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Public health emergency about to be declared

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Albert View Drop Down
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    Posted: July 14 2019 at 12:47pm


It’s time to declare a public health emergency on Ebola By Ronald A. Klain and Daniel Lucey
July 10

Ronald A. Klain, a Post contributing columnist, served as White House Ebola response coordinator from 2014 to 2015 and is an adviser to Joe Biden’s 2020 campaign. Daniel Lucey is a senior scholar with the O’Neill Institute for National and Global Health Law and an adjunct professor of medicine-infectious diseases at Georgetown University Medical Center.

A year ago this week, the first patient was diagnosed with Ebola in the northeastern region of Congo, launching a new outbreak of the disease. Today — notwithstanding the first-ever large-scale deployment of an Ebola vaccine, improved performance by the World Health Organization and valiant efforts by Congolese health workers and global nongovernmental organizations — that single case has grown into the second-worst Ebola outbreak in history.

As the case count approaches 2,500 with no end in sight, it is time for the WHO to declare the outbreak a public health emergency of international concern, or PHEIC, to raise the level of global alarm and signal to nations, particularly the United States, that they must ramp up their response.

A few months ago, it looked like the response efforts then underway might succeed in bringing the outbreak under control. Yet the disease has since crossed one border (into Uganda) and continues to spread. In the absence of a trajectory toward extinguishing the outbreak, the opposite path — severe escalation — remains possible. The risk of the disease moving into nearby Goma, Congo — a city of 1 million residents with an international airport — or crossing into the massive refugee camps in South Sudan is mounting. With a limited number of vaccine doses remaining, either would be a catastrophe.

WHO Director-General Tedros Adhanom Ghebreyesus has convened a WHO Emergency Committee meeting on this latest outbreak three times before, but he has declined to declare a public-health emergency. It is time for Tedros, as he is known, to trigger the process one more time and make the emergency declaration that is overdue.

Why? Because the failure to make such a declaration — fairly or unfairly — has fed global complacency about the outbreak, which in turn is edging us closer to the brink of true disaster. Moreover, when an official PHEIC is declared, specific recommendations are issued by the WHO; these could make a difference in Congo. Such steps could lead to improved security for health workers in the region, stepped-up community engagement and extended health care beyond Ebola treatment.

The last of these is most overlooked: Expanding the health-care response to include diagnosis and treatment of malaria, diarrheal diseases and maternal health can build trust and community engagement critical to stopping Ebola. Improved trust will improve the effectiveness of the Ebola response and make the responders safer.

Instead of self-congratulation, the United States should release “non-emergency” aid to Congo that is being withheld in the absence of a presidential waiver under the Trafficking Victims Protection Act of 2000. Such aid could enable the proposed expansion of public health efforts in Congo beyond Ebola.
Second, the White House should reverse its policy ordering Centers for Disease Control and Prevention personnel to stay out of outbreak zones in northeast Congo. While security is paramount, optimizing the involvement and number of CDC personnel in areas close to these outbreak zones, as well as in neighboring nations, could help stop the epidemic from expanding further and from reaching international airports.

Third, the United States must step up to do more to make Ebola countermeasures — specifically the leading Ebola vaccine — more available. While a new recommendation to use fractional doses of this Ebola vaccine will make existing supplies go further, the risk of spread of the disease to cities or refugee camps that could swamp existing supply demands immediate action. The United States should put its weight and pocketbook behind increasing vaccine supply before a critical shortage occurs.

This is the second-largest Ebola outbreak in history, and it will only get worse as it enters its second year. The WHO and the United States must urgently step up their actions before this simmering tragedy explodes into something far worse.

https://www.washingtonpost.com/opinions/its-time-to-declare-a-public-health-emergency-on-ebola/2019/07/10/c77641fc-a327-11e9-b732-41a79c2551bf_story.html?utm_term=.42ae903e91ef

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Post Options Post Options   Thanks (0) Thanks(0)   Quote FluMom Quote  Post ReplyReply Direct Link To This Post Posted: July 14 2019 at 6:24pm
WHY do the Americans have to put THEIR weight and pocketbook to increase vaccine production. What about Russia, UK, France, Germany, Italy, China? We should of course help but everyone HATES the U.S. but expects us to step up to the plate to save the world.   Double standard!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote EdwinSm, Quote  Post ReplyReply Direct Link To This Post Posted: July 14 2019 at 9:52pm
Meanwhile Ebola continues to spread. It has now spread to Goma a city of 1 million people.

The patient was traveling by bus as was soon diagnosed, so it was possible to trace the other passengers and hopefully this branch of the outbreak could be stopped....but we will have to wait and see.

Link to BBC story
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Post Options Post Options   Thanks (0) Thanks(0)   Quote FluMom Quote  Post ReplyReply Direct Link To This Post Posted: July 15 2019 at 11:12pm
Yep I saw that story too EdwinSm! Well if it spreads to a city of 1,000,000 we will not stop it with vaccine not enough to go around. It is bound to happen one day we will just have to see where this goes.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: July 17 2019 at 4:30pm
It now is:

DR Congo Ebola outbreak declared global health emergency

3 hours ago


The World Health Organization has declared the Ebola crisis in the Democratic Republic of Congo a "public health emergency of international concern".

The move may encourage wealthy donor countries to provide more cash.

But the WHO stopped short of saying borders should be closed, saying the risk of the disease spreading outside the region was not high.

The outbreak in DR Congo has killed more than 1,600 people.

This week, the first case was detected in Goma, home to more than a million.

The PHEIC emergency provision is the highest level of alarm the WHO can sound and has only been used four times previously.

This includes the Ebola epidemic that devastated parts of West Africa from 2014 to 2016, and killed more than 11,000 people.

"It is time for the world to take notice," WHO chief Tedros Adhanom Ghebreyesus told a news conference in Geneva on Wednesday at which the emergency was declared.

He said he accepted recommendations there should be no restrictions on travel or trade, and no entry screening of passengers at ports or airports outside the immediate region.

The International Federation of Red Cross and Red Crescent Societies welcomed the move.

"While it does not change the reality on the ground for victims or partners engaged in the response, we hope it will bring the international attention that this crisis deserves," it said in a statement.

How bad is the situation in DR Congo?

The outbreak, the second largest in history, started in August 2018 and is affecting two provinces in DR Congo - North Kivu and Ituri.

More than 2,500 people have been infected and two-thirds of them have died.

It took 224 days for the number of cases to reach 1,000, but just a further 71 days to reach 2,000.

About 12 new cases are being reported every day.

Isn't there a vaccine?

Yes.

It is 99% effective and more than 161,000 people have been given it.

However, everybody is not vaccinated - only those who come into direct contact with an Ebola patient, and people who come into contact with them.

The vaccine was developed during the epidemic in West Africa and has been available throughout the latest outbreak.
Why hasn't the outbreak been brought under control?

Tackling the disease has been complicated by conflict in the region.

Since January, there have been 198 attacks against healthcare workers or Ebola treatment facilities leading to seven deaths and 58 injuries.

Another major problem has been distrust of healthcare workers leading to about a third of deaths being in the community rather than at a specialist Ebola treatment centre.

It means those people are not seeking treatment and risk spreading the disease to neighbours and relatives.

There has also been difficulty tracking the spread of the virus.

A significant number of cases are coming as a surprise as those affected have not come into contact with known Ebola cases.

"We are one year into the outbreak and the situation is not getting any better," said Trish Newport, from the charity MSF.

"It's a complex environment with a long history of violence, of conflict, so there's a lot of mistrust of foreigners from outside the area.

"We have to build ties and connections with the community so they trust us."

Could the disease spread further?

The WHO says the risk to neighbouring countries is "very high".

Uganda has already had some isolated cases including two people - a five-year-old boy and his 50-year-old grandmother - who died from the disease. Rwanda is also at risk.

This week a priest died from Ebola in the city of Goma, which is home to more than a million people. The city is a major transport hub and sits on the DR Congo-Rwanda border.

The WHO said cases there were a "game-changer", however, there have been no reported cases of the disease spreading in Goma.
Is the world doing enough to help?

The WHO has been clear for months that it has insufficient money to tackle the problem.

It had estimated that it needed $98m to tackle the outbreak between February and July. Yet it faced a shortfall of $54m.

Source:   https://www.bbc.co.uk/news/health-49025298
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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: July 17 2019 at 4:43pm
The only time to worry about Ebola,

Is when/if it becomes airborne,

I believe there is an airborne Ebola virus that is not harmful to humans,

however if it recombines with the fatal strain,

Humans are in trouble....
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Post Options Post Options   Thanks (0) Thanks(0)   Quote ME163 Quote  Post ReplyReply Direct Link To This Post Posted: July 20 2019 at 12:39pm
From my source at the CDC, Ebola is evolving rapidly and in fact may go airborne soon. On a more Ominous note, my contacts in Uganda and Kenya have been told to expect massive Ebola outbreaks this summer. Ebola is expected to flow eastward in to Rwanda and then to Uganda and the great lakes area of Africa.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: July 20 2019 at 1:16pm
Ebola is not likely to go airborne anytime soon. Here is why:

Airborne viruses have a structure which protects the operational bits of themselves, like the structure of the common cold, which is roughly spherical with spikes coming off of it. Ebola on the other hand, is a filovirus. That is a filamentous strand of RNA using the host cell for all of its functions and processes. Being a single strand of RNA it is profoundly sensitive to external forces (ultraviolet light, drying, chemical damage, oxidation) and as such is unlikely to survive any length of time outside of the host, or biological matter from said host. Filoviridie are a family of viruses and are also unlikely to mutate quickly into another type of virus.

Transmission through the air has occured*, but not by the air; this was accidental and not the use of a proper vector. (During tests on the Ebola Reston strain in Virginia, ebola appeared to be transmitted through an airborne vector, but the trials in this case were poorly designed and what appeared to be airborne transmission was very, VERY, VERY probably merely splashing.)

The lack of airborne transmission, while it is a soupçon of good news, does not change the fact that this virus is extremely contagious. Most viruses need thousands of viral particles to attack the prospective host simultaneously to cause infection. On average, ebola needs ten. JUST TEN!!! As if that were not bad enough, its ability to continue to propagate after the death of the host is both very unusual and profoundly horriffic.

Although ebola is not classically airborne, it does use a vector which itself is airborne. It hitches a ride on planes - via us. Because it is a virus primarily attacking poor people in the third world, we tend to ignore it. Our continued indiference is its greatest strength.



*Once that we know of.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: July 20 2019 at 1:36pm
This one is nearer to those of you in the USA. It too is unlikely to go airborne, but it is already a whole lot nearer.



CDC issues travel notice for Bolivia due to outbreak of hemorrhagic fever

by News Desk
July 20, 2019


The Centers for Disease Control and Prevention (CDC) issued a travel notice this week for Bolivia. The notice is in response to an outbreak of hemorrhagic fever was recently reported in Bolivia, which is likely due to an arenavirus that appears similar to Chapare virus.
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The first case was in a man from Caranavi Province. A health care provider who treated him became ill and was transferred to La Paz. Currently, 5 cases have been reported; all have been in health care providers or family members of the first patient.

Testing suggests that the virus is genetically similar to Chapare virus, a New World arenavirus that was first documented in Bolivia in 2003.

Although the animal source for this virus has not been confirmed, CDC recommends travelers should avoid contact with rodents and rodent urine or feces and to avoid contact with people who are sick.

Arenaviruses are usually spread to people through contact with infected rodents or the urine or feces (droppings) of an infected rodent. Some arenaviruses have also been associated with secondary person-to-person spread, including spread in health care settings. While symptoms of arenaviruses can vary, New World arenaviruses have typically caused hemorrhagic fevers in people.


Source:   http://outbreaknewstoday.com/cdc-issues-travel-notice-for-bolivia-due-to-outbreak-of-hemorrhagic-fever-58029/

Chapere virus:   https://www.cdc.gov/vhf/chapare/index.html
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