Ebola Outbreak - Latest Updates as of November 5th, 2014

Sierra Leone extends Ebola state of emergency: The state of emergency declared three months ago in Sierra Leone will remain in force for the next nine months if the Ebola epidemic is not contained, the Justice ministry said. In addition to the emergency stipulation, President Ernest Bai Koroma has since announced other additional measures to fight the epidemic. Many Sierra Leoneans have been fixated on what happens next and the legality of any extension of the state of emergency. Initially the emergency was supposed to be for a three-month period only. The extension comes as the outbreak worsens in the north and west of the country. According to figures from the ministry of Health and Sanitation released Monday, 61 new cases were recorded between Friday and Sunday. The Western Area which includes the capital Freetown accounted for 51 of the new cases. This brings to 4,059 the total number of confirmed cases, with Freetown accounting for 1,233. Meanwhile, the fifth Sierra Leonean doctor to contract the virus died Monday, a day after a UNICEF worker was evacuated to France for treatment after contracting the virus at a treatment centre in the country. The doctor who died, Godfrey George, was the medical superintendent at the Kambia Government Hospital in the north of the country, one of the Ebola epicentres. He died at the Hastings Treatment Centre, a few kilometers outside Freetown. The UN Ebola point man in Sierra Leone is already warning of an escalation of cases in in the country. Anthony Banbury said at a press conference at the newly created National Ebola Response Centre that lack of correct figures makes the situation even more worrisome. Neither the government's nor the World Health Organization's (WHO) figures represent the true picture, he said. According to WHO's latest statistics, released on October 31, some 1,510 people have died from the disease, while the ministry of Health's figures indicate 1,085 had died as of Monday November 3.

United States - US requires West Africa travelers to arrive at 5 airports: The U.S. government announced that all travelers from three West African Ebola-affected countries will be required to fly into one of the five airports that are conducting enhanced screening. The travel restrictions, which are to go into effect Wednesday, will ensure all passengers from Liberia, Sierra Leone and Guinea are subject to secondary screening and added protocols, including having their temperature taken, before they can be admitted into the United States, the Department of Homeland Security (DHS) said. Last week, the DHS implemented enhanced screening measures at five airports, including New York's JFK, New Jersey's Newark, Washington Dulles, Atlanta and Chicago. These airports account for about 94 percent of travelers flying to the United States from these countries. At present, there are no direct, non-stop commercial flights from the three countries to any airport in the United States. The first person diagnosed with Ebola in the United States was Thomas Eric Duncan, a Liberian national. He arrived in the United States to visit family on Sept. 20 and died Oct. 8. Two nurses who treated him have become infected.

United States - Johns Hopkins and CDC Ebola training modules for health care workers now available: The Ebola virus disease training modules for health care workers developed in collaboration between experts at Johns Hopkins Medicine and the Centers for Disease Control and Prevention (CDC) are now available. This interactive, Web-based learning program, called Ebola Preparedness: PPE Guidelines, is available for free through the CDC’s website. The program trains health care providers in three critical areas: proper donning of personal protective equipment (PPE), the safe removal of gear and active monitoring skills. Program modules include:

Options for wearing different combinations of PPE, allowing health care workers to view training material based on gear outlined in their facility’s specific protocols

How to put on, or don, personal protective equipment

How to safely remove, or doff, personal protective equipment

Monitoring skills used by the designated observer during donning and doffing procedures to help staff avoid possible contamination

Effective teamwork skills, such as communication strategies

Tips for how to anticipate and mitigate potential contamination risks during the donning and doffing processes.

The modules can be accessed online.

Ebola – Latest Research: Could the blood of survivors be the key to beating the epidemic? Researchers from the Belgian institute which first identified the virus have flown in to Guinea for first large-scale test of whether antibodies from survivors could be used to treat victims. Scientists from one of the world’s leading institutes of tropical medicine, which first discovered the Ebola virus in the 1970s flew out to Guinea yesterday to begin ground-breaking research into a possible cure for the disease, racing against the clock to find a treatment which will help stem the deaths in the current epidemic. Johan van Griensven, lead researcher from Antwerp’s Institute of Tropical Medicine (ITM), told that he was “moderately positive” that the study into whether blood from Ebola survivors can treat new victims would yield results in time to have an impact. “There surely is a real urgency to get started soon, yet careful preparation is of the essence,” he said just before boarding a plane to Guinea. “If the treatment works and Ebola survivors are willing to donate blood... [then] I am confident that the treatment, in particular whole blood therapy, can be rolled-out across the affected countries,” he added. The institute has the history and expertise to deal with the deadly virus: in 1976 a flask of blood taken from a sick Belgian nun working in Zaire arrived in Antwerp. ITM scientists were at first flummoxed by the disease, then diagnosed the first recorded case of Ebola. A subsequent research trip into the central African rainforests to try and understand and treat the mysterious new virus laid the groundwork for the way the Ebola is identified and contained today. Now the institute is back at the forefront of the fight against the virus, and the scale of an epidemic which has killed more than 4,900 people in parts of West Africa means they are getting to work as quickly as possible. Mr. Van Griensven and his colleague will be arriving in Guinea less than two weeks after the ITM got the final go-ahead and a €2.9m (£2.3m) grant from the European Union to lead an international consortium studying the experimental treatment. Their first task is to identify a local partner and start recruiting up to 200 patients to take part in the study, which is backed by 13 leading institutes including the World Health Organisation, the London School of Hygiene and Tropical Medicine, Oxford University and France’s Institute Pasteur. “Using antibodies contained in the blood of recovered patients is a well-established technique used for several other infectious diseases,” explained Mr. Van Griensven. “For Ebola it has been tried too already, albeit on a very small scale... What we need now is a well-designed study according to high ethical and scientific standards to confirm it works and see whether it can be scaled up.” The institute has plenty of field experience to draw on. It was when trying to tackle a 1995 outbreak of the virus in Kikwit in the Democratic Republic of Congo (formerly Zaire) that ITM researchers first used blood transfusions to treat eight patients. Seven of them survived. Blood from survivors has also been used in the United States to treat four people infected in the current Ebola outbreak. Three of them received plasma from Dr Kent Brantly, who himself was treated with the blood of the 14-year-old patient in Liberia. Teresa Romero, the Spanish nursing assistant who contracted Ebola while treating an infected missionary in Madrid, was also given plasma from the blood of a survivor. Yesterday she said she would be a willing to become a donor too. “If my blood works to cure people, I’m ready to give it to the last drop,” she said. But Spanish doctors acknowledged that they had used so many different experimental treatments that it was impossible to pinpoint which one ultimately led to her recovery. The same problem applies to the other recent cases, and right now there remains no standard Ebola treatment beyond dealing with the individual symptoms. Mr. Van Griensven and his team are now determined to prove conclusively whether or not the antibodies in the blood used by immune systems to fight Ebola can indeed cure other patients. Their research will be divided into two parts: up to 100 patients will be given whole-blood transfusions, while 100 others will be treated using just blood plasma, in which the antibodies are extracted from the blood of the survivor. The results of the two test groups will be compared with other patients who receive the same level of care but do not receive donor blood or plasma. The World Health Organization (WHO) has said that blood therapies offer the most promising chance of finding a short-term treatment, and Mr. Van Griensven says they have the added value of being relatively easy to then roll out across the worst-affected nations of Guinea, Liberia and Sierra Leone.
Other studies into experimental drugs led by pharmaceutical companies could come with large price tags.
“Whole-blood therapy via blood transfusion is a rather straightforward procedure,” he said. And while the blood plasma extraction was a more challenging operation, it could also be effective if one donor provided the antibodies to several patients.