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PostPosted: Tue Aug 26, 2014 6:53 pm 
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Media reports cite comments from CDC director Tom Frieden on Ebola situation in western Africa.

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PostPosted: Tue Aug 26, 2014 6:54 pm 
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CDC Director On Ebola: 'We Are Definitely Not At The Peak'

by NPR Staff

August 26, 2014 4:41 PM ET
Image
Shops are closed in Monrovia's West Point neighborhood as part of a quarantine to contain the spread of Ebola.

On Monday, Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, arrived in Liberia to assess the Ebola outbreak. The situation "is overwhelming," he said.

The outbreak "really is a crisis and is affecting most if not all the counties in Liberia already," he told NPR from Monrovia, the capital city and first stop on a three-country visit. "This is absolutely unprecedented."

The CDC, Frieden said, "is working flat out on this, but this is huge and needs a global response. ... They need a lot of help from the world."

He emphasized that the toll is "far larger than has been recorded, not because they are trying to hide anything but because they are really overwhelmed by these numbers." Beyond this, he said, the cases "are increasing at an extremely quick rate, and this is very alarming."

As bad as the Ebola situation is, Frieden warned that the worst is yet to come. "Unfortunately, we are definitely not at the peak. It's going to get worse before it gets better," he said. "The real question is how much worse will it get? How many more people will be infected and how much more risk to the world will there be?"

Because of the outbreak, Liberians who require other kinds of medical care have avoided seeking help. "Urgent health needs are definitely going unmet," Frieden said. "Hospital occupancy" is 10 percent. This means one of the urgent tasks ahead is to make sure treatment is available to patients who are not suffering from Ebola.

Ending the crisis hinges largely on improving infection control and burial practices, Frieden said. Until now, "cremation was not part of the burial culture here," he said, but people are increasingly accepting it.

Liberia suffered immensely even before Ebola struck, with a prolonged civil war that killed 250,000 people. "Liberia has been through so much in the last 15 or 20 years," Frieden said. "This is really almost re-traumatizing people here."


http://www.npr.org/blogs/goatsandsoda/2 ... t-the-peak

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PostPosted: Tue Aug 26, 2014 7:04 pm 
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Posted: 12:02 p.m. Tuesday, Aug. 26, 2014
Ebola outbreak 'worse than we'd feared,' CDC chief says on visit to West Africa
10 42 28 1548

We can stop Ebola, CDC chief vows photo
Lauren Victoria Burke

The Atlanta Journal-Constitution
CDC Director Thomas Frieden, who is in Liberia to assess the Ebola outbreak, said today the contagion is “even worse than we’d feared.”
“This is an absolute emergency,” Frieden told WSB Radio in a phone interview this morning. “We have never seen anything on this scale with Ebola before. Unfortunately, this situation is going to get worse before it gets better. We’ve not yet turned the tide. The outbreak is ahead of our response.”
Frieden, who heads the Atlanta-based U.S. Centers for Disease Control and Prevention, said Liberia desperately needs to set up treatment centers across the country that can safely handle Ebola patients, giving the patients a chance to survive and also keeping them out of the community, where they can spread the virus to others.
“We’ve seen patients with Ebola with nowhere to go, an increasing number of corpses put onto the street,” Frieden said. “A whole system of picking up and cremating corpses has had to be developed.”
Cremation, which was not culturally acceptable in Liberia before the outbreak, is now widespread practice, the CDC chief said.
The death toll in Liberia and neighboring Guinea and Sierra Leone now stands at 1,427, the World Health Organization said, with total infections of about 2,600 since the outbreak was identified in March.
The Associated Press reported today that two more cases of Ebola infection have been identified in Nigeria.
“The numbers just keep going up, and the need for a global emergency response is enormous,” Frieden told WSB.
Two American charity workers who were flown from Liberia to Atlanta for treatment of Ebola infection at Emory University Hospital were released last week and do not pose a threat to public health, their doctors said. Dr. Kent Brantly, the second of the two to be discharged, noted upon his release that his fight against the disease is at an end, but the real fight, in West Africa, is just beginning.
Frieden, in his WSB Radio interview, warned that failure to control the outbreak could be catastrophic.
“This isn’t just a risk to Liberia and West Africa,” Frieden said. “With this kind of transmission, every day it goes on, it increases the risk of spread to other countries in Africa, other countries in the region.
“The impact not just from Ebola but on the delivery of healthcare, on economies, on families and societies. It’s huge. It’s absolutely an emergency.”

http://www.ajc.com/news/news/ebola-outb ... ibe/ng85M/?

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PostPosted: Tue Aug 26, 2014 9:08 pm 
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WHO pulls Ebola team, probes site of staffer's infection
Filed Under: Ebola; VHF
Lisa Schnirring | Staff Writer | CIDRAP News | Aug 26, 2014

Because of airline flight cutbacks, Ebola treament centers like this one in Guinea are starting to be hampered by shortages of workers and supplies, officials say.

The World Health Organization (WHO) said today that is temporarily pulling its staff from a part of Sierra Leone where one of its deployed workers was sickened by the Ebola virus, as health officials battling the outbreak struggled with problems caused by bans on airline flights to the affected countries.

In a press release e-mailed to journalists the WHO said it pulled health workers from Kailahun, one of the outbreak hot spots, to Freetown, Sierra Leone's capital, after announcing over the weekend that one of its workers was infected.

The worker is reportedly an epidemiologist from Senegal who is with the Global Outbreak Alert and Response Network (GOARN) and was in Kailahun district tracing EVD cases, according to earlier reports. Kailahun district is not far from where the borders of Sierra Leone, Guinea, and Liberia meet—a region that global health officials have called one of the outbreak's most intense hot spots.

WHO team 'exhausted'
Daniel Kertesz, MD, MPH, the WHO representative in Sierra Leone, said in the statement that the move was the responsible thing to do and that the field team has been through a traumatic time during the incident. "They are exhausted from many weeks of heroic work, helping patients infected with Ebola. When you add a stressor like this, the risk of accidents increases."

"We recognize that this will interrupt the work in the field for the short term, but it ensures we protect health workers and help the community over the longer term, " Kertesz said. "We are working rapidly to ensure we can return to the field as quickly as possible."

In a related action, the WHO said it sent another team to the area, which borders Guinea, to review how the health worker was infected, what the living and working conditions are like for employees, and what factors increase the risk of infection. Once actions are taken to address the issues, the agency said, it will move the team back to Kailahun, and for now, lab work will be conducted at the center in Kenema.

Frieden says situation worse than he feared
US Centers for Disease Control and Prevention (CDC) Director Tom Frieden, MD, MPH, was in Liberia today to observe the outbreak and its response, and met with the country's president and other officials. He told Atlanta's WSB Radio that the outbreak is worse than he feared.

"This is an absolute emergency," Frieden said, adding that the top priority is getting people into treatment to stop the spread of the virus. He said product shortages are starting to be felt, and the response efforts of the CDC and its partners are being hobbled by flight reductions and countries not allowing aircraft to refuel.

While visiting Liberia, Frieden said he's seen Ebola patients with nowhere to go and an increasing number of corpses put into the street. He is scheduled to visit Sierra Leone and Guinea, as well.

At a United Nations (UN) briefing yesterday, officials repeated WHO warnings that flight limitations in and out of the outbreak countries are hobbling response operations. In a statement, UN spokesman Stephane Dujarric said, "It [flight restriction] is not an optimal measure for controlling the import of Ebola virus disease. The measure does not reflect what is known about the way in which the virus passes between people."

Flight bans choke response
He said the restrictions are impeding the movement of international experts involved in disease control efforts, hindering the deployment of workers from aid groups such as Doctors Without Borders, and severely hampering the flow of equipment and supplies to the area.

After a 2-day meeting, a high-level UN delegation promised to step up response operations in Sierra Leone, the WHO said yesterday in an e-mail statement.

David Nabarro, MD, the UN secretary-general's Ebola response coordinator, said in the statement that the outbreak is still advancing in parts of Sierra Leone. "Our partnership with Sierra Leone to end the Ebola outbreak means upgrading all the UN is doing to get the scale-up required."

However, David McLachlan-Karr, UN resident coordinator for Sierra Leone, said the surge is possible only if the flights return to Sierra Leone.

In other developments, a draft blueprint of a response strategy that the WHO is expected to release this week estimates that more than $430 million will be needed to control the outbreak, Bloomberg News reported yesterday. Goals include reversing new case trends in 2 months and curbing transmission in 6 to 9 months, according to the report, which calls on governments, developments banks, the private sector, and in-kind contributions to support the funding.

The African Development Bank (ADB) on Aug 19 approved $60 million as part of a $210 million package to help strengthen West Africa's public health systems in response to the EVD outbreak, according to an ADB statement.

See also:

Aug 26 WSB Radio report

Aug 25 UN News Center report

Aug 25 WHO African regional office statement
Aug 25 Bloomberg News story

Aug 19 ADB statement

Aug 25 CIDRAP News story "WHO: Medical worker infections and shortages hamper Ebola response"

http://www.cidrap.umn.edu/news-perspect ... -infection

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PostPosted: Tue Aug 26, 2014 11:06 pm 
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Location: Pittsburgh, PA USA
niman wrote:
CDC Director On Ebola: 'We Are Definitely Not At The Peak'

by NPR Staff

August 26, 2014 4:41 PM ET
Image
Shops are closed in Monrovia's West Point neighborhood as part of a quarantine to contain the spread of Ebola.

On Monday, Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, arrived in Liberia to assess the Ebola outbreak. The situation "is overwhelming," he said.

The outbreak "really is a crisis and is affecting most if not all the counties in Liberia already," he told NPR from Monrovia, the capital city and first stop on a three-country visit. "This is absolutely unprecedented."

The CDC, Frieden said, "is working flat out on this, but this is huge and needs a global response. ... They need a lot of help from the world."

He emphasized that the toll is "far larger than has been recorded, not because they are trying to hide anything but because they are really overwhelmed by these numbers." Beyond this, he said, the cases "are increasing at an extremely quick rate, and this is very alarming."

As bad as the Ebola situation is, Frieden warned that the worst is yet to come. "Unfortunately, we are definitely not at the peak. It's going to get worse before it gets better," he said. "The real question is how much worse will it get? How many more people will be infected and how much more risk to the world will there be?"

Because of the outbreak, Liberians who require other kinds of medical care have avoided seeking help. "Urgent health needs are definitely going unmet," Frieden said. "Hospital occupancy" is 10 percent. This means one of the urgent tasks ahead is to make sure treatment is available to patients who are not suffering from Ebola.

Ending the crisis hinges largely on improving infection control and burial practices, Frieden said. Until now, "cremation was not part of the burial culture here," he said, but people are increasingly accepting it.

Liberia suffered immensely even before Ebola struck, with a prolonged civil war that killed 250,000 people. "Liberia has been through so much in the last 15 or 20 years," Frieden said. "This is really almost re-traumatizing people here."


http://www.npr.org/blogs/goatsandsoda/2 ... t-the-peak

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PostPosted: Wed Aug 27, 2014 8:05 pm 
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CDC staffer exposed to Ebola amid growing concerns for health workers
Filed Under: Ebola; VHF
Lisa Schnirring | Staff Writer | CIDRAP News | Aug 27, 2014

The Ebola virus threat to health workers and international responders in West Africa saw no letup today, with news of the US Centers for Disease Control and Prevention (CDC) returning one of its deployed staff members after contact with a patient and Canada pulling a lab team after infections were detected at their hotel.

CDC Director Tom Frieden, MD, MPH, is in West Africa this week getting a first-hand look at the steep challenges the affected countries and international health responders face. In Monrovia, Liberia, today he told CNN that the outbreak is worse than he feared. He said each day the outbreak continues increases the threat of exporting the disease to other countries.

"The sooner the world comes together to help Liberia and West Africans, the safer it will be," Frieden told CNN.

CDC staffer had low-risk exposure
In a statement today the CDC said it brought an employee back on a charter jet following low-risk contact with an international health worker who recently tested positive for Ebola virus disease (EVD). The CDC staff member worked within 3 feet of and in the same room with the infected health worker for a prolonged period when the international worker was symptomatic and capable of spreading the virus to others.

The CDC said its staffer practiced good personal infection control. The individual is not sick, does not have any disease symptoms, and does not pose a threat to others. Also, the CDC said the staff member is rotating back to the United States, as scheduled, from the assignment in West Africa.

The agency said it is handling the case based on its interim guidance for monitoring and moving people who have been exposed to the Ebola virus, which stipulates that contacts can travel long distances only by private means during a 21-day interval after last contact.

The restriction addresses the possibility that a person could start having symptoms during travel and ensures that individuals would have quick access to care if they had symptoms. The CDC also recommends that travelers who have visited Sierra Leone, Guinea, or Liberia monitor their health for 21 days and seek medical care if they start experiencing EVD symptoms during that time.

Once the CDC staffer returns to the United States, he or she will not be on home restriction and could return to duties at the CDC during the 21-day symptom monitoring period, the group said.

Canada pulls lab team from Sierra Leone field unit
In a related development, the Public Health Agency of Canada (PHAC) said yesterday that it has recalled a three-member mobile lab team that worked a field unit with a World Health Organization (WHO) employee who was recently infected with EVD, according to a Canadian Press report today. The PHAC also said people at a hotel complex where the Canadian lab team was staying were diagnosed with EVD.

The PHAC said the Canadian lab workers are not sick but will be in voluntary isolation during their flight home and after they return to Canada.

The WHO said yesterday that it was pulling its staff from a unit in Sierra Leone's Kailahun district after one of its deployed workers, a Senegalese epidemiologist, was sickened by EVD. It also announced that it would send another team to the area to review how the worker was infected. The field site is located in a part of West Africa that has been called one of the outbreak's most intense hot spots.

Christy Feig, WHO director of communications, told the Canadian Press that the unit where the epidemiologist and the Canadian lab team were working did not treat patients but rather supported operations at a nearby treatment center run by Doctors Without Borders.

ZMapp for one evacuated health worker
The Senagalese WHO worker, who was affiliated with the Global Outbreak Alert and Response Network (GOARN), was flown to Germany last night and is being treated today at a hospital in Hamburg, the University Medical Center Hamburg-Eppendorf, CBS News reported today. The city is home to the Bernhard-Nocht Clinic for Tropical Medicine.

Ansgar Lohse, MD, the hospital's internal medicine director, said the Hamburg area has expertise in caring for tropical diseases, which swayed the decision to treat the man at one of the city's hospitals.

Another doctor at the hospital who is helping coordinate the patient's treatment, Stefan Schmiedel, MD, said the clinic would not be using the experimental drug ZMapp, which was been given to some medical workers, including two Americans who were infected with EVD and have since recovered, according to the CBS report. He indicated that the supply of ZMapp has been depleted and that the patient's treatment will focus on supportive care, including fever reduction and fluid management.

However, Royal Free London, where a British nurse is being treated after being infected in Sierra Leone, said the man has decided after careful consideration that he would like to take the experimental drug ZMapp and took the first dose on Aug 25. The hospital said in a press release yesterday that the patient, William Pooley, is in good spirits and is sitting up and talking to his caretakers.

Mike Jacobs, MD, an infectious disease consultant at the hospital, said in the statement, "We are giving him the very best care possible. However, the next few days will be crucial. The disease has a variable course and we will know much more in a week's time."

See also:

Aug 27 CNN report

Aug 27 CDC statement

Aug 27 Canadian Press story

Aug 26 CIDRAP News story "WHO pulls Ebola team, probes site of staffer's infection"

Aug 27 CBS News story

Aug 26 Royal Free London press release
http://www.cidrap.umn.edu/news-perspect ... th-workers

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PostPosted: Thu Aug 28, 2014 12:08 am 
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27 August 2014 Last updated at 22:36 ET
Ebola outbreak: US official says epidemic will worsen

There have been more than 2,600 confirmed cases of Ebola, with around half of those being deadly

The Ebola outbreak in West Africa is going to get worse before it gets better, according to the top US public health official.

Tom Frieden, the director of the Centers for Disease Control, said the epidemic would need an "unprecedented" response to bring it under control.

Health ministers from across West Africa are due to meet in Ghana to discuss the growing crisis.

The World Health Organization says the outbreak has killed 1,427 people.

The health body says it is the largest ever Ebola epidemic and has infected an estimated 2,615 people.

Liberia has been hardest-hit of the affected countries, with 624 deaths and 1,082 cases since the start of the year.

The current outbreak is the deadliest since Ebola was discovered in 1976
Mr Frieden met Liberian President Ellen Johnson Sirleaf to discuss ways to fight the disease.

"The cases are increasing. I wish I did not have to say this, but it is going to get worse before it gets better," he admitted.

"The world has never seen an outbreak of Ebola like this. Consequently, not only are the numbers large, but we know there are many more cases than has been diagnosed and reported," he added.

He said there was a need for "urgent action" and called on Liberians "to come together" to stop misconceptions that have helped the outbreak spread.

Despite rumours to the contrary, the virus is not airborne and is spread by humans coming into contact with bodily fluids, such as sweat and blood, from those infected with virus.

Supportive care such as rehydrating patients who have diarrhoea and vomiting can help recovery
Fruit bats, a delicacy for some West Africans, are considered to be virus's natural host
line
Health ministers from the Economic Community of West African States will meet in Ghana's capital Accra on Thursday to discuss the regional response to the crisis.

The extraordinary meeting comes after the African Development Bank warned that the outbreak is causing enormous economic damage to West Africa as foreign businessman quit the region.

Meanwhile, medical charity Medecins Sans Frontieres (MSF) has branded the international response "entirely inadequate".

Brice de la Vigne, MSF operations director, said efforts to bring the outbreak under control had been far too chaotic.

"It is simply unacceptable that serious discussions are only starting now about international leadership and coordination," he said.

"Self-protection is occupying the entire focus of states that have the expertise and resources to make a dramatic difference."

http://www.bbc.com/news/world-africa-28 ... um=twitter

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PostPosted: Thu Aug 28, 2014 5:48 pm 
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Tom Frieden's Ebola Assessment: The Risk Is Increasing
by JASON BEAUBIEN
August 28, 2014 4:54 PM ET
Image
Dr. Tom Frieden, director of the CDC, talks with staff from Doctors Without Borders during a visit to the nonprofit group's newest Ebola treatment center in Monrovia, Liberia.
Tommy Trenchard for NPR

The Ebola outbreak has crippled local health systems. It's flooded wards with patients, killed doctors, scared away medical staff and forced some hospitals to shut down entirely.

That's the grim assessment of Dr. Tom Frieden, head of the U.S. Centers for Disease Control and Prevention, who's visiting West Africa this week for a firsthand look at the situation. Frieden spoke to Goats and Soda by cell phone as he was traveling by car from the hard-hit eastern Sierra Leone city of Kenema back to the capital, Freetown.

Related NPR Stories

Frieden says there's now a vicious cycle around Ebola in Sierra Leone and Liberia, which is amplifying the spread of the disease. "More cases are leading to less adequate management of each case, which is leading to more cases," he says. "That cycle has got to be broken for us to stop this."

The best hope lies in a new $489 million plan proposed by the World Health Organization, with the goal of stopping Ebola transmission within nine months. The ambitious plan would deploy hundreds of international experts and thousands of local medical staff. But first, Frieden stresses, the money has to be raised.

Meanwhile, the bad news is mounting. "The number of cases is spiraling upward," he says. "There's an urgent need to get patients into isolation and start to get better control of the disease."

But there aren't even enough isolation beds for current Ebola patients, and the World Health Organization predicts that the outbreak will get far worse before it gets better. So far, WHO says, over 3,000 people have been infected with the virus this year and roughly half have died. WHO estimates that some 20,000 people could fall ill with Ebola before this current outbreak is over.

"This is a threat not just to West Africa and to Africa, this is a threat to the world," Frieden says, emphasizing the need to fund WHO's effort. Every day the outbreak continues "increases the risk of spread to other countries."

West African health departments don't have the staff, training or equipment to control this disease on their own, Frieden says. That means the international community must pick up the pace of its response to the crisis.

"Literally every day that we don't make more progress controlling the outbreak," Frieden says, "is another day that the outbreak will not just continue — but grow much larger."

http://www.npr.org/blogs/goatsandsoda/2 ... um=twitter

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