Wüstenschiff

Zum ersten Mal wird ein Mensch in Europa mit dem Ebola Virus infiziert.

Erste Ansteckung mit Ebola in Europa

Die Mitarbeiterin einer Madrider Klinik, in der zuvor zwei Patienten an Ebola gestorben sind, hat sich mit dem hoch ansteckenden Virus infiziert. Wie die Gesundheitsbehörden der Region Madrid am Montagabend mitteilten, fielen zwei Tests bei der Krankenpflegerin positiv aus. Erstmals steckte sich demnach ein Mensch außerhalb von Afrika mit dem Virus an. mehr...

Grüsse
Alexander

Was vor kurzem noch als "Schlagzeilen machen" eingestuft worden ist traf mittlerweile zu.
Zum Glück hat Ebola eine relativ lange Inkubationszeit von bis zu drei Wochen - das gibt eine grössere Chance zur eindämmung, wenn der Krankheitsfall erkannt wird.

Zum Glück hat Ebola eine relativ lange Inkubationszeit von bis zu drei Wochen - das gibt eine grössere Chance zur eindämmung, wenn der Krankheitsfall erkannt wird.

Na da wäre ich aber ganz anderer Ansicht. Je kürzer die Inkubationszeit, desto weniger Kontakte, desto eher wird es erkannt und desto eher können Maßnahmen getroffen werden. Die Krankheit ist sicherlich auch ansteckend, bevor Symptome offen zu Tage treten.
Oder hast Du das Ironie-Tag vergessen?

CU
Steffen

Die Inkubationszeit beträgt zwischen 2 und 21 Tagen, im Mittel eine Woche. Während der Inkubationszeit kann der infizierte niemanden anstecken. Erst nach dem Ausbruch wird der Patient zur "Virenschleuder".

Die im Schnitt verhältnismässig lange Inkubationszeit erlaubt es in Verdachtsfällen den Erkrankten rechzeitig zu isolieren. Die lange Zeit bis zum Ausbruch hat haber auch den Nachteil, dass ein Patient, der nichts von seiner Erkrankung weiß, u.U. in andere Länder bzw. Gebiete reisen kann und dort den Virus weiterverbreitet.

Grüsse
Alexander

steffen hat geschrieben:Oder hast Du das Ironie-Tag vergessen?

Absolut nicht. Ich habe mich in den letzten Wochen wahrscheinlich mehr mit dieser Krankheit befasst als die meisten hier im Forum. Wenn es so wäre, wie du schreibst, dass man den Virus bereits vor Ausbruch der Krankheit weitergeben kann, dann wären Lagos und Port Harcourt in Nigeria mittlerweile wohl erheblich von Ebola betroffen. Gerade dank der langen Inkubationszeit bzw. dank des Umstandes, dass der Infizierte den Virus nicht vor Ausbruch der Krankheit weitergeben kann, hatten die Behörden überhaupt eine Chance, die Leute, welche mit kranken Menschen in Kontakt gewesen waren zu identifizieren.

EBOLA VIRUS DISEASE - ex AFRICA: USA ex LIBERIA, WHO
************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:
[1] USA ex Liberia: chain of infection
[2] USA: follow up
[3] WHO: Ebola virus disease - United States of America

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[1] USA ex Liberia: chain of infection
Date: 1 Oct 2014
Source: NY Times [edited]
http://nytimes.com/2014/10/02/world/afr ... ?referrer=


A man who flew to Dallas and was later found to have the Ebola virus was identified by senior Liberian government officials on Wed [1 Oct 2014] as ... a resident of Monrovia in his mid-40s. Mr. D., the 1st person to develop symptoms outside Africa during the current epidemic, had direct contact with a woman stricken by Ebola on 15 Sep 2014, just 4 days before he left Liberia for the United States, the woman's parents and Mr. D.'s neighbors said.

In a pattern often seen here in Monrovia, the Liberian capital, the family of the woman, MW, 19, took her by taxi to a hospital with Mr. D.'s help on 15 Sep 2014 after failing to get an ambulance, said her parents, [Mr & Mrs] Williams. She was convulsing and 7 months pregnant, they said. Turned away from a hospital for lack of space in its Ebola treatment ward, the family said it took MW back home in the evening and that she died hours later, at around 3 a.m.

Mr. D., who was a family friend and also a tenant in a house owned by the Williams family, rode in the taxi in the front passenger seat while MW, her father and her brother, SB, shared the back seat, her parents said. Mr. D. then helped carry MW, who was no longer able to walk, back to the family home that evening, neighbors said. "He was holding her by the legs; the pa was holding her arms, and SB was holding her back," said Arren Seyou, 31, who witnessed the scene and occupies the room next to Mr. D.'s. SB, 21, also started getting sick about a week ago, his family said, around the same time that Mr. D. 1st started showing symptoms [in the USA].

In a sign of how furiously the disease can spread, an ambulance had come to their house on Wed [24 Sep 2014] to pick up SB. Another ambulance picked up a woman and her daughter from the same area, and a team of body collectors came to retrieve the body of yet another woman; all 4 appeared to have been infected in a chain reaction started by MW. A few minutes after the ambulance left, the parents got a call telling them that SB had died on the way to the hospital...

The way Mr. D. appears to have been infected with the Ebola virus is typical in Monrovia, where the epidemic is spreading rapidly, and most people are dying at home because of a lack of ambulances and Ebola treatment centers. At home, they spread the virus to family and friends who are taking care of them. MW's family said they had no choice but to take her back home after being turned away from John F. Kennedy Memorial Hospital, 1st at its maternity ward and then at its Ebola center. While she was sick at home, she appeared to have also infected a neighbor, SS, whose corpse was picked up on Wed [24 Sep 2014]. Neighbors said that an ailing MW used to visit SS, who lived in a pink house next door. After SS fell ill, a friend of hers living nearby started coming over to take care of her. That friend, [a 2nd MW], did chores for SS, including washing her clothes.

On Wed [24 Sep 2014], a visibly ill 2nd MW was taken by ambulance to a hospital; her daughter, Mercy, 9, joined her in the ambulance, though she was not showing symptoms herself. Other neighbors, fearful of the growing contagion in their neighborhood, had insisted angrily that Mercy be taken away. While [the 1st] MW appears to have been the 1st patient in her area of the neighborhood, members of a local volunteer Ebola task force say they believe that the virus was brought in by an outsider. MW rarely left home because of her pregnancy, they said. But a cousin who came to visit MW later died of Ebola after apparently being infected by her [the cousin's or MW's?] mother, who is now in a Ebola treatment center, members of the task force said. "That's how Ebola came here," said Mark Kpoto, 21, a task force member.

[Byline: Norimitsu Onishi]

--
Communicated by:
Ryan McGinnis http://bigstormpicture.com

[This chain of events illustrates the danger that anybody arriving from Liberia, even without symptoms on departure from there or on arrival in the USA (or anywhere else in Africa or overseas) may be incubating Ebola -- but not international volunteers who have only been in contact with Liberians while wearing adequate PPE (personal protection equipment). - Mod.JW]

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[2] USA: follow up

Ebola patient told hospital he had been to Liberia
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1 Oct 2014: (USA TODAY) A man infected with Ebola was allowed to leave the hospital last week because the results of a screening weren't shared with his healthcare team, which concluded he had a common virus and discharged him, hospital officials said Wed [1 Oct 2014]. While health experts agree that the USA is not at risk for a large Ebola epidemic like the one affecting West Africa, some doctors are concerned that the infected patient was sent home from a Dallas hospital without treatment the 1st time he sought care.

The unidentified Ebola patient, now in intensive care at Texas Health Presbyterian Hospital in Dallas, arrived in the USA on 20 Sep 2014 without symptoms but sought care on 26 Sep 2014. He was sent home, only to return to the hospital 2 days later and be admitted. At a press conference on Wed [1 Oct 2014], hospital officials said that a triage nurse performed the recommended screening -- asking about both his symptoms and his travel history -- but her report wasn't communicated to the rest of his healthcare team. He's now in serious but stable condition, according to hospital officials http://www.usatoday.com/story/news/nati ... t/16527143.

[This was a communication failure that is unlikely to be repeated after all the media coverage. - Mod.JW]


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US Ebola patient said he was from Liberia
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1 Oct 2014: (WFAA) Three Dallas Fire-Rescue paramedics and several emergency room workers at Texas Health Presbyterian Hospital are off work and under observation after making contact with the patient being treated for Ebola... Tuesday night [30 Sep 2014], the Centers for Disease Control [CDC] flew in a team of 10 Ebola experts to help local officials and the hospital staff...

Dallas Fire-Rescue told News 8 that the paramedics who treated the man put on gloves and a mask after the patient exhibited possible signs of a communicable disease. "The patient did exhibit high fever, nausea, vomiting, GI [gastro-intestinal] issues along those lines," said Assistant Chief Norman Seals. Those 3 Dallas paramedics are under observation for at least 3 weeks. That's the maximum amount of time, the CDC said, for Ebola symptoms to develop. "I spoke to all 3 medics personally this evening [1 Oct 2014]. They seem relaxed," Seals said. "They didn't have a lot of concern at this time, and were kind of getting a little tickled [pleased] with the hype coming with this. They seem perfectly at ease." While doctors at Presbyterian treat the patient, the CDC and Dallas County health officials will begin a "contact investigation," which requires interviewing everyone the patient contacted. Dallas County Health Director Zachary Thompson said that includes 4 or 5 children, several adults, and the emergency medical personnel, about a dozen people in all. "What we're hearing is that the individual was a traveler," Thompson said. "Then, we're hearing they might live here. All this has to be flushed out in this contact investigation." Thompson maintained that this is a manageable health situation http://wfaa.mlnwap.com/article.html#!/1 ... e8783403df.


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5 Dallas ISD students at 4 schools may have had contact
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1 Oct 2014: (Dallas News) 5 Dallas ISD [Dallas Independent School District] students at 4 schools [2 elementary, a middle and a highschool] may have had contact with the Ebola patient in Dallas and stayed home from school as a precaution, according to a district email sent to employees today [1 Oct 2014]... The schools are in the Vickery Meadow area in northeast Dallas, where many refugee families and other immigrants have settled in apartments... - more
http://educationblog.dallasnews.com/201 ... -sick.html

[It is important to note that none of the students had symptoms, so could not have transmitted to classmates before they were home quarantined. - Mod.JW]
--
Communicated by:
Ryan McGinnis http://bigstormpicture.com

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[3] WHO: Ebola virus disease - United States of America
Date: 1 Oct 2014
Source: WHO Disease outbreak news [edited]
http://www.who.int/csr/don/01-october-2014-ebola/en


On 30 Sep 2014, the Pan American Health Organization/World Health Organization (PAHO/WHO) was informed of the 1st confirmed imported case of Ebola virus disease (EVD) in the United States.

The case is an adult with recent travel history to West Africa who developed symptoms compatible with Ebola on 24 Sep 2014, approximately 4 days after arriving in the United States on 20 Sep 2014. The patient did not have symptoms when leaving West Africa. The case sought medical care on 26 Sep 2014 and was admitted into isolation on 28 Sep 2014 at Texas Health Presbyterian Hospital in Dallas.

Samples were sent for testing to the US Centers for Disease Control and Prevention in Atlanta, Georgia and at the Texas state laboratory. Results were positive for ebolavirus.

Identification of close contacts for further daily monitoring for 21 days after exposure is underway. Given that the case did not exhibit symptoms of Ebola during the flights from West Africa, contact tracing of people on the same commercial airline flights is not indicated.

***PLEASE NOTE: Future WHO updates on EVD in the United States will not be posted on the Disease Outbreak News. Further information will be available in WHO's Ebola Situation Reports, which provide regular updates on the WHO response http://who.int/csr/disease/ebola/situation-reports/en.

WHO does not recommend any travel or trade restrictions be applied by countries except in cases where individuals have been confirmed or are suspected of being infected with EVD or where individuals have had contact with cases of EVD. Contacts do not include properly-protected health-care workers and laboratory staff.

Temporary recommendations from the Emergency Committee with regard to actions to be taken by countries can be found at:
http://www.who.int/mediacentre/news/sta ... 0140808/en and at

IHR Emergency Committee on Ebola outbreak in West Africa http://www.who.int/mediacentre/news/sta ... 0140808/en.

For more information on this case, see:
Texas Department of State Health Services news release
https://www.dshs.state.tx.us/news/relea ... 40930.aspx;

Centers for Disease Control and Prevention [CDC] press release
http://www.cdc.gov/media/releases/2014/ ... -case.html.

--
Communicated by:
ProMED-mail Rapporteur Marianne Hopp

[A HealthMap showing the distribution & timeline of EVD cases and deaths can be seen at http://healthmap.org/ebola/#timeline. - Mod.JW

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/1637.]

EBOLA VIRUS DISEASE - ex AFRICA (02): USA ex LIBERIA, PREVENTION, FALSE ALARMS
******************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:
[1] Texas: up to 100 people being monitored
[2] Prevention & false alarms

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[1] Texas: up to 100 people being monitored
Date: Thu 2 Oct 2014
Source: ABC News [edited]
http://abcnews.go.com/Health/ebola-pati ... d=25912405


Ebola patient's family ordered to stay inside after trying to leave
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The family of the Texas Ebola patient D. have been ordered to stay in their home after violating official's initial request not to leave. "There were violations of the request to not leave their premises," Dallas judge Clay Jenkins said of the breach that prompted the Texas Department of State Health Services to order the quarantine. D. was staying with family members in Dallas when he became ill and was confined to an isolation unit at Texas Health Presbyterian Hospital Dallas. His family members, including 5 school age children, were told to remain at home. The entire apartment complex is being power washed today [2 Oct 2014].

The order came as authorities track all the people who D. is believed to have come in contact with since his arrival. The circle of people who have come into contact with him has grown rapidly from 18 Wednesday night [1 Oct 2014] to 100, according to Texas health officials. "Out of an abundance of caution, we're starting with this very wide net, including people who have had even brief encounters with the patient or the patient's home," Texas Department of State Health Services spokesperson Carrie Wilson said in a statement. "The number will drop as we focus in on those whose contact may represent a potential risk of infection."

A team of 10 experts from the Centers for Disease Control and Prevention have arrived in Dallas and will be helping the local health officials "find, assess, and assist everyone who came into contact" with D., according to a CDC news release.

[Byline: Meghan Keneally]

[Correction: 2 Oct 2014: An earlier version of [a New York Times] article, using information from federal and Texas health officials, misstated the day that the Ebola patient, D., 1st visited the hospital. It was Thursday [25 Sep 2014], not Friday.
http://www.nytimes.com/2014/10/02/us/af ... tient.html

When did his symptoms begin? Was he symptomatic and therefore infectious to contacts all day Thursday and even earlier? He arrived in the USA without symptoms on 20 Sep 2014. - Mod.JW]

--
Communicated by:
Ryan McGinnis
http://bigstormpicture.com

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[2] Prevention & false alarms


Liberia to prosecute man who brought Ebola to USA
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2 Oct 2014 (ABC News): Liberia plans to prosecute the airline passenger who brought Ebola into the U.S., alleging that he lied on an airport questionnaire about not having any contact with an infected person, authorities said Thursday. D. filled out a series of questions about his health and activities before leaving on his journey to Dallas. On a 19 Sep 2014 form obtained by The Associated Press, he answered "no" to all of them. Among other questions, the form asked whether D. had cared for an Ebola patient or touched the body of anyone who had died in an area affected by Ebola. "We expect people to do the honorable thing," said Binyah Kesselly, chairman of the board of directors of the Liberia Airport Authority in Monrovia. The agency took the case to the Ministry of Justice, which will formally prosecute it.
http://abcnews.go.com/International/wir ... ePage=true

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Isolated patient in Honolulu does not have Ebola virus
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2 Oct 2014 (Hawaii News Now): The Hawaii State Department of Health said Thursday [2 Oct 2014] it had ruled out the possibility that a patient isolated at a Honolulu hospital has the Ebola virus.
http://www.hawaiinewsnow.com/story/2668 ... newsnowcom

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Dallas braces for 2nd Ebola case
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Dallas health officials are bracing for a possible 2nd case of the deadly Ebola virus connected to the infected man now in isolation. Dallas County Health and Human Services Director Zachary Thompson said there is one particular contact of the patient who he fears may have Ebola. "Let me be real frank to the Dallas County residents: the fact that we have one confirmed case, there may be another case that is a close associate with this particular patient," Thompson said Wednesday morning [1 Oct 2014] in an interview with local ABC affiliate WFAA ... -- more
http://thehill.com/policy/healthcare/21 ... ebola-case

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Another Possible Ebola Case Investigated In Utah
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2 Oct 2014 (Zerohedge News): Fox13 reported that Health officials confirmed they are investigating a possible case of Ebola at Primary Children's Hospital. "Primary Children's said it is unlikely the patient has Ebola however officials are taking this opportunity to use the emergency plan they have been working on to provide maximum protection to staff, patients, families and the greater community. Officials said they admitted a patient who has symptoms raising concerns about Ebola." The hospital plans to explain how it is caring for the patient, what it is doing to protect the community and answer questions about the virus itself, at a 1 p.m. news conference.
http://www.zerohedge.com/news/2014-10-0 ... gated-utah

--
Communicated by:
Ryan McGinnis
http://bigstormpicture.com

[

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/106.]

EBOLA VIRUS DISEASE - ex AFRICA (03): USA ex LIBERIA, GERMANY CASE ex SIERRA LEONE
*****************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this post:
[1] USA: Texas update
[2] Liberia: US journalist with Ebola being evacuated
[3] Germany ex Sierra Leone: 2nd evacuated case
[4] Prevention & false alarms

******
[1] USA: Texas update
Date: Thu 2 Oct 2014
Source: WFAA [edited]
http://www.wfaa.com/story/news/local/da ... t/16622445


Dallas Co. sheriff's officers entered quarantined apartment
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5 members of the Dallas County [Texas] Sheriff's Department who were briefly inside the apartment where a man with Ebola stayed have been temporarily put on leave.‎ "They're very concerned," said Christopher Dyer, president of the Dallas County Sheriff's Association. ‎"Their families are concerned..." ... The 3 deputies, a sergeant, and a lieutenant accompanied the head of Dallas County Health and Human Services Department and a doctor into the apartment late Wednesday [1 Oct 2014] night. They had gone there on the orders of Sheriff Lupe Valdez to get the people inside to sign a court order forbidding them from leaving the apartment ...
Dyer said deputies should never have been involved to begin with, because he considers it a federal issue and not a local matter ... "Let's move that family. Let's move everybody out of that building. I don't care if it's overkill. Let's do overkill. I don't think sending a few deputies in there is the right course of action.‎" -- more

[This is over-reaction. The sick man, D., had left the apartment for the hospital days ago. Nobody else in the apartment (or the building) had symptoms. The 7 people who entered the apartment could not have become infected. A lot more public education is necessary at all levels. - Mod.JW]

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Dallas: cleaning problems
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2 Oct 2014 (New York Times): More than a week after a Liberian man fell ill with Ebola and 4 days after he was placed in isolation at a hospital in Dallas, the apartment where he was staying with 4 other people had not been cleaned and the sheets and dirty towels he used while sick remained in the home, health officials acknowledged on Thursday [2 Oct 2014] afternoon ... -- more
http://www.nytimes.com/2014/10/03/us/da ... tacts.html

[See: Interim Guidance for Environmental Infection Control in Hospitals for Ebola Virus:
"Limited laboratory studies under favorable conditions indicate that Ebola virus can remain viable on solid surfaces, with concentrations falling slowly over several days. In the only study to assess contamination of the patient care environment during an outbreak, virus was not detected in any of 33 samples collected from sites that were not visibly bloody... There is no epidemiologic evidence of Ebola virus transmission via either the environment or fomites [objects] that could become contaminated during patient care (e.g., bed rails, door knobs, laundry). However, given the apparent low infectious dose, potential of high virus titers in the blood of ill patients, and disease severity, higher levels of precaution are warranted to reduce the potential risk posed by contaminated surfaces in the patient care environment."
http://www.cdc.gov/vhf/ebola/hcp/enviro ... itals.html - Mod.JW]

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Cleaners turned away at Ebola patient's home, cleanup delayed
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3 Oct 2014 (CNN): Brad Smith of the Cleaning Guys, which was hired to sanitize the apartment, said his company does not have the proper permits to transport hazardous waste on Texas highways. The company specializes in hazmat and biohazard cleaning services. Smith said authorities sent his crew away late Thursday [2 Oct 2014] before they entered the apartment and told them to come back with proper permits. It's unclear how long that will take. "The permit is being processed through DOT (the Department of Transportation) because it is a special permit," Smith said. "This is a unique situation. Once awarded, our hazmat teams will be allowed back inside to do their jobs."

D. was visiting his son and his son's mother in Dallas, said his half-brother. The woman told CNN's Anderson Cooper she is quarantined with one of her children under age 13 and 2 nephews in their 20s. She used bleach to clean her apartment, "but it's not clear to me how systematic the cleaning was," Cooper said.
http://www.cnn.com/2014/10/03/health/eb ... ?c=&page=0

[Bureaucracy manages to trump public health once again. - Mod.JW]

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About 50 under observation after Ebola diagnosis in Texas
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3 Oct 2014 (Reuters): Health officials in Dallas charged with checking the spread of Ebola have narrowed their focus to about 50 people who had direct or indirect contact with an infected Liberian traveler, including 10 at high risk who are being checked twice daily for symptoms. A cleanup crew began decontaminating the Dallas apartment where the man, D., had been staying before he was admitted to the hospital 5 days ago and where he remained in serious condition on Friday [3 Oct 2014].

4 people close to D. who were quarantined in the apartment in a northeastern section of the city "will be moved to another location soon," Dallas County Fire Marshal Robert De Los Santos told reporters. Earlier, the county said it was safe for them to remain there during the cleanup.
http://www.reuters.com/article/2014/10/ ... F720141003

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Unprotected workers cleaned up 'Ebola Vomit' in Dallas
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3 Oct 2014 (Prison Planet): Image shows unprotected workers cleaning up 'Ebola Vomit' in Dallas
http://www.prisonplanet.com/shock-image ... allas.html

[Pressure water cleaning aerosolizes vomit. Contaminated areas needed to be cordoned off from passersby and cleaned by workers wearing gloves, boots and masks at a minimum. I hope these 2 workers are being followed up. - Mod.JW]

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Apartment complex power washed
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3 Oct 2014: Perhaps someone could comment on why the apartment complex is being power washed. 1st, is such extensive cleaning actually required, and 2nd, wouldn't power washing likely aerosolize any virus present and increase the risk of transmission?

--
Richard Gould MD MHSc FRCPC
AMOH, Public Health, Community & Health Services
Canada
<Richard.Gould@york.ca>

[Yes, it would. - Mod.JW]

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[2] Liberia: US journalist with Ebola being evacuated
Date: Fri 3 Oct 2014
Source: Wall Street Journal [edited]
http://online.wsj.com/articles/u-s-jour ... 1412340037


AM, an American freelance journalist diagnosed with Ebola, and the NBC News team he worked with here will be flown to the USA, yet another demonstration of the international repercussions of the epidemic sweeping West Africa. AM is scheduled to be picked up Sunday night [5 Oct 2014] in Liberia and will be transported to the Nebraska Medical Center in Omaha, his father said Friday [3 Oct 2014].

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

******
[3] Germany ex Sierra Leone: 2nd evacuated case


Ebola Virus Disease, Germany, ex Sierra Leone, HCW
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I would like to send you a reminder about the case of an international staff doctor working at Emergency ONG Ebola Treatment Centre in Sierra Leone who fell ill with ebolavirus and subsequently medevac'd to Germany. The Italian website of the ONG reporting as following:
http://www.emergency.it/comunicati-stam ... -2014.html
BBC on Germany MEDEVAC: http://www.bbc.com/news/world-europe-29473623 [see below]

This also to highlight that despite the ebolavirus hit at the centre of USA's wealthiest region, other people and other countries are facing issues with infected [evacuated] patients.

--
Giuseppe Michieli
<gimi69@libero.it>

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Ebola outbreak: 2nd patient arrives in Germany
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Photo: Medical staff in protective equipment attend the arrival of an Ebola patient at Frankfurt University Hospital, 3 Oct 2014.
3 Oct 2014 (BBC News): A hospital in the German city of Frankfurt-on-Main has taken in an Ebola patient after he was flown in during the night under tight security. After arriving on a medical flight from West Africa, the man was brought to Frankfurt University Hospital where he was placed in an isolation ward. He is a Ugandan doctor who worked with Ebola patients in Sierra Leone. It is Germany's 2nd case, with a man undergoing treatment in Hamburg after arriving from West Africa in August [2014] ... Giving details of the sufferer, Hesse Minister of Social Affairs Stefan Gruettner said he had been working for an Italian aid organisation in Sierra Leone and had helped Ebola sufferers there before becoming infected himself.
http://www.bbc.com/news/world-europe-29473623

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

******
[4] Prevention & false alarms


DC, Maryland & Virginia testing patients with Ebola-like symptoms
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3 Oct 2014 (NBC): A patient is being evaluated for Ebola at Howard University Hospital in Washington, DC, a hospital spokesperson confirmed Friday [3 Oct 2014]. That person has been admitted to the hospital in stable condition and is isolated. The medical team is working with the CDC and other authorities to monitor the patient's condition ... There are no confirmed cases of Ebola in DC, said the statement ... Meanwhile, at Shady Grove Adventist Hospital in Rockville, Maryland, a patient is in isolation with "flu-like symptoms and a travel history that matches criteria for possible Ebola," according to a statement from the hospital. Lab results indicate the patient has another illness, though the patient's Ebola status is not known ... And 2 Virginians are being tested for the disease after they met the travel criteria set by the CDC, according to NBC12 in Richmond. The patients were isolated from the general population, but were not ordered to be quarantined, NBC12 reported.
http://www.nbcwashington.com/news/local ... 25181.html

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Liberia: airport screening defects fixed
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3 Oct 2014 (IB Times UK): People infected with the Ebola virus in West Africa can avoid detection in airport screenings and board a plane with ibuprofen and lies, according to healthcare experts. Experts have called for more to be done to identify the virus in travellers, as the current screening methods are insufficient. "The fever-screening instruments run low and aren't that accurate," infection control specialist Sean Kaufman, president of the Atlanta-based biosafety company Behavioral-Based Improvement Solutions, told Reuters. "And people can take ibuprofen to reduce their fever enough to pass screening, and why wouldn't they? If it will get them on a plane so they can come to the United States and get effective treatment after they're exposed to Ebola, wouldn't you do that to save your life?" ...

Professor David Heymann, part of the international team who investigated the 1st outbreak of Ebola in the 1970s, is an expert of infectious diseases at the London Schools of Hygiene and Tropical Medicine, and explained that screenings are inaccurate. "You can't find it by screening, because people could be in an incubation period for days," he told IBTimes UK ... The arrival and subsequent hospitalisation of D. has highlighted the extent that US authorities are relying on West African officials to detect the virus. Connection airports between Ebola-affected countries and the USA also have to increase their methods of detection, experts have argued. Virologist Heinz Feldmann, of the US National Institute of Allergy and Infectious Diseases, told Science magazine in September [2014] that staff carrying out screenings in Monrovia airport "don't really know how to use the devices." He said he saw screeners record temperatures of 32 C (90 F), which is so low it is "impossible for a living person."

Feldmann said that his colleagues who had recently returned from Liberia reported the checks had since improved.
http://www.ibtimes.co.uk/ebola-outbreak ... gs-1468372

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Exxon bans employees from traveling to West Africa
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2 Oct 2014 (CNBC/Reuters): Exxon Mobil announced on Thursday [2 Oct 2014] that it has banned employees to travel to areas most affected by Ebola, as the disease has disrupted its operations in West Africa, including future plans to drill off the shore of Liberia. Shares of the energy firm fell after the news.
http://www.cnbc.com/id/102053701
--
Communicated by:
ProMED-mail
<promed@promedmail.org>

EBOLA VIRUS DISEASE - ex AFRICA (04): USA ex LIBERIA, PREVENTION
****************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:
[1] USA: Texas case
[2] Prevention & false alarms

******
[1] USA: Texas case


Retraction: Re: Ebola virus disease - ex Africa (03): USA ex Liberia, Germany case ex S. Leone 20141003.2830392
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"Unprotected workers cleaned up 'Ebola Vomit' in Dallas
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"3 Oct 2014 (Prison Planet): Image shows unprotected workers cleaning up 'Ebola Vomit' in Dallas
http://www.prisonplanet.com/shock-image ... allas.html

"[Pressure water cleaning aerosolizes vomit. Contaminated areas needed to be cordoned off from passersby and cleaned by workers wearing gloves, boots and masks at a minimum. I hope these 2 workers are being followed up. - Mod.JW]"

This is a hoax -- probably gone viral on the internet. I should have known not to trust a recognizable conspiracy website. The photo was taken on Thu 2 Oct 2014, days after he vomited, and any virus would have been killed by drying and sunlight ultra-violet radiation long ago. Dead viruses are not revived by water.

[Somebody is bound to write in "But doctor, viruses can be frozen alive in protein-containing water-based solutions." Like vomit. True -- but it's just not that cold and wet on a Dallas sidewalk in September! So there was no hazard to those workers. Period. - Mod.JW]

----
Electronic records flaw
-----------------------
3 Oct 2014 (Texas Health): Clarification from Texas Health Resources. We would like to clarify a point made in the statement released earlier in the week. As a standard part of the nursing process, the patient's travel history was documented and available to the full care team in the electronic health record (EHR), including within the physician's workflow. There was no flaw in the EHR in the way the physician and nursing portions interacted related to this event ... [But see below. - Mod.JW].

In response to questions raised about D.'s 1st visit to the hospital emergency department on the night of 25 Sep 2014, we have thoroughly reviewed the chain of events. In the interest of transparency, and because we want other US hospitals and providers to learn from our experience, we are, with D.'s permission, releasing this information ...

- When he was asked whether he had nausea, vomiting, or diarrhea, he said no.
- Additionally, D.'s symptoms were not severe at the time he 1st visited the hospital emergency department.
- When D. was asked if he had been around anyone who had been ill, he said that he had not.
- D. was asked if he had traveled outside the United States in the last 4 weeks, and he said that he had been in Africa.

The nurse entered that information in the nursing workflow of the electronic health record.

[Note there is no record of the name Liberia. Other news reports said he had been asked whether he had touched the body of anyone who had died in an area affected by Ebola, and he answered no. (Of course, the sick person was not dead at the time he carried her indoors back at the house.) - Mod.JW] ...

Protocols were followed by both the physician and the nurses.

However, we have identified a flaw in the way the physician and nursing portions of our electronic health records (EHR) interacted in this specific case. In our electronic health records, there are separate physician and nursing workflows. The documentation of the travel history was located in the nursing workflow portion of the EHR ... As designed, the travel history would not automatically appear in the physician's standard workflow.

As result of this discovery, Texas Health Dallas has relocated the travel history documentation to a portion of the EHR that is part of both workflows. It also has been modified to specifically reference Ebola-endemic regions in Africa. We have made this change to increase the visibility and documentation of the travel question in order to alert all providers. We feel that this change will improve the early identification of patients who may be at risk for communicable diseases, including Ebola.

--
Contact:
Wendell Watson, Director
Public Relations
Office: 682-236-6963

[Well, let's hope all US hospitals are checking their electronic data systems. - Mod.JW]

----
Ebola case blood test delay may have violated federal guidelines
----------------------------------------------------------------
State and local health officials waited more than 2 days to perform crucial blood tests that confirmed a Dallas patient was the nation's 1st Ebola case, a delay that appears to have violated federal guidelines. State health officials say they were alerted about 8 p.m. Sunday [28 Sep 2014] by the Dallas County health department to a suspicious case involving a patient who had arrived recently from Liberia. His symptoms were consistent with Ebola. However, instead of sending a blood specimen for immediate testing for Ebola, as suggested by guidelines from the Centers for Disease Control and Prevention, local health officials spent the next 24 hours doing other bloodwork and testing to apparently rule out other causes.
http://www.dallasnews.com/news/metro/20 ... elines.ece

[Well, the state lab probably has a bio-safety level 3 lab because of the risk from tuberculosis in respiratory specimens, but I doubt if blood work is done with the same precautions and PPE (personal protective equipment). I hope the blood lab techs are among those people being closely monitored. - Mod.JW]

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******
[2] Prevention & false alarms


Canada: Toronto hospital patient kept in isolation tests negative for Ebola
---------------------------------------------------------------------------
4 Oct 2014 (Global News Canada): "The result is negative which means that the Ebola isolation protocol is discontinued," said Gillian Howard, VP of public affairs for the University Health Network, in a statement released late Friday night [3 Oct 2014].
http://globalnews.ca/news/1598325/toron ... -for-ebola

----
USA: CDC officials meet flight after passenger from Liberia shows possible Ebola symptoms
--------------------------------------------------------------------------------
4 Oct 2014 (ABC News): A United Airlines flight from Brussels [Belgium] was met by US Centers for Disease Control and Prevention [CDC] officials today [4 Oct 2014] at Newark Liberty International Airport [New Jersey, USA] after a passenger on board believed to be from Liberia exhibited possible signs of Ebola. The passenger was traveling with his daughter on United Flight 998 and both were removed from the plane by CDC crew in full hazmat gear. Other passengers remained on the plane while the 2 were being removed.... "Medical professionals instructed that customers and crew of United flight 988 remain on board until they could assist an ill customer," the statement said. "We are working with authorities and will accommodate our customers as quickly as we can."
http://abcnews.go.com/Health/cdc-offici ... d=25965383

----
USA: Ebola ruled out in 2 suspected cases in Washington DC region
-----------------------------------------------------------------
4 Oct 2014 (Baltimore Sun): Howard University Hospital in Washington DC quarantined a patient Friday [3 Oct 2014] who had recently traveled to Nigeria out of "an abundance of caution," officials said. On Saturday [4 Oct 2014], officials said the hospital, in conjunction with the Centers for Disease Control and Prevention, had determined the patient did not have Ebola.

Shady Grove Adventist Hospital in Rockville [Maryland, USA] also determined late Friday [3 Oct 2014] that their patient had malaria, not Ebola. The unidentified patient was isolated after arriving with suspicious symptoms and travel history. Ebola, malaria and cholera have similar symptoms early on, including fever and vomiting.... Maryland is one of 13 states capable of testing for Ebola, in tandem with the CDC and with its authorization.... -- more
http://baltimoresun.com/#section/-1/art ... p-81586866

----
USA: National nurse survey shows hospitals still not prepared for US Ebola patients
--------------------------------------------------------------------------------
3 Oct 2014 (RNRN Press Release): 80 percent say their hospital has not provided policy for admission of potential infected patients. Following reports that a Dallas hospital failed to hospitalize a patient infected with the Ebola virus and failed to properly communicate essential information to caregivers about his health status, National Nurses United is stepping up the call on US hospitals to immediately upgrade emergency preparations for Ebola in the US. Several weeks ago, National Nurses United began surveying registered nurses across the US about emergency preparedness. Most of the nurses are telling NNU that their hospital is not prepared for the Ebola virus. In updated preliminary results from nearly 700 RNs at over 250 hospitals in 31 states released Friday [3 Oct 2014].... -- more
http://www.nationalnursesunited.org/pre ... r-us-ebola

[I hope this long list of nurses' questions is being addressed urgently. - Mod.JW]

----
Proposals to restrict air travel
--------------------------------
3 Oct 2014 (New York Times): Federal officials flatly rejected the idea of expanding the screening of passengers arriving from West Africa, and said they would not support calls for a ban on travel to the United States from countries being ravaged by the disease. They said such moves would be ineffective and, at worst, could prevent medical workers and other assistance from reaching Africa. "We believe those types of steps actually impede the response," Lisa Monaco, the president's homeland security adviser, said of proposals to restrict air travel. "They impede and slow down the ability of the United States and other international partners to actually get expertise and capabilities and equipment into the affected areas." Representative Tim Murphy, Republican of Pennsylvania, the chairman of a health oversight committee in the House, said he was "deeply concerned" about the travel decision, and said his committee would hold a hearing in about 2 weeks to examine the government's response.
http://www.nytimes.com/2014/10/04/us/co ... frica.html

----
Survival of ebolavirus on laundry
---------------------------------
4 Oct 2014 (Dallas News): "Ebola dried on surfaces can survive for several hours, according to the CDC. For example, people might get infected by handling soiled clothing or bed sheets and then touching their nose, mouth or eyes, or if they are not wearing gloves while doing those tasks and have a cut on their hand."
http://www.dallasnews.com/news/metro/20 ... -guard.ece

[Note that the link to CDC's Interim Guidance for Environmental Infection Control in Hospitals for Ebola Virus in ProMED-mail post Ebola virus disease - ex Africa (03): USA ex Liberia, Germany case ex S. Leone 20141003.2830392 was updated on 3 Oct 2014, after I viewed it, to delete the sentence "There is no epidemiologic evidence of Ebola virus transmission via ... laundry."
http://www.cdc.gov/vhf/ebola/hcp/enviro ... itals.html

In any case, according to the housewife, the bedsheets had not been touched for several days -- i.e., for much more than "several hours." - Mod.JW]

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[<Map of Texas, USA at http://healthmap.org/promed/?p=1637>]

EBOLA VIRUS DISEASE - ex AFRICA (05): USA ex LIBERIA, PREVENTION
****************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:
[1] USA: Texas case
[2] Prevention & false alarms

******
[1] USA: Texas case
Date: 5 Oct 2014
Source: Boston Globe [edited]
http://www.bostonglobe.com/news/nation/ ... story.html


The hospital's explanation about what they knew about D's travel history has changed in the time since his diagnosis was revealed on Tue [30 Sep 2014].

Federal health officials have advised hospitals to take a travel history for patients with any Ebola-like symptoms. When D's diagnosis was 1st disclosed, the hospital said it wasn't until he came back Sun [28 Sep 2014] that they discovered he had been in West Africa. The hospital later acknowledged that D had told a nurse about his travel history on his 1st visit but said the information hadn't been fully communicated to the whole team.

On Thu [2 Oct 2014], the hospital elaborated by saying that a flaw in the electronic health records systems led to separate physician and nursing workflows and that the doctor hadn't had access to D's travel history.

But the hospital issued a statement late Fri [3 Oct 2014] saying that the doctor who initially treated D did have access to his travel history after all. Hospital spokesman Wendell Watson said on Sat 4 Oct 2014 that he could provide no further details, saying: "We're still looking into the entire chain of events."

[But did the doctor see the names Liberia and/or West Africa? The transcript excerpt released by the hospital stated simply: "Africa," which would have raised malaria as the most likely diagnosis; see ProMED-mail post "Ebola virus disease - ex Africa (04): USA ex Liberia, prevention," archive No. 20141004.2832236. - Mod.JW]
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******
[2] Prevention & false alarms

Canada: Toronto hospital patient negative for Ebola
-----------------------------------------------
[4 Oct 2014]: (Global News Canada) "The result is negative, which means that the Ebola isolation protocol is discontinued," said Gillian Howard, VP of public affairs for the University Health Network, in a statement released late Friday night [3 Oct 2014].
http://globalnews.ca/news/1598325/toron ... -for-ebola

--
USA: Patients monitored for possible Ebola symptoms
-----------------------------------------------
5 Oct 2014: (WFLA) 2nd Florida patient with Ebola-like symptoms cleared...
http://www.wfla.com/story/26709355/a-se ... en-cleared

--
USA: Vomiting man removed from flight in Newark is Ebola-free
-----------------------------------------------
4 Oct 2014: (Bloomberg) A sick passenger was pulled off a flight arriving at New Jersey's Newark Liberty International Airport [New York] from Brussels [Belgium]. The man, who vomited on the plane, doesn't have the virus, according to state health officials. Still, passengers on United Airlines flight 998 were kept in their seats for almost 2 hours as quarantine officers from the Centers for Disease Control and Prevention removed the ill individual and a daughter traveling with him.
http://www.bloomberg.com/news/2014-10-0 ... -fear.html

[The Liberian in a Dallas hospital with EVD also arrived in the USA via Brussels, so the index of suspicion is high, although we are not told the country of origin of this person. - Mod.JW]

--
USA: Ebola ruled out in 2 suspected cases in Washington DC region
-----------------------------------------------
4 Oct 2014: (Baltimore Sun) Howard University Hospital in Washington DC quarantined a patient Fri [3 Oct 2014] who had recently traveled to Nigeria out of "an abundance of caution," officials said. On Sat [4 Oct 2014], officials said the hospital, in conjunction with the Centers for Disease Control and Prevention, had determined the patient did not have Ebola. Shady Grove Adventist Hospital in Rockville [Maryland, USA] also determined late Fri [3 Oct 2014] that their patient had malaria, not Ebola. The unidentified patient was isolated after arriving with suspicious symptoms and travel history. Ebola, malaria and cholera have similar symptoms early on, including fever and vomiting... Maryland is one of 13 states capable of testing for Ebola, in tandem with the CDC and with its authorization...
http://baltimoresun.com/#section/-1/art ... p-81586866

--
USA: more than 100 possible cases across the US, all false alarms
-----------------------------------------------------------------------------------------
The CDC has been scrambling to check more than 100 possible reported cases across the US over the last week, all of which have proved false alarms. Dr Frieden said: "We're seeing more people calling us, considering the possibility of Ebola. That's what we want to see. We don't want people not to be diagnosed."...- more
http://www.telegraph.co.uk/news/worldne ... in-US.html

--
USA: screening in West Africa & on arrival
---------------------------------------------------------
5 Oct 2014: (Daily Mail UK) Federal officials have said every passenger travelling from all countries ravaged by the infection could face the checks such as having their temperature taken on arrival. A source told CNN that 'all options are on the table' but says the increase in measures would not be as easy as it sounds as most routes from West Africa are not direct. They said: 'There aren't that many direct flights from Ebola-affected countries to the U.S. anymore. Many passengers are arriving on connecting flights from other parts of the world, and then they come here, so that makes it more of a challenge.' [CDC Director] Friedan stood by the screening procedures, pointing out today that 77 people have been prevented from getting on planes in West Africa thanks to the efforts of airport officials who were trained by the CDC.

http://www.dailymail.co.uk/news/article ... z3FK7vzG2l
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[

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/54.]

EBOLA VIRUS DISEASE - ex AFRICA (06): SPAIN CASE, USA CASE, US CASE MEDEVACED
*****************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:
[1] Spain: autochthonous case
[2] USA: Texas case
[3] USA: sick cameraman arrives at Nebraska hospital
[4] Prevention & false alarms

******
[1] Spain: autochthonous case
Date: 6 Oct 2014
Source: NY Times [edited]
http://www.nytimes.com/2014/10/07/world ... frica.html


A Spanish nurse has become the 1st person to be infected with Ebola outside of West Africa after contracting the virus while treating a missionary who died in a Madrid hospital, Spain's health ministry said Mon [6 Oct 2014]. The assistant nurse was part of the medical team at Madrid's Carlos III hospital that treated MGV, the missionary, who was repatriated from Sierra Leone but then died in the Madrid hospital on 25 Sep 2014.

Ana Mato, Spain's health minister, told a televised news conference that the nurse tested positive for Ebola twice and that the rest of the 30-person team that looked after the missionary were undergoing medical tests to determine whether they had contracted Ebola.

The nurse, whose name was not disclosed, worked in the Carlos III hospital that had been specially selected and prepared to treat AMP, another Spanish priest who had been working in Africa and was the 1st European to be repatriated after being infected with Ebola. Father P. died on 12 Aug 2014, 5 days after entering the special unit of the Carlos III hospital.

Ms. Mato, the health minister, would not discuss how a staff member could have contracted Ebola while working in a hospital specially equipped to handle such a dangerous virus. "We are trying to determine whether all the health safety protocols have been followed," she said. Ms. Mato urged people to remain calm, adding that "all the possible measures" were being taken to guarantee public health safety.

Antonio Alemany, a health official from the regional government of Madrid, told the news conference that the nurse went on vacation a day after Father GV died. She got in touch with a medical center on 30 Sep 2014, after feeling feverish, but had been leading "a normal life" while on vacation, he added, without giving details on her whereabouts during that period.

Mr. Alemany said the nurse initially showed only "low symptoms" of illness, with a fever of roughly 100 F. He described her current condition as stable, after the Ebola infection was confirmed in 2 separate tests. He would not estimate how many people had contact with the nurse in the past 2 weeks, saying that a complete list was being drawn up. On the list is the nurse's husband, Mr. Alemany said, but she has no children. She is 44, according to the website of El Pais, the Spanish newspaper, which cited unidentified medical sources.

The nurse had direct access to Father GV on 2 occasions, Mr. Alemany said, one of which occurred after his death on 25 Sep 2014. Father GV, 69, had been repatriated 3 days earlier from Sierra Leone. The nurse was kept in isolation in a hospital in Alcorcon, on the outskirts of Madrid, but not in a unit specialized to treat infections like Ebola. She was expected to be transferred to the Carlos III hospital late Monday [6 Oct 2014].

[Byline: Raphael Minderoct]

--
Communicated by:
Ryan McGinnis
http://bigstormpicture.com

[It is urgent to identify all possible contacts and follow them up. - Mod.JW]

******
[2] USA: Texas case
Date: 6 Oct 2014
Source: NY Times [edited]
http://www.nytimes.com/2014/10/07/us/eb ... .html?_r=0


The Liberian man [now] in critical condition in a Dallas hospital with the Ebola virus is being treated with an experimental antiviral drug, Texas officials said Mon [6 Oct 2014]. Candace White, a spokeswoman for Texas Health Presbyterian Hospital in Dallas, said Monday that the patient, D., was receiving the drug, brincidofovir, after the Food and Drug Administration approved its use on an emergency basis.

Brincidofovir, made by Chimerix of Durham, N.C., is taken orally and is being tested against several common viruses...

--
Ebola patient D.'s passenger health screening form
------------------------------
2 Oct 2014: (Gazettenet) This 2 Oct 2014 photo shows a copy of a passenger health screening form filled out by Ebola patient D., which was obtained by the Associated Press from the Liberia Airport Authority. Liberia plans to prosecute D, who brought Ebola into the U.S., alleging that he lied on a health questionnaire about not having any contact with an infected person, authorities said Thursday, 2 Oct 2014...

[The last few lines read:
In the last 21 days, have you experienced any of the following? Yes No
Have you been stuck with a needle used on an Ebola patient? [He checked No.]
Have you had body fluids of an Ebola patient in your eyes, nose or mouth? [He checked No.]
Have you taken part in a burial or funeral rites, or touched the body of someone who has died in an area where there is Ebola?
[He checked No.]
Did you stay in a house with or have other casual contact with an Ebola patient? [He checked No.]
Have you taken care of an Ebola patient or come into contact with body fluids of an Ebola patient? [He checked No.]
If your answer was yes, did you _always_ use a mask and gloves, and other protection? [He checked N/A (not applicable).]
Have you worked in a laboratory that processes body fluids of confirmed Ebola cases? [He checked No.]
If your answer was yes, did you _always_ use personal protective equipment? [He checked N/A (not applicable).]
http://www.gazettenet.com/living/health ... ed-to-home

[A defense lawyer might argue that he thought the sick woman he helped carry from the house he lived in had a serious case of malaria, and they took her 1st to the John F. Kennedy Memorial Hospital's maternity ward, so that he was truthful when he said he did not contact an Ebola patient, and anyway, he didn't touch her or go to her funeral after she died. - Mod.JW]

--
Nephew strongly rejected allegations that D. lied
----------------------------------------------------------------
3 Oct 2014: (CNN) Before flying out, D. allegedly answered "no" to questions on a health screening questionnaire about whether he'd cared for anyone with Ebola, or touched the body of someone who died in an area affected by the disease. But Tugbeh Chief Tugbeh, a community leader in Liberia, has said that D was "a caretaker" for a woman who died from Ebola at a residence outside the capital of Monrovia. Because of these and other claims, Liberia Airport Authority officials say they may prosecute D if he lied before leaving that West African nation...

D's nephew on Fri [3 Oct 2014] strongly rejected such allegations, much like other relatives have in recent days. Sitting alongside NG, D.'s mother, in Charlotte, North Carolina, D.'s nephew JW told CNN's Jim Sciutto that D. told him "he had moved a long time ago" from an area hit hard by Ebola. "He said, 'Well, I wasn't even in that area,'" said Weeks in direct response to Tugbeh's claim. "... He wasn't a part of that whole scenario that has been populating the news all these many days. So that's inaccurate."
http://www.cnn.com/2014/10/03/health/eb ... =allsearch

[This is a conflicting, 2nd-hand story, repeated on CNN TV tonight, 6 Oct 2014. We shall see what transpires. - Mod.JW]

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******
[3] USA: sick cameraman arrives at Nebraska hospital
Date: 6 Oct 2014
Source: USA Today [edited]
http://www.usatoday.com/story/news/nati ... t/16805529


An American freelance TV cameraman working for NBC News in West Africa walked off a plane today [6 Oct 2014], waving as he arrived in the USA for treatment after contracting Ebola in Liberia.

AM arrived Monday morning [6 Oct 2014] at the Nebraska Medical Center's special biocontainment unit in Omaha, one of 4 such units in the USA, which are all equipped to handle the most dangerous infectious diseases. Staff at these centers have undergone special training to handle Ebola and other biohazards for the past decade.

The video journalist, 33, reported symptoms on Wed [1 Oct 2014] and was running a slight fever. On Thu [2 Oct 2014], he was tested for the virus at a treatment center, with the result coming back positive, NBC News said in a story posted on its website... [His] parents said they haven't yet decided on the best treatment for their son. "We are assessing all treatment options," [said] Brad Britigan, dean of the college of medicine at the University of Nebraska Medical Center. Other Ebola patients treated in the USA have received experimental treatments, one of which is in short supply...

AM had been hired last Tue [1 Oct 2014] as a 2nd cameraman for NBC's medical correspondent, Nancy Snyderman, who is in Liberia reporting on the Ebola epidemic with 3 other NBC News employees... Snyderman and others in her crew will be flown back to the United States on a private charter flight and will be quarantined in the United States for 21 days "in an abundance of caution." http://www.usatoday.com/story/news/nati ... t/16805529

[In fact, supplies of ZMapp are reported to be temporarily exhausted. - Mod.JW]

--
US journalist believes he got Ebola while cleaning infected car
----------------------------------
6 Oct 2014: (ABC News) The American journalist with Ebola who arrived at a Nebraska hospital today believes that he may have gotten infected when he got splashed while spray-washing a vehicle where someone had died from the disease. AM arrived at the Nebraska Medical Center this morning [6 Oct 2014] after being flown directly from Liberia. "He's strong and his symptoms are not more advanced than when he talked to us before he left, which is a relief," said his father ... at a news conference today. He said his [son] has a fever and slight nausea... Levy said that his son is "not certain" when he got the disease but believes that he could have gotten infected by some of the spray back that came when he was using chlorine [bleach] to disinfect a car. "It was a vehicle that somebody had died in," Levy said... http://abcnews.go.com/Health/us-journal ... d=25987193

[Byline: Meghan Keneally]

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Communicated by:
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http://bigstormpicture.com

******
[4] Prevention & false alarms

USA: Self-quarantine by missionary family, Arizona
--------------------------------------------------------
Date: 2 Oct 2014 An Arizona man who spent about 2 weeks in Liberia on a religious mission has quarantined himself and his family inside their Payson home, even though he is showing no signs of the Ebola virus. AM returned to the U.S. on Sun [28 Sep 2014]. He was checked for a fever -- as are all passengers -- before leaving Liberia, the African country being hit the hardest by the Ebola outbreak, and he said he is now checking his temperature twice daily. Fever is one of the 1st signs of Ebola. The self-imposed quarantine and twice-daily checks are just 2 of the precautions AM has taken before and after his trip with CrossWay International to distribute sanitation supplies and preach the gospel...
http://www.usatoday.com/story/news/nati ... a/16620003

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[The missionary took exemplary precautions during his trip and on arrival back home. - Mod.JW

HealthMap/ProMED-mail maps can be accessed at: http://healthmap.org/promed/p/43 and http://healthmap.org/promed/p/106]

In Spanien befinden sich neben einer Krankenschwester drei weitere Menschen wegen des Verdachts auf Ebola im Krankenhaus. Dabei handle es sich um den Ehemann der Pflegerin, eine weitere medizinische Fachkraft sowie einen Reisenden aus einem der westafrikanischen Länder, in denen die Seuche grassiere, teilte die behandelnde Klinik in Madrid mit. Die Krankenschwester gilt als erster Mensch, der sich in Europa mit der zumeist tödlichen Krankheit infizierte. Sie hatte einen an Ebola erkrankten spanischen Priester betreut, der vor zwei Wochen zur Behandlung aus Sierra Leone nach Madrid gebracht worden war und dort wenige Tage später verstarb.

Weitere Ebola-Verdachtsfälle in Madrid
07.10.2014 - tagesschau

Gruß
Birgitt

Na da scheine ich mit der Ansteckbarkeit in der Inkubationszeit falsch gelegen zu haben. Danke für die Info.
Trotzdem sehe ich die lange Inkubationszeit kritisch, da in dieser Zeit einige Strecken zurück gelegt werden können und man merkt über herkömmliche Mittel (Temperaturmessung) noch nichts. Das war dann auch der Fall des Mannes in den USA.
Auf jeden Fall alles eine üble Sache. Ich hoffe es breitet sich nur langsam aus bzw. läuft sich "tot" (auch wenns makaber klingt)

EBOLA VIRUS DISEASE - ex AFRICA (07): EUROPE CASES, USA QUARANTINE STATIONS
***************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:
[1] Spain: nurse's Ebola infection blamed on substandard equipment
[2] Norway case
[3] USA: quarantine stations
[4] Where to find non-sensational Ebola coverage

******
[1] Spain: nurse's Ebola infection blamed on substandard equipment
Date: 7 Oct 2014
Source: The Guardian [edited]
http://www.theguardian.com/world/2014/o ... tive-spain


Health professionals in Madrid have blamed substandard equipment and a failure to follow protocol for the 1st case of Ebola to be contracted outside West Africa. Health authorities announced on Mon [6 Oct 2014] that a Spanish nurse at Madrid's Carlos III hospital who treated a patient repatriated from Sierra Leone had twice tested positive for Ebola.

Her husband had also been admitted to hospital and was in isolation, and a 2nd nurse from the same team that treated both repatriated Ebola victims was also being tested. In this case, the nurse contacted the authorities on Mon [6 Oct 2014] complaining of a fever. She was in isolation in the Carlos III Hospital while authorities waited for the test results, a spokesperson for the Madrid regional government said.

Staff at the hospital told El Pais that the protective suits they were given did not meet World Health Organization (WHO) standards, which specify that suits must be impermeable and include breathing apparatus. Staff also pointed to latex gloves secured with adhesive tape as an example of how the suits were not impermeable and noted that they did not have their own breathing equipment.

The nurse was part of a team attending to missionary MGV, 69, who died 4 days after being brought to Carlos III hospital on 20 Sep 2014. The same team, including the nurse, also treated missionary MP, 75, who was repatriated from Liberia in August 2014 and died 5 days later. Staff at the hospital said waste from the rooms of both patients was carried out in the same elevator used by all personnel and, in the case of the 2nd patient, the hospital was not evacuated.

The European commission said on Tue [7 Oct 2014] it had written to the Spanish health minister "to obtain some clarification" on how the nurse had become infected when all EU member states were supposed to have taken measures to prevent transmission. There is obviously a problem somewhere," the commission spokesman Frederic Vincent said.

Spanish health authorities have said that professionals treating Ebola patients in Spain always follow WHO protocols. The nurse would have entered GV's room just twice, said Antonio Alemany, from the regional government of Madrid, both times wearing protective equipment. "We don't know yet what failed," Alemany said. "We are investigating the mechanism of infection."

The nurse was in a stable condition. She had alerted the ministry of a slight fever on 30 Sep 2014 and been checked into a hospital in Alcorcon, on the outskirts of Madrid, with a high fever on Mon [6 Oct 2014]. The nurse, who is married with no children, was transferred to Carlos III hospital early on Tuesday morning [7 Oct 2014]. El Mundo reported that it was the nurse who asked to be tested for Ebola, having to insist repeatedly on being tested before it was done on Monday [6 Oct 2014].

While staff at the Alcorcon hospital were waiting for the test results, the nurse remained in a bed in the emergency room, separated only by curtains from other patients, hospital staff told El Mundo. Their version of events clashes with that of health authorities, who have said the patient was isolated from the 1st moment.

The woman was on holiday at an unknown location when she began showing symptoms. "We are drawing up a list of all the people she may have been in contact with, including with health professionals at the Alcorcon hospital," said Alemany, estimating that more than 30 people were being monitored for any sign of symptoms.

In August 2014, Spain became the 1st European country in the current, fast-spreading outbreak to evacuate patients for treatment. The decision prompted concern among health professionals, who said Spanish hospitals were not adequately equipped to handle Ebola.

[Byline: Ashifa Kassam]

--
Communicated by:
ProMED-mail Rapporteur Kunihiko Iizuka

--
Spain: contacts quarantined
-------------------------------------
7 Oct 2014: (BBC) Three other people, including the nurse's husband, have been quarantined. The nurse had twice gone into the room where Mr. GV had been treated to be directly involved in his care and to disinfect the room after his death. Both times, she was wearing protective clothing. Madrid healthcare director Antonia Alemany told reporters that according to the information available: "The nurse went into the room wearing the individual protection gear, and there's no knowledge of an accidental exposure to risk."... The hospital was reported to have had extreme protective measures in place including 2 sets of overalls, gloves and goggles.

However, health workers told El Pais newspaper that the clothing did not have level-4 biological security, which is fully waterproof and with independent breathing apparatus. Instead, it was level 2, the paper says, as photographs provided by staff indicated that the overalls did not allow for ventilation, and the gloves were made of latex and bound with adhesive tape.

Doctors are also monitoring 22 people with whom the nurse had contact at Alcorcon hospital and 30 people working at Carlos III, according to health sources quoted by Spanish newspaper El Pais. They include an ambulance crew and doctors and nurses, and all have been contacted by the health authorities.
http://www.bbc.com/news/world-europe-29516882

[The] case highlighted the dangers that health care workers face caring for Ebola patients; officials said she had changed a diaper for the priest and collected material from his room after he died. Dead Ebola victims are highly infectious, and in West Africa, their bodies are collected by workers in hazmat outfits.

[This posting from the Washington Post originally cited an AP report that said a Nigerian has been hospitalized in Spain. The AP has updated its reporting to say that the man is Spanish and had recently traveled to Nigeria. This post has been updated as well. - Mod.JW]

News of the quarantines hit Spain's stock market Tuesday [7 Oct 2014]. Spain is one of Europe's biggest tourist destinations, and stocks in tourism-related companies such as airlines and hotel chains fell on the Madrid stock exchange as investors feared the consequences of the Ebola case. Shares in International Airlines Group, formed in early 2011 by the merger of British Airways and Iberia, dropped more than 6 percent, while those of NH Hotel Group and Melia Hotels were down 4 percent. The Ibex 35 stock market index was 1.7 percent lower.

The nurse, who did not leave Madrid during her vacation, was currently being treated with drip using antibodies from previous infected patients... [presumably plasma from the 2 missionaries who died in the hospital. - Mod.JW]
http://abcnews.go.com/Health/wireStory/ ... ePage=true,
http://uk.mobile.reuters.com/article/id ... 7?irpc=932.

[Byline: Inmaculada Sanz]

--
Ryan McGinnis
http://bigstormpicture.com

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[2] Norway case
Date: 7 Oct 2014
Source: The Local, Norway [edited]
http://m.thelocal.no//20141007/norwegia ... e-of-zmapp


The Norwegian woman infected by Ebola [ebolavirus] in Sierra Leone and currently receiving treatment in Oslo, will get the last dose of the virus treatment medicine ZMapp available in the world. The news was released by the Norwegian Medicines Agency on Tue [7 Oct 2014], according to NTB. Steinar Madsen, medical director of the Norwegian Medicines Agency, said to Dagens Medisin: "It looks like we could get the last available dose of ZMapp to Norway. The medicine is now in Canada."

According to the professional medic's magazine, the agency has given Oslo University hospital the authorisation to import Ebola medicines not approved of in Norway. Madsen said: "When there are patients with an acute need for medicine, we allow import of medicines that are not approved."

While the medicine Avigan came to Norway already on Tue [7 Oct 2014], TKM-Ebola will arrive on Wed [8 Oct 2014]. Madsen reported that ZMapp has been the most difficult to get. "It must be said it is lucky that Norway will get the last dose of ZMapp. There are no more doses in the world, and it takes a long time to produce. It is the hospital pharmacy that gets the medicine through contact networks all over the world, while the Norwegian Medicines Agency gives the necessary approval," said Madsen.

Madsen explained further the medicine will be imported to the Ebola patient only. It has been tried on only a small number of patients, and the effect of the medicine is, therefore, not fully known. Madsen said: "Of those who have taken ZMapp, the majority have survived. Another person has survived with TKM-Ebola, but the medicines are used on a small number of patients."

It has been revealed that at least 27 Norwegians are still currently working in Ebola-ridden areas and include:
- Medecins Sans Frontiers: Around 20 Norwegians take part in the Ebola effort in Liberia, Sierra Leone and Guinea.
- Red Cross: 7 Norwegian employees in areas struck by Ebola.
- NORCAP: A Norwegian health logistics worker will travel to Liberia on Fri [10 Oct 2014]. Other Norwegians are also on NORCAP's preparedness lists.

--
Ryan McGinnis
http://bigstormpicture.com

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[3] USA: quarantine stations
Date: 6 Oct 2014
Source: Washington Post [edited]
http://www.washingtonpost.com/blogs/fed ... o-they-do/


Public health officials say Ebola is extremely unlikely to spread in the United States, but the Centers for Disease Control and Prevention is on the lookout for international travelers who might be carrying the deadly virus. The agency operates a network of 20 quarantine stations where health officers can "decide whether ill persons can enter the United States and what measures should be taken to prevent the spread of contagious diseases."

The locations of all 20 U.S. quarantine stations (Courtesy of CDC):
http://www.cdc.gov/quarantine/images/ju ... -925px.jpg.

On Sun [5 Oct 2014], one of those stations sprang to action after a passenger began vomiting on board an international flight headed from Brussels to New Jersey's Newark Liberty International Airport, according to a CNN report. Most of the 255 passengers on the flight were released to go through customs after about an hour and 35 minutes. The sick traveler was allowed to leave after the New Jersey Department of Health, in coordination with federal officials, determined that his condition was "consistent with another, minor treatable condition unrelated to Ebola."

The CDC has the authority to deny entry to the United States for ill people if they have one of 9 types of "quarantinable diseases," as defined by executive order. The agency can also admit patients to specialized hospitals for treatment. The list of quarantinable diseases, which was last updated by President Obama in July [2014], includes cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, viral hemorrhagic fevers, severe acute respiratory syndromes, and new types of flu that could cause a pandemic. Ebola counts as a viral hemorrhagic fever.

CDC quarantine centers are staffed by personnel who assess the health of travelers on board landed aircraft when passengers become ill. Sick individuals can be moved to isolation rooms at the quarantine facilities, or the agency can send them for care at hospitals. To be clear, the CDC considers "quarantine" to be different from "isolation." Quarantines apply to individuals who have been exposed to diseases but feel well and need monitoring, while isolation applies to those who are actually ill...

[Byline: Josh Hicks]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

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[4] Where to find non-sensational Ebola coverage
Date: 4 Oct 2014
Source: US4 [edited]
http://us4.campaign-archive2.com/?u=60b ... 6ca7d6f116


We talked to medical reporter Helen Branswell of The Canadian Press about where she goes to find reliable news about Ebola.

Your Sanity Guide To Ebola
------------------------------------
"A case of #Ebola in Dallas shows the risk this virus poses the world. But the fight needs to go to the source, West Africa. #containment," tweeted Helen Branswell, the longtime medical reporter for The Canadian Press, this week. She keeps us from going completely nutso with fear every day, so we asked her where she goes for her most reliable and up-to-date info.
- The World Health Organization is crucial for up-to-date information. "I don't think anybody trusts the Ebola numbers, but the best ones that are available are the ones WHO is generating."

- "It's hard to say that one thing is more important than the other, but ProMED-mail is critical for trying to keep on top of things." It's a push service and aggregator that sends out tailored email updates several times a day with context added in by infectious disease specialists.

- The Journal of Science has "some of the best English language science writers on the planet, and they are particularly strong on infectious diseases." The full stories appear weekly in the journal, but they put things up quickly on Science Insider.

- Dr. Richard Besser was an acting director of the CDC at one time and is now Chief Health and Medical Editor at ABC News. He's currently in Monrovia, and he's a good source of informative, non-hyped Ebola coverage.

- Follow Kai Kupferschmidt, a science writer, on Twitter; he's phenomenal. It's hard to follow Ebola on Twitter right now because it's moving so fast, but this is a good place to start.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[ProMED thanks Helen, a good friend and contributor to our list, for her kind mention. - Mod.JW

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/106.]

Nach dem Ebola-Fall in einem Krankenhaus in Madrid wächst die Sorge vor weiteren Ansteckungen. Vier Menschen aus dem Umfeld der infizierten Krankenschwester wurden nach Behördenangaben am Dienstag auf einer Spezialstation der Madrider Klinik isoliert, darunter auch ihr Ehemann. Außerdem lägen in der Klinik Carlos III noch ein spanischer Ingenieur, der aus Nigeria gekommen sei und bei dem ein erster Test negativ ausgefallen sei sowie eine Krankenschwester der Intensivstation. Bei ihr seien zwei Tests jedoch negativ geblieben. Beobachtet werde dort seit gestern Abend auch eine Pflegehelferin, die leichtes Fieber habe, berichteten spanische Medien.

Vier Menschen in Quarantäne
08.10.2014 - tagesschau

Denn inzwischen steht einigermaßen gesichert fest, dass die infizierte Frau mehrfach, auch in ihrer eigenen Klinik, darauf hingewiesen hatte, dass sie erhöhte Temperatur habe und sich schwach fühle. Erst als das Fieber weit über 38 Grad gestiegen war und die Hilfsschwester sich quasi selbst eingeliefert hatte, wurde sie stationär behandelt - und das auch noch ohne große Vorsichtsmaßnahmen. Niemand scheint darauf geachtet zu haben, dass sie Umgang mit einem Ebola-Erkrankten hatte. Zuvor war sie sogar nach Zeitungsberichten mit Paracetamol abgespeist worden.

Ebola-Fall in Madrid - Krisenmanagement in der Kritik
08.10.2014 - tagesschau

Gruß
Birgitt