Ebola: US confirms first case of virus

Medecins Sans Frontieres medical staff wearing protective clothing

Some parts of West Africa declared 'Ebola-free' as the first case is confirmed in Texas

LAST UPDATED AT 09:17 ON Wed 1 Oct 2014

The first case of the Ebola virus in the US has been confirmed by the Centers for Disease Control and Prevention (CDC).

The patient, currently quarantined in a hospital in Dallas, Texas, is believed to have been infected while in Liberia, and flew back to the US before he was symptomatic or contagious.

While a number of American healthcare workers infected with the disease have been brought back to the US for treatment, this is the first time a case has been diagnosed within its borders.

Health officials were quick to allay fears of an outbreak in the US.

"I have no doubt that we will control this importation or this case of Ebola so that it does not spread widely in this country," said Thomas Freidan, director of the CDC, according to CNN.

"It is a severe disease, which has a high-case fatality rate, even with the best of care, but there are core, tried and true public health interventions that stop it," he said.

Friedan explained there was "all the difference in the world" between the public health infrastructure in the US and parts of West Africa, where it has killed more than 3,000 people.

"The United States has a strong health care system and public health professionals who will make sure this case does not threaten our communities," he said.

Officials refused to confirm the man's identity, nationality or what treatment he is receiving, due to privacy concerns.

The crew on board his flight have been isolated, according to the chief of staff for Dallas Mayor Mike Rawlings and CDC officials are en route to Dallas to trace – and potentially isolate – people who may have come into contact with the man.

Meanwhile, US health officials say they believe that the Ebola virus may have been contained in Nigeria and Senegal after no new cases were reported in the last month, the BBC reports.

The response "shows that control is possible with rapid, focused interventions," said Friedman, in a separate statement.

However, the virus continues to spread across Liberia, Sierra Leone and Guinea, with the World Health Organization now reporting more than 6,000 confirmed cases of the disease.

Ebola virus factfile 

What is the Ebola virus and what are the symptoms?

The World Health Organisation 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. There are five known strains of the virus, the one currently spreading across West Africa is known as the Zaire Ebola virus and is one of the most dangerous. Patients who do not survive the disease most often die from blood loss, organ failure or shock.

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.

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 fatality rate of the current strain appears to be roughly 70 per cent, according to the latest WHO figures. The only routine treatment doctors can currently offer is palliative care such as rehydration and pain relief.

However, there are various experimental treatments and vaccines currently in development, most notably the zMapp drug which has been given to several healthcare workers who have contracted the disease. It's effectiveness and long-term safety is yet unknown.

What happens to people who survive the disease?

"There is strong epidemiological evidence that once an individual has resolved an Ebola virus infection, they are immune to that strain," according to Dr Bruce Ribner, director of the infectious disease unit at Emory University Hospital in the US.  Doctors believe that the antibodies present in a patient's blood could protect them from that virus, but warn they would still be susceptible to other strains.

 

Ebola: Sierra Leone quarantines 1m people 'indefinitely'

25 September

More than a million people in Sierra Leone have been ordered into indefinite quarantine in an attempt to stop the spread of the Ebola virus.

The move has come into immediate effect, meaning that more than one third of the country's population is now unable to move freely, Al Jazeera reports. Only those delivering essential supplies and services are allowed into the quarantined areas.

The decision was made after a three-day quarantine imposed across the country last week exposed "areas of greater challenges," said Ernest Bai Koroma, the country's president. Earlier this week government officials had said that the quarantine would not be extended.

"The isolation of districts and chiefdoms will definitely pose great difficulty," Koroma told the nation in a televised address. "But the lives of everyone and the survival of our country takes precedence over these difficulties."

The latest figures from the World Health Organization reveal that over 6,000 people have been infected with the virus, and nearly half of them have died. They also suggest that the spread of the disease has stabilised in Guinea, where the outbreak first originated, but is accelerating in Liberia and Sierra Leone.

Yesterday a Liberian minister warned that the disease could cause his country and others in the region to descend into civil war.

Lewis Brown, the country's information minister, told Al Jazeera: "Hospitals are struggling, but so too are hotels. Businesses are struggling. If this continues the cost of living will go to the roof. You have an agitated population.

He urged international action, saying "the world cannot wait for Liberia, Sierra Leone and Guinea, to slip back into conflict".

 

Ebola: 1.4 million people could be infected by January, experts warn

24 September

The Ebola virus could potentially infect up to 1.4 million people in Liberia and Sierra Leone by January next year, according to a statistical forecast by the US Centre for Disease Control (CDC).

However, scientists at the CDC caution that this estimate reflects the number of cases that would result if no action is taken.

Infections are doubling every 20 days in the worst affected areas of Sierra Leone and Liberia. Over 2,800 people are now known to have died from the disease and over 5,800 have been infected, but the CDC warns that the actual number of cases could be at least 2.5 times higher.

The US health institute has been accused of scaremongering, but scientists there say they are merely trying to help inform those planning responses to the outbreak by presenting them with a worst-case scenario, showing what could happen if no action is taken to contain the disease.

"It is still possible to reverse the epidemic, and we believe this can be done if a sufficient number of all patients are effectively isolated," CDC Director Tom Frieden told the Washington Post.

However, the World Health Organisation's (WHO) director of strategy told Sky News that predicting the spread of the outbreak is not an exact science. "This is a bit like weather forecasting. We can do it a few days in advance, but looking a few weeks or months ahead is very difficult," he said.

In a separate development, 164 NHS staff have volunteered to travel to West Africa to help treat victims of the virus, following an appeal by the chief medical officer Professor Sally Davies. According to the Department of Health, the number of volunteers continues to rise, with doctors, nurses and paramedics most needed.

The UK has contributed £5m to international health agencies working in the region and is training 90 health care workers a week in the Sierra Leonean capital of Freetown.

Ebola curfew in Sierra Leone will not be extended

22 September

A three-day curfew in Sierra Leone, under which the West African country's six million residents were confined to their homes while health workers went door-to-door to investigate the spread of the ebola virus, will not be extended.

Officials had earlier suggested that the emergency measure might be prolonged but last night they said that the lockdown had been successful and would not need to be extended, the BBC reports.

Around 30,000 medical volunteers spent the three days visiting affected neighbourhoods looking for infected patients, educating residents about the disease, handing out soap - and looking for bodies of victims.

Yesterday, Sky News reported that 92 bodies and at least 56 previously unknown infections had been identified – though it is unclear whether all of the 56 were 'new' cases, with the BBC today reporting just 22.

Deputy chief medical officer Sarian Kamara said discovering the new cases was crucial. He said: "Had they not been discovered, they would have greatly increased transmission."

He said that up to 70 victims had been buried in the past two days. Ebola-infected bodies are highly contagious, so quick burial is essential to stop the spread of infection.

The curfew is the most aggressive measure taken against the disease in West Africa yet, says the BBC. Its introduction was controversial, with Medecins Sans Frontieres warning it could alienate the public from health workers and unnecessarily criminalise people.

However, the head of Sierra Leone's Emergency Operations Centre (EOC), Stephen Gaojia, said it had been a "huge success". It was largely respected, with some residents of the capital, Freetown, coming on to the streets to celebrate when it ended. · 

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