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PostPosted: Mon Aug 25, 2014 6:06 pm 
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WHO situation assessment cites unprecedented number of Ebola infected HCWs.

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PostPosted: Mon Aug 25, 2014 6:07 pm 
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Unprecedented number of medical staff infected with Ebola

Situation assessment - 25 August 2014

The outbreak of Ebola virus disease in west Africa is unprecedented in many ways, including the high proportion of doctors, nurses, and other health care workers who have been infected.

To date, more than 240 health care workers have developed the disease in Guinea, Liberia, Nigeria, and Sierra Leone, and more than 120 have died.

Ebola has taken the lives of prominent doctors in Sierra Leone and Liberia, depriving these countries not only of experienced and dedicated medical care but also of inspiring national heroes.

Several factors help explain the high proportion of infected medical staff. These factors include shortages of personal protective equipment or its improper use, far too few medical staff for such a large outbreak, and the compassion that causes medical staff to work in isolation wards far beyond the number of hours recommended as safe.

In the past, some Ebola outbreaks became visible only after transmission was amplified in a health care setting and doctors and nurses fell ill. However, once the Ebola virus was identified and proper protective measures were put in place, cases among medical staff dropped dramatically.

Moreover, many of the most recent Ebola outbreaks have occurred in remote areas, in a part of Africa that is more familiar with this disease, and with chains of transmission that were easier to track and break.

The current outbreak is different. Capital cities as well as remote rural areas are affected, vastly increasing opportunities for undiagnosed cases to have contact with hospital staff. Neither doctors nor the public are familiar with the disease. Intense fear rules entire villages and cities.

Several infectious diseases endemic in the region, like malaria, typhoid fever, and Lassa fever, mimic the initial symptoms of Ebola virus disease. Patients infected with these diseases will often need emergency care. Their doctors and nurses may see no reason to suspect Ebola and see no need to take protective measures.

Some documented infections have occurred when unprotected doctors rushed to aid a waiting patient who was visibly very ill. This is the first instinct of most doctors and nurses: aid the ailing.

In many cases, medical staff are at risk because no protective equipment is available – not even gloves and face masks. Even in dedicated Ebola wards, personal protective equipment is often scarce or not being properly used.

Training in proper use in absolutely essential, as are strict procedures for infection prevention and control.

In addition, personal protective equipment is hot and cumbersome, especially in a tropical climate, and this severely limits the time that doctors and nurses can work in an isolation ward. Some doctors work beyond their physical limits, trying to save lives in 12-hour shifts, every day of the week. Staff who are exhausted are more prone to make mistakes.

All personal protective equipment despatched or approved by WHO meets the appropriate international safety standards.

The heavy toll on health care workers in this outbreak has a number of consequences that further impede control efforts.

It depletes one of the most vital assets during the control of any outbreak. WHO estimates that, in the three hardest-hit countries, only one to two doctors are available to treat 100,000 people, and these doctors are heavily concentrated in urban areas.

It can lead to the closing of health facilities, especially when staff refuse to come to work, fearing for their lives. When hospitals close, other common and urgent medical needs, such as safe childbirth and treatment for malaria, are neglected.

The fact that so many medical staff have developed the disease increases the level of anxiety: if doctors and nurses are getting infected, what chance does the general public have? In some areas, hospitals are regarded as incubators of infection and are shunned by patients with any kind of ailment, again reducing access to general health care.

The loss of so many doctors and nurses has made it difficult for WHO to secure support from sufficient numbers of foreign medical staff.

The African Union has launched an urgent initiative to recruit more health care workers from among its members.

WHO media contacts:
Gregory Hartl
Telephone: +41 22 791 4458
Mobile: +41 79 203 6715
Email: hartlg@who.int

Fadéla Chaib
Telephone: + 41 22 791 3228
Mobile:+ 41 79 475 55 56
Email: chaibf@who.int

Tarik Jasarevic
Mobile: +41 793 676 214
Tel: +41 22 791 5099
E-mail: jasarevict@who.int

http://www.who.int/mediacentre/news/ebo ... t-2014/en/

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PostPosted: Mon Aug 25, 2014 7:09 pm 
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Airborne Transmission of Ebola
by Ronald R. Cherry, M.D.

http://www.americanthinker.com/2014/08/airborne_transmission_of_ebola.html


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PostPosted: Mon Aug 25, 2014 9:01 pm 
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Location: Pittsburgh, PA USA
WHO: Medical worker infections and shortages hamper Ebola response

Filed Under: Ebola

Lisa Schnirring | Staff Writer | CIDRAP News | Aug 25, 2014


Two medical workers assisting with the Ebola outbreak response in Sierra Leone have been sickened by the disease, one of them deployed by the World Health Organization (WHO) and the other a British nurse who was airlifted to a London hospital for treatment.

News of two more infected aid workers comes as the WHO today expressed heightened concerns about the impact the outbreak is having on health workers battling the disease and obstacles the infections pose to getting enough workers from overseas to staff treatment centers.

Response worker infections

According to media reports, the WHO-deployed health worker is an epidemiologist from Senegal. The WHO said on its Twitter feed that the worker is with the Global Outbreak Alert and Response Network (GOARN). In a statement yesterday the WHO said it was working to ensure that the patient, who got sick in Sierra Leone, has the best care possible, with the option of medical evacuation if needed.

The health worker was in Kailahun district tracing Ebola virus disease (EVD) cases, according to Politico SL, a newspaper based in Sierra Leone. The district has been one of Sierra Leone's EVD hot spots.

The WHO said it has so far deployed about 400 staff members of its own and from partner organizations, and the patient is the first of that number to be infected in the outbreak. It added that it recognized the risk Ebola virus poses to health workers and takes many precautions before they deploy to help them protect themselves in the field.

Meanwhile, Public Health England (PHE) yesterday said a British national living in Sierra Leone has been diagnosed with EVD and is being medically evacuated to the United Kingdom, to be treated in an isolation unit at the Royal Free NHS Foundation hospital in London. It said the patient was not currently in serious condition.

John Watson, MBBS, MSc, PHE's deputy chief medical officer, said in the statement that the UK has a robust, well-tested system for handling unusual infectious diseases and that the country's hospitals have a proven record of managing imported infectious diseases. "This patient will be isolated and will receive the best care possible."

The PHE said it would provide no other details about the patient, to protect the patient's privacy. However, according to a media report, the patient is a man who has been working as a volunteer nurse at Kenema Government Hospital over the last 3 months.

The British patient is the fifth medical worker to be flown out of West Africa because of EVD. The others are two Americans who worked for a Christian missionary group, both of whom have recovered, a Spanish priest who died from his infection, and a Spanish nun who reportedly did not have EVD.

WHO details burden on workers, outbreak challenges

The WHO today singled out the high burden the disease has had on health workers as one of the outbreak's unprecedented features. More than 240 healthcare workers have been sickened by Ebola virus disease (EVD) in the four West African countries affected by the event, the agency said. More than half of them have died. Among them have been some of the top doctors in Liberia and Sierra Leone.

Several factors explain the high toll the disease is taking on medical staff, the WHO said. They include shortages and improper use of personal protective equipment (PPE), too few medical staff to respond to the outbreak, and compassion that prompts health workers to work in isolation wards beyond the number of hours recommended for safety reasons.

Aside from shortages, the PPE is hot and cumbersome, especially in tropical climates, pushing clinicians beyond their physical limits, with some working 12-hour shifts. "Staff who are exhausted are more prone to make mistakes," the WHO said.

Medical staff and the people in West Africa aren't familiar with EVD, given that the current outbreak is the region's first, the WHO said. Also, other diseases in the area such as malaria have symptoms that often resemble the initial symptoms of EVD, and patients often seek emergency care in settings where doctors and nurses don't initially suspect Ebola and aren't taking protective measures against the disease.

The heavy toll on medical staff is complicating response efforts, because it not only depletes personnel who can treat sick patients, but also makes it difficult for the WHO to secure foreign workers to come to West Africa to help with the outbreak. The WHO added that the African Union has launched an urgent push to recruit more health workers from its member countries.

CDC advice for humanitarian workers

In view of the risk to health workers and other outbreak responders, the US Centers for Disease Control and Prevention (CDC) on Aug 23 issued advice for humanitarian workers traveling to the outbreak countries to assist with the EVD response. It urged people planning trips to the region to consult a travel medicine doctor beforehand to discuss individual recommendations based on medical history and travel plans.

The CDC said humanitarian workers should pack a basic first aid kit. If they expect to work in a healthcare setting where close contact with EVD patients could occur, travelers should ensure that the organization will provide PPE, and if not, workers should pack them and bring them along. It urged workers to check their health insurance plans, or those of their organization, and to purchase one if not fully covered. Workers should also ask organizations about medical evacuation plans.

The CDC's advice also covers special recommendations for health workers, what to do if a worker gets sick during the trip, and what steps to take when returning to the United States.

Alternative treatment developments

In other medical developments, an official from Liberia's health ministry said today that a doctor who received the experimental EVD drug ZMapp has died, Agence France-Presse (AFP) reported. The country's information minister, Lewis Brown, told AFP that the doctor had been improving, but died last night. Two other health workers who received the drug are still being treated and show encouraging signs.

A WHO ethics panel has given the green light to the use of experimental drugs and vaccines in the outbreak, but it has also warned that supplies are extremely limited and that the therapies aren't expected to have an impact on the course of the outbreak. However, the group will host a meeting in Geneva on Sept 4 and 5 to discuss the most promising treatments, safety and efficacy issues, and possible ways to speed up clinical trials.

Meanwhile, Japan's government today said it can provide a Japanese-developed antiviral drug, if the WHO requests it, the Associated Press (AP) reported yesterday. The drug favipiravir is approved in Japan for treating new and reemerging influenza viruses.

Chief Cabinet Secretary Yoshihide Suga said Japan is watching for more details from the WHO on the use of untested drugs and in the case of an emergency can respond to individual requests before any decisions from WHO.

The drug's developer, Toyama Chemical Co., a subsidiary of Fujifilm, is talking with the US Food and Drug Administration (FDA) about clinical tests of the drug for treating EVD, a company spokesman told the AP. The company has enough of the drug to treat 20,000 patients.

See also:

Aug 25 WHO Ebola situation assessment

Aug 24 WHO statement

Aug 24 Politico SL story

Aug 24 PHE statement

Aug 23 CDC advice for humanitarian workers

Aug 25 AFP story

Aug 24 AP story

http://www.cidrap.umn.edu/news-perspect ... a-response

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PostPosted: Tue Aug 26, 2014 12:21 am 
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Press briefing discusses logistic problems due to flight restrictions

http://webtv.un.org/media/watch/daily-p ... 7903862001

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PostPosted: Tue Aug 26, 2014 3:53 am 
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Joined: Mon Aug 04, 2014 5:45 pm
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Location: Lisbon, Portugal
I am still insisting on sweat transmission during asymptomatic stage. I hope someone, somewhere, does lab work on this.


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PostPosted: Tue Aug 26, 2014 9:32 am 
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GENEVA,Aug. 26 (Xinhua)-- The World Health Organization (WHO) on Tuesday said in a statement that the Ebola outbreaks in West Africa is unprecedented in many ways, including the high proportion of doctors, nurses, and other health care workers who have been infected.

To date, more than 240 health care workers have developed the disease in Guinea, Liberia, Nigeria, and Sierra Leone, and more than 120 have died.

WHO said the deadly virus has taken the lives of prominent doctors in Sierra Leone and Liberia, depriving these countries not only of experienced and dedicated medical care but also of inspiring national heroes.

WHO noted shortages of personal protective equipment or its improper use, far too few medical staff for such a large outbreak, and the compassion that causes medical staff to work in isolation wards far beyond the number of hours recommended as safe contributed to the high proportion of infected medical staff.

WHO said capital cities as well as remote rural areas are affected, vastly increased opportunities for undiagnosed cases to have contact with hospital staff.

In many cases, medical staff are at risk because no protective equipment is available, not even gloves and face masks. Even in dedicated Ebola wards, personal protective equipment is often scarce or not being properly used.

In addition, personal protective equipment is hot and cumbersome, especially in a tropical climate, and this severely limits the time that doctors and nurses can work in an isolation ward. Some doctors work beyond their physical limits, trying to save lives in 12-hour shifts, every day of the week. Staff who are exhausted are more prone to make mistakes.

The loss of so many doctors and nurses has made it difficult for WHO to secure support from sufficient numbers of foreign medical staff.

According to WHO, the African Union has launched an urgent initiative to recruit more health care workers from among its members.

http://www.globalpost.com/dispatch/news ... cted-ebola

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