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PostPosted: Thu Aug 28, 2014 3:54 pm 
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Media reports describe the folly of the Ebola quarantine of West Point.

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PostPosted: Thu Aug 28, 2014 4:00 pm 
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As Ebola Grips Liberia’s Capital, a Quarantine Sows Social Chaos
By NORIMITSU ONISHIAUG. 28, 2014
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A burial team removes the body of an Ebola victim from an isolation ward in Monrovia, Liberia. Credit Daniel Berehulak for The New York Times

MONROVIA, Liberia — Some people are swimming in and out of the Ebola quarantine zone in this seaside capital. One man slips out every day to reach his job at a Western embassy. Another has turned his living room into a tollbooth, charging others to escape through his apartment at the edge of the cordoned area. Countless others have used a different method: bribing their way out with fees that soldiers determine according to a person’s appearance, circumstances and even gender.

Christian Verre, a 26-year-old clothing salesman, sneaked out through an abandoned building with his girlfriend, Alice Washington, 21, and eight friends. “Go back! Go back!” soldiers and police officers yelled, he recalled, but the conversation quickly took on a different turn: “What do you got?”

Those carrying goods handed over more than $8, Mr. Verre said. Traveling light, he was charged $4.25 for his girlfriend and about $6 for himself, “because I’m a man.” The couple now share a shack a few blocks outside West Point, the vast, sprawling slum that was placed under an Ebola quarantine last week.

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Residents, of the quarantined slum West Point in Monrovia, confront an official representing President Ellen Johnson Sirleaf. Credit Daniel Berehulak for The New York Times
“I didn’t want to stay in West Point for 21 days,” he said, referring to Ebola’s maximum incubation period. “I wouldn’t die of Ebola but of hunger.”

The five-month outbreak here in West Africa, already worse than all other Ebola epidemics combined, is for the first time spreading uncontrollably in a major city — one in which a third of Liberia’s 4.5 million people is estimated to rub shoulders, often uneasily. Though Ebola reached Monrovia three months after its appearance in the rural north, the city has become, in a few short weeks, a major focal point of the epidemic.

The outbreak has overwhelmed the government of President Ellen Johnson Sirleaf, who has won the Nobel Peace Prize and the admiration of leaders around the world. But her management of Liberia has long drawn criticism at home, and now her handling of the Ebola epidemic has presented her with a political crisis that is galvanizing her opposition.

“We suffering! No food, Ma, no eat. We beg you, Ma!” one man yelled at Ms. Johnson Sirleaf as she visited West Point this week, surrounded by concentric circles of heavily armed guards, some linking arms and wearing surgical gloves.

“We want to go out!” yet another pleaded. “We want to be free, Mama, please.”

International Ebola experts and her own health officials advised against imposing the quarantine in West Point, worried that it would antagonize a population whose cooperation the government desperately needs to stop the epidemic. But Ms. Johnson Sirleaf sided with the army, which was the strongest proponent of the quarantine and took the lead in enforcing it, especially in the first two days.

“Putting the police and the army in charge of the quarantine was the worst thing you could do,” said Dr. Jean-Jacques Muyembe, a Congolese doctor who helped identify the Ebola virus in the 1970s, battled many outbreaks in Central Africa and has been visiting Monrovia to advise the government. “You must make the people inside the quarantine zone feel that they are being helped, not oppressed.”

Isolating communities has succeeded in some rural areas in past outbreaks in Central Africa. But the quarantine of an entire urban neighborhood, where an estimated 60,000 to 120,000 people are crammed into crumbling shacks, has proved to be more than just porous. It has also led to deadly clashes with soldiers and may even be helping spread the disease, experts say, forcing people to crowd together for basic humanitarian aid, like food relief.

Cordoned off from the city, young men in West Point squeeze together in dense lines for rice and water, pushing and shoving, sweat mixing, saliva flying, blood sometimes spilling. One morning, a man in a wheelchair trying to cut to the front was beaten, stripped and left sprawled in the middle of the road, urinating over himself.

“The quarantine is going to worsen the spread of Ebola,” said Dr. Muyembe, the director of the National Institute for Biomedical Research in Kinshasa, Democratic Republic of Congo. “It’s difficult to understand the motivation behind it. It’s simply not a good strategy.”

Lewis Brown, the Liberian minister of information, said the president made the decision based on both health and security concerns. Though Ebola has been spreading throughout other parts of the city, he said, the government singled out West Point because of its dense population and its potential for political instability, as shown when residents recently stormed an Ebola holding center that they did not want in the neighborhood.

“We’re not saying that Ebola is any more present in West Point than other places in the country — that’s not the argument we’re making,” Mr. Brown said. “But the potential is in the size of the area and the interaction with the city itself.”

He added: “We’re not claiming to be experts on Ebola. We’ve never had to deal with this kind of thing, but we’ve always had to deal with our people. We understand our people more than we understand this disease.”

Ms. Johnson Sirleaf has made no public statement since the start of the quarantine and the fatal shooting of a 15-year-old West Point boy, Shakie Kamara, who was caught in a battle between soldiers and men trying to break out of the quarantine zone.

During her visit to West Point, she apologized to his family and looked at those calling for help with sympathy in her eyes, saying little. Walking several feet behind her, a man in a checkered shirt pulled out Liberian dollar bills from a backpack with his gloved hand and tossed the money to the loudest protesters. The money silenced their criticism but immediately set off fistfights.

A Toyota Land Cruiser took the president out of West Point. Her guards and entourage followed on foot, tossing their used gloves on the ground on their way out.

No one knows yet why Ebola has succeeded in spreading at such an alarming rate here in the capital. Ebola has reached the capital cities of Freetown, Sierra Leone, and Conakry, Guinea — the two other West African nations most affected by the current outbreak — but the disease has been more effectively contained in those cities.

The first cases in Monrovia were reported only in June. Infections have multiplied quickly here in recent weeks, illustrating the speed with which Ebola can spread in a major urban area. The county containing Monrovia quickly registered the nation’s biggest death toll — now 274 deaths out of a national total of 754, according to the Ministry of Health.

“The Conakry outbreaks have been very small, and they haven’t exploded in Freetown,” said Dr. Armand Sprecher, an Ebola expert for Doctors Without Borders here. “So something is different in Monrovia. It’s something in the disease transmission behaviors in Monrovia that has done this. That’s my guess. We’ve never seen this kind of explosion in an urban environment before.”

Others point to a political system long dominated by an elite out of touch with the population and more focused on jockeying for power. Politicians, including members of the president’s own party, publicly expressed doubts about the extent of the outbreak and even accused her administration of exaggerating it to collect money from international donors.

Among Liberians, still grappling with the consequences of a 14-year civil war that ended in 2003, distrust of the government runs deepest in Monrovia’s poorest neighborhoods. Despite billboards and posters throughout the city declaring that “Ebola is Real,” many Liberians believe it is not.

Dr. Moses Massaquoi, who has been heading Ebola case management for Liberia’s health ministry during the crisis, said that high-level political denials delayed the expansion of a treatment center just as cases mushroomed last month.

“Unfortunately, Ebola is not waiting for politics,” he said. “That was a missed window of opportunity.”

As the situation worsened in the capital in mid-August, the government established the city’s first Ebola holding center in West Point, Monrovia’s biggest slum and political opposition stronghold. Locals ransacked and closed down the center within days.

On Aug. 20, under the president’s orders, the army and police placed West Point under quarantine — the first time, some experts say, that a quarantine was attempted on such a scale. West Point reacted with fury: hundreds of young men tried to storm through the barricades. As soldiers fired live rounds to drive them back, the 15-year-old boy, Shakie, was killed. Only heavy rain starting around noon put a stop to the riots.

In rural areas, quarantining communities can work if they are small enough and unified under political or traditional leadership, experts say.

“What is important is for the people to participate in the process; otherwise it becomes too difficult to implement effectively,” said Dr. Nestor Ndayimirije, the World Health Organization’s director for Liberia.

A week into the quarantine of West Point, life has been getting harder for those without the means or connections to get out. The price of goods that find their way into the quarantine zone — rice, water, coal, prepaid cellphone cards, soap — has doubled.

“People are fighting for food to eat,” said Victor Nwanodu, who owns one of West Point’s most popular public toilets and baths. Business has dropped, he said, as people can no longer afford to pay for a hot bath.

Serena Wallo, 31, was one of a few dozen people whose houses were washed away this week along West Point’s heavily eroded shoreline. Unable to leave the quarantine zone, her family now has to stay with friends in the area, in the kind of overcrowded conditions where Ebola thrives.

“I’m not happy with the government,” Ms. Wallo said. “They are treating us like we are slaves.”

A Political Backlash

Like her counterparts in Sierra Leone and Guinea, Ms. Johnson Sirleaf was dealing with Ebola for the first time. She decided to do so with a firm hand by deploying the army — an institution that remains troubled despite being rebuilt after the civil war with American training and hundreds of millions of dollars in American assistance.

Mr. Brown, the information minister, said that it was necessary for the army to take the lead in the first couple of days of the quarantine. “If the military had not backed up the police the way they did, probably not only West Point would have been overrun, but the city center would have also been overrun,” he said.

But the president’s handling of the crisis is drawing new political challenges and leading to defections. Political parties and newspapers are calling for her resignation. This week, Ms. Johnson Sirleaf announced she had fired high-ranking government officials who refused to return to Liberia because of the Ebola outbreak. Though she inspired great hope among Liberians when she was first elected in 2005, becoming the first woman elected head of state in Africa, the crisis has fueled longstanding criticism that her reputation abroad was inflated by foreigners with little knowledge of the conditions in Liberia.

“This Ebola thing now has basically laid the thing out like this: the system is bad and the emperor has no clothes,” said Samuel P. Jackson, who served as an economic adviser to the president until the end of July but is now backing, Benoni Urey, a businessman believed to be Liberia’s richest man and a candidate in the next presidential election.

Mr. Urey, who for months has been criticizing the government’s handling of the outbreak, said Ms. Johnson Sirleaf “must take the ultimate blame for everything.” One of the greatest sources of public anger, he pointed out, has been the government’s inability to pick up the bodies of the Ebola dead, which have often been left in people’s houses or even dumped on public streets.

“Come on!” Mr. Urey said, calling it an example of the government’s incompetence.

Jerolinmek Piah, the president’s press secretary, said that Ms. Johnson Sirleaf was no longer giving interviews.

In a very brief exchange, Ms. Johnson Sirleaf said of the quarantine in West Point, “We are trying to make it go well.”

Little the Hospital Could Do

Shakie Kamara, the 15-year-old boy who was killed in the clashes in West Point, was raised by his aunt. His mother died when he was a toddler, and his father a couple of years later.

On the morning of his own death, Shakie had gone to buy tea and bread for his aunt at a shop near the entrance to West Point, but apparently got caught between a crowd of rock-throwing men and soldiers firing live rounds.

“No pa, no ma,” he said, pleading for help as he lay on the ground with wounds to both legs.

The defense ministry said the wounds were caused by barbed wire. But Dr. Mohammed Sankoh, the medical director of Redemption Hospital, where Shakie died, and two other hospital staff members said that the boy died after suffering deep bullet wounds. There was little that the hospital, where a doctor and several nurses had died recently of Ebola, could do, hospital workers said.

“There was no material in the emergency room,” said Dr. Alphonso Gray. “The theater was not operating.”

While visiting West Point, the president promised Shakie’s family an investigation into his death.

Shakie’s older brother, Lusine Kamara, 27, said he told the president he wanted nothing — just Shakie’s body for a proper funeral. Shakie’s aunt, Eva Nah, left the door open.

“She told me that after everything, she will get back to me,” Ms. Nah said.

A couple of hours later, the military released Shakie’s body to his family, and he was buried at Monrovia’s Muslim cemetery.

http://www.nytimes.com/2014/08/29/world ... .html?_r=1

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PostPosted: Thu Aug 28, 2014 4:04 pm 
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Quarantining an entire Liberian slum to fight Ebola is a recipe for disaster

By Amesh Adalja August 28 at 3:18 PM

An aid worker tosses a small bag of water to quarantined West Point residents last week. (Abbas Dulleh/AP)
As the Ebola outbreak spread beyond its control, the Liberian government took the extraordinary step last week of quarantining the entire slum of West Point, an area near the capital of Monrovia, with barbed wire and wooden barricades. With 70,000 people trapped, rioting ensued. A teenager died after he was shot by troops enforcing the cordon.

A county in North Carolina is quarantining anyone who worked with or around Ebola-stricken West African patients in an RV park, regardless of whether they show symptoms of contracting the disease.

Such moves have obvious appeal to a public worried about an incurable disease that kills 60 percent of the people who contract it. But in fact they make matters worse. The quarantine in West Point is a recipe for disaster.

A vestige of the Middle Ages, the term “quarantine” originates with the Black Death, the calamitous outbreak of plague that decimated Europe in the 14th century. To ensure that plague was not introduced into a port, ships in the harbor were forced to wait 40 days before they were allowed to disembark passengers.

But a quarantine, or cordon sanitaire, restricts the movement of individuals who may be healthy and pose no risk to others, such as those in North Carolina's Mecklenburg county. Quarantining individuals who have no symptoms is not justified. It is not evidence-based.

Much worse, it may prohibit the critical basics of civilized society from entering the quarantined region, as is happening in West Point. There, the situation is much more dire, with water, food and medical supplies becoming scarce in the quarantine zone. Total breakdowns in law and order, barbarism and lethal force exerted against those who defy orders are serious concerns in quarantined regions.

Even worse, a disease like Ebola, free of the sterilizing effects of civilization, can flourish in such environments, where bodies, waste and refuse collect. This provides ample opportunity for the virus to prey on healthy people, potentially increasing the burden of infection. And those healthy people quarantined may turn against their government, which is violating the very liberty it is constituted to protect.


Where quarantine, or more accurately, "isolation" is effective is in the treatment of individuals with symptoms of contagious diseases, who must be separated from others to decrease the spread of infection. Quarantine periods are ended when it is apparent that the individuals are free from disease. Isolation can be applied to a contagious tuberculosis patient, for example, who represents a true risk of spreading the infection to others. In fact, authorities in California's Santa Barbara County issued an arrest warrant last week for a tuberculosis patient who discontinued his treatment and vanished.

While decisive action is needed to combat Ebola and other diseases, the quarantine of a geographic location applied to people without evidence of infection functions not to control disease but to promote its further development.

Amesh Adalja is an infectious diseases physician at the University of Pittsburgh Medical Center (UPMC) and a faculty member in the Division of Infectious Diseases at the University of Pittsburgh School of Medicine. He is on Twitter @AmeshAA and his blog www.trackingzebra.com.

http://www.washingtonpost.com/news/to-y ... 30406038=1

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PostPosted: Thu Aug 28, 2014 5:22 pm 
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Ebola outbreak: Why Liberia's quarantine in West Point slum will fail

A relic of the Middle Ages, quarantines do more harm than good

By Amber Hildebrandt, CBC News Posted: Aug 25, 2014 5:00 AM ET| Last Updated: Aug 25, 2014 10:02 AM ET
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Last week, military personnel set up a barricade around the West Point slum in Liberia, but medical experts say there's no proof the medieval measure is effective. (Abbas Dulleh/The Associated Press)

Medical experts say that mass quarantine is rarely if ever effective in stemming the spread of a contagion like Ebola, and the move by Liberia to cordon off a sprawling slum is likely to do more harm than good.

"It's a measure that basically goes back to the Middle Ages. It's a reflection really of ignorance and panic," said Dr. Richard Schabas, formerly chief medical officer for Ontario and now in that role in Hastings and Prince Edward counties.

"Mass quarantine of this kind really has no place at all in disease control."

The concept of quarantine "has an intuitive appeal to a layperson, and leaders of these countries are lay people," adds Dr. William Schaffner, a Vanderbilt University professor of preventive medicine.

"But the practical aspects of implementation are very substantial and there aren't any data that would tell you securely that this works."

What's more, he suggests, the measure will also likely foment further public mistrust of the government.

Liberia is already struggling with fallout over its move to try to contain the spread of Ebola with a barricade around the West Point slum, located near the capital city of Monrovia.

Image
A woman sits with a baby on Monday in the West Point area that has been hardest hit by the Ebola virus spreading in Monrovia, Liberia. (Abbas Dulleh/The Associated Press)

Clashes broke out in West Point after Liberia's military set up the barricade late Tuesday using scrap wood and barbed wire. Officials patrolled the expansive coastline to prevent the more than 70,000 residents from fleeing in canoes.

Several residents were shot during the unrest, including a 15-year-old boy who later died. Food prices in the crowded peninsula have skyrocketed.

Liberia — one of the poorest countries in the world and long wracked by civil war — has been the hardest hit of the four West African nations suffering under the five-month-long Ebola epidemic. As of Friday, the country had incurred 624 of the 1,427 deaths.

Desperate to control the spreading epidemic, the government has quarantined both remote villages in the northern Lofa County as well as the West Point slum, creating what some humanitarian workers dubbed "plague villages."

Sierra Leone and Guinea have also set up quarantine zones in areas severely affected by Ebola to try to reduce the chance of people spreading the virus outside their borders.

Quarantine during SARS 'damaging'

Dr. Schabas stresses that isolation — the act of segregating a person showing symptoms of the disease — is key to containing infections.

But he argues there is no scientific proof that a quarantine — separating an entire category of people on the assumption they may be incubating the disease — is effective in zoonotic diseases (that can be transmitted between species) like Ebola.

Sierra Leone West Africa Ebola
Ebola can only be transmitted when a patient is showing symptoms of the disease. That's why some say patient isolation is a better way to control the spread of the disease. (Michael Duff/Associated Press)

As the World Health Organization has noted, a person infected with Ebola can only spread the virus once he or she starts to show symptoms. Transmission comes from contact with the bodily fluids of an infected person, whether dead or alive, or from animals.

It's believed that fruit bats are the carriers of Ebola, and that residents of the region may have caught the disease while handling the animals to cook the bush meat.

Schabas notes that a mass quarantine was tried during the 2003 outbreak of SARS in Toronto, with about 30,000 people ordered to stay home. But the measure failed.

"It involved a huge disruption and huge investment of public health resources," said Dr. Schabas. "It created the perception that SARS was more dangerous and more widespread than it was. It triggered things like travel advisories, which were economically damaging."

Dr. Schabas argues that for a quarantine to be useful, it has to make sure people comply with quarantine conditions, and the infectious disease must be transmissible when patients don't yet show symptoms. Neither SARS nor Ebola is transmissible when a patient is asymptomatic.

Medieval measure

Cordoning off a community to protect it or the outside world from the spread of an infectious disease is a Medieval measure dating back to the Black Death pandemic that killed up to 200 million people in the 14th century.

There have been other attempts to close off towns and villages in following centuries, including a rare instance in the British village of Eyam in the 1660s when villagers voted to voluntarily quarantine themselves.



Medical supplies to fight the Ebola epidemic from a USAID cargo flight are unloaded on Aug. 24, 2014 in Harbel, Liberia. International aid agencies and the Liberian government are struggling to keep up with the rapidly-expanding Ebola epidemic - a deadly virus that has killed nearly 1,430 people in West Africa, according to figures released Friday by the WHO.
Liberians quarantined in the West Point township in the capital, Monrovia, wait for relatives to deliver food and personal items on Aug. 23. Authorities began allowing deliveries after locals complained they were not receiving enough basic necessities. The Liberian government sealed the neighborhood on Aug. 20, spurring violent clashes between armed Ebola Task Force members and angry residents.
A UN soldier prepares a truckload of Ebola relief aid after it was airlifted by UNICEF on Saturday in Harbel, Liberia. The cargo plane arrived from Belgium carrying 68 tonnes of medical and hygiene supplies to help contain the worst Ebola epidemic in history.
Burial teams disinfect themselves before burning the bodies of Ebola victims at a crematorium on Aug. 22 in Marshall, Liberia. More Liberians have fallen victim to the deadly virus than any other West African country.
A Doctors Without Borders worker in protective clothing ushers in people requesting to be tested for the Ebola virus at the MSF treatment center on Aug. 22 near Monrovia. The MSF center had to turn patients away on Friday after reaching capacity.

They circled the town with piles of stones to prevent the spread of the plague beyond its border. Three-quarters of the 350 townspeople died.

But, as Joseph Byrne, a historian at Nashville's Belmont University, notes "most of the cordoning off [in history] occurred before germs were understood to be the cause."

"There were other more effective ways of dealing with disease from the late-1800s on, rather than simply saying, 'Well, let's seal off an area'," said Byrne. "I think that's why there aren't many contemporary attempts to do that."

There is also little research pointing to the effectiveness of quarantines, and many questions about not only infringing on individuals' human rights but physically harming them and spreading mistrust in the authorities.

Keeping West Point — a densely packed stretch of land largely bordered by the Atlantic Ocean — secure over a lengthy period of time, perhaps weeks, will pose a major challenge.

Among them will be trying to stop townspeople from trying to bribe their way out.

As well, the 24-hour security will stretch government coffers and those inside the barricades may suffer. Some work outside the township and so will lose income while food costs are soaring and general frustration is rising.

Distrust and misunderstanding of the disease is already hindering attempts to get the outbreak under control. Families are hiding relatives suspected of being infected, fearful of the stigma attached to Ebola.

Some believe the virus is a hoax, and many infections are happening because family members touch bodies during funeral rites.

Dr. Keith Martin, a former Liberal MP who now heads the Washington-based Consortium of Universities for Global Health, says isolating a small group of unhealthy people with a large group of healthy residents can cause more harm than good if they don't get access to food, water and medical care — all of which are in increasingly short supply as groups like Doctors Without Borders have pointed out.

"Quarantining a large area like West Point in the way that it's done can contribute to the death rate because you're essentially isolating healthy and unhealthy people, and not implementing what's more important — good public health measures," said Martin.

'Biggest bang for buck'

The World Health Organization said that such "extraordinary" measures as quarantine should only be taken when "considered necessary," but countries must take human rights into account if they resort to quarantines and give residents the necessities of life.

The UN World Food Program is planning to distribute food to an estimated one million people living in quarantine zones in West Africa. But residents have already complained that there's not sufficient food or water, creating the potential for a humanitarian crisis.

Ultimately, the WHO stresses that the primary way to control a disease is "quality clinical care." Though it is advising countries on the health crisis, WHO notes "national authorities take decisions based on their assessment of local conditions."

Dr. Schaffner notes that the oil-rich nation of Nigeria has been successful in containing Ebola by using "standard public health practices." There, medical officials have focused on isolating cases of suspected Ebola, then tracking down and monitoring their contacts with daily temperature checks for the disease.

Though clean water, food, education and good medical care give the "biggest bang for the buck," it's those basic necessities that the poorest countries lack, says Dr. Martin.

That's led them to desperately try to stem the contagion through other means.

"In Liberia, at the present time, they have more soldiers than they have doctors," observes Dr. Schaffner. "So they're using the resources that they have in the hopes that it will do some good."

http://www.cbc.ca/news/world/ebola-outb ... -1.2744292

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PostPosted: Sat Aug 30, 2014 10:32 am 
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A Liberian health worker who recovered from Ebola after receiving an experimental drug urged the manufacturer to speed up its production and send it to Africa, while crowds celebrated in the streets Saturday after authorities reopened a slum that had been barricaded for more than a week to try to contain the disease.

Physician's assistant Kyndy Kobbah was expected to be released from hospital Saturday after she survived Ebola, which has been fatal in more than half the cases sweeping West Africa. Kobbah contracted the disease while working at a government-run hospital north of the capital.

In an interview with The Associated Press before her release, Kobbah urged the manufacturer of the experimental drug known as ZMapp to step up production. The company has said that all its supplies are exhausted and it will take months to make more.

"They need to make more Zmapp and send to us," she said.

Doctors have said there is no way to know whether ZMapp made a difference or if survivors like Kobbah recovered on their own, as about 45 percent of people infected in this outbreak have. The drug had never been tested in humans before it was given to two Americans who were infected with Ebola in Liberia. They survived Ebola and were released from an Atlanta hospital.

However, a study released online Friday by the journal Nature found that ZMapp healed all 18 monkeys infected with the deadly virus.

Meanwhile, tensions diminished Saturday in the West Point neighborhood of Liberia's capital after authorities lifted a blockade that had sparked unrest. Residents living in the area had feared running out of food and safe water on the peninsula.

Liberia's president had ordered the barricade on Aug. 19 after West Point residents stormed an Ebola health center several days earlier. Residents said they did not want sick people being brought into the community, although those staying at the center were only under observation during a 21-day incubation period.

Amid the melee, some protesters made off with blood-stained mattresses and other materials that could potentially spread the Ebola virus.

Lifting the quarantine Saturday morning doesn't mean there is no Ebola in the West Point slum, said Information Minister Lewis Brown. Authorities, though, are more confident now that they can work with residents to screen for the sick, he said.

"They're comfortable with the way the leadership and the community is working with the health team to make sure that the community remains safe," he said.

Liberia has been the hardest hit of the five countries with Ebola cases in West Africa, reporting at least 694 deaths among 1,378 cases. More than 3,000 cases have been reported across Liberia, Guinea, Sierra Leone and Nigeria, and on Friday Senegal announced its first case.

A student from Guinea who had been missing for several weeks showed up at a hospital in Dakar on Tuesday, seeking treatment but concealing that he had been in contact with other Ebola victims, Health Minister Awa Marie Coll Seck confirmed.

The next day, an epidemiological surveillance team in neighboring Guinea alerted Senegalese authorities that they had lost track of a person they were monitoring three weeks earlier, and that the person may have crossed into Senegal.

The student was tracked down in the Dakar hospital where he was confirmed with Ebola and immediately put into isolation where he is reported to be in satisfactory condition, Seck said. Authorities also sent out a team to disinfect the home where he was staying in Senegal.

———

Associated Press writer Babacar Dione in Dakar, Senegal contributed to this report.

http://abcnews.go.com/Health/wireStory/ ... l-25183370

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