In Brief

Ebola: US suit stockpile causes shortage in Africa

Biohazard suits are in short supply causing prices to rise as a result of 'increased anxiety' in the US

 

William Pooley: British Ebola nurse returns to Sierra Leone 

20 October

William Pooley, the British nurse who recovered from the Ebola virus has returned to work in West Africa.

The 29-year old, thought to be the first Briton to be infected with the disease, contracted Ebola while working as a health care volunteer in Sierra Leone. He was flown back to the UK, where he was quarantined and received the experimental drug zMapp and later made a full recovery. 

Pooley said returning to work in a region where over 4,500 people have died from the disease was an "easy decision" to make.

He has said he could not stand "idly by" while more people died. "I chose to go before and it was the right thing to do then and it’s still the right thing to do now," he told The Guardian.

It is still unclear whether or not Pooley is immune to the virus or how long it could last. "They have told me I very likely have immunity, at least for the near future, to this strain of Ebola," he said. "I have also been told it's a possibility that I don't, so I will just have to act as if I don't."

Pooley will join a team of British health care workers from King's College London and three NHS trusts working at a hospital in the capital Freetown.

He urged the West to direct more attention to the heart of the outbreak in West Africa. "The risk of a really damaging outbreak here [in the UK] is negligible. There's an absolute catastrophe happening in another part of the world," he said. "That should be our focus."

In other developments: 
  • Liberian president Ellen Johnson Sirleaf has warned that a generation of Africans were at risk of being lost to the disease, adding that the whole world has a stake in the fight against Ebola.
  • Nigeria has been officially declared Ebola-free, six weeks after the last infection was reported. The successful containment of the virus was due to early detection, a co-ordinated response from government healthcare workers and quick and effective contact tracing.
  • The Spanish nurse who was the first person to contract Ebola outside of Africa has now recovered from the disease, according to the Spanish government.

 

Ebola: new vaccine will be 'too late' for current epidemic

17 October 

An Ebola vaccine currently undergoing safety testing will not be ready in time to combat the current outbreak, according to the pharmaceutical company GlaxoSmithKline.

Dr Ripley Ballou, head of GSK's Ebola vaccine research has said that the safety and efficacy of the drug will not be established before the end of 2015. Two other vaccines are also currently in development.

Experts fear that the only way to contain this outbreak is with a safe and effective vaccine as the scale of the epidemic now means that traditional methods of containment will no longer work.

Over 9,000 people are now known to be infected with the virus and more than half have died, according to the latest figures from the World Health Organization (WHO). But the virus is spreading exponentially and the WHO has predicted that there could soon be 10,000 new cases a week.

Professor Peter Piot, the director of the London School of Hygiene and Tropical Medicine who discovered Ebola in 1976, warned that outbreak could last well into next year.

"Then only a vaccine can stop it, but we still have to prove that this vaccine protects, we don't know that for sure," he told the BBC.

In other developments:

  • The WHO has warned that 15 countries, neighbouring or trading with the three countries at the heart of the outbreak, face a real risk of the disease spreading across their borders. These include Ivory Coast, Ghana, Mali and the Central African Republic. "It could lead to major destabilisation of societies and also political destabilisation," Piot told The Guardian.
  • President Barack Obama is facing mounting pressure from Republicans to ban all incoming flights from Liberia, Guinea and Sierra Leone. He says he remains open to issuing travel bans, but only if recommended by public health experts.
  • David Cameron has urged European leaders to implement enhanced screening at airports, introducing measures like those in place at Heathrow airport, which will be extended to Gatwick and Eurostar terminal next week.

Ebola: Obama orders 'Swat team' response to outbreak

16 October

President Barack Obama has outlined enhanced measures to combat an Ebola outbreak in the US, including dispatching rapid response teams to hospitals.

Speaking after heading an emergency meeting in Washington, Obama promised "much more aggressive" monitoring of Ebola cases in the US.

He has also cancelled immediate travel plans in order to oversee the government's response to the Ebola crisis. This comes after a second nurse, Amber Joy Vinson, tested positive for the disease in Texas.

The Centres for Disease Control and Prevention (CDC) has been instructed to send 'Swat-teams' of experts to hospitals that report an infection within 24-hours, USA Today reports. Obama said that hospitals across the country were on stand-by for further cases and that an investigation into how the virus spread in Texas was ongoing.

Obama yesterday took part in a conference call with David Cameron and the leaders of France, Germany and Italy on how to respond to the crisis.

But despite the concerns, Obama continues to downplay the risk of an outbreak in the US, saying the chance of non-healthcare workers contracting the virus is currently "extremely low."

"I am absolutely confident that we can prevent a serious outbreak of the disease here in the United States," he said. "But it becomes more difficult to do so if this epidemic of Ebola rages out of control in West Africa. If it does, it will spread globally."

Over 4,500 people have now died from the outbreak in West Africa.

In other developments:
  • The CDC has come under intense criticism following allegations that Vinson informed them that she had a symptom of the virus, yet was allowed to board a plane and travel across the country. The CDC is now trying to contact all 132 people on board her flight.
  • The UN has warned that the West African region affected by Ebola is facing an impending food crisis as farmers abandon their crops and the movement of goods remains restricted.
  • The campaign group Avaaz says it has identified over 3,000 volunteers, including doctors and other health care workers, who are willing to travel to West Africa to help fight the outbreak.

 

Ebola remains 'out of control'  with death toll rising to 4,447

15 October

An end to Ebola in Nigeria and Senegal looks near, but elsewhere the outbreak remains "out of control", the World Health Organisation has warned.

New cases in Guinea, Liberia and Sierra Leone "continue to explode in areas that looked like they were coming under control", said the United Nations agency.

The estimated death toll, which multiplies confirmed cases to take into account under-reporting, currently stands at 4,447, reports the BBC.

Bruce Aylward, WHO's assistant director-general, has warned there could be up to 10,000 new cases a week within two months in Guinea, Liberia and Sierra Leone if efforts are not stepped up.

"An unusual characteristic of this epidemic is a persistent cyclical pattern of gradual dips in the number of new cases, followed by sudden flare-ups," the agency said in a statement. "WHO epidemiologists see no signs that the outbreaks in any of these three countries are coming under control."

Yesterday, Barack Obama said that "the world as a whole is not doing enough" to contain the Ebola threat. He will be discussing the crisis in a video conference later today with British, French, German and Italian leaders.

Nevertheless, WHO said it will declare the end of the outbreak in Senegal on Friday and in Nigeria on Monday so long as no new cases arise. In what the agency describes as a "piece of world-class epidemiological detective work", all confirmed cases in Nigeria have been linked back to a Liberian air traveller who introduced the virus into the country on 20 July.

Passengers arriving at Heathrow airport from countries affected by the disease are beginning to be screened by health officials. Passengers have had their temperatures taken and been asked to fill in health forms, which include questions about the traveller's temperature and whether or not they have come into contact with anyone who has died of unknown causes.

Ebola: 'protocol breach' blamed for first US transmission 

13 October 

A nurse in Texas has tested positive for the Ebola virus, marking the first transmission of the disease on US soil. The unidentified woman became infected after caring for Liberian national Thomas Eric Duncan, who later died of the disease.

The US Centers for Disease Control and Prevention (CDC) said a "breach in protocol" had led to the transmission, while health officials were quick to stress that there is little threat of a wider outbreak, the Wall Street Journal reports.

The nurse has been placed under quarantine at Texas Health Presbyterian Hospital and is said to be in stable condition.

"While this was obviously bad news, it is not news that should bring about panic," said Dallas County Judge Clay Jenkins who oversees the county health department. Officials said they had been working hard to establish exactly how the virus had spread.

Meanwhile, England's Chief Medical Officer Dame Sally Davies has said that the UK needs to be prepared for the arrival of the virus, saying she expects "a handful of cases in the next few months", the Daily Telegraph reports. Her views were echoed by London Mayor Boris Johnson who said that he had "little doubt" that the disease would reach the capital.

Over 4,000 people have now died from the disease in West Africa according to the latest figures from the World Health Organization (WHO), but experts predict that the actual figure could be at least twice as high.

In other developments:
  • Elections in Liberia have been postponed, as large groups of people gathering at polling stations would put lives at risk in a country that has been the worst affected by the outbreak.
  • Healthcare workers in Liberia have gone on strike after the government refused to increase their hazard pay. At least 200 medical staff have contracted the virus in the country, where personal protective equipment is scarce, Al Jazeera reports.
  • UN secretary-general Ban Ki-moon has urged the international community to step up response to the humanitarian crisis in West Africa, saying a 20-fold increase in resources and health care professionals is urgently needed just to slow down the rate of infection.
  • The Spanish nurse infected with Ebola is showing sign of improvement, according to the Spanish health ministry. Another 15 people remain in quarantine, but so far are showing no symptoms of the virus.

Ebola virus: UK to begin airport screening, but will it work?

10 October

Passengers arriving in the UK from West Africa will face enhanced screenings for Ebola virus, following an abrupt U-turn from government.

More stringent check are expected to take place at Heathrow and Gatwick airports and the Eurostar terminal in London in the coming days, as Downing Street said the measures would offer "an additional level of protection to the UK".

The government had previously ruled out enhanced screening, saying current policy was in line with World Health Organization (WHO) guidelines.

The decision was based on advice given by chief medical officer Professor Dame Sally Davies who cited "concern about the growing number of cases" of the virus and recommended the measures to ensure "potential cases arriving in the UK are identified as quickly as possible", The Guardian reports.

What measures are being introduced and who will be affected?
  • Passengers arriving from the worst affected nations of Sierra Leone, Liberia and Guinea will be pulled aside after passport control and will have their temperatures taken to check for fever, one of the many symptoms of the Ebola virus.
  • Health officials will also monitor passengers for any visible signs of illness.
  • Passengers will then be asked to fill out a questionnaire on their health and possible exposure to the virus.

If any of these measures lead health officials to suspect a person may be infected with the virus, they could be placed under precautionary quarantine until blood tests are done. If not, they will be given information about what to do if they develop symptoms at a later stage.

What has the reaction been?

The move has been welcomed by ministers who argued that more stringent detection methods needed to be implemented in order to prevent an outbreak in the UK.

"The announcement will absolutely reassure the public the everything is being done at our border and our ports to ensure that cases are being identified," said Keith Vaz, Labour MP and chairman of the Commons home affairs select committee.

However those in the health sector have their doubts. Public Health England had advised against fever screening, saying it was "almost never worthwhile".

Why might it not work?
  • As the virus has a long incubation period of up to three weeks, people who have the disease may not be exhibiting symptoms at the time of screening.
  • There are no direct flights between Britain and Liberia, Sierra Leone and Guinea and critics argue it will be difficult for officials to trace the movement of people, particularly those with long stopovers in Ebola-free countries.
  • Health experts argue that there is little point to entry screening in the UK as passengers are already screened in West Africa, and will be denied boarding if they exhibit symptoms. "They say it is extremely unlikely that many people would develop symptoms during a flight, so additional screening on entry would not pick up many cases," the BBC reports.
  • Most healthcare workers argue that fever screening is ineffective. This was evident in Australia during the SARS epidemic where 1.8 million passengers were checked and only 800 people with a fever were identified, and no cases of the disease were found. 
  • People may lie out of fear of being detained or quarantined, something that has been witnessed across West Africa during the outbreak.
So why has it been introduced?

"[Governments] are under a lot of pressure to do something [to] make the public feel reassured, even if it really doesn't make them safer," Larry Gostin, a professor of global health law at Georgetown University told National Public Radio in the US.

Lucy Moreton, general secretary of the UK's Immigration Services Union agrees. "Screening for Ebola is not effective. All the medical evidence says it isn't," she told The Times. "The only reason to do this is presentational and for political reasons."

Ebola: US to begin airport screening, why won't the UK?

09 October

The US is set to begin enhanced screening of travellers arriving from West Africa in order to prevent a wider outbreak of the Ebola virus.

President Obama said the measures would "give us the ability to isolate, evaluate and monitor travellers as needed, and we'll be able to collect any contact information that's necessary", the BBC reports.

"If we don't follow protocols and procedures that are put in place, then we're putting folks in our communities at risk," he added.

As screening comes into force in the US, the UK is facing increasing criticism for failing to introduce similar measures to prevent the global spread of the virus.

At least 8,011 people have been infected with the disease and 3,857 have died according to the latest figures from the World Health Organization (WHO).

Where will the screening take place and  how will it work?

Enhanced screening is expected to begin this weekend and will take place at five major airports in New York, Atlanta, Chicago, Washington and Newark, USA Today reports.

Travellers who began their journeys in Sierra Leone, Liberia or Guinea will have their temperature taken and will be asked question about their health by border patrol officers. More than 160 people from the region enter the US each day, over 90 per cent of them arriving at these airports. Fact sheets will also be distributed to passengers, informing them of symptoms of the disease.

If a traveller has a fever or has reason to believe they were exposed to the disease, an officer from the Centers for Disease Control and Prevention (CDC) will assess whether or not to place them under precautionary quarantine.

So, why is this not being adopted in the UK?

Public Health England says it has no plans to introduce the measures as it had not been recommended by the World Health Organization (WHO) and would involve screening "huge numbers of low-risk people", the BBC reports. Currently, immigration officials are only advised to take action if a traveller is showing visible signs of the disease.

The government is coming under widespread pressure to introduce more stringent screening methods, and in the US, Secretary of State John Kerry says there is "no time to wait".

Some British MPs agree. "What we need to ensure is that the public feel there is confidence at our borders and that means, we need to put in screening at our borders in order to give the public that confidence," Labour MP Keith Vaz told the Daily Telegraph.

In other developments:
  • The US has experienced its first Ebola fatality. Thomas Eric Duncan, who contracted the disease in Liberia but was diagnosed in Texas, died yesterday despite receiving the experimental drug brincidofovir. At least 50 people he came into contact with are being monitored by health officials.
  • Teresa Romero Ramos, the Spanish nurse with Ebola, believes she was infected due to error she made, recalling that she touched her face after treating a patient in Madrid. It has also emerged that Ramos informed health officials about her symptoms three times before being placed under quarantine.
  • Britain will deploy a further 600 troops to Sierra Leone, joining 150 already stationed there, to help fight Ebola. They will be responsible for building treatment centres as well as training healthcare workers.
  • The World Bank has warned that the Ebola outbreak could cost West African economies more than £20bn by the end of 2015 unless it is quickly contained.

 

Spain monitoring 50, but more cases 'unavoidable'

08 October

Spanish authorities are investigating how a nurse became infected with the Ebola virus, as health workers blame substandard protective clothing and equipment for the spread of the disease.

The woman, identified locally as Teresa Romero, was the first person to contract the virus outside West Africa, apparently while treating two infected missionaries in a Spanish hospital.

"We don't know yet what failed," a government representative told The Guardian. "We are investigating the mechanism of infection."

Romero, her husband and three other people remain under quarantine in Madrid. Another 50 people she is believed to have been in contact with are also being monitored. A court has also ordered that her dog be put down as a precaution.

A World Health Organization (WHO) Ebola advisor has warned of the risks to healthcare workers treating Ebola, saying that the disease can spread even in high level isolation units in Western hospitals. "The smallest mistake can be fatal," he told the BBC.

Over 3,400 people have died in the current outbreak across West Africa, with Sierra Leone, Liberia and Guinea the worst affected.

Meanwhile, US scientists have forecasted that there is a 50 per cent chance that the UK will see its first case of Ebola in the next three weeks. However, health officials in England insist the risk "remains low".

Despite this, four major NHS hospitals in London, Sheffield, Liverpool and Newcastle have been put on standby to receive infected patients, the Daily Telegraph reports. David Cameron is also expected to convene an emergency Cobra meeting this morning to discuss the UK's response to the outbreak.

This comes after the WHO warned that further cases of Ebola in Europe are "quite unavoidable".

The United States has drawn up plans to screen international arrivals for the disease, however public health officials have ruled out a similar response in the UK.

 

Ebola: Spain confirms first case of virus contracted in Europe   

07 October

A Spanish nurse has tested positive for the Ebola virus in the first confirmed case of the disease contracted outside of West Africa.

The 40-year-old woman was part of the medical team who treated two Spanish priests who were infected with the disease while working with charities in West Africa and later died, the BBC reports.

"All measures have been taken to give the best care to the patient and guarantee the safety of all citizens," said the Spanish health minister Ana Mato. "We are working hard to verify the source of the infection," she added.

The nurse, who has not yet been named, is currently under quarantine in a hospital in Madrid and her condition is reportedly stable. At least 30 health care workers who were involved in the treatment of the priests are now under observation.

Authorities in Spain have launched an investigation into how the disease could have spread in hospital with specialist equipment and isolation facilities.

"Exposure of health-care workers ... continues to be an alarming feature of this outbreak," said the World Health Organization. At least 382 health-care workers have been infected by Ebola in West Africa and 216 of them have died, according to the Washington Post.

The death toll from the outbreak has now reached over 3,400 with over 7,500 confirmed cases, though experts warn the actual number is much higher. Sierra Leone, Liberia and Guinea remain the worst affected.

Meanwhile, the first person to be diagnosed with Ebola in the US, Thomas Duncan is said to be in a critical but stable condition and is being treated with the experimental drug Brincidofovir.

President Obama has urged other world leaders to take action to combat the outbreak in West Africa. "Countries that think that they can sit on the sidelines and just let the United States do it, that will result in a less effective response, a less speedy response, and that means that people die," he said.

"And it also means that the potential spread of the disease beyond these areas in West Africa becomes more imminent." 

Ebola: US NBC cameraman diagnosed with virus in Liberia   

03 October

An American television cameraman working in Liberia has tested positive for the Ebola virus and will be flown back to the United States for treatment, his network has announced.

Ashoka Mukpo, a 33-year-old freelancer who was working for NBC, is believed to be the fourth US citizen to contract the disease in Africa.

He was hired by the network on Tuesday and began to suffer from symptoms the following day, reports The Guardian. NBC says he told colleagues he felt "tired and achy". He visited a Medicins Sans Frontieres treatment centre to be tested for the virus, and was given the positive result within hours.

"The doctors are optimistic about his prognosis," Mukpo's father told his family and friends, says the Washington Post. "Ashoka was well aware of the risks but felt strongly about trying to help provide honest perspective from the ground level," he added.

In a memo to network staff, NBC News president Deborah Turness said: "We are doing everything we can to get him the best care possible. He will be flown back to the United States for treatment at a medical centre that is equipped to handle Ebola patients."

The rest of the NBC crew, which includes the network's chief medical editor, Dr Nancy Snyderman, are being flown back to the US on a private charter flight. They will be placed under strict quarantine for three weeks, Turness said.

More than 3,330 people have died from Ebola in four West African countries in what has become the world's worst outbreak. US president Barack Obama has pledged federal support to contain the spread in the US.

Ebola conference begins amid warning over infection rate

2 October

International leaders will meet in London today to discuss the world's worst outbreak of Ebola.

The conference, held jointly by the UK and Sierra Leone, comes as Save the Children issued a warning that healthcare demands are far outstripping supply in the West African state. The charity says an estimated 765 new cases of Ebola emerged last week in Sierra Leone – a rate of five new cases an hour – but there are only 327 hospital beds in the country

The outbreak, which has developed at an unprecedented scale, has so far killed 3,338 people, nearly half of the 7,178 confirmed cases, with Sierra Leone, Liberia and Guinea suffering the most.

Save the Children says the disease is "massively unreported" because "untold numbers of children are dying anonymously at home or in the streets".

Rob MacGillivray, the charity's country director in Sierra Leone, told the BBC: "We are facing the frightening prospect of an epidemic which is spreading like wildfire across Sierra Leone, with the number of new cases doubling every three weeks."

MPs on the International Development Committee have warned that cuts in UK health aid to West Africa have "compromised the fight" to stop the spread of Ebola. A report from the committee, published ahead of the conference today, claimed that UK aid to Liberia and Sierra Leone had been cut by nearly a fifth.

However, the UK government says the report is "out of date" and that it has made a £125m pledge to "contain, control and defeat" the disease.

Foreign Secretary Philip Hammond says he hopes today's conference at Lancaster House will "encourage ambitious pledges" for Sierra Leone and the region.

It has also emerged that the Liberian man who became the first person to be diagnosed with Ebola in the US had come into contact with five children. The man arrived in Texas from Liberia on 20 September and became ill four days later, but was not admitted to hospital until 28 September, reportedly because of a mix-up. He is now being treated at the Texas Health Presbyterian Hospital in Dallas, where he is said to be in a serious but stable condition.

 

Ebola: US confirms first case of virus

01 October

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: 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.

Three days of ‘house arrest’ for entire population of Sierra Leone

19 September 

Almost all of Sierra Leone’s six million citizens have been ordered to stay inside for three days. The curfew, which began at midnight last night, is to allow health workers to assess and tackle the Ebola epidemic which is raging in West Africa.

As 30,000 volunteers begin to make house calls this morning – educating residents about the disease, distributing soap and checking for infected patients and bodies – the UN said the outbreak was a threat to world peace, The Guardian reports.

The country’s president, Ernest Bai Koroma, said that “extraordinary times” required extraordinary measures and claimed the action would be “a very big boost to our collective effort to stop the outbreak”.

However, Medecins sans Frontieres said the lockdown, from which security services are exempt, was too draconian and could be counterproductive. The medical NGO said the measures might criminalise people and “jeopardise the trust between people and health providers”.

The Daily Telegraph reports that the UN Security Council in New York yesterday declared the rise of Ebola in West Africa a “threat to international peace and security”. Ban Ki-moon, the UN secretary-general, announced a special mission to fight the disease.

“The gravity and scale of the situation now require a level of international action unprecedented for a health emergency,” said Ban, who announced he would be appointing an envoy to head the newly-created UN Mission for Ebola Emergency Response.

He added: “This international mission ... will have five priorities: stopping the outbreak, treating the infected, ensuring essential services, preserving stability and preventing further outbreaks.”

Ebola: outbreak a threat to global security, warns Obama

17 September 

President Barack Obama has promised to make the current Ebola outbreak in West Africa a top national security priority, saying yesterday that the world has "a responsibility to act" to tackle the deadly outbreak.

"This is an epidemic that is not just a threat to regional security, it’s a potential threat to global security,'' he said. ‘’If these countries break down, if their economies break down, if people panic, that has profound effects on all of us, even if we are not directly contracting the disease."

Almost 2,500 people have died from the disease since March, more than from all of the past outbreaks combined.

Obama's remarks came as the White House pledged $175 million to fund a military operation to the worst affected areas. US troops will be responsible for setting up a regional headquarters in Liberia as well as training thousands of healthcare workers and building Ebola treatment centres.

However healthcare leaders at the World Health Organization (WHO) say that at least $1 billion is now needed to fight a health crisis that is "unparalleled in modern times", the BBC reports.

The US Centre for Disease Control (CDC) warns that without further funding, cases of the virus could increase into the hundreds of thousands.

Kent Brantly, the American healthcare worker who was infected with the disease while working in West Africa and has since recovered, described the outbreak as a "fire straight from the pit of hell", according to Vox.  Speaking to the US senate, he said: "We cannot fool ourselves into thinking that the vast moat of the Atlantic Ocean will keep the flames away from our shores."

Meanwhile, human trials for an Ebola vaccine have begun in Oxford. The vaccine, developed by GlaxoSmithKline and the US National Institute was proven to be 100 per cent successful in animal tests and has now been fast-tracked for safety trials on humans.

Ebola: Obama to send US troops to fight West Africa outbreak 

16 September

President Barack Obama is expected to announce plans to send 3,000 US military personnel to Liberia to help tackle the deadly Ebola virus that continues to spread across West Africa.

Last month Obama said he was prepared to lead an international response to the crisis in Liberia and will today outline details of the US military operation.

Aid agencies and the World Health Organization have previously criticised the international community for failing to respond to the humanitarian crisis which began over six months ago.

Almost 2,500 people have died and nearly 5,000 people have now been infected with the disease. Over half of the deaths have occurred in Liberia, with the World Health Organization warning that thousands more cases are to be expected. "We all recognize that this is such an extraordinary, serious epidemic," a senior government official told the New York Times.

'Operation United Assistance' is expected to involve:

  • Setting up a regional headquarters in the Liberian capital of Monrovia to coordinate the international response
  • Training up to 500 healthcare workers a week
  • Building 17 Ebola treatment centres across the country with 1,700 beds in total
  • Distributing healthcare kits and tests to thousands of households
  • Educating and training locals about the disease

Dr. William Schaffner, an infectious disease and public health expert at Vanderbilt University, said the response was "coordinated and coherent" and showed a serious commitment from the US government. Others have criticised the government for waiting this long to act.

Ebola: Bill and Melinda Gates donate $50m 

11 September

Following calls from the UN for $600 million to fight the Ebola outbreak, philanthropists Bill and Melinda Gates have pledged $50 million to help fight the spread of the disease across West Africa.

Their organisation had previously donated $10 million to the emergency operations, treatment and research.

The money will go towards the purchase of medical supplies and the strengthening of existing healthcare systems, as well as towards research into possible cures and vaccines.

"We are working urgently with our partners to identify the most effective ways to help them save lives now and stop transmission of this deadly disease," said Sue Desmond-Hellmann, the Gates Foundation's chief executive officer, according to AP.

The funds will be split between the United Nations, the World Health Organization (WHO), the US Centre for Disease Control and various other organisations working towards containing the virus.

Liberia, the country facing the largest Ebola outbreak in West Africa, is "fighting a biological war", according to Sarah Crowe, a Unicef health worker.

Her comments come days after the country's health minister warned that the disease was a threat to the nation's existence.

Crowe, who just returned from Liberia, said the country is involved in a war against "an unseen enemy without foot soldiers", according to the BBC.

"Ebola has turned survivors into human booby traps, unexploded ordinance - touch and you die. Ebola psychosis is paralysing."

Ebola: 'plague' threatens Liberia's existence 

10 September

Liberia's health minister has said his country is facing "a serious threat to its existence" and has appealed to the international community for urgent support.

Brownie Samukai told the UN Security Council that the disease was beyond the country's control and was "devouring everything in its path", the BBC reports.

More than 2,200 people have now died from the disease across Liberia, Guinea and Sierra Leone. Liberia has been the worst affected nation by far, with over a 1,000 of the total deaths. Doctors warn that Ebola is spreading at an exponential rate, with half of all cases in West Africa occurring in just three weeks.

Karin Landgren, the UN Secretary-General's special representative for Liberia, described the outbreak as a "latter-day plague" saying that "Liberians are facing the greatest threat since their war". 

The blame has been placed on traditional burial practices as well as the country's crumbling infrastructure which was damaged by two civil wars in as many decades. The UN has said at least 160 health workers in the country have contracted the disease as they do not have adequate protective clothing. Hospitals are severely understaffed and there are not enough beds, with many patients being told to go home.

The World Health Organization (WHO) has called on the international community to scale-up their response to the outbreak.

UN Secretary General Ban Ki-moon says a meeting on the international response to the outbreak will be held at this month's General Assembly.

"I don't think anyone can say right now that the international response to the Ebola outbreak is sufficient," said US ambassador to the UN Samantha Power. 

Ebola vaccine: human trials after monkey test a success

08 September

Human trials of an experimental Ebola vaccine have begun in the US after it proved successful in protecting monkeys from the virus.

The World Health Organization is working to fast-track experimental vaccines and treatments for Ebola to combat the outbreak in West Africa, and says that if the latest vaccine turns out to be safe it could be used in West Africa as early as November.

The tests, conducted by the US National Institutes of Health, showed that 100 per cent of the macaque monkeys survived after being vaccinated and then infected with the disease. However, a booster injection is needed to extend its effectiveness.

"The good part of this vaccine is that at five weeks or earlier you get full protection," Dr Anthony Fauci, the director of the US National Institute of Allergy and Infectious Diseases, told the BBC. "The sobering news is the durability isn't great, but if you give a boost, a second shot, you make it really durable."

Professor Jonathan Ball, a virologist at the University of Nottingham described it as "really encouraging data".

The vaccine contains a genetically modified combination of two different strains of Ebola. Scientists hope that patients will react to the small amount of the virus and develop immunity against it. 

Safety trials in humans have already begun in the US and are expected to be extended to the UK and Africa.

Over 2,100 people have now died from the disease that continues to spread across West Africa. There is currently no proven cure or vaccine against the disease, but several are in development across the world.

In other developments:

  • The government in Sierra Leone has ordered a three day lock-down of the entire country. Between 19 to 21 September people will not be allowed to leave their homes in order to enable healthcare workers to locate and isolate those who are infected.
  • Barack Obama has said the US must lead the international community in containing the spread of Ebola in Africa. He said he was prepared to deploy the US military to set up isolation centres and provide security for international health care workers.
  • American healthcare worker Dr Rick Sacra, who was infected with the disease while working in Liberia, has been flown to Nebraska for treatment and is said to be improving.

Ebola: British nurse makes 'full recovery' and leaves hospital

03 September

William Pooley, the first Briton to be infected with the deadly Ebola virus, has made a full recovery according to his doctors.

The 29-year old nurse from Suffolk was being treated in a specialist isolation centre in west London's Royal Free Hospital. His doctors say he is no longer infectious and poses "no risk to the wider community in any way".

He caught the virus while working as a volunteer nurse at the centre of the current Ebola outbreak in Sierra Leone. "I was worried that I was going to die, I was worried about my family and I was scared," he said.

He was flown back to the UK and received the experimental drug zMapp, but doctors are still unable to determine whether it was directly responsible for his recovery, as patients can get better naturally. However, "levels of the virus in his bloodstream did fall significantly" following the treatment, reports the BBC's health editor James Gallagher.

Pooley said he was very lucky in to receive such high quality care, saying treatment in the UK was a "world apart" from what people were receiving in the worst affected countries in West Africa.

He also said that despite experiencing some unpleasant symptoms, they never progressed to the "worst stage of the disease", adding: "I've seen people dying horrible deaths."

He praised healthcare workers that are still operating in the region. "In the face of quite likely a horrible death, they're continuing to work all day, every day helping sick people, it's amazing."

Meanwhile, the charity Medecins Sans Frontieres has criticised the international response to the outbreak in West Africa as "lethally inadequate".

Over 3,000 people are infected and more than half have died across Sierra Leone, Liberia, Nigeria, Guinea and Senegal, with a separate outbreak in the Democratic Republic of Congo.

Ebola virus outbreak: the economic cost

02 Septmber

The introduction of travel bans and quarantines in order to combat the outbreak of Ebola virus are having a devastating economic impact on several African countries, warns the UN.

The UN Food and Agriculture Organization (FOA) has issued a high-level food security alert for Liberia, Sierra Leone and Guinea, warning that the food crisis is expected to intensify in coming months, according to Reuters.

Food supplies

"With the main harvest now at risk and trade and movements of goods severely restricted, food insecurity is poised to intensify in the weeks and months to come," the FAO's Bukar Tijani told Deutsche Welle.

Production of vital crops such as rice, maize, and palm oil is being scaled back due to a shortage of labour. This in turn is leading to sharp price hikes. For example, the price of Cassava, a staple carbohydrate in the region, has risen by 150 per cent in just two weeks.

Even before the outbreak, many households were forced to spend as much as 80 per cent of their income on food, said Vincent Martin, also from FOA. "Now these latest price spikes are effectively putting food completely out of their reach".

The UN World Food Programme has launched an emergency response to the situation in West Africa and is sending 65,000 tonnes of food to 1.3 million people in the worst affected areas.

Tourism

Tourism is "one of the first casualties of any epidemic", according to the Economist.  Airlines have suspended flights to Sierra Leone, Guinea and Liberia and various governments have issued travel warnings. This comes despite advice from the World Health Organisation not to issue travel and trade bans as they are counterproductive.

The fears surrounding Ebola are even affecting popular tourist destinations in South Africa and Kenya – thousands of miles away from the affected area. Hannes Boshoff, managing director at Johannesburg-based ERM Tours, told Reuters that 80 per cent of his Asian customers had cancelled booked trips over fears of Ebola. A lot of tourists just see Africa "as one country", Boshoff said. "I try and tell people that Europe and America are closer to the Ebola outbreak than South Africa."

Mining

Several foreign mining companies including London Mining began evacuating staff based in West Africa in June, when the outbreak was still in its early stages. Since then, many more have followed suit. China Union has threatened to shut down its entire operation in Liberia if the outbreak continues to spread. Sierra Leone will miss its goal of producing $200 million worth of diamonds as miners are frightened to go down the diamond pits to work.

Despite fears of a looming food crisis, the UN says that "preventing further loss of human life and stopping the spread of the virus" remains their primary objective.

Ebola: healthcare workers go on strike over safety fears

01 September 

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 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.

Ebola: Liberian doctors receive 'last' of untested zMapp drug

12 Aug

Two Liberian doctors will be the first African patients to receive the experimental zMapp drug to treat Ebola, The Guardian reports.

The drug was provided to the West African country "at no cost in all cases", according to the producer Mapp Biopharmaceutical, but it warned that its current supply of the drug had now been exhausted. More of the drug is being produced, but scientists say that it could take several months.

It follows a direct appeal by the Liberian president, Ellen Johnson Sirleaf, to the US government. The country's information minister Lewis Brown told the BBC that the alternative to taking the untested drug was almost certain death.

There has been growing anger in the region as the only patients to have received the potentially life-saving treatment are Westerners. Two US health care volunteers who were given zMapp are reportedly recovering, but it is yet unclear if their improving condition is directly related to the drug. However, a Spanish priest who was also given the drug has now died in Madrid, the BBC reports.

The death toll in the world's deadliest outbreak of Ebola has now exceeded 1,000 in four West African countries.

The BBC's Will Ross warns that the untested use of drugs in Africa can become very controversial, citing the deadly Nigerian meningitis outbreak in 1996. The US drug company Pfizer gave 100 children an experimental antibiotic, but was later sued by the families as well as the government after 12 children died and many more were left with permanent disabilities including brain damage.

The company denied responsibility, saying the outcome was a result of the disease, not the drug, but was forced to pay a multi-million dollar settlement. Ross says that the result contributed to a suspicion of Western medicine in the region.

The World Health Organization is expected to announce the results of its emergency ethics meeting on using untested drugs to try and contain the outbreak.

Ebola: WHO debates ethics of giving untested drug to Africans

11 Aug

A group of specialists are meeting at the World Health Organization (WHO) today to discuss the ethical dilemma of whether or not to make experimental Ebola drugs available to infected patients across West Africa.

The ethics group will include doctors, medical historians, anthropologists, clinicians, epidemiologists, logisticians and other specialists, says the BBC. The diverse group will allow for "a nuanced appreciation of the likely risks and benefits" to be determined.

The deadliest Ebola outbreak ever recorded has so far killed almost 1,000 people in West Africa. Two infected US volunteers were given the untested drug zMapp earlier this month and experts have called for its use to be extended to patients across the region and not just to Western health care workers.

The pharmaceutical company GlaxoSmithKline has said that it will begin trials of a separate vaccine for the disease later this year, Reuters reports. However, even if it is fast-tracked and proven to be safe and effective it is unlikely to be released until 2015.

In other developments:

  • Doctors believe they have traced the outbreak to a two-year old boy in Guinea. 'Patient Zero' went on to infect his mother, sister, and grandmother in a village bordering Sierra Leone and Liberia, the New York Times reports.
  • Guinea has become the latest country to close its borders in order to contain the virus.
  • Health care workers in Liberia have admitted that the "overwhelmed" public health system was responsible for the spread of the disease within the country. Medecins Sans Frontieres told the BBC that the country's health care system was "falling apart".

 

Ebola declared an 'international health emergency'

08 Aug

The Ebola outbreak which has resulted in over 930 deaths in West Africa has officially been declared a global health emergency by the World Health Organisation.

The outbreak has been placed in the category of "public health emergencies of international concern" at an emergency meeting in Geneva.

WHO officials called the spread of the disease an "extraordinary event" and said the possible global consequences were "particularly serious", the BBC reports.

The announcement will trigger a "coordinated international response" which will aim to contain and control the deadly outbreak. However, action would stop short of a widespread ban on travel or trade.

Containment of the disease is becoming "impossible for these governments to handle themselves", Stephen Morrison, the director of the Global Health Policy Centre at the Centre for Strategic and International Studies told Newsweek.

While health officials at the WHO said the threat was serious, they also said "it is an infection which can be controlled". Much of the blame of the spread of the disease has been placed on the region's poor public health infrastructure.

Ebola: give Africans new experimental drug, say experts

07 August

The World Health Organization (WHO) should extend the use of experimental new treatments for Ebola to patients in West Africa, say the world's leading experts on infectious diseases.

The death toll from the outbreak in West Africa has now reached 932, with Liberia now the second country to officially declare a state of emergency due to the virus.

Three leading Ebola experts, including Dr Peter Piot who co-discovered the disease in 1976, are calling for the experimental new drug zMapp to be used to treat patients across Sierra Leone, Guinea, Liberia and Nigeria , Al Jazeera reports. This comes as doctors report that the two US health workers being treated with the untested drug in Atlanta are continuing to show signs of recovery.

Piot, David Heymann, of Chatham House, and Wellcome Trust director Jeremy Farrar, issued a joint statement saying that African governments should be "allowed to make informed decisions" on whether or not to use the drugs.

They said that people suffering in West Africa were not being afforded the same chance of survival as Westerners, arguing that if Ebola was spreading through the US or the UK "rapid decisions" would be made about extending the use of this potentially life-saving treatment.

The three professors called on the WHO to take on a "greater leadership role" in this crisis, adding, "These dire circumstances call for a more robust international response". 

The pharmaceutical company that created the drug has warned that production is in its early stages and very little of it currently exists, but it said it would be working to increase production.

President Obama said the use of an untested drug to treat Ebola would be "premature", Al Jazeera reports. "We've got to let the science guide us and I don't think all the information is in on whether this drug is helpful", he said. He placed the blame of the outbreak on the overwhelmed public health infrastructure in the affected countries.

The WHO has said that it will meet next week to discuss the merits of extending the use of experimental drugs in West Africa. 

In other developments:

  • Nigeria's health minister says the country is facing a national health emergency after a second person died from the disease in the region's most populous country.
  • A Spanish priest suffering from the disease is to be flown back to Spain this week, the first confirmed case of Ebola to be treated in Europe.
  • The WHO is holding a second day of talks in Geneva to decide whether to declare a global health emergency.

Ebola outbreak: BA cancels flights as disease spreads

06 Aug

British Airways has suspended flights on some West African routes as concern grows that Ebola has spread to Nigeria.  

Health care workers in the country have confirmed that eight people are showing signs of the deadly disease, increasing fears that the it has now spread to a fourth country, Reuters reports.

All of the patients came into contact with infected doctor Patrick Sawyer, who flew from Liberia to Nigeria and later died in Lagos.

In a seperate development, a businessman believed to have contracted Ebola after travelling to Sierra Leone has died in Saudi Arabia. If confirmed, it would be the first time anyone outside of Africa has died of the disease. 

The World Health Organisation (WHO) is currently meeting in Geneva to discuss whether to declare the outbreak a global health emergency, the BBC reports. 

The world's largest Ebola outbreak has now killed almost 900 people across Sierra Leone, Guinea, Liberia and Nigeria.

Hundreds of troops have been deployed in Sierra Leone and Liberia to help contain the disease. The plan, known as Operation Octopus, is the latest attempt to enforce stricter quarantines across the worst affected areas.

"We hope it will not require excessive force, but we have to do whatever we can to restrict the movement of people out of affected areas," said Liberia's information minister, Lewis Brown.

Germany has now joined France and the US in issuing official travel warnings to West Africa.

British Airways announced this morning that is had cancelled flights to Liberia and Sierra Leone due to a "deteriorating public health situation". The suspension is expected to last until the end of August, but will be reviewed over the coming weeks.

In a statement it said "the safety of our customers, crew and ground teams is always our top priority".

The move by BA follows similar decision by Emirates and smaller regional airlines earlier this week.

Ebola: 'miraculous' zMapp drug saved lives of workers

05 Aug

An experimental drug to treat Ebola was given to two American medical volunteers and probably "saved their lives", claims CNN.

Frozen vials of the drug called 'zMapp' were reportedly flown to West Africa last week and given to Dr Kent Brantly and Nancy Writebol, aid workers who had been infected after treating patients in Liberia. Their conditions improved after taking the drug and they have now been flown back to the US for further treatment.

"Within an hour of receiving the medication, Brantly's condition was nearly reversed", says CNN's chief medical correspondent, Dr Sanjay Gupta. He said one of the doctors described the turnaround as "miraculous", which is "not a term we scientists like to throw around".

But what is this new drug and if it is so effective, why wasn't it administered to the hundreds of patients who have died of the disease across West Africa?

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 tabacco leaves. "It works by preventing the virus from entering and infecting new cells", says Gupta. 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 recent trials, the treatment is only effective within a limited time frame after infection, with optimum results reported when administered within 24-hours.

Has it been tested on humans?

Not properly. The two American aid workers would have been among the first humans to take the medication and would have been made aware of the risks and been required to give "informed consent".

The drug is still in early stages of testing and had only been tested on monkeys, with scientists reporting "promising" results.

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. 

So, why hasn't it been given to other dying patients?

The FDA only grants compassionate use on a case-by-case basis for individual patients or "intermediate-size" groups of patients. It could only allow the use to be broadened if there was sufficient evidence on the safety and effectiveness of the drug.

When is it likely to be readily available?

Scientists from the National Institute of Health in the US have announced that they expect to begin testing a possible vaccine for the disease in September. Despite these developments, health professionals warn that it doesn't mean a cure is close. Clinical trials are not quick and doctors suggest that it is unlikely either a cure or a vaccine will be delivered before the end of 2015.

What has the response been?

While many were quick to celebrate the positive effects of the drug, others warned of the ethical, legal and medical dilemmas of using untested drugs. The World Health Organization (WHO) has said that health authorities "cannot start using untested drugs in the middle of an outbreak". Doctors without Borders warned that using drugs in their early stages of development would have a "series of scientific and ethical implications".

Ebola scare at Gatwick: disease 'has not spread to UK'

04 Aug

Tests carried out on an elderly woman who died shortly after arriving at Gatwick airport from the Gambia have come back negative for Ebola, the Department of Health has said.

A woman, believed to be in her early 70s, collapsed at the airport shortly after landing and was later pronounced dead in hospital.

Dr Brian McCloskey, director of global public health at Public Health England, confirmed that "there was no health risk to other passengers or crew". He told the BBC that it was considered "very unlikely" that the woman was carrying Ebola, but tests were carried out as a precaution.

"The correct procedures were followed to confirm there was no reason to quarantine the airplane, the passenger or staff," he said.

The disease, currently only known to have spread in Liberia, Sierra Leone and Guinea, has resulted in at least 826 suspected deaths, according to the figures released by the World Health Organization (WHO). The organisation said the disease was "moving faster than our efforts to control it".

The second UK scare comes as two infected American medical volunteers were flown to a US hospital for treatment. Dr Kent Brantly and Nancy Writebol were infected while treating patients in Liberia, The Guardian reports. Doctors working to treat the pair allayed fears that the disease could spread in the US, saying that strict isolation procedures are in place to prevent an outbreak.

Emirates has become the first major airline to suspend flights in response to the outbreak. "The safety of our passengers and crew is of the highest priority and will not be compromised," it said, according to Al Jazeera

Meanwhile, a leading British doctor has blamed Western pharmaceutical companies for delaying the development of a vaccine for the disease as it "only affects Africans".

In cases of Ebola, like HIV/Aids, "the involvement of powerless minority groups has contributed to a tardiness of response and a failure to mobilise an adequately resourced international medical response", Professor John Ashton, president of the UK Faculty of Public Health wrote in the Sunday Independent.

Ebola: Commonwealth games athlete cleared of disease

01 Aug

The death toll of the worst-ever Ebola outbreak has risen to 729, as global efforts to test for, treat and contain the disease intensify.

A cyclist from Sierra Leone taking part in the Commonwealth games in Glasgow was tested for the disease after he fell ill and was hospitalised last week, according to the BBC. Moses Sesay has been cleared of the virus and has since returned to the competition.

"There is no Ebola in the Athletes' Village," a spokesperson confirmed, and "no one has tested positive for Ebola in Scotland".

Across the Atlantic, a US aid worker infected with the disease in West Africa is to be flown to Atlanta for treatment in the next few days in an unprecedented move. The unnamed patient will be placed in a high-security isolation unit at Emory University hospital, the BBC reports.

The US Centre for Disease Control (CDC) yesterday issued a travel warning for parts of West Africa that have been worst affected by the disease. It has advised against all non-essential travel to Sierra Leone, Guinea and Liberia. The CDC will also be sending 50 disease control specialists to the region to work alongside World Health Organization (WHO) and local officials, Time reports.

A state of emergency has been now declared in Sierra Leone by President Ernest Bai Koroma. He said tighter quarantine restrictions would be put in place and that the army and police would work together to restrict the movement of people in affected areas in the country.

The WHO and leaders from West Africa are expected to announce a $100m response plan later today to better equip health workers in their fight against Ebola.

Meanwhile, scientists from the National Institutes of Health in the US have announced that they expect to begin testing a possible vaccine for the disease in September.

Ebola virus: UK 'not ready' to deal with outbreak

31 July

The Ebola outbreak in West Africa, described yesterday by the Foreign Secretary as a threat to the UK, could catch UK Border staff unprepared, a union official has said.

Lucy Moreton, general secretary of the Immigration Service Union, said border, immigration and customs staff are "very concerned" about the risk of Ebola reaching the UK.

She said her members told her they felt unprepared to deal with people entering the UK with suspected cases of the deadly virus, and that staff who are serving on the "front line" need further training and guidance to deal with the threat.

"There is no health facility at the border, there is no containment facility, and until extremely recently there has been no guidance issued to staff at all as to what they should do," She told the BBC Radio 4's The World Tonight. "They are phoning us up and asking 'what are we supposed to do, how do we spot this, how do we protect ourselves?', and we can't answer that for them just now."

Yesterday Philip Hammond, the Foreign Secretary chaired an emergency meeting of the Cobra committee to discuss ways of managing the risk. He had earlier said that Ebola posed a threat to the UK.

The deadliest Ebola outbreak on record has so far killed more than 670 people in Sierra Leone, Guinea, Liberia and Nigeria and there are fears of a global epidemic.

However, Hammond said that he was "fairly confident" that no Britons had been infected so far and added that the disease had not been detected in the UK. He said the government was "absolutely focused" on dealing with the risk and was planning to look at "whether there are precautions we need to take either in the UK or to protect our nationals".

An alert has been issued by Public Health England for doctors across the UK to be aware of symptoms of the disease. One man in Birmingham was tested for the disease but results came back negative, the BBC reports.

Several airlines have followed the lead of Nigerian carrier Arik Air, which has suspended flights to the affected areas of West Africa in order to contain the disease.

The government's chief scientific adviser Sir Mark Walport told the Daily Telegraph that by living in such an interconnected world "disruptions in countries far away will have major impacts" across the globe.

"We were lucky with Sars. But we have to do the best horizon scanning", he said. "We have to think about risk and managing risk appropriately." 

Ebola: flights suspended as virus spreads to Nigeria

29 July

Extraordinary measures are being taken across West Africa to contain the deadliest ever outbreak of Ebola, which has killed at least 672 people in the past seven months.

Flights across the region have been cancelled, a Nigerian hospital has been shut down and armed police are patrolling hospitals in Sierra Leone, The Guardian reports. The new measures follow Liberia's decision to shut most of its borders yesterday in an attempt to contain the highly infectious disease.

Last week, a Liberian man died of the disease after flying into Lagos despite feeling unwell. Before then, there had been no reported cases of the disease in Nigeria. Liberian president Ellen Johnson Sirleaf criticised the man for not following medical advice, saying the victim put others at serious risk due to "disrespect for the advice which had been given by health workers".

Anyone who was seated near the infected man could be in "serious danger", Derek Gatherer, a virologist at the University of Lancaster told The Guardian. The hospital where he died has been closed and quarantined, and the World Health Organisation is working to trace all the passengers on board the flight. 

One of the largest airlines in the region, Arik Air has suspended flights between Nigeria, Liberia and Sierra Leone, Reuters reports.

As public fear continues to grow, armed police have been called in to guard a hospital in Sierra Leone, which houses several confirmed cases of the disease. Local residents had threatened to burn the centre down because of popular misconceptions surrounding the disease, according to Reuters.

Ebola outbreak forces Liberia to close most of its borders

28 July

The Liberian government has closed its borders in a bid to stop the deadly Ebola virus from spreading further across the continent.

More than 670 people have died from Ebola across West Africa, including one of Liberia's most high-profile doctors, Dr Samuel Brisbane.

An American physician, Dr Kent Brantly, is currently being treated for the deadly virus, as well as a US missionary, Nancy Writebol, who was working in the capital city, Monrovia.

Brantly, who had been wearing protective coveralls from head to toe while treating patients, was lucky to notice the signs early but he is "not out of the woods yet", said aid workers.

Yesterday, Liberia's president, Ellen Johnson Sirleaf, said: "All borders of Liberia will be closed with the exception of major entry points. At these entry points, preventive and testing centres will be established, and stringent preventive measures to be announced will be scrupulously adhered to."

Public gatherings such as marches and demonstrations have also been restricted.

The virus, which is highly contagious, is transmitted by direct contact with the blood, body fluids and tissues of infected animals or people. It also has no known cure, making it one of the deadliest in the world. It begins with symptoms such as a fever and sore throat and escalates to vomiting, diarrhoea and internal and external bleeding.

At least 1,201 people have been infected in Liberia, Sierra Leone and Guinea, according to the World Health Organisation. Ebola can kill up to 90 per cent of those who catch it, although the fatality rate of the current outbreak is around 60 per cent.

On Friday, Nigerian officials said that a Liberian man had died of Ebola in Lagos. "An outbreak in Lagos, a megacity where many live in cramped conditions, could be a major public health disaster," says the Washington Post.

Experts believe the outbreak in Africa might have begun in January in south-east Guinea, though the first cases were not confirmed until March.

Ebola: chief doctor fighting outbreak infected with virus

24 July

The head doctor fighting an outbreak of Ebola in Sierra Leone has himself been infected with the disease, the president’s office has announced.

Sheik Umar Khan, a 39-year-old virologist who has treated more than 100 people infected with the deadly Ebola virus, has now been admitted to a treatment ward in Kailahun, the epicentre of the latest outbreak.

More than 630 people have died in Sierra Leone, Liberia and Guinea since the outbreak began in February, according to the latest data from the World Health Organisation.

The outbreak in the three West African states is the deadliest to date. There is no known vaccination, cure or treatment for Ebola, beyond the relief of symptoms. The disease kills 90 per cent of those it infects.

Health minister Miatta Kargbo said the news about Dr Khan reduced her to tears. She described him as a "national hero" and said she would do "anything and everything in my power to ensure he survives," The Independent reports.

Medical charity Medecins Sans Frontieres described the latest outbreak as "out of control".

Nurses in the government hospital in Kenema town in Sierra Leone went on strike on Monday following the death of three of their colleagues of suspected Ebola, the BBC reports. The strike was suspended after the government promised to investigate their demands, which included the relocation of the Ebola ward from the hospital to a separate facility administered by Medecins Sans Frontieres.

It is not known how Dr Khan contracted the illness. Ebola is spread through bodily fluids such as sweat and saliva – but according to Reuters, the doctor was "always meticulous with protection, wearing overalls, mask, gloves and special footwear".

Nevertheless, Khan said he feared Ebola. "I am afraid for my life, I must say, because I cherish my life," he said. "Health workers are prone to the disease because we are the first port of call for somebody who is sickened by disease. Even with the full protective clothing you put on, you are at risk."

Ebola outbreak: why the disease is 'out of control'

11 July

The Ebola virus is "out of control" and continuing its rapid spread across Guinea, Liberia and Sierra Leone, with the World Health Organisation recording 44 new infections and 21 deaths in just two days, Al Jazeera reports.

This comes despite agreement between West African nations about how to tackle the deadly disease at crisis talks held in Ghana.

We examine why governments and health workers are having such difficulty controlling the spread of the disease, and how humans are making it worse.

Where did the virus originate?

The Ebola virus was first identified in the Democratic Republic of Congo in 1976. It gets its name from the Ebola River, which is situated near the village where it was discovered.

Ebola is a "zoonotic" disease, meaning that the virus can spread easily between animals and humans, according to the WHO. Scientists believe it was initially present in wild animals living in tropical rainforests in equatorial Africa. Fruit bats have been identified as one of the main hosts as they can transmit the disease while remaining unaffected by it.

The disease spread to humans when they came into contact with blood or other bodily fluids from infected animals through hunting. 

Why is it so difficult to control? 

Ebola is highly infectious. It can be transmitted through bodily fluids, skin and other organs or through indirect contact with environments contaminated by the disease.

The disease can also have a long incubation period, lasting up to three weeks, which allows it to spread rapidly before diagnosis and quarantine can take place. Men who have been infected with the disease and recovered can still pass it on through sexual contact for up to seven weeks.

High population densities in the affected West African cities and the difficulty in regulating the movement of people across the region further compounds the problem.

How are humans making it worse? 

The consumption of bush meat is a significant contributing factor in West Africa, Mother Jones reports. Bush meat is often sold from roadside grills, and despite being banned in the Ivory Coast in an attempt to stop the spread of the disease, people continue to sell and consume it.

Traditional burial rituals, such as embalming, commonly practised in West African countries, involves direct contact with the body. Even where such customs have been banned or discouraged, relatives have risked transmitting the disease further by insisting on traditional burials.

Human activity in the region, particularly deforestation, mining and conflict all contribute to the destruction of rainforest and animal habitats and causes "people and animals to have more contact" than usual", says epidemiologist and Ebola expert Dr Jonathan Epstein.

In this way, "human activity is driving [infected] bats to find new habitats amongst human populations".

West Africa faces deadliest Ebola outbreak in history

3 July

Health ministers from across West Africa are meeting in Ghana to form a regional response to the Ebola outbreak that has killed almost 500 people.

The World Health Organisation has confirmed that this outbreak, which affects Sierra Leone, Liberia and Guinea, is the deadliest and most aggressive in history.

The organisation says "drastic" action is needed to contain the spread of the virus.

"We’re hoping to take decisions about how to enhance collaboration and responses [of these countries] so we can get a grip and halt this outbreak," WHO spokesman Daniel Epstein told the BBC.

The disease is described as "a severe acute viral illness". It kills up to 90 per cent of those infected and is highly contagious, with no known vaccine or cure.

There are various challenges facing the containment of the disease. "In Liberia, our biggest challenge is denial, fear and panic. Our people are very much afraid of the disease," Bernice Dahn, Liberia’s deputy health minister, told Reuters at the meeting in Ghana.

Sierra Leone’s health minister says more money is needed to pay for drugs, medical staff, protective clothing and isolation centres to halt the spread of the disease.

The WHO sites three main reasons it has been so difficult to contain the spread of the disease: high population densities in the major cities affected, the difficulty in regulating the movement of people across the region and families insisting on traditional burials of victims which risk spreading the disease.

Medical charities in the region are also reporting attacks on foreigner aid workers, who some blame for the disease. "We are seeing an increasing level of hostility borne out of fear in some communities," said Dr Bart Janssens, director of operations for Médecins Sans Frontières.

Ebola outbreak: London Mining staff leave Sierra Leone

3 June

A number of staff from a British mining firm have left Sierra Leone following an outbreak of the deadly Ebola virus.

London Mining said it was not aware of any incidences of the disease among its own workforce, but said it was monitoring the health of all of its employees and has imposed restrictions on travel in the region – which prompted "non-essential" staff to return home.

The BBC says London Mining is the first company to go public on an "evacuation" since 50 suspected cases of the incurable and highly contagious disease emerged in the west African country. Five people have died in Sierra Leone, while more than 100 people have died in neighbouring Guinea where the outbreak started. Cases have also been reported in Liberia.

Symptoms of Ebola, which first emerged in central Africa 20 years ago, include internal and external bleeding, diarrhoea and vomiting. The disease kills between 25 and 90 per cent of its victims.

It emerged last month that relatives of Ebola patients in Sierra Leone had been removing their loved ones from community health centres despite protests from medical staff.

The family of one woman said they had removed her from a clinic because they did not trust the medical system and feared she would die if a planned transfer to a general hospital went ahead.

BBC international development correspondent Mark Doyle said some families apparently wanted to have their loved ones treated by traditional African healers.

Amara Jambai, the Health Ministry's director of disease prevention and control, warned that those patients now risk infecting their family members and others in the community.

London Mining said in a statement: "A number of non-essential personnel have left the country due to voluntary restrictions on non-essential travel."

It said it has established "proactive health monitoring" of the workforce, including screening all staff and visitors entering its sites and ensuring its facility has the appropriate medication and equipment to manage any potential occurrences of the disease. It added that production at its Marampa mine is "not currently affected".

Ebola death toll passes 100 as disease spreads from Guinea

9 April

THE DEADLY Ebola outbreak in West Africa is one of the "most challenging" seen since the virus emerged four decades ago, the UN World Health Organisation (WHO) says.

More than 100 people have now died from the disease in Guinea, Liberia and Mali, and experts say that it may take up to four months to contain.

Guinea now has 157 suspected and confirmed cases of Ebola and 101 deaths. The virus has also spread across the border to Liberia where there are another 21 suspected and confirmed cases and 10 deaths.

So why is this outbreak so challenging? The BBC's global health reporter Tulip Mazumdar says that the virus's broad geographical spread is to blame.

Previously, much smaller areas have been affected. The last significant outbreaks in the Democratic Republic of Congo and Uganda in 2012 led to 60 deaths in total. Health officials were able to contain the spread of the virus in both cases because the outbreaks occurred in remote locations.

By comparison, the recent outbreak in Guinea has now spread to the capital of Conakry, which has a population of two million people, and across the border to Mali and Liberia.

"We fully expect to be engaged in this outbreak the next two to three to four months before we are comfortable that we are through it," Keiji Fukuda, assistant director-general of the World Health Organisation, said at a briefing in Geneva.

Saudi Arabia has suspended visas for Muslim pilgrims from Guinea and Liberia hoping to take part in the Hajj in October. Mali has also promised to tighten border controls.

The WHO describes Ebola as "a severe acute viral illness". Early symptoms include the sudden onset of fever, intense weakness, muscle pain, headache and sore throat, it adds. There is no known cure or vaccine for the virus. Medecins Sans Frontiers said that the current Zaire strain of Ebola was the most aggressive and most deadly it had ever seen, killing nine out of ten patients. 

Ebola virus: 'unprecedented' outbreak kills 78 in Guinea

1 April

SEVENTY-EIGHT people have died in an outbreak of the Ebola virus across Guinea that a medical charity describes as "unprecedented".

Medecins Sans Frontiers (MSF) said that the Zaire strain of the Ebola virus was the most aggressive and most deadly it had ever seen, killing nine out of ten patients, Al Jazeera reports.

"We are facing an epidemic of a magnitude never before seen in terms of the distribution of cases in the country: Gueckedou, Macenta Kissidougou, Nzerekore, and now Conakry," said Mariano Lugli, who is coordinating MSF's project in Conakry, the capital of Guinea.

Guinean health authorities report that to date there have been 78 deaths and 122 suspected patients. The virus is also believed to have spread to Liberia and Sierra Leone, but so far no cases have been confirmed in either country.

On Saturday, Senegal announced that its border crossings to Guinea would be closed "until further notice".

Liberia's Health Minister Walter Gwenigale advised people to stop having sex, as the virus can be spread through bodily fluids, the BBC reports. People have also been recommended to stop kissing and shaking hands.

The WHO describes Ebola as "a severe acute viral illness". Early symptoms include the sudden onset of fever, intense weakness, muscle pain, headache and sore throat, it adds.

"This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes." The virus is said to have a fatality rate of up to 90 per cent.

Senegalese singer Youssou N'Dour cancelled his concert in Guinea over concerns that bringing large groups of people together could help the virus spread.

This is the first outbreak of Ebola in west Africa in two decades. Since it was discovered in Zaire, now the Democratic Republic of Congo, in 1976, the virus has killed an estimated 1,500 people. 

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