American Center for Disease Control on highest alert level as Ebola spreads in West Africa

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THE US Centers for Disease Control and Prevention has placed its emergency operations centre in Atlanta on the highest response level because of the worsening Ebola outbreak in West Africa.

The move comes as more cases of the deadly virus have migrated from rural villages and towns in Guinea, Liberia and Sierra Leone to urban areas in Nigeria, where it could spread more quickly.

The situation has become so critical and the fears so great that people are putting the bodies of dead family members on the street so they are not targeted for quarantine.

It is the first time the CDC has issued a Level 1 alert since 2009. That alert five years ago was in response to the outbreak of H1N1 flu.

The number of Ebola deaths in the region has reached 932, according to the World Health Organisation, while the number of confirmed or suspected cases has now reached 1,711.

The World Health Organisation convened a special summit of international experts in Geneva on Wednesday to determine if the outbreak constitutes a “public health emergency of international concern.”

If so, WHO will recommend temporary measures to reduce the international spread of the disease.

UNTESTED DRUGS BEING USED ON PATIENTS

Next week, WHO will convene a panel of medical ethicists to explore using experimental treatments for Ebola patients in West Africa.

Ebola only spreads through contact with infected bodily fluids. It cannot be transmitted through airborne particles.

While no vaccine is available, several are being developed. They include ZMapp, an experimental immune system booster made by Mapp Biopharmaceutical Inc. of San Diego.

Two Americans who had been working with patients in West Africa and were stricken with Ebola have been hospitalised at Emory University Hospital in Atlanta and reportedly have been treated with ZMapp, even though the drug has never been tested in humans.

“We don’t even know if it works,” said Dr Anthony Fauci of the National Institutes of Health, which helped fund research that led to the drug’s development.

The drug is a cocktail of three antibodies engineered to recognise Ebola and bind to infected cells so that the immune system can kill them. People’s immune systems make antibodies to fight off various diseases, and attempts to cull those antibodies — from the blood of people who survive an illness, or from animals — date back to the 19th century and early diphtheria treatment. Using modern techniques to fight Ebola, scientists culled antibodies from laboratory mice, Fauci said, and ZMapp’s maker now grows the antibodies in tobacco plants and then purifies them.

That process is “painfully slow,” he added, saying the manufacturer has told the government that it would take two to three months to produce even “a modest amount.”

“We’ve got to do better than that,” Fauci said. The NIH and other government scientists are looking into ways to increase production, necessary to attempt formal testing or to consider more so-called compassionate use, he said.

“We’re hoping the outbreak is going to die down soon, but it doesn’t look that way,” said Fauci, director of NIH’s National Institute of Allergy and Infectious Diseases. “Everybody’s trying to speed things up.”

President Barack Obama told reporters on Wednesday that the US would not send supplies of ZMapp to the epicentre of the outbreak in West Africa because it’s unclear whether the drug is actually helpful. It’s also “premature,” Obama said, to discuss fast-tracking the approval process for Ebola drugs until more information about their effectiveness is known.

“We are in an unusual situation in this outbreak,” says Dr Marie-Paule Kieny, WHO assistant director-general.

“We have a disease with a high fatality rate without any proven treatment or vaccine. We need to ask the medical ethicists to give us guidance on what the responsible thing to do is.”

Ideally, regulatory approval for new medications involves a series of small clinical trials in humans to determine if the treatment is safe.

The tests are later expanded to more people to determine their effectiveness and the best course of treatment.

OBAMA: EBOLA CAN BE CONTAINED IF WE USE ‘RIGHT PROTOCOLS’

Obama said the outbreak continues to grow, in part because the affected countries have weak public health systems that have been overwhelmed by the challenge of quickly identifying and isolating Ebola patients.

In addition, distrust of public health workers by local villagers has also hampered response efforts.

“As a consequence, it spread more rapidly than has been typical with the periodic Ebola outbreaks that have occurred previously,” Obama said.

While the US must take the crisis seriously, Obama said, Ebola can be “controlled and contained very effectively if we use the right protocols.”

As the US and other international players continue to provide public health assistance in West Africa, Obama said it may become “entirely appropriate to see if additional drugs or medical treatments” can improve survival rates for the virus.

“I will continue to seek information about what we’re learning about the drugs going forward,” he said.

The CDC is sending 50 additional disease control experts to the four affected African nations to help treat patients and contain the disease.

As of Monday, six CDC officials had been deployed to Guinea, 12 to Liberia, four to Nigeria and nine to Sierra Leone.

CDC spokeswoman Karen Hunter said the movement of the centre’s emergency operations centre to Level 1 activation is “reserved for the largest-scale responses, which often require substantial agency-wide effort.”

Hunter said the designation is appropriate “given the significance of this outbreak, the extension to Nigeria, and the potential to affect many lives.”

“The bottom line with Ebola is we know how to stop it: traditional public health,” said CDC Director Tom Frieden.

“Find patients, isolate and care for them, find their contacts, educate people, and strictly follow infection control in hospitals. Do those things with meticulous care and Ebola goes away.”

He said health care workers “should isolate and evaluate people who have returned from Guinea, Liberia and Sierra Leone in the past 21 days and have fever or other symptoms suggestive of Ebola. We will save lives in West Africa and protect ourselves at home by stopping Ebola at the source.”

EBOLA: THE LATEST CASES

WEST AFRICA: 108 new cases of Ebola were reported between Saturday and Monday in Liberia, Sierra Leone, Guinea and Nigeria, CNN reported.

Liberia declared a state of emergency on Wednesday. Photos of bodies lying in the street in towns in Guinea and Liberia are a sign of the worsening public panic about the disease.

The focus in Nigeria has turned towards obtaining isolation tents for patients, after five men were diagnosed with the disease in Lagos.

The Lagos diagnoses have especially alarmed health authorities as they occurred in an urban area, unlike previous cases which were reported in more sparsely populated rural areas.

MIDDLE EAST: A Saudi Arabian man died on Wednesday in a Jeddah hospital after a trip to Sierra Leone, CNN reported. Local authorities stated he had been “exhibiting symptoms of viral haemorrhagic fever” since his trip, although it has not been confirmed that it was Ebola.

EUROPE: Spanish priest Miguel Pajares, who contracted Ebola in Liberia, has been flown in a specially-equipped plane to a hospital in Madrid where he is receiving treatment, CNN reported. He becomes Europe’s first known victim during this outbreak.

UNITED STATES: Two American aid workers who had been dealing with the Ebola response in West Africa are currently being treated at Emory University Hospital in Atlanta.

Nancy Writebol, 59, had been in isolation at her home in Liberia since she was diagnosed last month. The other patient has been named as Dr Kent Brantly, 33,

The isolated unit at Emory where Brantly and Writebol are being treated is one of four of its kind in the US and was built in partnership with the Centers for Disease Control and Prevention. The unit was built to house patients suffering from serious infectious diseases and in 2005 handled patients with SARS, a viral respiratory illness that spreads when carriers cough or sneeze.

A man who appeared at a New York hospital earlier this week with a high fever and gastrointestinal symptoms after a visit to West Africa has tested negative for the Ebola virus, health officials said on Wednesday.

Source: Courier Mail