Experts: Ebola deaths could top 100,000 by year’s end

By Todd Beamon From Newsmax

New Ebola cases in West Africa could explode to nearly 100,000 — even as close to 200,000 — by the end of the year, according to a new study.

If the virus were to continue at the current transmission rate of 1.4 to 1.7 people for every new person infected, West Africa could gain 77,181 to 277,124 more cases by the end of 2014, Gerardo Chowell-Puente, a researcher at Arizona State University, told the Arizona Republic on Friday.

“The above scenario is highly unlikely as the intervention response is definitely improving,” he said.

But to illustrate how rapidly the epidemic is surging, The New York Times reported Friday that earlier predictions of 20,000 cases in a year had now worsened to projections of 20,000 a month. The fatality rate of Ebola is now somewhere between 70 and 90 percent, meaning most of those cases represent projected deaths.

Lone Simonsen, a research professor of global health at George Washington University, told the Times that estimates by the World Health Organization seemed conservative and the higher projections more reasonable.

“The final death toll may be far higher than any of those estimates unless an effective vaccine or therapy becomes available on a large scale or many more hospital beds are supplied,” she told the Times in an email.

His numbers envision a worst-case scenario, Chowell-Puente said. Each person infected with Ebola spreads the virus to as many as two others on average.

Chowell-Puente, a researcher at the university’s School of Human Evolution and Social Change, conducted the study with Hiroshi Nishiura, a professor at the University of Tokyo. Their study was published on Thursday in Eurosurveillance, a European online scientific journal.

According to statistics from the World Health Organization cited by the Republic, 3,707 Ebola cases have been identified as of Aug. 31.

These include 2,106 confirmed cases, 1,003, probable and 598 suspected cases among Sierra Leone, Liberia, Nigeria, Guinea and Senegal.

At least 2,288 people have died from the Ebola virus in the current outbreak, which officials believe started late last year, The Canadian Press reports.

The numbers are higher than the total of all known Ebola cases and Ebola deaths since the first known outbreak, in the Congo in Central Africa, in 1976.

However, WHO officials consider the current numbers underestimates, because the outbreak is so widespread — and the situation so chaotic in so-called “hot zones” — that the agency cannot fully count the cases, the Canadian Press reports.

“There are currently hundreds of new Ebola virus disease cases reported each week,” said scientists Peter Piot and Adam Kucharski in an editorial published with the study. “With the number of infections increasing exponentially, it could soon be thousands.”

Piot, now director of the London School of Hygiene and Tropical Medicine, was one of the scientists who first identified the Ebola virus in 1976.

“Fear and mistrust of health authorities has contributed to this problem, but increasingly it is also because isolation centers have reached capacity,” the authors said. “As well as creating potential for further transmission, large numbers of untreated — and therefore unreported — cases make it difficult to measure the true spread of infection, and hence to plan and allocate resources.”

Piot and Kucharski called the Ebola epidemic a worldwide crisis that demanded a global response.

“It is true that outbreaks of acute infections will generally decline once a large number of people have been infected because there are no longer enough susceptible individuals to sustain transmission,” they said.

“But … given the vast populations in affected areas and the disease’s high fatality rate, this is clearly not an acceptable scenario.”

In his interview with the Arizona Republic, Nishiura said that the Ebola epidemic could best be stopped by isolating the infected individuals and then tracing each case back to its source.

“Our findings suggest that control of the Ebola epidemic that has taken so many lives could be attained by preventing more than half of the secondary transmissions for each primary case,” Nishiura said.

In essence, if government officials and aid workers reduce the transmission rate to fewer than one individual, that would stop the epidemic spread of the virus, he said.

None of the efforts to contain the Ebola virus, however, will be successful until everything is centralized and coordinated through the United Nations, said Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota.

The U.N., he said in an op-ed piece in The New York Times, “is the only international organization that can direct the immense amount of medical, public health and humanitarian aid that must come from many different countries and nongovernmental groups to smother this epidemic.

“Thus far, it has played at best a collaborating role — and with everyone in charge, no one is in charge.”

Osterholm called for U.N. Security Council resolution giving the organization full responsibility for controlling the Ebola outbreak, “while respecting West African nations’ sovereignty as much as possible.”

Besides securing aircraft and landing rights, the U.N. could tap the military support of the G-7 nations to “ensure supply chains for medical and infection-control products, as well as food and water for quarantined areas.”

The U.N. can also provide the number of beds — estimated at as many as 1,500 by WHO — and can also work to provide preventative health care throughout other parts of Africa, Osterholm said.

“Because people are now too afraid of contracting Ebola to go to the hospital, very few are getting basic medical care,” he said.

“This is about humanitarianism and self-interest,” Osterholm concluded. “If we wait for vaccines and new drugs to arrive to end the Ebola epidemic, instead of taking major action now, we risk the disease’s reaching from West Africa to our own backyards.”

Reuters contributed to this report.

Image: Experts: Ebola Deaths Could Top 100,000 by Year’s End A Liberian burial team wearing protective clothing retrieves the body of a 60-year-old Ebola victim from his home. (John Moore/Getty Images)

For more on this story go to: http://www.Newsmax.com/Newsfront/ebola-western-africa/2014/09/12/id/594369/#ixzz3DCouObsg

Where did Ebola come from? Likely one person, gene study finds

By Maggie Fox From NBC News

The Ebola virus outbreak that’s ravaging West Africa probably started with a single infected person, a new genetic analysis shows.

This West African variant can be traced genetically to a single introduction, perhaps a person infected by a bat, researchers report in the journal Science.

Their study paints a remarkably detailed picture of how the virus spread from Guinea to Sierra Leone and Liberia in an outbreak that’s taken the lives of more than 1,500 people — including five of the researchers who worked on the report.

One thing is clear — it is definitely being spread by people, not by animals repeatedly infecting people, the researchers say.

“We can see it entering different villages,” said Pardis Sabeti, a senior associate member at the Broad Institute and an associate professor at Harvard University, who led the study. “All the sequences are very similar, suggesting it came from a common source.”

In Sierra Leone, it started with a traditional healer, says virologist Robert Garry of Tulane University, one of the researchers on the report. The healer treated patients from across the border in Guinea, where an outbreak of Ebola had started in February. Her patients flocked to her funeral, and 14 became infected as they prepared and buried the healer’s body, Garry said.

“One of those ladies turned out to be a 20-something woman who was pregnant,” Garry said. She lost the baby, but sought medical care at Kenema hospital in Sierra Leone, which almost certainly saved her life. Genetic sequences taken from this lucky woman confirm the story.

Ebola surveillance at Kenema Governement Hospital is done by polymerase chain reaction, or PCR.

The researchers managed to get blood samples from 12 people infected at the healer’s funeral. In total, they got samples from 78 people and checked the sequences against what was known about the spread of the virus.

The World Health Organization predicted Thursday that the epidemic would spread to as many as 20,000 people before it’s stopped. It’s already infected 3,000 people and killed 1,500 of them — and that’s just the people that doctors know about. Many have vanished into the forests, mistrustful of the medical system or afraid to go to hospitals.

More than 200 of the victims have been health care workers. “Five members of our team have lost their battle with Ebola,” Sabeti told NBC News. “It’s frightening.”

U.S. officials announced they’ll start the first human trials of a new vaccine next week, the first in a series of small safety tests. Any results will come too late to help anyone in the current outbreak, which must be fought using the old-fashioned methods of quick diagnosis, quarantine and isolation, supportive medical care and proper disposal of bodies, health experts say.

The genetic testing can bolster efforts to understand just how the virus is spreading so that health workers can get ahead of it.

“Our data is explainable by a single introduction into Sierra Leone from Guinea. It is also consistent with a single introduction from the reservoir into humans (in Guinea),” said Danny Park of the Broad Institute, who worked on the study.

All viruses mutate, and scientists can use the mutations as a kind of clock to trace the evolution and movement of a virus. Right now, says Garry, the Ebola virus strain in West Africa appears to be mutating twice as fast as it did in the past when it lived in an animal “reservoir,” probably a bat.

“It’s going to change,” Garry said. “A human being is not a bat. The longer this virus is allowed to propagate human to human, the more it is going to adapt.”

The genetics show that this particular strain of Ebola separated from the strains known to pop up in Central Africa in around 2004.

Augustine Goba, laboratory director at Kenema Government Hospital Lassa fever laboratory, diagnosed the first case of Ebola in Sierra Leone.

One cluster can be traced to an infected healthcare worker, who infected a truck driver. The sequences also show that infection control can work. The pregnant woman whose case was the first seen in Sierra Leone went to a hospital prepared to deal with a different virus, the one that causes Lassa fever, so staffers there wore protective gear and did not become infected. The pregnant woman also did not infect anyone else, Garry said.

“They’re most likely to get it from another human.”

But people are the source of the outbreak, Sabeti stressed. “At least from the data that we see right now, it is not repeated transmission from animals,” Sabeti said. That makes her question warnings from the government in Sierra Leone that caution people to avoid eating “bush meat” — animals hunted in the forest — and fruits such as mangoes. “I don’t think it is the best messaging,” she said. “They’re most likely to get it from another human.”

Sabeti’s team has immediately posted all its data publicly on the internet for other researchers to use and analyze. “We’ve got to crowdsource the epidemic,” she said. “This is a frightening situation and we need to work together.”

It was collaboration and quick groundwork that made the study possible, added Augustine Goba, director of the Lassa Laboratory at the Kenema Government Hospital in Sierra Leone. “This was possible because of our long-standing work to diagnose and study another deadly disease, Lassa fever. We could thus identify cases and trace the Ebola virus spread as soon as it entered our country,” Goba said in a statement.

Images:

Ebola surveillance at Kenema Government Hospital is done by polymerase chain reaction, or PCR – Stephen Gire

Augustine Goba, laboratory director at Kenema Government Hospital Lassa fever laboratory, diagnosed the first case of Ebola in Sierra Leone – Stephen Gire

For more on this story go to: http://www.nbcnews.com/storyline/ebola-virus-outbreak/where-did-ebola-come-likely-one-person-gene-study-finds-n191161

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No cases of Ebola in the Caribbean according to CARPHA

From Caribbean360

PORT-OF-SPAIN, Trinidad, Thursday September 11, 2014, CMC – The Trinidad-based Caribbean Public Health Agency (CARPHA) while there has not been any case of the deadly Ebola visa in the Caribbean, the region should not rest on its laurels.

“The overall risk assessment remains low risk for the Caribbean region. Be that as it may this is not a time for complacency because of the consequence of an imported case…will be serious for the health of our residents and for the tourism industry in the Caribbean,” said CARPHA executive director Dr. James Hospedales.

Dr. Hospedales told a regional news conference that while the virus for which there is no vaccine is confined mainly to Central and South Africa, his organisation is continuing to monitor the situation and advising member states “to continue their efforts to attain a high level of preparedness for a possible, though unlikely introduction of case to a CARPHA member state”.

He said that this low level of risk “may change as the satiations changes and new information becomes available”.

Dr. Hospdales said that while the risk level remains low “it is important that each member state takes the opportunity to ensure that several mechanisms are in place to mitigate the potential impact of its arrival”.

He said these measures are included in the international health regulations (IAHR) that came into force in 2005 and include appropriate communication messages to be disseminated to the general population, to travellers and to health workers ensuring that people know how to reduce their risks.

“This is key, we will have other problems beyond Ebola in the future, achieving compliance with the international health regulations is the way to be able to be prepared,” he said.

Dr. Hospedales said that while the Trinidad-based organisation will not be able to carry out tests to determine whether a person had contracted the deadly virus, international arrangements have been made with the United States Centre for Disease Control (CDC) and the Public Health agency in Canada for such testing.

He said CARPHA is also bolstering regional preparedness by establishing an incident management team here “to facilitate coordination of the regional response.

“We have executed several video and teleconferences with chief medical officers, epidemiologists and laboratory directors… providing answers to questions and queries alongside PAHO (Pan American Health Organization) and the US Centre for Disease Control.

“PAHO will maintain the efforts to keep the Caribbean public apprised of the developments in this area as they unfold and will continue our efforts in facilitating the development of our regional preparedness for the threat of the Ebola virus disease,” he said.

Meanwhile, CARPHA’s Director, Surveillance, Disease Prevention and Control Division, Dr Babatunde Olowokure told reporters that while there has also been no report of the West Nile virus in the Caribbean, it is a “potential threat to the region.

“It is another disease which we have to be aware of and which we should be prepared to deal with. It is a mosquito borne disease,” he said.

Dr. Olowokure said CARPHA is in the process of preparing a regional health security plan “and within that we will be encouraging member states with regards to preparedness for what we would term all hazards.

“This would include mosquito borne viruses, dengue and chikungunya have been mentioned here, there are number of others as well and so within that, yes you will include West Nile fever as one of those that CARPHA member states should be prepared to deal with,” he told reporters.

IMAGE: Laboratory-test-of-Ebola-virus-740

For more on this story go to: http://www.caribbean360.com/news/no-cases-of-ebola-in-the-caribbean-according-to-carpha#ixzz3D9DLMwZN