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As Ebola patients vanish in Liberia’s health system, survivors go on a desperate search

WASHINGTON POST                           OCT. 21, 2014
BY  Kevin Sieff

MONROVIA ...many people who have simply vanished as Ebola tears through the city.

Ebola ravaged this capital so quickly that some patients passed through an already broken medical system with hardly any paper trail. Others were admitted to one clinic and transferred to another without notice. Hundreds were cremated long before their families were notified that they had died.

The world has heard about the deaths. Ebola has claimed 2,500 lives in this country, most of them in Monrovia. But the epidemic has also left in its trail another form of grief and anguish for those whose friends and relatives are missing. About 30 percent of Ebola victims survive. That’s the number many here obsess over — it is just high enough to offer hope and to fuel uncertainty.

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Fighting Ebola, and the Mud

NEW YORK TIMES                         Oct. 21, 2014

Op-ed in Today's New York Times by Karen Huster, a nurse working in Liberia for Last Mile Health says that Liberia’s dysfunctional transportation system is standing in the way of fighting the Ebola epidemic and suggests some solutions
 

"Patients have died on grueling journeys to treatment units. Blood samples have sat waiting for days, eventually becoming invalid....

 "The best solution is removing the need to travel altogether by building more easily accessible treatment centers all over the country, where patients with confirmed or suspected cases of Ebola can be housed and treated. The United States military is building these structures, but it is taking time. Nimbler nongovernmental organizations must also step in. Save the Children has already done so and is also building smaller community care centers — sort of homes away from home, where families can continue to care for their sick loved ones safely removed from the community. A makeshift center with tents instead of permanent structures could be set up within a week.

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Ebola crisis: Worst-hit African nations get key supplies

BBC                                                                                   Oct. 20, 2014

Vital supplies and resources to tackle Ebola are beginning to arrive in the three worst-hit West African countries, Ghana's President John Mahama has said.

Mr Mahama, who heads the regional bloc Ecowas, also told the BBC that treatment centres were being set up in Guinea, Liberia and Sierra Leone. But he called for proper co-ordination between agencies to avoid duplication.

Red Cross workers are among those fighting the outbreak in Sierra Leone

Mr Mahama told the BBC that the World Food Programme was airlifting humanitarian aid to Liberia, Sierra Leone and Guinea.

"Vehicles, motorcycles and other means of transport are going in there. There's more protective clothing being provided," he said.

"But there's no need for us to duplicate each other and have more treatment centres when we do not have volunteers and health workers to treat the people in the treatment centres.

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Rwanda to screen U.S. visitors for Ebola

USA TODAY                                  Oct. 21, 2014
By Doug Stanglin

The East African nation of Rwanda is requiring all visitors from the United States and Spain to self-monitor, fill out an extensive questionnaire and report their medical condition for the first 21 days of their visits because of the Ebola cases that have surfaced in the two Western countries.

Coincidentally or not, the new screening follows an embarrassing uproar in a New Jersey school over the imminent enrollment of two Rwanda children that initially prompted their parents to keep them at home for 21 days.

The U.S. and Spain have both recorded deaths from Ebola. In Dallas, a Liberian national died of the virus two weeks ago and two nurses who treated him tested positive for the virus. At least two Spanish missionaries died in Spain after contracting the disease in West Africa. One Spanish nurse also tested positive for the virus.

Rwanda,  located about 2,600 miles east of Liberia, the closest of the three West African countries with the Ebola outbreak...  has reported no cases of the virus.

The dust-up in New Jersey involving two Rwanda children took a new turn Monday with an apology by the superintendent of the Maple Shade School District in Burlington County.

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DHS requires West Africa travelers to arrive at five airports

USA TODAY                                                                                     Oct. 21, 2914By Bart Jansen

WASHINGTON — The Department of Homeland Security announced Tuesday that all travelers from Ebola outbreak countries in West Africa will be funneled through one of five U.S. airports with enhanced screening starting Wednesday.

                                                                       (Photo: Melissa Maraj, AP)

Customs and Border Protection within the department began enhanced screening — checking the traveler's temperature and asking about possible exposure to Ebola — at New York's John F. Kennedy International Airport on Oct. 11.

Enhanced screening for travelers from Liberia, Sierra Leone and Guinea was expanded Oct. 16 to Washington's Dulles, Chicago's O'Hare, New Jersey's Newark and Atlanta's Hartsfield-Jackson international airports.

Those airports were supposed to screen 94% of the average 150 people per day arriving from the three countries. But lawmakers from other states asked for enhanced screening at their airports, too.

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Ebola Cases Rise Sharply in Western Sierra Leone

FREEOWN, SIERRA LEONE ---After emerging months ago in eastern Sierra Leone, Ebola is now hitting the western edges of the country where the capital is located with dozens of people falling sick each day, the government said Tuesday. So many people are dying that removing bodies is reportedly a problem.

Forty-nine confirmed cases of Ebola emerged in just one day, Monday, in two Ebola zones in and around the capital, the National Ebola Response Center, or NERC, said. Lawmaker Claude Kamanda who represents a western area said more than 20 deaths are being reported daily.

Authorities say the uncontrolled movement of people from the interior to Waterloo which is the gateway to Freetown, the capital, has fueled the increase of Ebola cases in the west. There is a strong feeling that people are violating the quarantines elsewhere and coming to Freetown through Waterloo.

See full story

http://abcnews.go.com/International/wireStory/ebola-cases-rise-sharply-w...

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Donations for Ebola Relief Are Slow to Gain Speed

NEW YORK TIMES

“Have you had any email solicitations?” asked Patrick M. Rooney, associate dean at the Indiana University Lilly Family School of Philanthropy. “If there had been an earthquake or tsunami, my question would be who had solicited you and how many times? Americans aren’t giving because they haven’t really been asked.”

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EU seeks $1.27 billion in Ebola aid for W. Africa

ASSOCIATED PRESS                               Oct. 20, 2014

By Raf Casert
LUXEMBOURG (AP) — The European Union committed itself Monday to step up efforts toward getting 1 billion euros ($1.27 billion) in aid to fight Ebola in West Africa and rejected the idea of halting direct flights coming from the region.

The EU foreign ministers set off a week of continentwide action with a pledge "to play an active role in enhancing the international response" to Ebola, which so far has been late and insufficient to contain the deadly virus that has claimed at least 4,500 lives.

British Prime Minister David Cameron wants a two-day summit of the 28 EU leaders ending Friday to reach the $1.27 billion aid threshold, agreeing on a variety of topics from more financial aid to common repatriation procedures, more Ebola treatment facilities and better training for health care workers.

...So far, the overall anti-Ebola total for the EU, including EU national contributions, stands at 500 million euros ($640 million), with Britain contributing 160 million euros ($204 million). The Netherlands also promised to send a frigate to West Africa to help, matching a similar contribution from Britain.

EU ministers rejected the idea of scrapping flights from West Africa to keep the virus out of Europe.

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Special Report - A Primer on Ebola for Clinicians

journals.cambridge.org -  Eric Toner, Amesh Adalja and Thomas Inglesby. A Primer on Ebola for Clinicians.
Disaster Medicine and Public Health Preparedness, available on CJO2014. doi:10.1017/dmp.2014.115.

Abstract

The size of the world’s largest Ebola outbreak now ongoing in West Africa makes clear that further exportation of Ebola virus disease to other parts of the world will remain a real possibility for the indefinite future. Clinicians outside of West Africa, particularly those who work in emergency medicine, critical care, infectious diseases, and infection control, should be familiar with the fundamentals of Ebola virus disease, including its diagnosis, treatment, and control. In this article we provide basic information on the Ebola virus and its epidemiology and microbiology. We also describe previous outbreaks and draw comparisons to the current outbreak with a focus on the public health measures that have controlled past outbreaks. We review the pathophysiology and clinical features of the disease, highlighting diagnosis, treatment, and hospital infection control issues that are relevant to practicing clinicians. We reference official guidance and point out where important uncertainty or controversy exists. (Disaster Med Public Health Preparedness. 2014;0:1-5)

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CDC releases revised Ebola gear guidelines

UPDATED WITH MORE DETAILS      

WASHINGTON POST                                                 Oct. 20, 2014

During a media briefing late Monday, CDC Director Thomas Frieden said the updated guidelines give a greater margin of safety to health-care workers. They are modeled closely on those used by Doctors Without Borders, the aid group that has worked most extensively in West Africa... The guidance also reflects the consensus of specialists at Emory University Hospital, Nebraska Medical Center and the National Institutes of Health, which are currently treating Ebola patients.

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