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Lack of federal authority makes fashioning coherent national Ebola policy difficult

Discussion of conflicting quarantine guidelines

HOMELAND SECURITY NEWSWIRE                     Oct. 30, 1014
Earlier this week, the Centers for Disease Control and Prevention(CDC) issued new guidelines on how states should deal with travelers from Ebola-stricken regions, but a lack of federal authority to mandate such guidelines has led to conflicting strategies, varying from state to state, which includes mandatory at-home quarantine for some travelers. Under current U.S. law, the states have the authority to issue quarantine or isolation policies, and they also control the enforcement of these policies within their territories.

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http://www.homelandsecuritynewswire.com/dr20141030-lack-of-federal-authority-makes-fashioning-coherent-national-ebola-policy-difficult

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Home> Health Ebola: Danger in Sierra Leone, Progress in Liberia

ASSOCIATED PRESS                                                                      Oct. 30, 2014
By CLARENCE ROY-MACAULAY and JONATHAN PAYE-LAYLEH

FREETOWN, Sierra Leone --Liberia is making some progress in containing the Ebola outbreak while Sierra Leone is "in a crisis situation which is going to get worse," the top anti-Ebola officials in the two countries said.

The people of both countries must redouble efforts to stop the disease, which has infected more than 13,000 people and killed nearly 5,000, the officials said. Their assessments underscore that Ebola remains a constant threat until the outbreak is wiped out. It can appear to be on the wane, only to re-emerge in the same place or balloon elsewhere if people don't avoid touching Ebola patients or the bodies of those who succumb to the disease.

"We need to go ahead to stop the transmission in order to arrest the situation," Palo Conteh said late Wednesday in the Sierra Leone capital, in his first press conference since the president this month appointed him CEO of the National Ebola Response Center. Conteh was previously the defense minister....

...the outbreak is now hitting areas in and around Sierra Leone's capital, posing a huge threat, Conteh noted that it is on the wane in the former Ebola hotpots of Kenema and Kailahun, across the nation in the east.

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No Ebola, S'il Vous Plait, We're French: The Ivory Coast Mindset

NPR                                                  Oct. 29, 2014
By Gregory Warner

There are all kinds of theories why Ebola hasn't arrived in Ivory Coast, despite the fact that it shares a long and very porous border with two Ebola-afflicted countries, Liberia and Guinea....

 

  Mumadou Traore, a field coordinator for CARE International, says the Ivory Coast's French bureaucracy is a "blessing"    when it comes to Ebola.

Dr. Seydou Coulibaly is the regional health director of Tompki county, which shares the longest border with Liberia and Guinea. He says that in the first weeks of the outbreak, before official prevention directives were issued from the capital, he was telling clinics and hospitals to send him daily Ebola watch reports. He gets a hundred a day. Even before the borders were sealed, he was sending health workers to take people's temperature when they crossed. He's also arranged trainings for schoolteachers and soldiers.

All these efforts will help, he says — maybe not to prevent the virus from coming to the country but at least the first eventual case will be well-managed. That's the main objective.

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Ebola: Better Maps Could Have Helped Fight Virus

How Maps Could Help Fight Ebola

SKY NEWS                                             Oct. 0, 2014

By Tom Cheshire, Technology Correspondent

LONDON -- Better maps could have helped contain the deadly Ebola virus, according to Medecins Sans Frontieres.

Ivan Gaytan, technology advisor to MSF, told Sky News the disease is "preventable" and could have been "easier to contain" if there was more knowledge of the region.

He said: "In any country where Ebola or any other infectious disease arrives, if you already have a good map which actually reflects the way people describe geography, you set up your clinical activities to take that data in the first place in the right way."

MSF, also known as Doctors Without Borders, will launch a project next month called Missing Maps, which lets anyone, anywhere in the world, annotate maps to show dwellings and infrastructure.

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Rate of new Ebola infections in Liberia is slowing, WHO says

OVERVIEW OF DEVELOPMENTS DURING PAST DAY

WASHINGTON POST                            Oct. 30, 2014
By Lena H. Sun, Brady Dennis and Joel Achenbach
New Ebola infections in virus-ravaged Liberia appear to be declining for the first time in months, the World Health Organization said Wednesday.

Until now, officials have been suspicious of this encouraging trend, thinking it might be an artifact of poor data collection, a symptom of chaos in countries that were overwhelmed by the crisis. But Bruce Aylward, a top WHO official, said Wednesday that the decline in new cases “is real,” measured by scores of empty beds in Ebola clinics, fewer cases confirmed by laboratory tests and a drop in burials by specially trained teams.

Still, the WHO and other officials remain wary because the nature of this outbreak has been one of unpredictable surges and declines.

“It’s like saying your pet tiger is under control,” Aylward said. “This is a very, very dangerous disease.”

Meanwhile President Obama continued to criticize the calls for mandatory quarantines for returning volunteers

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Ebola Virus Disease and the Need for New Personal Protective Equipment

JOURNAL OF AMERICAN MEDICICAL ASSOCIATION      Oct. 28, 2014
Michael B. Edmond, MD, MPH, MPA1; Daniel J. Diekema, MD, MS1; Eli N. Perencevich, MD, MS

"...it is clear that reengineering of personal protecion equipment is required, both in US hospitals but more critically for the outbreak zones in Africa. The use of cumbersome PPE in the extreme heat and difficult working conditions of Ebola treatment centers in Africa places great stress on health care workers and limits the time they can spend providing patient care.

" A novel approach to PPE that provides an impermeable fluid barrier that is both more comfortable and easier to don and remove would be a substantial step forward.

"This will require new materials and designs. Indeed, the US Agency for International Development, White House Office of Science and Technology Policy, CDC, and US Department of Defense have recently announced a campaign to develop and test innovations for PPE in response to the Ebola outbreak."

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http://jama.jamanetwork.com/article.aspx?articleid=1920943

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Ebola: California is latest state to impose 21-day quarantine for those exposed to Ebola

SAN JOSE MERCURY NEWS                                                        Oct. 29, 2014

By Julia Prodis Sulek

California on Wednesday became the latest state to order a 21-day quarantine for travelers who have been in close contact with Ebola patients.

In an attempt to avoid the criticism lodged against New York, New Jersey and Maine that had blanket quarantine orders, however, California will allow county health agencies to impose the quarantine on a case-by-case basis.

By working with county health departments to assess the individual risks, the California Department of Public Health said it "respects the individual circumstances of each traveler while protecting and preserving the public health."

Quarantine can range from observation and monitoring to the "limitation on his or her freedom of movement."

In the Bay Area, a Stanford doctor who returned last week from Liberia where he was treating Ebola patients was already being monitored by the San Mateo County Department of Public Health. The department coordinated with the CDC and San Francisco International Airport when Dr. Colin Bucks arrived late last week. He had no symptoms of the disease and came to an agreement with health officials to avoid contact with others but can leave the house for limited activities, such as jogging alone.

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Assessing the Science of Ebola Transmission

THREE ARTICLES DESCRIBING DETAILS OF THE EBOLA VIRUS AND OTHER VIRUSES.
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Advances in microscopy have allowed scientists like Sriram Subramaniam and colleagues at the National Cancer Institute to look at the workings of tiny viruses. In this case, microscopy was used to illustrate the complex process in which human cells infected with HIV-1, green and blue, are linked to uninfected cells. Credit Illustration by Donald Bliss/N.I.H, from The Journal of Virology/American Society for Microbiology

The research on how the virus spreads is not as ambiguous as some have made it seem

THE ATLANTIC                                                                                                          Oct. 28, 2014

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How Ebola quarantines actually work, explained

A young man, dressed in a biohazard costume, stands on the corner of 546 West 147th Street in New York City. Bryan Thomas/Getty Images

VOX                                                                       Oct. 29, 2014
By Julia Bellez
As Ebola fears wash over America, some state governors are turning to mandatory quarantines: locking up healthy workers returning from West Africa for 21 days, Ebola's incubation period. The policy in New Jersey made national headlines after it resulted in a nurse who had no Ebola symptoms — and had been fighting the disease in West Africa, no less — being isolated in a poorly heated tent with no running shower or toilet.

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Sierra Leone Leader: Change Behavior to End Ebola

ASSOCIATED PRESS                                      Oct. 29, 2014

By Clarence Roy-Macaulay

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Maine state police dispatched to back nurse's quarantine

USA TODAY                                                                        OCT. 29, 2014
By Doug Staglin
Maine state police were stationed outside the home of Ebola nurse Kaci Hickox Wednesday as Gov. Paul LePage said he was seeking legal authority to force the "unwilling" health care workers to remain quarantined for 21 days.

The 33-year-old nurse, who has shown no symptoms of the deadly virus, arrived in Maine on Monday after being forcibly held in an isolation tent in New Jersey for three days under that state's strict new law for health care workers who have recently treated Ebola patients in West Africa.

Over Hickox's objections, Maine health officials insisted that she stay in her home in Fort Kent for 21 days until the incubation period for Ebola had passed.

"I don't plan on sticking to the guidelines," Hickox tells Today show's Matt Lauer. "I am not going to sit around and be bullied by politicians and forced to stay in my home when I am not a risk to the American public."

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Chuck Hagel Approves 21-Day Ebola Quarantine For Troops

Defense Secretary Chuck Hagel briefs reporters at the Pentagon, Wednesday, Oct. 1, 2014, on the military health care system. (AP Photo/Cliff Owen)

ASSOCIATED PRESS                                  Oct. 29, 2014
By Robert Burns

WASHINGTON (AP) — Defense Secretary Chuck Hagel on Wednesday approved a recommendation by military leaders that all U.S. troops returning from Ebola response missions in West Africa be kept in supervised isolation for 21 days.

 The move goes beyond precautions recommended by the Obama administration for civilians, although President Barack Obama has made clear he feels the military's situation is different from that of civilians, in part because troops are not in West Africa by choice.

In explaining his decision, Hagel noted that the military has more people in Africa helping with the Ebola effort than any other segment of the U.S. government.

 "This is also a policy that was discussed in great detail by the communities, by the families of our military men and women, and they very much wanted a safety valve on this," he said at a public forum in Washington.

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Exclusive: New test for diagnosing Ebola goes unused

WABC NEWS                                          Oct. 28 2014
By Jim Hoffer

NEW YORK

Report says that when a 5-year-old boy who came back from Guinea was admitted to New York's Bellevue hospital  recently,  city officials stopped the use of a a one-hour testing device although it had received the FDA's emergency approval.

As a result, it took 10 hours from the time he spiked a fever till his parents, medical staff, and the public found out, he did NOT have Ebola.

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http://7online.com/health/new-test-for-diagnosing-ebola-goes-unused/369875/

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Low HIV and Aids rates saw west Africa ‘miss out on health investment'

THE GUARDIAN                                                                                Oct. 28, 2014
By Sarah Boseley

West Africa, now in the throes of a calamitous Ebola epidemic, missed out on significant health investment over the past decade or more because it had low rates of HIV, a detailed survey of the changing health of Africa and Asia reveals.

The US ambassador to the UN, Samantha Power (centre), visits an ebola emergency response centre in Freetown, Sierra Leone. Healthcare in west Africa now has the world’s attention. Photograph: Reuters

A major project called Indepth, which has looked at the causes of death of more than 110,000 people in 13 countries shows that health improved generally in those given substantial international aid to try to turn around the HIV and Aids epidemic. But west Africa, with severe poverty and low healthcare standards but relatively little HIV, did not benefit.

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