The Lancet: Assessment of the potential for international dissemination of Ebola virus via commercial air travel.

The Lancet: Assessment of the potential for international dissemination of Ebola virus via commercial air travel during the 2014 west African outbreak. HT: Crof.

Thanks to Greg Folkers for sending the link to this report in The Lancet: Assessment of the potential for international dissemination of Ebola virus via commercial air travel during the 2014 west African outbreak. The summary:

Background 

The WHO declared the 2014 west African Ebola epidemic a public health emergency of international concern in view of its potential for further international spread. Decision makers worldwide are in need of empirical data to inform and implement emergency response measures. Our aim was to assess the potential for Ebola virus to spread across international borders via commercial air travel and assess the relative efficiency of exit versus entry screening of travellers at commercial airports. 

Methods 

We analysed International Air Transport Association data for worldwide flight schedules between Sept 1, 2014, and Dec 31, 2014, and historic traveller flight itinerary data from 2013 to describe expected global population movements via commercial air travel out of Guinea, Liberia, and Sierra Leone. 

Coupled with Ebola virus surveillance data, we modelled the expected number of internationally exported Ebola virus infections, the potential effect of air travel restrictions, and the efficiency of airport-based traveller screening at international ports of entry and exit. 

We deemed individuals initiating travel from any domestic or international airport within these three countries to have possible exposure to Ebola virus. We deemed all other travellers to have no significant risk of exposure to Ebola virus. 

Findings 

Based on epidemic conditions and international flight restrictions to and from Guinea, Liberia, and Sierra Leone as of Sept 1, 2014 (reductions in passenger seats by 51% for Liberia, 66% for Guinea, and 85% for Sierra Leone), our model projects 2·8 travellers infected with Ebola virus departing the above three countries via commercial flights, on average, every month. 91 547 (64%) of all air travellers departing Guinea, Liberia, and Sierra Leone had expected destinations in low-income and lower-middle-income countries. Screening international travellers departing three airports would enable health assessments of all travellers at highest risk of exposure to Ebola virus infection. 

Interpretation 

Decision makers must carefully balance the potential harms from travel restrictions imposed on countries that have Ebola virus activity against any potential reductions in risk from Ebola virus importations. 

Exit screening of travellers at airports in Guinea, Liberia, and Sierra Leone would be the most efficient frontier at which to assess the health status of travellers at risk of Ebola virus exposure, however, this intervention might require international support to implement effectively.

Only three Ebola-infected travellers per month are likely to fly from West Africa

Only three Ebola-infected travelers per month are likely to fly from West Africa. HT: Crof.

Via The Guardian: Only three Ebola-infected travellers per month are likely to fly from west Africa. Excerpt:

Fewer than three people a month infected with the Ebola virus are likely to try to board planes out of west Africa, according to a study that says exit screening would be the most efficient way to try to prevent travellers spreading disease. 

The UK and US have set up entry screening at airports for passengers arriving from west Africa, but the paper in The Lancet medical journal says this will have little chance of detecting somebody infected with the virus and that it will cost money that could be better spent.

The paper is written by Dr Kamran Khan at St Michael’s Hospital in Toronto, Canada, and colleagues. The team analysed worldwide flight schedules from 2014, taking account of the routes that have been suspended because of the crisis, and flight itineraries from 2013 to establish the population’s normal travel patterns. They used World Health Organisation data on Ebola virus infections. 

The authors say that restricting air travel from Guinea, Sierra Leone and Liberia, where the epidemic is raging, is damaging to the countries’ economies and may potentially handicap efforts to end the Ebola outbreak, which is the best way to safeguard the rest of the world. 

They found that most travellers from the three countries – more than 60% – fly to low- and middle-income countries, with Ghana and Senegal as the top destinations. The arrival of somebody infected with Ebola is a greater threat to less affluent countries than to the UK, which was the third most popular destination, with 8.7% of travellers, or to the USA, where 2% would be headed. 

“Given that these countries have limited medical and public health resources, they may have difficulty quickly identifying and effectively responding to imported Ebola cases,” said Khan. 

“The risk of international spread could increase significantly if the outbreak in west Africa persists and grows. Risks to the global community would further increase if Ebola virus were to spread to and within other countries with weak public health systems.” 

Screening passengers either at exit or entry will miss cases, the paper says, because of the long incubation period of the virus – up to 21 days. Because many direct flights to countries like the UK have been stopped, travellers anyway have to change planes or use additional forms of transport and may not be identified as coming from west Africa.

Ebola: No more Canadian health workers to Africa

Ebola: No more Canadian health workers to Africa. HT: Crof.

Via Canoe.ca, a QMI report: No more Canadian health workers to Africa: Feds. Excerpt:

Health Minister Rona Ambrose says no more Canadian health workers will be going to West Africa to help in the fight against Ebola until "medical evacuation is guaranteed." 

She said the countries most affected by Ebola don't have the necessary equipment to deal with an influx of health-care workers who could become infected with the virus. 

Canada has an agreement with a U.S. charter, but other countries have similar arrangements with the same company. 

"It's one thing to have an arrangement, but if there was more than a few people sick, a number of countries would be in a very difficult position," Ambrose said Monday. 

The government's reaction to the international crisis has already sparked criticism from some medical groups. 

The federal government's "paltry" response to the Ebola crisis in West Africa leaves it significantly responsible if a case arrives in Canada, Michael Hurley, president of the Ontario Council of Hospital Unions/CUPE (OCHU), said earlier in the day. 

He said Canada should be encouraging health-care workers to volunteer their skills, as well as using its budget surplus to provide more than $65 million for the front-line battle. 

The federal government shouldn't wait for the virulent disease to show up on Canadian soil; it should be addressing the problem at its source, he said. "It is inevitable if we do nothing — there's no question about it," Hurley said Monday. "Their financial contribution has been paltry...I've seen no evidence of any mobilization of financial or health human resources behind the fight from Canada in West Africa." 

The number of cases of Ebola could hit 1.4 million by January. 

"The Harper government's theory that Ebola's coming to Canada is inevitable is true only if it remains committed to doing almost nothing to assist West Africa," Hurley said.

WHO: Nigeria is now free of Ebola virus transmission.

WHO: Nigeria is now free of Ebola virus transmission. HT: Crof.

WHO has published a situation assessment that reads more like a paid advertorial for the Goodluck Jonathan government: Nigeria is now free of Ebola virus transmission. Excerpt from the third of a three-page document and then a comment:

For some time now, with dedicated and enthusiastic support from President Goodluck Jonathan, Nigeria has been running one of the world’s most innovative polio eradication campaigns, using the very latest satellite-based cutting-edge GPS technologies to ensure that no child misses out on polio vaccination. 

The country, which passed through the high-transmission season with only 1 single case of polio detected by a finely-tuned and sensitive surveillance system, is on track to interrupt wild poliovirus transmission from its borders before the end of this year. 

When the first Ebola case was confirmed in July, health officials immediately repurposed polio technologies and infrastructures to conduct Ebola case-finding and contact-tracing. 

The use of cutting-edge technologies, developed with guidance from the WHO polio programme, put GPS systems to work as support for real-time contact tracing and daily mapping of links between identified chains of transmission. 

This is a good public health story with an unusual twist at the end. As part of preparedness for an imported case, several advanced countries with good health systems are now studying technologies “made in Nigeria”, with WHO support, to improve their own contact tracing capacities. 

The story has another very clear message, as noted by Dr Margaret Chan, the WHO Director-General. “If a country like Nigeria, hampered by serious security problems, can do this – that is, make significant progress towards interrupting polio transmission, eradicate guinea-worm disease and contain Ebola, all at the same time – any country in the world experiencing an imported case can hold onward transmission to just a handful of cases.” 

World-class epidemiological detective work would eventually link every single one of the country’s 19 confirmed cases back to direct or indirect contact with that 20 July air traveller from Liberia. 

In another strategy, traditional, religious and community leaders were engaged early on and played a critical role in sensitizing the public. Like many others, the strategy drew on successful experiences in the polio programme. 

The awareness campaigns that worked so well to create public acceptance of polio immunization were likewise repurposed to encourage early reporting of symptoms, backed by the message that early detection and supportive care greatly increase an Ebola patient’s prospects of survival. 

All of these efforts were supported by social mobilization experts from UNICEF, CDC and Médecins sans Frontières, while the staff from the WHO Nigeria office, the Regional Office for Africa and headquarters boosted outbreak investigation, risk assessment, contact tracing and clinical care. 

In the end, Nigeria confirmed a total of 19 cases, of whom 7 died and 12 survived, giving the country an enviable case fatality rate of 40% – much lower than the 70% and higher seen elsewhere.

This document may have been generated in WHO's Regional African Office, which is effectively autonomous and run by political appointees. It certainly doesn't sound like the usual sitreps WHO publishes.

The Nigerians can be proud of the way they stopped Ebola, but a puff piece like this only undercuts their achievement.

Israeli prof.: US lagging behind on Ebola precautions, U.S. needs infrared screening at airports.

Israeli prof.: US lagging behind on Ebola precautions, U.S. needs infrared screening at airports. (TOI).HT : IsraelMatzav.

An American-Israeli expert in infectious diseases has attacked the United States' failure to screen airline passengers by taking their temperatures using infrared cameras as a means of preventing passengers with Ebola from boarding planes.

According to Ben-Gurion University of the Negev Professor Leslie Lobel, “the world has been asleep for 50 years regarding infectious diseases and Ebola is the wake-up call.”

Lobel is a world-recognized virologist who has studied the virus and others emanating from the African continent.

“Fifty years ago, we were dealing with eradicating polio, smallpox and yellow fever which had similarly high mortality rates. Today, most of the world seems to understand the need to screen passengers in airports using infrared cameras for elevated temperature as a simple precaution — the US is lagging behind,” said Dr. Lobel.

The American-Israeli professor has been researching a cure for hemorrhagic fever viruses, including Ebola, for a decade, the university said in a press release. ...

Earlier Friday, the World Health Organization admitted that it botched attempts to stop the now-spiraling Ebola outbreak in West Africa, blaming factors including incompetent staff and a lack of information.

“Nearly everyone involved in the outbreak response failed to see some fairly plain writing on the wall,” WHO said in a draft internal document obtained by The Associated Press, noting that experts should have realized that traditional containment methods wouldn’t work in a region with porous borders and broken health systems.

Of course, if TSA ever started screening passengers for fevers, you can bet that (a) it would be done randomly rather than targeting people carrying the passports of affected countries and (b) it would cause long lines at the check-in counters.

As to WHO, anyone who depends on any UN agency to do anything reliably (other than hate Israel) is simply detached from reality. Read the full story here.

Ebola in West Africa: MSF's blunt assessment.

Ebola in West Africa: MSF's blunt assessment. HT: Crof.

Via MSF's Ebola page, a nation-by-nation summary of the situation. Scroll down to find it. Excerpt:

Sierra Leone 

Update: October 16, 2014 

Every district in Sierra Leone is now affected by the epidemic. New hotspots for the disease include the capital, Freetown, and the areas of Port Loko, Bombali, and Moyamba. The government has put five of the worst-affected districts under quarantine, setting up checkpoints on roads to prevent people leaving the area—measures that affect between one and two million people. 

The government’s response is hampered by a lack of resources and coordination at both national and district level. There is no strong surveillance system in place, while up to 85 percent of calls to the national telephone helpline get no response. Transit centers are full and management is an issue, creating the risk of cross-contamination. 

As a result of overcrowding, delays in lab testing, and too few ambulances, staff in transit centers are obliged to send people untested to CMCs, risking that positive cases infect those who are negative. As there are few CMCs, and these are often far away, people often die on the long journey there. Dead bodies have the highest viral load possible, putting other passengers at risk. 

With so many deaths from Ebola, we are seeing an increasing number of orphaned children in our centers, and a lack of caregivers. 

The international response is beginning to get underway, but it is slow and uncoordinated. Governments (including the UK and China) and various NGOs have sent teams to construct new centers at different locations around the country, including Jiu, Port Loko, and Freetown. Getting these new centers up and running is a matter of urgency.

WHO response to internal Ebola document leaked to media

WHO response to internal Ebola document leaked to media. HT: Crof.

Via email:

WHO response to internal Ebola document leaked to media. 

A WHO internal document recently obtained by some media outlets was the first draft of a small team documenting the chronology of the Ebola outbreak events for future review.  

This document has not yet been fact-checked or reviewed by WHO staff involved in the initial response to Ebola, and is part of an on-going analysis of our response. 

WHO will not do interviews or explain details on this document until it is completed. 

WHO believes in transparency and accountability and will release this review when it is fact-checked. For now, WHO's focus is to obtain the resources needed to successfully fight this Ebola outbreak. 

A full review and analysis of global responses to this, the largest-ever Ebola outbreak in history, will be completed and made public once the outbreak is under control. 

We are a public health organization and our focus right now must be to stop this outbreak and save lives. We cannot divert our limited resources from the urgent response to do a detailed analysis of the past response. That review will come, but only after this outbreak is over.

Obama 'Admin' Plans to Let Ebola-infected Foreigners Into U.S. for Treatment

Source picture 

Obama 'Admin' Plans to Let Ebola-infected Foreigners Into U.S. for Treatment. (Jwatch).

Washington, DC – Judicial Watch has learned that the Obama administration is actively formulating plans to admit Ebola-infected non-U.S. citizens into the United States for treatment.  Specifically, the goal of the administration is to bring Ebola patients into the United States for treatment within the first days of diagnosis.

It is unclear who would bear the high costs of transporting and treating non-citizen Ebola patients.  The plans include special waivers of laws and regulations that ban the admission of non-citizens with a communicable disease as dangerous as Ebola.

One source tells us that the Obama administration is keeping this plan secret from Congress. The source is concerned that the proposal is illegal; endangers the public health and welfare; and should require the approval of Congress. Hmmm.....Someone explain to me why to send US troops to build hospitals and then bring the patients to the US?


The post Obama Plans to Let Ebola-infected Foreigners Into U.S. for Treatment appeared first on Judicial Watch.

Nigerian Tourist, Possible Ebola case dies in Istanbul hospital.

Nigerian Tourist, Possible Ebola case dies in Istanbul hospital. (DS).


A Nigerian transit passenger who was transferred from Istanbul's Atatürk Airport to Bakırköy Dr. Sadi Konuk Hospital died Friday with the suspicion of Ebola virus.

It was reported that the Nigerian woman was travelling from Saudi Arabia after her Hajj pilgrimage to Indonesia.

The woman's corpse was quarantined at the Forensic Medicine Institution and blood samples were sent abroad for examination.

Ebola in the US: The Obama Ebola Czar's Twitter feed immediately "suspended"

Not anymore. RT @MichaelBenny: The White House’s new #Ebola czar is on #Twitter now. @WH_ERC pic.twitter.com/Md2GESZyRh
— A. Wesley Jones (@PinstripesNY) October 17, 2014

Ebola in the US: The Obama Ebola Czar's Twitter feed immediately "suspended" HT: Crof.

Thanks to André Picard for retweeting the link to the new Twitter feed for the Ebola Response Coordinator (@ERC_WH).

I logged on, became follower #420, and when I returned I found the message "Sorry, that user is suspended." 

My gosh, I know the guy is a political appointee, not a doctor, but at least give him a chance.

Brussels Airport hires specialized firm to handle and screen baggage from Ebola-infected areas.

Brussels Airport hires specialized firm to handle and screen baggage from Ebola-infected areas. (Yahoo).

Brussels Airport, a hub for flights coming from Africa, said on Friday it had hired a specialized firm to check baggage coming from Ebola-hit regions, after a union told its members to no longer handle such items.

The company will screen luggage from Sierra Leone, Guinea and Liberia and destroy any it suspects may be contaminated.

Belgium's socialist union on Wednesday had called on its members at Brussels Airport to no longer handle baggage from infected areas.

The airport said in a statement it was "taking such concerns seriously."

European Union health ministers have agreed to try to improve West African nations' screening of departing passengers for Ebola, but disagreed on the need to check travelers arriving in their own countries.

Brussels Airlines, Belgium's largest airline, flies to 19 destinations in Africa including regular flights to Liberia, Sierra Leone and Guinea.

Belgium's health ministry on Friday appointed a national coordinator for Ebola and said it was considering measures such as checking incoming passengers from infected areas.

"I don't want panic to break out in the country," Health Minister Maggie De Block told a news conference in Brussels.

"Autumn is a time of infections and a runny nose or flu has nothing to do with Ebola," she added. Hmmm........The Belgium Health minister said that leaking Suitcases will be removed, i suggest the health minister to read up on Ebola at the CDC, Ebola can survive on hard DRY surfaces for several hours!  More on Ebola measures taken in Belium here.

  Are they right to be concerned? YOU BET THEY ARE ! 

SOURCE

Considering that Ebola can survive  for several hours dried on surfaces, it's only logical that anyone handling the luggage at the departure country is also in a higher risk category, from the person issuing the ticket at the airport to all staff handling the baggage.

Ebola: Is a 21-day quarantine period long enough?

Ebola: Is a 21-day quarantine period long enough? HT: Crof.

 Via PLOS Currents Outbreaks: On the Quarantine Period for Ebola Virus. The abstract:

Background: 

21 days has been regarded as the appropriate quarantine period for holding individuals potentially exposed to Ebola Virus (EV) to reduce risk of contagion. There does not appear to be a systematic discussion of the basis for this period. 

Methods: 

The prior estimates for incubation time to EV were examined, along with data on the first 9 months of the current outbreak. These provided estimates of the distribution of incubation times. 

Results: 

A 21 day period for quarantine may result in the release of individuals with a 0.2 – 12% risk of release prior to full opportunity for the incubation to proceed. It is suggested that a detailed cost-benefit assessment, including considering full transmission risks, needs to occur in order to determine the appropriate quarantine period for potentially exposed individuals.

Texas Based carnival cruise ship stuck at sea near Belize, Possible Ebola nurse on board.

Texas Based carnival cruise ship stuck at sea near Belize, Possible Ebola nurse on board. (Belizean)

Reports tonight are that two individuals possibly infected with the Ebola virus are in Belizean waters. 

Local TV station Channel 7 monitored in the capital City Of Belmopan tonight, reported having credible reports that a couple from a Texas-based cruise ship presently anchored off Belize City, is on a ship tender, unable to return to the cruise ship, while being refused entry to Belize City to catch an air ambulance awaiting at the International Airport to take them to the their country of origin, the U.S.A.

The television station in its broadcast tonight said Belize health authorities contacted tonight have so far refused to deny or confirm the report. The patient exhibiting Ebola symptoms has been confirmed to be a nurse at a Dallas hospital traveling with her husband.

Later tonight in breaking news, Channel 5 Belize reported that it has:

“Confirmed with representatives of the Ministry of Health that they have indeed received a report that there is at least one passenger on board the cruise ship, Carnival Magic, showing symptoms similar to that of the Ebola virus. According to the report made to MOH, the person exhibiting the symptoms did not come ashore today. The ship is reportedly carrying 3652 passengers and a total population of 4633 persons.

“The Carnival Magic departed from Galveston Texas on Sunday, October 12 arrived in Mahogany Bay, Honduras on Wednesday October 15 and arrived in Belize this morning, Thursday October 16.

“The ship was scheduled to leave Belize en route to Cozumel this evening at 5pm. However, it is still anchored in Belizean waters near State Bank Caye.”

“We have also have confirmed that the Belize Coast Guard has been deployed to prevent anyone from leaving the ship; including the Belizean pilot on board.”

Channel 7 news anchor Indira Craig has posted on her Facebook page that Belize Prime Minister Dean Barrow in a callous move in view of very close Belize-U.S. relations, has denied entry into Belize for the stricken U.S. nationals to be air lifted to the U.S.A. for treatment:

“Talks have concluded with the PM and The US State Department officials. Belize WILL NOT BE GRANTING ACCESS to the suspected passengers to have entry onto our shores. An official release will be sent out shortly by government followed by a press conference to be held tomorrow.Passports have been returned so this scare has ended.”

In a late night official press release issued by the Belize Press Office, the Belize government offered its version of the Belize Ebola Incident.It stresses that while the patient did not disembark in Belize, it does not address the question that thousands of cruise ship passengers that may have had contact with the patient(s) did in fact disembark and tour Belize City today. More here from WAPO.

Baggage handlers in Belgium National airport refuse unloading bags from Ebola countries.

Baggage handlers in Belgium National airport refuse unloading bags from Ebola countries. (NOS) (DeTijd).[GoogleTranslate].

Baggage handlers at Brussels Airport Zaventem refuse to unload Luggage from countries where Ebola prevails. They are afraid that they are infected and want that protective measures are taken.

It is the members of the union ABVV. They want no more baggage handling flights from Guinea, Liberia, Sierra Leone, Nigeria and parts of Congo.

The union says to continue the action until a clear prevention lies with procedures and aftercare in case there is a contamination event at the airport. Such a plan must come from the airport and the government.

Other unions representing baggage handlers are worried and want a prevention plan is for airport personnel. The liberal union ACLVB wants all flights to Ebola Countries are deleted until the staff is knowledgeable about the epidemic.

The airline Brussels Airlines flies several times a week on West African countries.

"We demand guidelines and procedures for the prevention and aftercare if there is a case at the airport have been," said BTB secretary Sandra Langenus.

The members of BTB, claims to be the largest union in the baggage handlers will no baggage or cargo unloading more coming from Guinea, Liberia, Sierra Leone, Congo and parts of Nigeria .

There is likelyhood of a victim of it. Brussels Airlines Society has include six connections per week with Congo and receives Thursday in Zaventem already a flight from Sierra Leone and Guinea.

Langenus wants the airport operator and the National Public Health come up with measures quickly. "I'm trying to get the procedures already the whole week.  No one can give us the prescribed procedure, "she says.

As long as the union does not get "clear guarantees associated with the risk of infection," the actions will continue.

The liberal union believes that the airport staff is not sufficiently informed.The Union ACLVB therefore requires that flights to and from the Ebola countries are suspended . "Till flights can be resumed in a safe way"

Are they right to be concerned? YOU BET THEY ARE ! 

SOURCE

Update:

Considering that Ebola can survive  for several hours dried on surfaces, it's only logical that anyone handling the luggage at the departure country is also in a higher risk category, from the person issuing the ticket at the airport to all staff handling the baggage.

Obama approves reservists for Ebola fight; government under fire

Obama approves reservists for Ebola fight; government under fire. HT: Crof.

Via Reuters: Obama approves reservists for Ebola fight, government under fire. Click through for the full report and a series of photos—one of which implies Ebola is a biowarfare creation of the US. Excerpt:

President Barack Obama authorized calling up military reservists for the U.S. fight against Ebola in West Africa on Thursday, as lawmakers criticized his administration's efforts to contain the disease at home. 

Obama's move came after lawmakers held a congressional hearing to probe the federal response to the virus. Amid criticism of perceived missteps by the administration, many House of Representatives members joined calls for a ban on travel from the hardest-hit West African countries: Liberia, Sierra Leone and Guinea. 

Obama signed the executive order authorizing the use of U.S. military reservists to support humanitarian aid efforts in those countries, highlighting the need to launch an all-out attack against the disease. The order did not specify how many personnel would be involved. 

A congressional hearing on Thursday came as concerns about the virus in the United States intensified after two Texas nurses who cared for Liberian patient Thomas Eric Duncan contracted the virus. 

After the hearing, the White House said Obama met with top administration officials handling the government's response to Ebola. 

News that one of the nurses, Amber Vinson, traveled aboard a commercial airliner while running a slight fever ratcheted up public health concerns on Wednesday, prompting several schools in Ohio and Texas to close because people with ties to the schools shared the flight with Vinson. 

The U.S. National Institutes of Health (NIH) said it would take over the care of the first Texas nurse diagnosed with Ebola, Nina Pham, who contracted the virus while caring for Duncan, who later died. 

Lawmakers focused questions and pointed criticism at the hearing on Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention. 

"The administration did not act fast enough in responding in Texas," Democratic Representative Bruce Braley of Iowa told the hearing. "We need to look at all the options available to keep our families safe and move quickly and responsibly to make any necessary changes at airports." 

Several Republicans said flights from West Africa, where the virus is widespread, should be stopped. Hmmm.....Calling up reservists for something they have not be trained for...not exactly the best move.

Canada: Ottawa readies Ebola response team; provinces designate treatment centers

Canada: Ottawa readies Ebola response team; provinces designate treatment centers. HT: Crof.

Via The Globe and Mail, Kelly Grant writes: Ottawa readies Ebola response team, provinces designate treatment centres. Excerpt:

Ottawa has a team of infectious disease experts on standby and the majority of Canadian provinces have designated specific Ebola treatment centres as this country tries to prepare for a killer virus that has now infected two U.S. nurses, raising serious questions about whether the average North American hospital can safely treat Ebola patients.  

Health Minister Rona Ambrose said Wednesday evening that if Ebola makes its way to Canada, the Public Health Agency of Canada would send a crew of epidemiologists and other experienced outbreak managers to help halt the spread of the virus, something the U.S. Centers for Disease Control and Prevention now admits it should have done in a more robust manner after the first case of Ebola was diagnosed in Dallas last month. 

Meanwhile, every province from Alberta to Nova Scotia – with the exception of Ontario – has already selected two or more designated hospitals where health-care workers are supposed to receive extra training to treat possible Ebola patients. 

At least one British Columbia health authority has designated a hospital, and Ontario is in the process of choosing its designated hospitals now, according to the province’s Health Minister. 

The Canadian approach is an acknowledgment that not all hospitals can cope with Ebola patients, a reality underscored by the apparent bungling at the Dallas hospital that treated the first patient diagnosed with Ebola in the U.S. – Thomas Eric Duncan, a Liberian national who died of the disease. 

Ottawa has a team of infectious disease experts on standby and the majority of Canadian provinces have designated specific Ebola treatment centres as this country tries to prepare for a killer virus that has now infected two U.S. nurses, raising serious questions about whether the average North American hospital can safely treat Ebola patients.

Turkey - First Ebola case in Istanbul?

Turkey - First Ebola case in Istanbul? HT: Crof.

October 16 report in Daily Sabah: Man with Ebola virus hospitalized in Istanbul. The complete report:

A man arriving from Ivory Coast infected with the Ebola virus has been hospitalized in Istanbul on Wednesday. 

The patient was brought to the Marmara University Education and Research Hospital. He was diagnosed with Ebola after landing in Istanbul's Sabiha Gökçen Airport. The hospital was briefly quarantined and current patients immediately were transferred to other hospitals. 

The patient will be transferred to Süreyyapaşa Breast Diseases Education and Research Hospital on Thursday morning.

It's a dramatic development, if true. But I can't find confirmation yet in the Turkish online media. 

The implications are pretty serious, however. 

If the man was living in Ivory Coast, he must have acquired Ebola there—in a country that has so far escaped it, and which is economically far more significant than the hot-zone countries. If he came from Liberia or Guinea, that's even worse—he might have been infecting people en route.

 

If it's a real case, the Turkish authorities and media will let us know very soon. If it's not, well, you can catch Ebola jitters even next door to ISIS in Syria and Iraq.

Update:

Yesterday Daily Sabah reported a man infected w Ebola hospitalized in #Istanbul. Today link to same story changes to a woman with malaria.

— Benjamin Harvey (@BenjaminHarvey) October 16, 2014

Ebola cases in East Africa?

Ebola cases in East Africa? HT: Crof.

Via Hara Ethiopia: Ebola Outbreak Spreads in Ethiopia, Kenya and South Sudan as passenger dies at Kenya’s Jomo Kenyatta International Airport. Excerpt:

Health officials at Kenya’s Jomo Kenyatta International Airport (JKIA) told Xinhua on Sunday that the female passenger on board Kenya Airways flight alighted at 6:45 p.m. with high fever and bleeding from the openings of her body. 

“We have not established what exactly caused the death but medical officials including director of medical services are carrying out tests to establish the cause,” an official who sought anonymity told Xinhua by telephone. 

The official said the female passenger who had arrived from Juba was later rushed to the hospital but died in the evening. The health ministry is expected to issue a formal statement concerning the incident later on Sunday to confirm whether the patient had Ebola. The incident caused panic at the busy airport which was immediately deserted for hours after the death of the passenger. However, the fate of the other passengers on the flight is still unknown. 

In other developments 

 Ethiopia’s Ministry of Health on Sunday disclosed establishing a modern laboratory center in a bid to control deadly Ebola virus after four reported cases of ebola in Addis Ababa. 

The facility will start operating on Monday for tasting of four suspected cases of Ebola. A disease that medical doctors believe is Ebola appears to be suspected in the Ethiopian capital. One western African origin diplomat has been admitted for flu like symptoms in Saint Yared General Hospital. Three more people have been also admitted to the Black Lion hospital, with a reported cases of bleeding and fever.

I don't know Hara Ethiopia, so I don't yet trust its reliability. Xinhua has a report on its website saying Kenya has closed its border with Uganda after reports of case of Ebola in eastern Uganda. But it doesn't say anything about a dying passenger from Juba, which is the capital of South Sudan.

Liberia: 41 UN staffers under observation for Ebola - Sierra Leone: 140 Ebola deaths in one day

Liberia: 41 UN staffers under observation for Ebola. HT: Crof.

Via The Globe and Mail, a report by The Associated Press: Liberia: 41 UN staffers under observation for Ebola. Excerpt:

Liberia’s United Nations peacekeeping mission has placed 41 staff members, including 20 military personnel, under “close medical observation” after an international member of its medical team was diagnosed with Ebola this week — the second mission member to test positive for the deadly disease. 

“This measure is precautionary and meant to ensure no possible further transmission of the disease,” the mission said in a statement Friday. “None of the personnel who are contacts have shown any symptoms but will be observed for the full 21-day possible incubation period.”  

The World Health Organization says 21 days is the maximum incubation period for Ebola, which is spread via the bodily fluids of infected people. The 41 staffers were identified as having possibly come into contact with the member of the medical team, whose name and nationality have not been disclosed. 

The patient tested positive Monday and arrived in Germany Thursday for treatment — the third Ebola patient to be flown there. The St. Georg Hospital in Leipzig said this week the patient would be placed in a special isolation unit. 

The first U.N. staffer in Liberia to come down with Ebola died Sept. 26.

Sierra Leone: 140 Ebola deaths in one day

Thanks to Umaru Fofana for tweeting the news that Sierra Leone has experienced 140 Ebola deaths in one day. The data are at Ebola Virus Disease (EVD) Update | Ministry of Health and Sanitation, which reports 853 cumulative deaths as of October 10.

However, to understand that number you need to compare it with the report of the previous day, which reports 713 deaths. Sierra Leone's health authorities are not knocking themselves to provide interpretation and analysis of their numbers.

Time to start thinking about it! 

EBOLA - Is this the time to put West Africa under UN trusteeship?

Canadians in West Africa should leave by commercial means while they are still available: Government

Canadians in West Africa should leave by commercial means while they are still available: Government. HT: Crof.

Thanks to Lucie Lecomte for sending the link to this Canadian Press report in Metro: Canadians in West Africa should leave. Excerpt:

The federal government wants Canadians who live in three countries in West Africa where the Ebola virus is raging to consider leaving now. 

Health Minister Rona Ambrose said Friday the updated travel advisory is aimed at 216 Canadians who live in Guinea, Sierra Leone and Liberia. 

“Today we are asking Canadians living in Sierra Leone, Guinea and Liberia to consider leaving by commercial means while they are still available,” she said in Edmonton.  

The World Health Organization says these countries face ongoing outbreaks of Ebola and more cases of the deadly disease can be expected. 

Ambrose said airline passengers who come from the region will be asked to see a quarantine officer when clearing customs if they’re feeling sick. 

“If they are coming in from one of the affected countries, we would like them to answer specific questions and be referred to a quarantine officer for a health assessment, should it be needed,” she said. 

The Public Health Agency of Canada recommends that Canadians avoid all non-essential travel to these countries.

I'm not sure what to make of this, but it sounds as if our government knows something it's not telling us. It wouldn't be the first time.