"No way we can keep Ebola contained in West Africa": US general

"No way we can keep Ebola contained in West Africa": US general. HT: Crof.

Thanks to Lucie Lecomte for sending the link to this article from the US Department of Defense; it may be the single most alarmist piece I've seen yet on the outbreak: Kelly: Southcom Keeps Watch on Ebola Situation.

The potential spread of Ebola into Central and Southern America is a real possibility, the commander of U.S. Southern Command told an audience at the National Defense University here yesterday. 

“By the end of the year, there’s supposed to be 1.4 million people infected with Ebola and 62 percent of them dying, according to the [Centers for Disease Control and Prevention],” Marine Corps Gen. John F. Kelly said. “That’s horrific. And there is no way we can keep Ebola [contained] in West Africa.” 

If it comes to the Western Hemisphere, many countries have little ability to deal with an outbreak of the disease, the general said. 

“So, much like West Africa, it will rage for a period of time,” Kelly said. 

This is a particularly possible scenario if the disease gets to Haiti or Central America, he said. If the disease gets to countries like Guatemala, Honduras or El Salvador, it will cause a panic and people will flee the region, the general said. 

“If it breaks out, it’s literally, ‘Katie bar the door,’ and there will be mass migration into the United States,” Kelly said. “They will run away from Ebola, or if they suspect they are infected, they will try to get to the United States for treatment.” 

Also, transnational criminal networks smuggle people and those people can be carrying Ebola, the general said. Kelly spoke of visiting the border of Costa Rica and Nicaragua with U.S. embassy personnel. At that time, a group of men “were waiting in line to pass into Nicaragua and then on their way north,” he recalled. 

“The embassy person walked over and asked who they were and they told him they were from Liberia and they had been on the road about a week,” Kelly continued. “They met up with the network in Trinidad and now they were on their way to the United States -- illegally, of course.” 

Those men, he said, “could have made it to New York City and still be within the incubation period for Ebola.” 

Kelly said his command is in close contact with U.S. Africa Command to see what works and what does not as it prepares for a possible outbreak in the area of operations.

Ebola screening: Hey CDC! Is it an AND or an OR?

Ebola screening: Hey CDC! Is it an AND or an OR? HT: Crof.

Thanks to Lucie Lecomte for sending the link to this post on Controversies in Hospital Infection Prevention—a likably tactless blog: Ebola Screening: Hey CDC! Is it an AND or an OR? Click through for links. The complete post, with original emphases:

Like many of you, we've all been assisting with Ebola planning for the past several months. Just today, Mike and I were in another planning meeting and the subject of our screening algorithm came up. 

Mike had noticed that the September 4th CDC Definition of Person Under Investigation (PUI) that we've been using: "fever of greater than 38.6 degrees Celsius or 101.5 degrees Fahrenheit, AND additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained hemorrhage" is now different in the PDF algorithm that the CDC posted on October 2nd. 

It now says "FEVER OR EVD symptoms." I've included the important portion of the PDF algorithm above. 

This may seem like a minor change, but for many facilities it will be a big deal. To go from a relatively sensitive "fever AND" to a very sensitive "fever OR" is not a small change. 

This may require EDs and clinics to screen additional patients and result in a large increase in laboratory tests being sent for Ebola diagnosis. I think that CDC meant to suggest that fever is enough to prompt a travel history, but now anyone with fever, headache, weakness, muscle pain, vomiting, diarrhea, abdominal pain or hemorrhage will also need to be asked a travel history. 

In practice this will mean that every patient that walks into an ED or clinic should be asked a travel history first and then asked about symptoms. 

I'm not convinced this should happen and feel much more comfortable with having symptoms guide travel history. But since almost any general complaint is now included, we may be left with no other choice but to ask travel history first. And of course, we don't know what CDC wants us to do since both documents are live and offer conflicting advice. 

So, which is it CDC?  Is it an AND or an OR?

Medical scientist Peter Piot who discovered Ebola fears that it may spread to India.

Medical scientist Peter Piot who discovered Ebola fears that it may spread to India. HT: Crof.

Professor Peter Piot who discovered Ebola in 1976 fears that it might spread to India. In an interview with British newspaper 'The Guardian', he expressed concerns over India's ability to prevent the deadly disease from entering India.

He said, "There will certainly be Ebola patients from Africa who come to us in the hopes of receiving treatment. And they might even infect a few people here who may then die. But an outbreak in Europe or North America would quickly be brought under control.

I am more worried about the many people from India who work in trade or industry in West Africa. It would only take one of them to become infected, travel to India to visit relatives during the virus's incubation period, and then, once he becomes sick, go to a public hospital there. Doctors and nurses in India, too, often don't wear protective gloves. They would immediately become infected and spread the virus."

Professor Peter Piot, the Director of the London School of Hygiene and Tropical Medicine, was a researcher at a lab in Antwerp when a pilot brought him a blood sample from a Belgian nun who had fallen mysteriously ill in Zaire (now known as DR Congo).

He said, "In 1976 I discovered Ebola, now I fear an unimaginable tragedy."

A large number of Indians work or engaged in trade and commerce in the Western African countries like Nigeria, Ghana, DR Congo, Congo Brazwille, Angola, Namibia etc.

The government of African nations has put all international airports in India on alert and the passengers from India are made to go for a compulsory medical check up before exiting the airport

Ebola could reach France and UK by end of month, calculate scientists

Ebola could reach France and UK by end of month, calculate scientists. HT: Crof.

Via The Globe and Mail, a Reuters report: Ebola could reach France and U.K. by end of month, calculate scientists. Excerpt:

Scientists have used Ebola disease spread patterns and airline traffic data to predict a 75 percent chance the virus could be imported to France by October 24, and a 50-per-cent chance it could hit Britain by that date. 

Those numbers are based on air traffic remaining at full capacity. Assuming an 80 percent reduction in travel to reflect that many airlines are halting flights to affected regions, France’s risk is still 25 per cent, and Britain’s is 15 per cent.   

“It’s really a lottery,” said Derek Gatherer of Britain’s Lancaster University, an expert in viruses who has been tracking the epidemic - the worst Ebola outbreak in history. 

The deadly epidemic has killed more than 3,400 people since it began in West Africa in March and has now started to spread faster, infecting almost 7,200 people so far. Nigeria, Senegal and now the United States - where the first case was diagnosed on Tuesday in a man who flew in from Liberia - have all seen people carrying the Ebola haemorrhagic fever virus, apparently unwittingly, arrive on their shores. 

France is among countries most likely to be hit next because the worst affected countries - Guinea, Sierra Leone and Liberia - are French-speaking [not so: Sierra Leone and Liberia are English-speaking--CK] and have busy travel routes back, while Britain’s Heathrow is one of the world’s biggest travel hubs.

France and Britain have each treated one national who was brought home with the disease and then cured. The scientists’ study suggests that more may bring it to Europe not knowing they are infected. 

“If this thing continues to rage on in West Africa and indeed gets worse, as some people have predicted, then it’s only a matter of time before one of these cases ends up on a plane to Europe,” said Gatherer. 

Belgium has a 40-per-cent chance of seeing the disease arrive on its territory, while Spain and Switzerland have lower risks of 14 percent each, according to the study first published in the journal PLoS Current Outbreaks and now being regularly updated at http://www.mobs-lab.org/ebola.html. 

The World Health Organization (WHO) has not placed any restrictions on travel and has encouraged airlines to keep flying to the worst-hit countries. British Airways and Emirates airlines have suspended some flights. 

But the risks change every day the epidemic continues, said Alex Vespignani, a professor at the Laboratory for the Modeling of Biological and Socio-Technical Systems at Northeastern University in Boston who led the research. 

“This is not a deterministic list, it’s about probabilities - but those probabilities are growing for everyone,” Vespignani said in a telephone interview. “It’s just a matter of who gets lucky and who gets unlucky.” 

The latest calculations used data from October 1. 

“Air traffic is the driver,” Vespignani said. “But there are also differences in connections with the affected countries (Guinea, Liberia and Sierra Leone), as well as different numbers of cases in these three countries - so depending on that, the probability numbers change.”

Why mutant airborne Ebola is "highly unlikely"

Why mutant airborne Ebola is "highly unlikely" HT: Crof.

Via her blog Pathogen Perspectives, Heather Lander explains Why Ebola Airborne Mutation(s) are "Highly Unlikely": Let's Talk Mutation and Natural Selection. Excerpt:

... there’s no selective advantage to becoming airborne for Ebola. It is clear that Ebola’s current mode of transmission is working well. The virus is spreading and reproducing successfully. This means there is no selective pressure on the virus to keep any mutations that might confer airborne transmission, especially when this kind of significant change would most likely bring with it some serious deleterious side effects. 

And while some argue that this is the first time Ebola has been replicating to this extent in humans, we need to keep in mind that it’s been doing this for far longer in the wild in the primate species it infects and in its bat reservoir host. And yet, this mutation hasn't happened.  

So, can we say it's impossible? No. But I'm not losing any sleep over it.

Israel - Three teams of medical professionals, along with mobile emergency clinics, will be sent to fight Ebola.

Israel - Three teams of medical professionals, along with mobile emergency clinics, will be sent to fight Ebola. (Jpost).


Israel announced Sunday that it will expand its efforts in the global fight against Ebola by sending three mobile emergency clinics and corresponding medical teams to West Africa, according to the Ministry of Foreign Affairs.

Each clinic's team of professional medical trainers will teach the local medics how to use the vehicles and its equipment. The mobile clinics, produced in Israel, all meet the World Health Organization's Ebola treatment guidelines, the Ministry said.

MASHAV, Israel's international aid organization, is in charge of this endeavor and says it will center training around Ebola prevention, providing education for not only the medical community but the general population as well.

Israel previously sent an Ebola treatment team to Cameroon, sent emergency equipment to Sierra Leone, and sent protective equipment to African Union teams.

Former Ebola patient Dr. Rick Sacra hospitalized

Former Ebola patient Dr. Rick Sacra hospitalized. HT: Crof.

Via NBC News: Former Ebola Patient Dr. Rick Sacra Hospitalized. Click through for a video. Excerpt:

An American doctor who contracted Ebola in Liberia and was successfully treated for the deadly disease was taken to a Boston-area hospital Saturday for what health authorities suspect is pneumonia. 

Dr. Rick Sacra, who contracted Ebola while working with the relief organization SIM, is being kept in isolation at UMass Memorial Medical Center in Worcester, Mass., as a precaution, the hospital said. 

“We think it is highly unlikely that he has Ebola. We suspect he has an upper respiratory tract infection, with symptoms of cough and conjunctivitis,” Dr. Robert Finberg, chair of medicine at UMass Memorial Medical Center, said in a statement. 

Tests are expected back from the federal Centers for Disease Control and Prevention on Monday, he said. 

Dr. Phil Smith, medical director of the biocontainment unit at the Nebraska Medical Center where Sacra was treated, said three blood tests showed Sacra was virus-free. 

“Because of his recent battle with the Ebola virus, his immune system is compromised,” Smith said. “The public shouldn't be concerned that his disease has returned."

Ebola in the US: Duncan now in critical condition.

Ebola in the US: Duncan now in critical condition. HT: Crof

Via The Dallas Morning News: Ebola patient in critical condition says Texas Health Presbyterian. Excerpt:

The condition of the first Ebola case in the United States was downgraded to critical Saturday by Texas Health Presbyterian Hospital Dallas. 

The patient, Thomas Eric Duncan, had been listed in serious condition in recent days. He was diagnosed with the deadly virus Tuesday. 

There is no vaccine or specific treatment that kills the Ebola virus, only supportive care that addresses certain symptoms, such as dehydration, diarrhea or vomiting. 

Federal, state and local health officials have declined all week to comment on any treatments Duncan was receiving. Several experimental therapies have been used successfully on selected Ebola patients, including U.S. medical volunteers who became infected while working in West African countries. They returned to the U.S. for care. 

Asked to comment on the availability of such treatments, officials have said the use of any therapy would depend on the advice of Duncan’s physicians and whether or not the patient and his family wanted to use them. 

Duncan was visiting Dallas from Liberia, where the disease is rampant. He arrived in Dallas Sept. 20 and became ill five days later. It was learned this week that he had had contact with several Ebola patients before leaving Liberia.

In another report, The Dallas Morning News says that contact tracing has now extended to persons who were transported in the ambulance after it took Duncan to hospital.

US Ebola outbreak 'extraordinarily unlikely', White House officials insist......

US Ebola outbreak 'extraordinarily unlikely', White House officials insist. HT: Crof.

Via The Guardian: US Ebola outbreak 'extraordinarily unlikely', White House officials insist. Excerpt:

White House officials on Friday sought to reassure people that an Ebola outbreak in the United States was unlikely, despite missteps in the case of Thomas Eric Duncan, the first patient diagnosed with the virus outside Africa. 

“The United States has the most capable health infrastructure and the most capable doctors in the world, bar none,” Lisa Monaco, President Obama’s senior counter-terrorism adviser, said at a White House briefing. 

Monaco and other administration officials urged calm as they faced criticism over the handling of the Ebola case in Dallas. But they announced no new procedural guidelines for hospitals or health officials, insisting the ones in place are working. 

“The United States is prepared to deal with this crisis, both at home and in the region,” she said. “Every Ebola outbreak in the past 40 years has been stopped. We know how to do this and we will do it again.” 

Duncan, of Liberia, was placed in isolation at the Texas Health Presbyterian hospital in Dallas on Tuesday after testing positive for Ebola. Duncan had gone there previously, but officials admitted that because of a “flaw” in the hospital’s electronic health record workflows, Duncan’s travel history was not communicated to the treating physician, resulting in the hospital sending him home with a course of antibiotics. 

“There were things that did not go the way they should have in Dallas, but there are a lot of things that went right and are going right,” Dr Anthony Fauci, director of the National Institute of Allergy and Infectious disease, said at the briefing. 

“The person is now in isolation being properly taken care of, and the fundamental basis of preventing an outbreak – contact tracing – is now going on. That’s the important thing.” 

Fauci said it was entirely possible that there will be more Ebola cases diagnosed in the US, but stressed that an outbreak is “extraordinarily” unlikely, given the quality of the nation’s health care infrastructure.

I agree that an Ebola outbreak is highly unlikely in the US. Still, the CDC and Texas authorities really botched this case: Either Tom Frieden wasn't fully informed about Duncan's history at Texas Presbyterian (which would say something about Texas health communications), or he was deliberately trying to soft-pedal the case while hoping Duncan's first visit to the hospital wouldn't come out. That would have been both unwise and desperate.  Hmmmm....Reminds me of 'The war on terror is over'

Really interesting, President Obama was quick to shut down flights to Isreal but is totally unwilling to shut down flights from West Africa!
— Donald J. Trump (@realDonaldTrump) October 3, 2014

WHO: "No threat of airborne Ebola"

WHO: "No threat of airborne Ebola" HT: Crof.

Via email from WHO:

UN Mission for Ebola Emergency Response statement for clarification: No threat that Ebola is airborne  

ACCRA, GHANA, 3 October 2014

Following recent media reports, the UN Mission for Ebola Emergency Response (UNMEER) seeks to clarify that Ebola is not an airborne disease. At this point in time we have no evidence and do not anticipate that the Ebola virus is mutating to become airborne.

However, there are real risks and concerns with this outbreak: every day more people are becoming infected and more are dying because they cannot get the care they need. 

Energy needs to be focused on swiftly addressing the real needs and gaps in communities affected by this disease. 

The Ebola virus only spreads through contact with bodily fluids. The World Health Organization (WHO) monitors the virus closely. Viruses do mutate but it is a complex process that takes time. 

Right now, as advised by WHO, the safest thing anyone can do is avoid direct contact with bodily fluids of people who have Ebola, and with surfaces and materials (e.g. bedding, clothing) contaminated with fluids.

Fearing Ebola, Israel will not send medical teams to Africa

Fearing Ebola, Israel will not send medical teams to Africa. HT: Crof.

Thanks to Lucie Lecomte for sending the link to this Ynetnews report: Fearing Ebola, Israel will not send medical teams to Africa.  Excerpt:

Israel has rejected a special request by the US and UN to send IDF field hospitals to Ebola hit Liberia and Sierra Leone. Defense Minister Moshe Ya'alon, who rejected the request, cited the threat of infection to Israeli medical teams in explaining his decision.   

The request was lodged by the UN and US, and was passed onto Israel though US Ambassador to the UN Samantha Power and Ron Prosor, Israel's envoy. 

The Foreign Ministry recommended the Defense Ministry respond positively to the American's request, even though it was a complex mission, which runs the risk of infection for medical crews, who would have been forced to wear full NBC suits.  

The mission was further complicated by the need to provide security for each such encampment.   

Despite all these risks, the Foreign Ministry believed that participation in such a mission would help bolster Israel's international standing, which suffered a severe blow in the aftermath of Operation Protective Edge.   

However, after examining the request and mission details, the Defense Ministry decided against Israel's participation, saying there was no feasible way to provide for the safety of the Israeli doctors and medical crews, which could then return to Israel and further spread the virus.

Despite the decision – or maybe because of it – the foreign minister decided to up the level of Israeli aid to the Ebola effort.   

In explaining their request, the US and UN cited the past success by the IDF's field hospital in natural and humanitarian disasters – like in earthquake hit Haiti or tsunami stricken Japan. The two international powers praised past missions, saying that in these cases the IDF showed its impressive capabilities in dealing with such disasters.

Hmmm....That's a first...they know something we don't ?

Ebola virus 'could become airborne' in nightmare scenario, UN mission chief warns.  

Nephew of US Ebola Patient Forced to Call CDC to Get Action Taken: Report

Nephew of US Ebola Patient Forced to Call CDC to Get Action Taken: Report. (RN).

The first person diagnosed with the Ebola virus in the United States did not receive proper help before his nephew personally urged the US Centers for Disease Control and Prevention (CDC) to take action, NBC News reported Thursday.

"I called CDC to get some actions taken, because I was concerned for his life and he was not getting the appropriate care. . . I feared other people might also get infected if he was not taken care of, and so I called them to ask them why is it a patient that might be suspected of this disease was not getting appropriate care?" Josephus Weeks, nephew of the first US Ebola patient, is cited as saying by NBC News.

The first case of Ebola virus infection was confirmed by the US Centers for Disease Control and Prevention (CDC) and Texas Health Department in Dallas on Tuesday. The patient was later identified by officials in Liberia as Thomas Eric Duncan, a resident of Monrovia.

Duncan first sought medical help on Thursday, September 25, but was not admitted or tested for the Ebola virus, as he "was not exhibiting symptoms" specific to the disease, Texas health officials informed.

The patient was rushed to the Texas Health Presbyterian hospital on Sunday, "at which time emergency medical services had already identified potential need for isolation," said a statement published by Texas Health Resources. According to Duncan's nephew, the action was taken the same day he contacted the CDC.

On Wednesday, Texas Governor Rick Perry informed that the Ebola-infected man had been in contact with five school-age children who had come to visit him during the weekend. The children are not under quarantine but are being closely monitored and have been asked to remain in their homes, he said.

.@RedNationRising United Airlines map of Ebola patient trip 2 US & effort 2 alert passengers http://t.co/zkP0ILrWNB pic.twitter.com/AUvjLUHRcU

— Mickey Lyn (@Joy4Life77) October 2, 2014

Farrakhan: Ebola is a ‘race targeting’ bio-weapon that doesn’t affect white people

Methods of Depopulation: Disease infection through bio-weapons such as Ebola & AIDS, which are race targeting weapons http://t.co/5PSNyCoOjM
— MINISTER FARRAKHAN (@LouisFarrakhan) September 30, 2014

Farrakhan: Ebola is a ‘race targeting’ bio-weapon that doesn’t affect white people. (Twitchy).


From the linked article:

Another method is disease infection through bio-weapons such as Ebola and AIDS, which are race targeting weapons. There is a weapon that can be put in a room where there are Black and White people, and it will kill only the Black and spare the White, because it is a genotype weapon that is designed for your genes, for your race, for your kind.

@LouisFarrakhan why were the 2 Americans who had Ebola, White? Stop the race-bating and hating. I know it pads your wallet but damn. Enough
— Laurie ن (@LLH713) October 1, 2014

  Hmmm....only it's a Zionist plot is missing.......oh wait...3....2....1

The implications of more Ebola 'bombs'.

The implications of more Ebola 'bombs'. HT: Crof.

Today's announcement by the CDC and Texas health authorities certainly got everyone's attention. Dr. Tom Frieden's news conference was brisk and reassuring and not too dominated by talking points. 

It was also not too dominated by real information. Dr. Frieden and his colleagues were excessively coy about the patient, citing privacy to decline saying whether he was an American citizen. Like the US MERS cases a few months ago, the Ebola patient was "visiting family in the US." But we do know that he was not involved in fighting Ebola in Liberia.

So he could be a Liberian visiting émigré relatives, or an American working in a Liberian mining enterprise, or a Chinese merchant in Monrovia visiting his Texas cousins.

No doubt the CDC itself knows this person's curriculum vitae down to the last comma, and is tracing his contacts in Liberia at least as assiduously as his contacts in Dallas. We can hope that CDC will eventually publish its findings, carefully laundered of anything that might identify this person.

(Digression: If we're going to deplore the irrational stigma attached to Ebola cases and their families in West Africa, could we please not treat it here as a stigma-free misfortune instead of something that might shame the case's children unto the seventh generation?)

We've already seen several HCWs return to the US from West Africa with Ebola, and no doubt more will follow. As a commenter noted earlier this afternoon, if Ebola can get into the US, it can get into anywhere. That seems to me the lesson of this particular case.

As a recent survivor of air travel to and from Scandinavia, I can attest to the absurdity of the security theatre in several major Canadian and European airports. (At Schiphol, a young Dutch guy patted me down with almost erotic zeal, which at 73 I found oddly flattering. The Finns at Vantaa didn't find me attractive at all.)

Nowhere, amid all the trays full of men's belts and iPads, did anyone aim a high-tech thermometer at me. No one asked me to stick out my tongue and say "Ah." I could have been crawling with fleas infected with Yersinia pestis; if I had, my cute Dutch pal would now be studying his buboes in some damn good Dutch hospital.

Airport security for over a decade has obsessed over suicidal lunatics with exploding shoes, inflicting stress and humiliation on millions of ordinary people.

It will take something like a bureaucratic upheaval to get the Dutch to quit copping a feel on septuagenarians and start taking temperatures.

Guys like today's anonymous Ebola case are far more dangerous than quartets of idiots with box cutters and a bad case of "Let's Pretend."

Whoever today's guy is, he's the harbinger of many more Ebola bombs with the price of an air ticket out of Freetown or Monrovia.

They may be headed for countries with far feebler health security than the US, and if they get through some airport in Nairobi or Singapore or Jeddah, Hell will present us with an invoice we'd rather not pay.

Ebola in US: What route flight did the case take from Monrovia?

Ebola in US: What route flight did the case take from Monrovia? HT: Crof.

Via The New York Times: Ebola Is Diagnosed in Texas, First Case Found in the U.S. Excerpt:

Dr. Frieden declined to disclose flight information or to say whether the patient is an American citizen. He said the man was not a health worker, and officials had no idea how he had become infected.

The man left Monrovia's Roberts International Airport on September 19, a Friday, and arrived in Dallas on Saturday. On the assumption that it was a regularly scheduled flight, then the departures schedule for Friday, October 3, should indicate the most likely flight: One codeshared as United Airlines 9974, Air Canada 6374, and Lufthansa 5549.

The flight would have left at 8:40 p.m. for Brussels, where the case would have arrived about 5:15 a.m. local time. He would then have transferred to at least one other flight to Dallas. 

I may be wildly wrong, but any competent travel agent could figure out the man's complete itinerary in a few minutes. So it seems pointless for Dr. Frieden to "decline to disclose" that information. The CDC certainly has it, whether or not it thinks tracing the passengers is worthwhile, and the Belgian health authorities presumably have it as well.

Why and Where Ebola isn't ?

Why and Where Ebola isn't? HT: Crof.

Since last spring I have watched this stupid virus take over my blog as well as three countries in West Africa that the world hasn't bothered its pretty head over in years.

The WHO map above dates from September 16, but it's the most recent I can find in a usable format. A few provinces or counties may have fallen to Ebola in the last two weeks, but the interesting aspect of this map is the blank areas. And I want to know why they're still blank.

From a single case last December, Ebola spread across part of eastern Guinea, then jumped to Conakry, the capital on the coast. A few months later it was in Sierra Leone and Liberia, where it has spread and intensified in some areas but not in others.

A terrified civil servant took Ebola to Nigeria, and a Guinean student took it to Dakar in Senegal. But it's fizzled out in those countries, and we owe their health ministries a unanimous vote of thanks.

It remains stuck in three countries where cases are apparently doubling every three weeks. Maybe more, depending on the mendacity and surveillance capacity of the governments involved.

If anything, Ebola's biggest allies are now the governments that insist on flying their infected nationals home to the US or Spain or France. On its own ground, Ebola is showing a surprising lack of enterprise.

Why hasn't it migrated to every village in West Africa the way cholera did in Haiti in 2010? Why hasn't someone sick staggered across a border into Cote d'Ivoire or Mali seeking help, as Guineans and Sierra Leoneans staggered into Liberia last spring?

These aren't trick questions. I'm clueless about this. Amid all the uproar where Ebola is, someone should be looking into what's going on where Ebola isn't.

Doctor: "I survived Ebola, but ZMapp almost killed me"

Doctor: "I survived Ebola, but ZMapp almost killed me" HT: Crof.

Thanks to Dr. Ian Mackay for tweeting the link to this fascinating report from France 24: 'How I survived Ebola'. Excerpt:

Senga Omeonga is doing better. Much better. Three weeks ago, FRANCE 24 interviewed this Congolese doctor who contracted the Ebola virus while working in Monrovia, Liberia. At the time, he was wasting away in the hallway of a hospital, without any treatment or food. Today, while he still feels weak, he no longer has the virus. He told us about his journey to hell and back. 

Doctor Senga Omeonga lost 20 kilos, and still speaks with a weak voice, but he’s regained much of his strength, both physical and mental. He is one the very few, very lucky survivors of the deadly Ebola epidemic, which has spread through Western Africa in the past few months. 

Omeonga and two other doctors in Liberia were given Zmapp, a drug that was tested for the first time in early August on two American health workers, who have since recovered from the virus. However, this experimental treatment hasn’t cured everyone: one of the doctors in Liberia who was given Zmapp as treatment died last Sunday. 

"My status as a doctor working internationally worked in my favour in getting me this drug" 

Omeonga has worked for the five years at the John Fitzerald Medical Centre in Monrovia, the capital of Liberia. He is originally from the Democratic Republic of Congo. 

"I’m still exhausted, but I know I’m out of the woods. On Thursday, I underwent one last medical test, and it proved I am no longer infected. I had gone home on Tuesday after having spent nearly three weeks at Elwa hospital, the only medical centre in Monrovia that’s taking Ebola patients.   

"People around me were dying like flies"  

"The first few days at that hospital were a real nightmare. There was not nearly enough staff or medical supplies. Since there were no rooms available, I had to wait in a hallway, lying on the ground, for a week. There was only one toilet for several dozen patients. A friend of mine came every day to give me food. In these conditions, I thought I would never survive; people around me were dying like flies. 

"A bed finally opened up, and a doctor treated me with Zmapp. He administered it to me three times. I believe my status as a doctor working internationally worked in my favour in getting me this drug. 

"Still, it was risky – the third dose of Zmapp almost killed me, since I had a strong allergic reaction to it and went into anaphylactic shock. 

"Every day since then, I’ve been steadily getting better. I intend to go back to work soon. My job as a doctor is to keep treating patients, including those who have contracted the Ebola virus. 

"Since I left the hospital, some of my friends are scared of me"  

Since I’ve left the hospital, it’s been interesting to see that some of my friends are a bit scared of me, at least those that don’t have any medical knowledge. Many of them refuse to come visit me, thinking I may still be carrying the virus. In Liberia, people living in regions touched by the epidemic have gone into a sort of mass psychosis leading to very irrational acts [Editor’s Note: Villagers in a town north-east of Monrovia recently barricaded a family in their home, where they died]. 

"This fear is starting to spread all over the country. The health ministry is having trouble recruiting medical staff – which means that hundreds of people will no doubt die simply due to lack of personnel – and politicians are fleeing the country." [Editor’s Note: President Ellen Johnson Sirleaf fired a number of high-ranking officials who refused to return to the country to help fight the epidemic].

Ebola: Speeches are not enough, MSF chief tells Obama

Ebola: Speeches are not enough, MSF chief tells Obama. HT: Crof.

In the army, we called it "kicking ass and taking names"; MSF International president Dr. Joanne Liu is very good at it (and, I'm proud to say, a Canadian). Via The Guardian: Ebola epidemic: speeches are not enough, MSF chief tells Obama. Excerpt:

The head of the aid group Médecins sans Frontières has warned Barack Obama and other world leaders that UN resolutions on the Ebola crisis are worthless unless they are translated into immediate action. 

Joanne Liu said that there was no end in sight for the epidemic in western Africa, with infection rates doubling rapidly. 

“Fear and panic have set in, as infection rates double every three weeks. Mounting numbers are dying of other diseases, like malaria, because health systems have collapsed,” she told a United Nations general assembly high-level meeting on Thursday evening. 

Her warning came as the UN secretary general Ban Ki-Moon warned that “despite the valiant efforts of local communities, health systems are buckling under the strain” with more than 200 a day dying. 

MSF’s latest country-by-country update on the Ebola epidemic shows the outbreak is worsening in Liberia and Sierra Leone. Hopes that it was finally under control in Guinea have been dashed with new cases in districts close to Conakry and Lola near the Ivory Coast. 

In Liberia, patients numbers are increasing every day with doctors turning away sick people from its two hospitals in Monrovia. 

“Our 150-bed facility in Monrovia opens for just 30 minutes each morning,” Liu said. Only a few people are admitted - to fill beds made empty by those who died overnight. The sick continue to be turned away, only to return home and spread the virus among loved ones and neighbours,” she added. 

In Sierra Leone, MSF’s field hospital in Kailahun received 28 patients in one day as a result of the house-to-house search during curfew at the weekend. It said there was a shortage of ambulances to collect patients, with many travelling for hours in “cramped and deplorable conditions”. As a result, some were dead on arrival. 

She said just a few states were carrying the load in west Africa and that “complacency is a worse enemy than the virus”. Hmmm....'Empty barrels make the most noise' !

Liberia responds to prediction of 1.4 million Ebola cases by January

Liberia responds to prediction of 1.4 million Ebola cases by January. HT: Crof.

Via FrontPageAfrica: 1.4M Ebola by Cases Jan? Liberia Welcomes Troops - What’s Next? Excerpt:

Damning new “worst-case-scenario” projections by the U.S. Center for Disease Control, that if nothing is done to effectively control the outbreak — there could be 1.4 million Ebola cases in Liberia and Sierra Leone by Jan. 20 and an earlier report by the New England Journal of Medicine that the number of Ebola cases could hit 21,000 in six weeks, coincides with the start of arrival of some 3,000 United States Troops, pledged by President Barack Obama to help control the epidemic at its source in West Africa. 

For Liberia, which has taken the biggest toll, fears are already beginning to arise that the government, which has been widely criticized over its handling of the outbreak, risks shifting responsibility on the Americans to solve the problem which has so far resulted in an estimated 5,800 illnesses with half of those numbers befalling Liberians. 

Opposition Liberty Party political leader Charles Walker Brumskine in an Op-Ed in FrontPageAfrica cautions the Liberian government against relying too much on America to rid the menacing virus from its midst. 

Says Brumskine: “As we welcome the intervention of the United States of America to help deal with the national health catastrophe, occasioned by the Ebola outbreak, let us not forget that the responsibility of containing the outbreak and eventually eradicating the Ebola virus from Liberia remains ours, as a Government, a nation, and a people." 

‘Natural Responsibilities'  

Cllr. Charles Brumskine says the beefed up U.S. intervention should greatly assist in the fight against the Ebola virus, as the US military’s unique expertise in engineering, and command and control should be especially useful in dealing with many of the infrastructural and logistical challenges. But he, however, cautions that that the intervention is not intended to be, and will not be a panacea for dealing with the Ebola crisis. 

“It most certainly will not rebuild our health care system. This is something that Liberia will have to do for itself. So, whether it is controlling the epidemic or mitigating the adverse economic, social, or political impacts on our nation, we must remain cognizant of our national responsibilities.” 

Asserts Brumskine: "The experts have told us, in no uncertain terms, that Ebola is a public health problem, which, like any other public health issue, is more effectively dealt with through prevention rather than cure. So, as the Americans assist us in the short term, it remains our responsibility, as a nation, to deal with the real public health issue of prevention.”

Liberia: US troops not testing Ebola patients - Health Ministry

Liberia: US troops not testing Ebola patients - Health Ministry. HT: Crof.

Via The New Dawn: US troops not testing Ebola patients -Health Ministry clarifies. Excerpt:

The Ministry of Health and Social Welfare has clarified that US troops who arrived in the country on Friday are not involved in testing Ebola patients at various health centers as being rumored here. 

The ministry has also dismissed reports of people begging to have suspected Ebola patients tested at the ELWA Hospital, terming the rumor as baseless. 

Speaking on Monday, September 22nd  during a regular press briefing at the Ministry of Information, Cultural Affairs and Tourism, the Assistant Health Minister for Preventive Services, Tolbert Nyeswah, said the 3,000 US military personnel, who arrived in Liberia over the weekend are not here to test people with the Ebola virus disease. 

He said the coming of the US military has nothing to do with testing or touching patients with the deadly Ebola virus, adding that they are here to render assistance and help maximum security for health care workers at various health centers. 

Minister Nyenswah said the Americans are also in Liberia to train soldiers of the Armed Forces of Liberia in combating the deadly Ebola virus. 

The US intervention includes establishing a regional intermediate staging base (ISB) to facilitate and expedite the transportation of equipment, supplies and personnel. Of the U.S. forces taking part in this response, many will be stationed at the ISB. 

Command engineers will build additional Ebola Treatment Units in affected areas, and the U.S. Government will help recruit and organize medical personnel to staff them. The military will establish a site to train up to 500 health care providers per week, enabling healthcare workers to safely provide direct medical care to patients. 

The US will deploy 65 experts from its public health Corps to Liberia to manage and staff a previously announced Department of Defense (DoD) hospital to care for healthcare workers who become ill. The deployment roster will consist of administrators, clinicians, and support staff. 

The US will also supply Ebola prevention kits targeting 400,000 most vulnerable households in Liberia. The package will subsequently be scaled to cover the country and the broader region. 

As part of the effort, this week, USAID is expected to airlift 50,000 home health care kits from Denmark to Liberia to be hand-delivered to distant communities by trained youth volunteers.