ER doctor discusses role in Ebola patient’s initial misdiagnosis

DALLAS MORNING NEWS 

The Dallas emergency-room doctor who missed signs of Ebola in a Liberian man who later became the first to die of the disease in the U.S. describes the fateful night for the first time.

Dr. Joseph Howard Meier told The Dallas Morning News that when he treated Thomas Eric Duncan in the early morning hours of Sept. 26, he was unaware that Duncan had recently arrived from a country ravaged by the Ebola outbreak in West Africa. He also said he did not realize Duncan had such a high fever.

"I was unaware of a 103-degree fever," Meier said in written answers to questions from the paper, released by his attorney. "It appears in the chart, but I did not see it...."

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Rapid Ebola test is focus of NIH grant to Rutgers scientist

REPORTS Of RESEARCH ON TWO METHODS OF RAPID TESTING FOR EBOLA

(Two items, scroll down)

MEDICAL PRESS                                                                                     Dec. 8, 2014

Rutgers researcher David Alland, working with the California biotechnology company Cepheid, has received a grant of nearly $640,000 from the National Institutes of Health to develop a rapid test to diagnose Ebola as well as other viruses that can cause symptoms similar to Ebola.

Researchers will adapt this cartridge, now used worldwide for tuberculosis screenings, to collect and test samples from potential Ebola patients. Credit: John Emerson

Alland, a professor of medicine and associate dean for clinical research at Rutgers New Jersey Medical School and the principal investigator of the project, says would be able to take the test to small villages and other remote locations where the spread of Ebola has been especially rampant and diagnose patients where they live...

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With Ebola Cases Down, Officials Worry Liberians Aren't Worried Enough

NATIONAL PUBLIC RADIO  by OFEIBEA QUIST-ARCTON                                          Dec. 8, 2014

MONROVIA -- Treatment units in Liberia stand nearly empty, but a dozen or so Ebola cases still appear each day, with clusters in Monrovia and rural areas. The CDC's chief there wants the nation to stay alert.

Interview with Kevin De Cock, the doctor leading the Ebola response effort in Liberia for the Centers for Disease Control and Prevention. He warns that the new enemy in the fight against the virus may be people letting down their guard.

Read rest of interview.

http://www.npr.org/2014/12/08/369276253/with-ebola-cases-down-officials-worry-liberians-arent-worried-enough

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In Ebola Outbreak, Bad Data Adds Another Problem

ASSOCIATED PRESS -By MARIA CHENG and SARAH DiLORENZO Dec. 14, 2014

LONDON--As health officials struggle to contain the world's biggest-ever Ebola outbreak, their efforts are being complicated by another problem: bad data.

Having accurate numbers about an outbreak is essential not only to provide a realistic picture of the epidemic, but to determine effective control strategies. Dr. Bruce Aylward, who is leading the World Health Organization's Ebola response, said it's crucial to track every single Ebola patient in West Africa to stop the outbreak and that serious gaps remain in their data.

"As we move into the stage of hunting down the virus instead of just slowing the exponential growth, having good data is going to be at the heart of this," Aylward said. "We are not there yet and this is something we definitely need to fix."

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Sierra Leone Baffled by Doctors' Ebola Deaths

VOICE OF AMERICA  by James Butty                             Dec. 8, 2014
FREETOWN --Sierra Leone’s chief medical officer has said he is baffled by the deaths of three doctors from Ebola over a three-day period.  

Dr. Brima Kargbo said a survey conducted jointly with the U.S. Centers for Disease Control (CDC) found that 70 percent of infections did not come from either the country’s Ebola holding centers or treatment facilities. 

FILE - A health worker prepares to disinfect a van used for burial purposes in Freetown, Sierra Leone.

Kargbo said Dr. Aiah Solomon Konoyeima died Saturday, becoming the 10th Sierra Leonean physician to die of the virus. 

“We have Dr. Tom Rogers and Dr. [Dauda] Koroma, who were buried yesterday, and also Dr. Konoyeima,” Dr. Kargbo said.

Rogers was a surgeon at the Connaught Hospital, the main referral unit in the capital, Freetown. He was reportedly being treated at the British-run Kerry Town Ebola treatment center. He was said to be responding well to treatment when his condition deteriorated dramatically on Friday.

Koroma died at the Hastings Treatment Center, which is run entirely by local Sierra Leone medics.

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Response to Typhoon in Philippines Shows Lessons Learned From a Year Ago

NEW YORK TIMES  by Austin Ramzy                                                                 Dec. 7, 2014

LEGAZPI, the Philippines — As Typhoon Hagupit churned across the Philippines on Sunday, residents of the eastern part of the island nation expressed relief that they had joined the hundreds of thousands who had evacuated to safer ground.

Residents waded through floodwaters on Sunday in Borongan City, the Philippines. Typhoon Hagupit is expected to churn over the country until Wednesday. Credit Francis R. Malasig/European Pressphoto Agency

By late Sunday, what had been classified as a super typhoon was far weaker than Haiyan was when it hit, and was continuing to weaken. The storm, which is expected to push its way across the country until Wednesday, was generating strong winds and rain, but the overall effect was not as devastating as worst-case scenarios had anticipated.

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An Ebola Doctor’s Return From the Edge of Death

Detailed description of one Doctor’s Story of Fighting Back From Ebola’s Deadly Grip

NEW YORK TIMES by Denise Grady                                Dec. 8, 2014

Dr. Ian Crozier, 44, contracted Ebola in Sierra Leone while treating patients. He was evacuated to Atlanta on Sept. 9 and had an agonizing illness, with 40 days in the hospital and dark stretches when his doctors and his family feared he might sustain brain damage or die. His identity was kept secret at his request, to protect his family’s privacy.

 

Now, for the first time, he is speaking out. His reason, he said, is to thank Emory for the extraordinary care he received, and to draw attention to the continuing epidemic.

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How ‘phenomenal’ staff in Nigeria cut Ebola fatality rate in half

THE TORONTO GLOBE AND MAIL by Kelly Grant                Dec.7, 2014

When the World Health Organization declared Nigeria officially Ebola-free in October, most of the fanfare centred on how Africa’s most populous country had managed to keep the virus from spreading.

But there was another, less heralded aspect of Nigeria’s success story that a Canadian doctor and her colleagues wanted to explore in more depth: How had 12 of Nigeria’s 20 Ebola patients beaten the virus?

The hospitals in Nigeria weren’t maybe to the standards of a Western hospital in terms of equipment, but the staff were phenomenal. They managed to get a very high survival rate,” said Eilish Cleary, a New Brunswick chief medical officer of health who travelled to Nigeria to provide epidemiological support to the World Health Organization during the outbreak. “Case fatality rate for Ebola can be up to 70 to 90 per cent. In Nigeria, it was 40 per cent.”

Dr. Cleary conducted detailed, videotaped interviews with six of the Nigerian patients to learn more about their treatment and recovery. The key to their survival seemed to be guzzling a stunning amount of water with oral rehydration solution [ORS] to fend off the cascade of internal failures typically caused by the virus.

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Ebola fight sees Canadian Forces medical team deployed to Sierra Leone

CBC NEWS                                                                                                                     Dec.6, 2014

A Canadian Forces medical team left CFB Trenton in Ontario on Saturday en route to Britain, where they’ll undergo training before deploying to Sierra Leone as part of the effort to combat the Ebola outbreak, the military said.

Judith Bosse, (left to right), Assistant Deputy Minister at the Public Health Agency of Canada, Defence Minister Rob Nicholson, Health Minister Rona Ambrose and Dr. Gregory Taylor, Canada's Chief Public Health Officer, watch a nurse demonstrate how to remove protective clothing after treating a hypothetical Ebola patient. (Patrick Doyle/Canadian Press)

The Forces said about 40 nurses, doctors, physicians’ assistants, medics and support are to train alongside U.K. military personnel, and most of them will continue on to Sierra Leone by later this month.

The Canadian Forces team will be working at a British-built clinic in Sierra Leone treating local and international health care workers, who themselves have become infected in the course of treating Ebola patients from the general population.

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10th Sierra Leonean Doctor Dies From Ebola

FREETOWN, Sierra Leone --Another Sierra Leonean doctor has died from Ebola, the 10th to succumb to the disease, a health official said Sunday.

Dr. Aiah Solomon Konoyeima died Saturday, according to Chief Medical Officer Dr. Brima Kargbo. His death came a day after two other doctors died from Ebola, emphasizing the tremendous toll the disease has taken on health care workers.

Konoyeima worked at a children's hospital in the capital and tested positive for Ebola about two weeks ago. He was treated at the Hastings Ebola Treatment Center, which is staffed exclusively by Sierra Leonean medical personnel, as compared to many other treatment units, which are run by international organizations or employ some foreign staff.

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http://abcnews.go.com/Health/wireStory/10th-sierra-leonean-doctor-dies-ebola-27424222

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Cuban Ebola patient recovers after treatment in Geneva

REUTERS                                                                                                                                      Dec. 2014
                   
GENEVA-- Cuban doctor who received experimental treatment for Ebola in a Geneva hospital has made a full recovery and left Switzerland to be reunited with his family, the hospital said on Saturday.

Felix Baez, 43, was one of 256 Cuban doctors and nurses who went to West Africa to treat patients from the worst outbreak of the virus on record...

Soon after arriving in Geneva, Baez received the Canadian experimental treatment ZMab, a precursor to the Ebola drug ZMapp, which has been used to treat several U.S. patients...

A hospital spokeswoman said he received both ZMab and the untested flu drug favipiravir, made by Japan's Fujifilm, which the WHO has included on a list of potential Ebola treatments

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http://www.reuters.com/article/2014/12/06/us-health-ebola-cuba-idUSKBN0JK0BN20141206

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What Ebola can teach us about a new bubonic plague outbreak in Africa

THE WEEK -- by S.E. Smith                                                                                                     Dec. 5, 2014
While West Africa battles Ebola, another outbreak is striking just across the continent. In Madagascar, cases of plague are erupting in the small village of Mandritsara and the disease is spreading to neighboring communities. The two outbreaks are related by more than simple surface similarities, though. In fact, fighting the first has provided an invaluable blueprint for containing the second.West Africa's Ebola outbreak could inform responders to Madagascar's plague cases.

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Ebola in Graphics: The toll of a tragedy

THE ECONOMIST                                                                                                      Dec. 4, 2014

THE first reported case in the Ebola outbreak ravaging west Africa dates back to December 2013, in Guéckédou, a forested area of Guinea near the border with Liberia and Sierra Leone. Travellers took it across the border: by late March, Liberia had reported eight suspected cases and Sierra Leone six. By the end of June 759 people had been infected and 467 people had died from the disease, making this the worst ever Ebola outbreak. The numbers keep climbing. As of November 30th, 17,145 cases and 6,070 deaths had been reported worldwide, the vast majority of them in these same three countries. Many suspect these estimates are badly undercooked.

Read complete posting
http://www.economist.com/blogs/graphicdetail/2014/12/ebola-graphics

Link to an interactive map of the virus's current global reach:

http://www.economist.com/blogs/graphicdetail/2014/12/interactive-ebola-map

 

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Mali releases UN peacekeepers from Ebola quarantine

DEUTSCHE WELLE                                                                                                     Dec. 6, 2014

Mali has released UN peacekeepers after involuntarily quarantining them in an Ebola clinic....

Mali released the peacekeepers from quarantine Saturday. Weeks ago, the Pasteur Clinic, in Mali's capital, Bamako, had admitted the soldiers from the UN's Multidimensional Integrated Stabilization Mission in Mali (MINUSMA) with various injuries connected to their service in the country's restive north. However, officials then locked the soldiers into the clinic with other patients and staff when a nurse died after contracting Ebola from a Muslim cleric who had traveled from Guinea to seek treatment for the virus.

"Having all been placed under observation, the quarantined MINUSMA soldiers showed no symptoms of the disease so they just left the establishment," the mission spokesman said.

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Doctors Try Survivors’ Blood to Treat Ebola

Clinical Trials Are Being Launched in Africa but Face Challenges in Designing Ethical Studies, Compensating Donors

WALL STREET JOURNAL                                                                                                    Dec. 5, 2014
by Betsy McKay in Atlanta, David Gauthier-Villars in Conakry, Guinea, and Patrick McGroarty in Monrovia, Liberia

...Nearly a year after Ebola began spreading in West Africa, and with a proven drug or vaccine still far off, researchers are launching clinical trials on a product at hand: the blood of survivors.

 They want to determine whether so-called convalescent plasma or serum, chock full of antibodies, can help fight off the disease. But they face a number of complexities in carrying out the trials, including persuading survivors to participate....

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