take them to become operational. He also wondered who will shoulder the important tasks of health education, contact tracing, and safe burials.

"We have learned an uncomfortable lesson over the past six months: none of the organizations in the most affected countries—the UN, WHO, local governments, [nongovernmental organizations] (including MSF)—currently have the proper set-up to respond at the scale necessary to make a serious impact on the spread of the outbreak," de le Vigne said.

He added that some groups simply have no capacity to do more, "and others may need to be encouraged to demonstrate more willingness to push the boundaries and scale up effective activities at a meaningful scale."

Outbreak escalation concentrated at hot spots
In its latest update on the outbreak, the WHO today put the latest outbreak total at 3,069, with the number of deaths at 1,552. The numbers reflect an increase of 454 EVD infections and 125 deaths since the WHO's last case update on Aug 22. The official numbers are thought to dramatically underestimate the true burden of the disease.

So far the overall case-fatality rate is 52%, ranging from 42% in Sierra Leone to 66% in Guinea, the WHO said.

Though the outbreak continues to escalate, most of the cases are concentrated in a few localities, and while a detailed analysis is still needed, early results show that 62% of all cases reported so far are still concentrated in the outbreak epicenter: the Gueckedou region of Guinea, the Lofa area of Liberia, and the Kenema and Kailahun areas of Sierra Leone.

The WHO added that infections occurring in the capital cities of the three countries are especially worrisome, given population density and the impacts on travel and trade.

Gene study yields outbreak clues
In other developments today, an international research team, with help from Sierra Leone's health ministry, published a detail genetic sequencing study on samples from 78 patients sickened with EVD in the country during the first 24 days of the outbreak, which showed mutations and clues about how the outbreak evolved. Their findings appear in the latest online edition of Science.

They looked at 99 Ebola virus genomes. Some were from the same patient, allowing researchers to watch how the virus can change in a patient over the course of an infection.

Based on sequence variations in the genomes they analyzed, they estimated that the EVD outbreak started from a single introduction into humans, spreading between humans over many months. They also found more than 300 genetic changes that make the outbreak virus distinct from Ebola viruses that have sparked other outbreaks.

Some of the variations they observed were often seen in the parts of the genome that encode proteins, which they said might affect the primers used in diagnostic tests, one reason why genetic surveillance and vigilance are so important.

The team released the full-length sequences to the National Center for Biotechnology Information (NCBI) DNA database before publication, which they said could help with response efforts.

Their sequencing study suggests that the strains fueling the current outbreak likely have a common ancestor dating back to 1976 when the first Ebola outbreak was recorded. West Africa's lineage diverged from the Middle African version within the last decade and spread from Guinea to Sierra Leone by 12 people who had attended the same funeral, according to the report.

In an unusual and sad twist, one of the senior authors of the study, Dr. Humarr Kahn, who was with Sierra Leone's Ministry of Health and Sanitation, died from an EVD infection in late July. Before his death he had been overseeing an Ebola treatment program at Kenema Government Hospital, where he headed a Lassa fever program..

Pardis Sabeti, MD, PhD, another senior author of the study and associated member at the Broad Institute and associate professor at Harvard University, said in a statement from the Broad Institute, "There is an extraordinary battle still ahead, and we have lost many friends and colleagues already like our good friend and colleague Dr. Humarr Khan."

She continued, "By making the data immediately available to the community, we hope to accelerate response efforts." She added that demonstrating transparency and partnership is one way she and her colleagues hope to honor Humarr's legacy. "We are all in this fight together," she said.

See also:

Aug 28 WHO statement

Aug 28 WHO Ebola response blueprint

Aug 28 MSF statement

Aug 28 WHO outbreak update

Aug 28 Science abstract

Aug 28 Broad Institute press release

http://www.cidrap.umn.edu/news-perspect ... est-africa

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