Ebola: healthcare workers go on strike over safety fears

A volunteering medical team in Sierra Leone

WHO is worried about the 'unprecedented' number of infected healthcare workers in West Africa

LAST UPDATED AT 14:09 ON Mon 1 Sep 2014

Healthcare workers at a large state-run hospital at the centre of the Ebola outbreak in Sierra Leone have gone on strike over pay and hazardous working conditions.

They say they are not being provided with adequate protection against the disease after more than 20 health care workers died from the disease, ITV reports.

"The workers decided to stop working because we have not been paid our allowances and we lack some tools," adds Ishmael Mehemoh, chief supervisor at the clinic in the city of Kenema in the east of the country.

The deadliest Ebola outbreak on record has now infected over 3,000 people and killed more than 1,500. The World Health Organization (WHO) has said that it is concerned about the "unprecedented" number of doctors and nurses who have been affected. So far 240 have been infected and 120 have died.

Separately, the British Red Cross is appealing for doctors and nurses with experience of "acute-care and working in a resource-poor setting" to join their team of healthcare workers battling Ebola in the same Sierra Leonean city.

In other developments:

  • In extensive animal tests, the experimental drug zMapp was proven to be "100 per cent effective" in treating the disease. It has yet to be clinically tested on humans but has been given to a handful of health workers.
  • Two Liberian doctors have been released from hospital and no longer test positive for the disease after receiving the experimental drug zMapp. Dr Senga Omeonga and Kynda Kobbah were infected while treating patients but have now made a full recovery, CNN reports.
  • In Sweden, a man returning from West Africa thought to have the disease has tested negative.
  • Ivory Coast is being threatened with expulsion from the Africa cup of Nations for refusing to play against Sierra Leone "because of fears over Ebola", BBC sport reports.

Ebola virus outbreak spreads to Senegal 

    29 August

    The first case of Ebola has been confirmed in Senegal, making it the fifth country in West Africa to be affected by the outbreak of the virus, according to Reuters.

    The country's Health Minister Awa Marie Coll Seck said the victim had arrived in Senegal from neighbouring Guinea, where the deadly outbreak began in March.

    The young man was immediately quarantined and health officials are working to find people he may have come into contact with.

    Senegal had previously shut its borders with Guinea, but has not been able to stop people travelling to its cities, which are major trade and transport hubs.

    At least 3,000 people have now been infected with the disease across West Africa and over 1,500 have died. The World Health Organisation has warned that outbreak could accelerate, ultimately infecting upto 20,000 people.

    Ebola virus factfile 

    What is the Ebola virus and what are the symptoms? 

    The World Health Organization describes Ebola as "a severe acute viral illness". Early symptoms are similar to malaria and include the sudden onset of fever, intense weakness, muscle pain, diarrhoea, vomiting and both internal and external bleeding.

    Is there a cure? 

    There is no known cure or vaccine for the virus and the disease kills between 25 and 90 per cent of its victims. The only treatment doctors can offer is "supportive intensive care" such as rehydration of infected patients under strict quarantine.

    Where did it come from? 

    Scientists believe it was initially present in wild animals such as fruit bats living in tropical rainforests in equatorial Africa. The disease spread to humans when they came into contact with the organs, blood or other bodily fluids from infected animals through hunting.

    How is it spread? 

    Ebola is highly infectious. It can be transmitted through contact with the blood, bodily fluids and organs, including skin, of sufferers or through indirect contact with environments contaminated by the disease. The disease can also have a long incubation period, up to three weeks, which allows it to spread rapidly before diagnosis and quarantine can take place.

    Ebola cases could rise to 20,000, warns WHO

    28 August

    Cases of the Ebola virus could exceed 20,000 as the disease continues to spread at an "alarming" rate across West Africa, the World Health Organization has warned.

    The view was echoed by US health officials. "The cases are increasing. I wish I did not have to say this, but it is going to get worse before it gets better," Tom Frieden, the director of the Centres for Disease Control and Prevention told Al Jazeera in Liberia.

    Over 1,500 people are known to have died in the deadliest Ebola outbreak in history and over 3,000 people have been infected, with 40 per cent of those cases occurring in just the last few weeks. The fatalities already include 120 health workers.

    The news comes as health ministers from across the region meet in Ghana for the second time in the last few months to co-ordinate a response to the crisis.

     In other developments:

    • Human safety trials for a new Ebola vaccine developed by GlaxoSmithKline are set to begin next week.
    • The British nurse Will Pooely who is being treated at a London hospital has been given the same experimental drug zMapp used to treat two American health care workers. It is yet unclear whether the medication contributed to their recovery.
    • In Nigeria the disease has spread to the oil hub of Port Harcourt, the first recorded case outside of Lagos. The country has closed all of its school until mid-October in an effort to contain the outbreak.
    • Several more airlines have suspended flights to the region, with Royal Air Morocco now said to be the only carrier still offering flights from the Liberian and Sierra Leonean capitals. This is despite the WHO's advice that travel and trade bans are not necessary.

    Ebola: WHO calls for screening at borders in West Africa

    19 Aug

    Countries affected by the Ebola outbreak have been asked to introduce exit screenings at all international airports, seaports and major land crossings in order to stop the spread of the disease in West Africa.

    The recommendation comes from the World Health Organization [WHO], which has set up a task force to monitor and contain the outbreak, reports Time magazine. The task force will also be responsible for providing information to governments and transport companies, but it has not so far not called for general travel bans.

    "Any person with an illness consistent with [the Ebola virus] should not be allowed to travel unless the travel is part of an appropriate medical evacuation", the UN health agency said. It added that non–affected countries in the region "need to strengthen the capacity to detect and immediately contain new cases".

    Separately, it has now been confirmed that 17 patients who were freed from a quarantine centre in Liberia last week are indeed missing, the BBC reports. This is despite claims from some health care workers that they had been moved to another facility. The attack on the centre was described as Liberia's "greatest setback" during the current Ebola outbreak by the country's information minister.

    "Assaults on health workers and facilities seriously affect access to health care, depriving patients of treatment and interrupting measures to prevent and control contagious diseases", said the WHO's Dr Richard Brennan.

    The death toll has now risen to 1,229 with 2,240 confirmed cases across Sierra Leone, Guinea, Liberia and Nigeria. Sierra Leone is currently the worst affected nation with 810 cases of Ebola across 12 of the country's 13 districts.

    Ebola: infected patients 'freed' after raid in Liberia

    18 Aug

    Hundreds of people have reportedly raided an Ebola quarantine centre in the Liberian capital of Monrovia and released infected patients, AFP reports.

    An "angry mob" of several hundred people attacked a health centre in city's West Point township on Saturday, but there are conflicting reports about what has happened to the patients.

    Some health officials told the BBC that the patients, who have all tested positive for Ebola, had been transferred to another medical facility. But witnesses and the head of the country's health workers association, George Williams, have claimed that 17 escaped and three were taken away by their families.

    Those responsible for the raid were heard chanting "there is no Ebola" amid claims from locals that the disease was a hoax. Residents had opposed the centre, saying "we told them not to (build) their camp here. They didn't listen to us."

    Blood-stained mattresses, bedding and medical equipment were looted from the health centre, a senior police officer told the BBC. These pose a significant health hazard as the disease is spread by contact with infected bodily fluids. 

    "This is one of the stupidest things I have ever seen in my life," the police source said.

    If the patients have escaped, there are fears that the outbreak will spread to nearby densely populated slums in West Point, where up to 50,000 people live.

    The deadly outbreak has so far killed at least 1,145 people in West Africa, including 413 in Liberia where health officials are struggling to contain the outbreak due to widespread misinformation and fear of the disease.

    In a separate development, Kenya has closed its borders to all incoming travel from Sierra Leone, Guinea, and Liberia. Kenya Airways has also suspended flights to the region, despite advice from the World Health Organization (WHO) not to issue travel bans as the risk remains low. Several other airlines including British Airways and Emirates have already cancelled suspended flights to the region.

     

    Ebola: scale of outbreak has been 'vastly underestimated'

    15 Aug

    The magnitude of the Ebola outbreak in West Africa has been "vastly underestimated", according to the World Health Organization (WHO).

    The WHO said it would be coordinating a "massive" scaling up of the international response after it discovered that the number of reported cases and deaths did not reflect the severity of the outbreak.

    Almost 2,000 people are reported to have been infected and the latest death toll stands at 1,069 across Sierra Leone, Guinea, Liberia, Nigeria and Spain, where a priest infected in Liberia died earlier this week.

    The WHO did not say what it thought the actual number of cases was, but it said it expected the outbreak to continue "for some time", with its response plan extending to several months.

    It said "extraordinary measures" were now needed to contain the outbreak affecting countries that are dealing with "extreme poverty, dysfunctional health systems, a severe shortage of doctors, and rampant fear".

    However, the organisation reiterated that the risk of transmission via air travel remains low. It has advised against travel or trade bans, instead advising countries to provide citizens travelling to the region with accurate information on how to reduce their risk of infection. 

    "Unlike infections such as influenza or tuberculosis, Ebola is not airborne," Dr Isabelle Nuttall, Director of WHO Global Capacity Alert and Response said in a statement. “It can only be transmitted by direct contact with the body fluids of a person who is sick with the disease.”

    In a separate development, two people in Nigeria have died after drinking salt water, rumoured to prevent the disease, according the BBC. Ministers warned the public not believe information from social media that had not been issued by the government or health officials, as fear of the disease spreads across the region.

    Ebola: Canada sends untested vaccine to West Africa

    13 Aug

    Canada has announced that it will donate an experimental Ebola vaccine to the World Health Organization (WHO) to be used in West Africa.

    It said it would be donating between 800 and 1,000 doses of the vaccine but experts have warned that supplies of the drug are limited as it takes months to produce.

    Dr Gregory Taylor, deputy head of Canada's Public Health Agency told Reuters that he believed the drug was a "global resource" to be shared.

    The vaccine has never been tested on humans and Taylor admitted that they have no idea how safe the vaccine is or what the side effects will be, "but in this extraordinary circumstance in Africa right now, we're trying to do everything we can to assist."

    This follows yesterday's decision by the WHO to allow untested and unlicensed drugs to be used in response to the epidemic. It decided that, with West Africa in the grip of the worst-ever Ebola outbreak, it would be ethical to use extend the use of experimental treatments.

    There is currently no proven Ebola vaccine or cure, but several pharmaceutical companies are developing different methods of treating and preventing the disease. 

    Treatments
    • zMapp, a cocktail of antibodies harvested from an infected animal's blood and grown in specially-modified tobacco leaves, works by stopping the virus from entering and infecting new cells. It has been used to treat three Western health care workers, including a Spanish priest who died yesterday, and is being sent to doctors in Liberia.
    • Blood serum is another treatment being considered by the WHO. Serum is part of blood plasma taken from a patient who has recovered from Ebola and is used to treat others as it contains essential antibodies against the disease. It has proven effective in previous outbreaks but the WHO wants stricter safety controls to be introduced.
    • The drug TKM-Ebola, developed by a Canadian pharmaceutical company, works by interfering with the virus's genetic code and stopping it from producing disease-causing proteins, the BBC reports. Human trials were halted earlier this year over safety concerns, but the company announced that the US Food and Drug Administration (FDA) had partially lifted the ban, raising hopes that the drug could be made available to combat the current outbreak.
    Vaccines

    Other vaccines, in addition to the one developed by the Canadian government, are currently in the pipeline. According to the WHO and FDA some clinical trials are being fast-tracked and new vaccines could be made available by 2016.

    Ebola: infected British nurse poses 'little risk' to public

    26 August

    Britain's first confirmed Ebola patient is being treated at a London hospital and is receiving "excellent care", as health officials insist the public risk from the disease remains "very low".

    William Pooley, a 29-year old volunteer nurse from Suffolk became infected while treating patients with the deadly disease at the centre of the Ebola outbreak in Sierra Leone.

    He arrived at London's Royal Free hospital after being flown into RAF Northolt in West London on Sunday night in a specially modified military aircraft, according to the BBC.

    Pooley is being treated at a high-level isolation unit, with a specially designed tent surrounding his hospital bed to contain the disease. The specialist equipment allows doctors to treat Pooley without coming into direct contact with him, Channel 4 reports.

    The UK Department of Health has said that Pooley is not currently "seriously unwell". There is no known cure for Ebola and the treatment is said to involve rehydration, pain relief and other palliative care.

    It is yet unclear whether Pooley will receive any experimental treatment for the disease. The untested drug zMapp was given to two infected American health care workers who recovered and were released from hospital last week, but the pharmaceutical company that produces it has said stocks of the drug had been depleted and will take months to replenish.

    Health experts insist the public risk from Ebola in the UK remains "very low". Professor John Watson, deputy chief medical officer described the NHS systems for dealing with unusual infectious diseases as "robust, well-developed and well-tested".

    "UK hospitals have a proven record of dealing with imported infectious diseases and this patient will be isolated and will receive the best care possible," he said.

    Pooley's co-worker Dr Oliver Johnson told Channel Four that he was a "remarkable man" who had been working tirelessly at "ground-zero" of the outbreak.

    "We consider him a hero," said Gabriel Madiye, the executive director of The Shepherd's Hospice, where he was working. "Somebody who is sacrificing to provide care in very difficult circumstances - when our own health workers are running away." 

    In other developments:

    • The Democratic Republic of Congo has reported cases of the disease, the first outside of West Africa. The current outbreak had previously been confined to Sierra Leone, Liberia and Guinea, with a few isolated cases in Nigeria.
    • One of the Liberian doctors who was given zMapp has died, despite initially showing signs of recovery.
    • Japan has said it is willing to offer its influenza drug favipiravir, or T-705, as an experimental Ebola drug if requested.

    Ebola: did zMapp cure American healthcare workers?

    22 August 

    Two missionary healthcare workers have been released from hospital in Atlanta and cleared of the Ebola virus after receiving the experimental zMapp drug.

    After three weeks in an isolation centre, doctors confirmed that Dr Kent Brantly and Nancy Writebol were now free of the disease and pose no health risk to the public.

    "I am thrilled to be alive, to be well and to be reunited with my family," said Brantly after his release, calling his recovery "miraculous".

    Brantly thanked the medical staff who treated him at Emory University Hospital and credited zMapp for the improvement in his condition. He also said his survival was a "direct answer to thousands and thousands of prayers".

    However, doctors are reluctant to directly attribute the patients' recovery to the drug. "We're all very happy Brantly and Writebol have gotten better", Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told the New York Daily News. "But I think it would be a misperception to say that the drug is the thing that made them well.

    "We don't have any idea whether this helped them get better, had no impact or even, unlikely, made their recovery delayed," he said.

    While Ebola has an extremely low survival rate, ten per cent of people do recover from the disease and Writebol and Brantly could have simply gotten better naturally.

    Dr Bruce Ribner, who runs the infectious disease unit at Emory University Hospital, reminded the public that the drugs were still in an experimental phase and much more research was needed before any conclusions on its effectiveness could be made.

    Stocks of the drug have now been depleted and scientists warn it could take months to produce more.

    What is 'zMapp'? 

    Developed by an American biopharmaceutical company, zMapp is a "cocktail" of antibodies harvested from an infected animal's blood and grown in specially-modified tobacco leaves. It works by stopping the virus from entering and infecting healthy cells. This type of drug has already been used in the treatment of some forms of cancer, but takes a long time to produce.

    However, according to previous trials, the treatment is only effective within a limited time frame after infection, with optimum results reported when administered within 24-hours.

    Who has it been given to? 
    • The two American aid workers would have been among the first humans to take the medication, before them, the drug had only been tested on monkeys.
    • A 75-year-old Spanish priest who was infected in Liberia was given the drug, but he later died in Madrid.
    • zMapp has also been given to three Liberian healthcare workers who are reportedly showing signs of improvement.
    Why was it given if it hadn't been approved? 

    The US Food and Drug Administration (FDA) allows drugs to be administered without testing under what it calls compassionate use. This "expanded access" is what many suspect happened in this case, as it can only be extended to individuals who are facing an immediately life-threatening condition where no other treatment is possible.

    The World Health Organization has also decided that the use of untested drugs to treat the deadly outbreak is ethical.

    Ebola: police open fire to enforce Liberia quarantine

    21 August

    Police in Liberia respond with force as slum residents attempt to break Ebola quarantine to get food and water

    Liberian police have fired live rounds and teargas at residents who attempted to leave a government-imposed Ebola quarantine zone in the country's capital, Monrovia.

    Officials sealed off the city's West Point slum, home to up to 75,000 people, in order to stop the spread of the Ebola virus. But the introduction of curfews and quarantines has angered residents who say they were given no advance warning of the measures which have stopped them from buying food and water.

    Some began throwing rocks at police who were enforcing the quarantine, according to Reuters. The police responded with live rounds, tear gas and beatings. Several serious injuries were reported but no-one is known to have died during the clashes.

    The country's president, Ellen Johnson Sirleaf, defended the quarantines, which have been established in areas around the country, saying they were essential to control the spread of the disease. She said that Ebola had continued to spread because of "continued denials, cultural varying practices, disregard for the advice of health workers and disrespect for the warnings by the government".

    There are fears that such large scale isolations could lead to widespread unrest as the movement of essential goods is cut off. "I don't have any food and we're scared," said Alpha Barry, a West Point resident.

    The World Health Organization has begun working with local authorities to deliver emergency food aid into quarantined regions in an attempt to reduce rising tensions.

    In a separate development, a multi-million pound research package has been announced by the UK's Department for International Development and the Wellcome Trust charity. £6.5m in funding will be given to researchers working on ways to tackle the disease.

    Welcome Trust Director Dr Jeremy Farrar said the severity of the outbreak demanded an immediate international response.

    Ebola: world 'failing to help' as Africa faces 'emergency'

    20 Aug

    The head of an international medical charity has accused world leaders of doing "almost zero" to help countries affected by the worst outbreak of the Ebola virus in history.

    "Leaders in the West are talking about their own safety and doing things like closing airlines –and not helping anyone else," Brice de la Vigne, the operations director of Medecins Sans Frontieres told The Guardian

    He argues that containing Ebola is not a complicated task, but requires international intervention. He accused leaders of lacking the political will to take action. "Time is running against us", he warned.

    Other healthcare workers have echoed De la Vigne's comments. "We are gone beyond the stage of a health crisis", said Sinead Walsh, head of Irish Aid working in Sierra Leonia's capital. "This is a humanitarian emergency now".

    In other developments, the Liberian government has imposed a curfew across the country in order to try and control the spread of the Ebola virus. Health officials have also managed to locate the missing patients who were freed from a quarantine centre last week, the BBC reports.

    Separately, the infected health care workers who have been treated with the experimental zMapp drug in Liberia are reportedly recovering, but it is yet unclear if their improving conditions are directly related to the drug. · 

    For further concise, balanced comment and analysis on the week's news, try The Week magazine. Subscribe today and get 6 issues completely free.