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Ebola

Ebola466 posts

Ebola is a disease caused by an ebolavirus. Symptoms start two days to three weeks after contracting the virus, with a fever, sore throat, muscle pain and headaches. Vomiting, diarrhea and rash follow, along with decreased function of the liver and kidneys. Victims bleed both within the body and externally. From 1976 through 2013, the World Health Organization reported a total of 1,716 cases. In 2013 an outbreak started in Guinea, spreading to neighboring African countries and infectied doctors, some of who were transported back to the US for treatment. The virus continues to claim victims as it spreads to more countries.

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28 Sep, 2014

Admitted to hospital

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Duncan arrives at Texas Health Presbyterian by ambulance and is admitted. A friend says that he called the CDC after Duncan was sent home from the hospital, who told him to call the Texas Board of Health and the message eventually got to the hospital. Health Presbyterian says by the time Duncan arrived:

EMS had already identified potential need for isolation. The hospital followed all suggested CDC protocols at that time.

29 Sep, 2014

United Nations: Combat Ebola Mission

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For the first time, the UN opens a health mission headquarters. UNMEER, or United Nations Mission for Ebola Emergency Response, provides coordinating international efforts to combat the Ebola virus. Team lead Anthony Banbury with crew members arrive on Monday in Accra, the capital of Ghana. Speaking to the Security Council, Ki-Moon:

This international mission, to be known as the United Nations Mission for Ebola Emergency Response, or UNMEER, will have five priorities: stopping the outbreak, treating the infected, ensuring essential services, preserving stability and preventing further outbreaks. Under the leadership of a Special Representative of the Secretary-General, the Mission will bring together the full range of UN actors and expertise in support of national efforts. Our best estimate is that we need a 20-fold increase in assistance.

30 Sep, 2014

First case diagnosed in US hospital

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Texas Health Presbyterian Hospital in Dallas becomes the first hospital in the US to diagnose a patient with Ebola. The patient, and unnamed man, is in isolation. CDC Director Tom Frieden said the patient had been traveling in Liberia, where he may have contracted the disease. He returned to the US on September 20, after which he sought care. Frieden:

It is certainly possible that someone who had contact with this individual…could develop Ebola in the coming weeks…there is no doubt in my mind that we will stop it here.

Frieden also said that “a handful” of people, including family members, may have been exposed to the patient prior to his seeking treatment.

CDC: Spread by bodily fluids

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The CDC says Ebola spreads through saliva, semen, blood, feces and mucus from people who are already showing symptoms, unlike the airborne transmission of other viruses. Frieden:

Ebola doesn’t spread before someone gets sick. Ebola does not spread … from someone who doesn’t have fever and other symptoms.

Symptoms generally occur abruptly eight to 10 days after infection, though it can range from two to 21 days. The virus can continue to spread after a patient dies. CDC’s Division of Global Migration and Quarantine director Dr. Marty Cetron:

There needs to be direct contact frequently with body fluids or blood.

1 Oct, 2014

Diagnosis missed

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Texas Presbyterian Health officials say Duncan wasn’t diagnosed with Ebola because of incomplete information. Infectious disease specialist Dr. Edward Goodman says the medical team thought it was a low-grade viral infection as he was not vomiting and did not have diarrhea:

All the information wasn’t present as they made their clinical decision

Dr. Mark Lester confirms Duncan told staff on his first visit he had been in an area affected by Ebola:

A checklist was in place for Ebola in this hospital for several weeks. That checklist was utilized by the nurse, who did ask [the] question [if the patient had been to Africa.] Regretfully, that information [was not shared] with the full team.

Schoolchildren exposed

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Dallas Independent School District Superintendent Mike Miles says five children from four of the district’s campuses were possibly exposed to the virus:

  • Conrad High School
  • Tasby Middle School
  • Hotchkiss Elementary School
  • Dan D. Rogers Elementary School

Tasby Middle School shares a campus with Jack Lowe Sr. Elementary School, but DISD officials say no students at Lowe Elementary were directly exposed. The students who may have had contact with Thomas Eric Duncan attended classes earlier in the week, but none have exhibited symptoms. Miles:

So, the odds of them passing on any sort of virus is very low

The children are at home and being monitored by Dallas County Health and Human Services, while the schools have been staffed with additional health employees and more sanitation staff.

U.S. Ebola patient identified

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The first person to develop Ebola symptoms in the U.S. is identified as Thomas Edward Duncan. His sister, Mai Wureh, says he was treated with antibiotics but then sent home from Texas Health Presbyterian despite telling a nurse that he was visiting from Liberia. CDC Center for Global Health director Dr. Tom Kenyon:

There were no signs of any disease when the gentleman boarded the flight. This was not a failure of the screening process at the airport.

Hospitals preparing since June

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Dr. Mark Gendreau of Peabody’s Lahey Medical Center says U.S. hospitals have protocols in place:

Every hospital in the commonwealth has been working on this since June. I would say that all of the hospitals in Massachusetts are very capable of handling a patient who presents with Ebola.

Doctors and nurses have been trained to ask patients with possible symptoms if they have traveled to Africa in the last 21 days. If the answer is yes, the medical staff would ‘gown up’ and the patient would be immediately isolated and tested. If the test is positive the CDC and state Department of Public Health will be notified. The patient will also be asked for the names of people he or she had been in contact with and contacts would be instructed to isolate themselves at home, check their temperature twice a day and immediately report any symptoms or fever to the local health department.

3,338 deaths

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The WHO says that 3,338 people in West Africa have died of confirmed, suspected or probable Ebola through Sept. 28. A total of 7,178 cases have been reported. It says the situation in Guinea appears to have stabilized somewhat, but the epidemic is growing in Sierra Leone and likely also in Liberia.

Second person in Texas monitored

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Health officials are closely monitoring a second person in Dallas County who had close contact with the first Ebola patient confirmed in the U.S. Zachary Thompson, director of Dallas County Health and Human Services:

The fact that we have one confirmed case, there may be another case that is a close associate with this particular patient. So this is real. There should be a concern, but it’s contained to the specific family members and close friends at this moment.

Contact with Monrovia patient

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Duncan helped transport Ebola patient Marthalene Williams to hospital in Monrovia on Sept. 15, four days before traveling to the U.S. Marthalene’s family took her by taxi to a hospital with Duncan’s help after failing to get an ambulance as she was convulsing and seven months pregnant, according to her parents, Emmanuel and Amie Williams. Duncan, who was the family’s friend and tenant, rode in the taxi in the front passenger seat while Marthalene, Emmanuel and her brother, Sonny Boy, shared the back seat. A neighbour says Duncan then helped carry Ms. Williams, who was no longer able to walk, back to the family home that evening:

He was holding her by the legs, the pa was holding her arms and Sonny Boy was holding her back.

Sonny Boy developed Ebola symptoms around the same time as Duncan, and died on the way to hospital in an ambulance.

Possible case in Honolulu

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Medical officials say a patient is being treated at The Queens Medical Centre in Honolulu. Dr. Melissa Viray, deputy state epidemiologist:

We are early in the investigation of a patient — very, very early — who we’re investigating that might have Ebola. It’s very possible that they do and they have Ebola. I think it’s also more likely that they have another condition that presents with similar symptoms.

She says the patient could have a number of illnesses including Ebola, flu, malaria and typhoid. The public should not be concerned:

Like I said, this is a possible case we’re investigating. We don’t know if this is Ebola or a number of other conditions.

Hasn’t eaten in a week

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A friend who speaks with Duncan says he is ‘all right’ but hasn’t eaten in a week:

He is in pain.

Health Presbyterian says he remains in serious condition.

Won’t be given ZMapp

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Duncan won’t be given ZMapp, as all the dosages currently in existence have already been used. ZMapp is manufacturing more supplies, but the drug takes months to produce.

2 Oct, 2014

American cameraman tests positive

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American freelance cameraman Ashoka Mukpo tests positive for Ebola in Liberia. Mukpo, working as second cameraman for NBC News Chief Medical Editor and Correspondent Dr. Nancy Snyderman, will return to the U.S. for treatment. Mukpo is the fifth American diagnosed with Ebola in West Africa. NBC News President Deborah Turness’ note to NBC staff:

As you know, Dr. Nancy Snyderman and our news team are in Liberia covering the Ebola outbreak. One of the members of their crew is an American freelance cameraman who has worked in Liberia for the past three years and has recently been covering the epidemic for US media outlets. On Tuesday he began working with our team. Today, he tested positive for Ebola.

We are doing everything we can to get him the best care possible. He will be flown back to the United States for treatment at a medical center that is equipped to handle Ebola patients. We are consulting with the CDC, Medicins Sans Frontieres and others. And we are working with Dr. Nancy on the ground in Liberia.

We are also taking all possible measures to protect our employees and the general public. The rest of the crew, including Dr. Nancy, are being closely monitored and show no symptoms or warning signs. However, in an abundance of caution, we will fly them back on a private charter flight and then they will place themselves under quarantine in the United States for 21 days – which is at the most conservative end of the spectrum of medical guidance.

We know you share our concern for our colleagues and we will continue to keep you up to date and informed. Please don’t hesitate to reach out to me or David Verdi with any questions.

Alert issued to hospitals

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The CDC has issued a nationwide alert to hospitals updating them on how to appropriately respond to possible Ebola cases after Duncan was sent home after contracting the virus. CDC director Frieden:

It’s a teachable moment.

The guidance includes a poster with quick rules for evaluating returned travelers and a checklist.

Hospital mistake

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National Institute of Allergy and Infectious Diseases director Dr. Anthony Fauci tells CNN’s The Lead with Jake Tapper that Texas Health Presbyterian made a mistake by releasing Duncan:

A travel history was taken, but it wasn’t communicated to the people who were making the decision. … It was a mistake. They dropped the ball. You don’t want to pile on them, but hopefully this will never happen again. … The CDC has been vigorously emphasizing the need for a travel history.

Plans to prosecute

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Liberia will prosecute Duncan for allegedly lying on an airport questionnaire about not having any contact with an infected person. He filled out a series of questions about his health and activities on Sept. 19, answering no to all of them. The form asked whether he had cared for an Ebola patient or touched the body of anyone who had died in an area affected by Ebola.Binyah Kesselly, chairman of the board of directors of the Liberia Airport Authority in Monrovia:

We expect people to do the honorable thing.

The agency obtained permission from the Ministry of Justice to pursue the matter.

100 people screened

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The number of people being screened in Dallas increases to around 100. CDC Director Frieden says only a ‘handful’ of people who had contact with Duncan have been identified. Most of the 100 people haven’t been ordered to stay home however officials say they ordered four of Duncan’s family members to remain in their home as the family disobeyed their request to stay there. The family was examined Thursday and hadn’t developed symptoms. A law enforcement official is stationed outside their apartment to make sure they don’t leave.

United contacts passengers

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United is contacting passengers who flew in and out of Dulles with Duncan and telling them how to contact health officials. United officials decline to say how many passengers were on the flights. The Brussels-to-Dulles flight used a Boeing 777 with 266 seats and the flight to Dallas used an Airbus A320 with 138 seats. United did a routine overnight ‘thorough cleaning’ after the flights:

Including cleaning of lavatories and galleys with heavy-duty all-purpose cleaners and wiping tray tables and armrests with disinfectant … We continue to clean and route the planes throughout our network as usual.