Sierra Leone readies for controversial ‘Ebola’ lockdown – 6 million people confined to their homes for three days

September 2014FREETOWN, Sierra Leone – Sierra Leone prepared Thursday, September 18, for an unprecedented 3-day nationwide lockdown to contain the deadly spread of the Ebola virus in a controversial move which experts claimed could worsen the epidemic. The population of six million will be confined to their homes from midnight (0000 GMT) going into Friday as almost 30,000 volunteers go door-to-door uncovering patients and bodies hidden in people’s homes. “Rain or shine, the shutdown exercise is going to go ahead. During the three days… the job is going to get done,” said Steven Gaojia, head of the government’s emergency operation centre. The worst-ever outbreak of Ebola has claimed more than 500 lives in Sierra Leone, one of three countries at the epicenter of the epidemic which has so far killed almost 2,500. “Ose to Ose Ebola Tok – house-to-house Ebola talk” in the widely-spoken Krio language – will see more than 7,000 volunteer teams of four visiting the country’s 1.5 million homes. They will hand out bars of soap and information on how to prevent infection, as well as setting up “neighborhood watch”-style community Ebola surveillance teams. The government has said the teams will not enter people’s homes and are not tasked with collecting patients or bodies, but will call emergency services or burial teams “if by chance the teams happen to bump into such situations.” Extra beds have been set up at schools and hospitals across the country, including 200 around Freetown, with the government projecting a 15 to 20 percent upsurge of cases as new patients are discovered.
Curfew ‘could backfire badly.’ The ministry of health has enlisted 14 burial teams across the Western Area, which includes the capital, and a fleet of motorcyclists to bike specimens from dead bodies straight to laboratories. Community activists and civil society leaders have been recruited to help thousands of police and soldiers enforce the curfew. Health workers, the emergency services and other security forces will be exempt, along with the media and other professionals deemed key workers, while air passengers have been given special dispensation to get to Freetown’s airport. The president was due to launch the shutdown in a televised address to the nation expected on Thursday evening which he has asked tribal chiefs to repeat across the country. Experts warned however that coercive measures to stem the epidemic, such as confining people to their homes, could backfire badly and would be extremely hard to implement effectively. Jean-Herve Bradol, a former director of medical aid group Medecins sans Frontiers (MSF) and an emergency physician with experience of working in Africa, said the goal seemed “highly unrealistic. The country doesn’t have the capacity to visit every household in just three days,” he told the Agence France-Presse (AFP). MSF, known in the English-speaking world as Doctors Without Borders, said health workers would find it extremely difficult to accurately identify cases through door-to-door screening. It warned that lockdowns and quarantines may end up driving people underground “and jeopardize the trust between people and health providers. This leads to the concealment of potential cases and ends up spreading the disease further,” it said in a statement. -Rappler
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Doctors Without Borders staffer infected with Ebola in Liberia – to be flown to France for treatment

September 2014 AFRICA - Doctors Without Borders staff member from France has contracted the Ebola virus while working in Liberia, the group announced Wednesday. She is the group’s first international staffer to become infected with Ebola in the current outbreak, a spokesman said. The French worker — on assignment in Monrovia, Liberia’s capital — was put in isolation Tuesday after developing a fever, the group said in a statement. Laboratory tests confirmed she had contracted Ebola, and she is to be evacuated to France for treatment, it said. Doctors Without Borders said it is investigating how the worker contracted the virus. The group said that for privacy reasons it was not identifying the worker or commenting further at this time. The Ebola outbreak in West Africa is the worst on record and has caused the most devastation in Sierra Leone, Liberia and Guinea, where it was first reported in March.
As of Saturday, nearly 5,000 Ebola cases were reported in the region, although many had not yet been confirmed through lab testing, the World Health Organization said Tuesday. Almost half of those believed infected have died. There is no cure or vaccine for Ebola, which is transmitted through contact with the bodily fluids of those infected. Doctors Without Borders said more than 2,000 of its personnel, including about 200 international volunteers, are working in West Africa. Two of the group’s national staff members — one from Guinea and one from Sierra Leone — died last month after contracting Ebola, a spokesman said. –LA Times
Scare from ship from Africa: NEW ORLEANS, La. —In a statement released late Wednesday night, the Centers for Disease Control stressed that crew members on a freighter inbound to New Orleans were suffering from malaria and show no traces of Ebola. First responders who took those individuals to the hospital wore protective garb as a precaution, though health officials noted early on that it was extremely unlikely that Ebola was to blame for the sickness on the Marine Phoenix. The ship remained at anchor in the Mississippi River near Belle Chasse. It was expected to continue its voyage to New Orleans early on Thursday. CDC, along with local and federal officials, responded today to a report of illness on a ship at the Port of New Orleans. Earlier today, local EMS transferred three of the ship’s crew members to a local hospital.
The Louisiana Department of Health and Hospitals (DHH) confirmed a positive test result this evening for malaria in the patient being treated at a New Orleans-area hospital. DHH shared this information with CDC and local officials. The other two patients had mild symptoms and are being assessed. Another ill crew member disembarked in the Bahamas two days ago, where he was diagnosed with malaria and later died. Malaria is spread by mosquitoes and does not spread from person to person. Approximately 1,500-2,000 cases are reported every year in the United States, almost all in recent travelers. The ship’s itinerary included Matadi, Democratic Republic of the Congo (DRC), in addition to other ports. Based on a hospital’s request, CDC conducted testing on the crew member who died, and the results showed that this crew member was negative for the type of Ebola that is causing the current outbreak in West Africa. Ebola is not suspected as a cause of the other crew members’ illnesses. No crew members had known exposures to Ebola. The CDC will continue to work closely with the hospital and local health authorities. -WDSU
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113 dead: number of Chikungunya cases in El Salvador tops 16,000 – Virgin Islands declare epidemic

Latin America
September 2014 – SAN SALVADOR, El Salvador – At least 16,000 patients have contracted the chikungunya virus in El Salvador, prompting health officials in the Central American country to step up the fight Monday to eliminate disease-carrying mosquitoes. “Of the 16,000 chikungunya cases, 11,000 are in the department of San Salvador,” where the capital is located, Health Minister Violeta Menjívar said during a press conference. Menjívar said the country remains on “national alert,” which was declared last June for both the chikungunya virus and dengue, both transmitted by mosquitoes. She said officials would “intensify the response,” including stepping up fumigation efforts and national awareness campaigns aimed at reminding residents to eliminate stagnant water. “We are calling for the unification of efforts by government agencies, municipalities and the Education Ministry [for a campaign] in schools,” the minister said. Chikungunya fever is transmitted by the Aedes aegypti and Aedes albopictus mosquitoes, and causes a sudden high fever, skin rashes, pounding headaches, nausea and muscle pain.
Last month, Costa Rican health officials asked for a preventive alert to be issued after 13 patients tested positive for chikungunya here. The number of chikungunya cases in Costa Rica is nowhere near El Salvador’s 16,000 cases, and all of the Costa Rican patients contracted the virus while traveling abroad. However, Costa Rican Health Ministry official Priscilla Herrera warned that “if the number of cases continues to increase [in Costa Rica], it will have a significant financial cost.” –Tico Times
Death toll reaches 113: At least 113 people have died in the Americas, with all the fatalities reported in the Caribbean region, after becoming infected with the Chikungunya virus, the Pan American Health Organization, or PAHO, said, adding that it was not yet clear if these deaths were directly attributable to the virus. In its latest report, which includes figures as of Sept. 12, the PAHO confirmed 55 deaths linked to the virus in Martinique since last December, when the disease was first detected in the Americas. Forty-nine deaths were reported in Guadeloupe, six in the Dominican Republic and three in St. Martin, where the virus was first found in the Americas. Although all the victims were infected with the virus, health authorities said Chikungunya may not have been the main cause of death. The Puerto Rican Health Department is investigating whether or not two recent deaths were related to the virus, and officials plan to provide more details on the results of medical tests in the next few days.
A total of 644,686 suspected and 9,640 confirmed Chikungunya cases have been reported in the region as of Sept. 8, the Caribbean Public Health Agency, or CARPHA, said. Chikungunya’s symptoms include acute fever, followed by a longer period of joint pains in the extremities that may persist for years in some cases. The disease is transmitted to humans by Aedes aegypti mosquitoes like dengue fever and while no specific treatment is known, medications can be used to reduce symptoms. The regional organizations emphasized the importance of taking preventive measures to control the breeding locations of the mosquitoes that transmit the two viruses, especially at this time of year, the peak transmission season in the Caribbean due to increased rainfall. Some 850,000 people in the Americas have contracted dengue and 470 others have died from the virus in 2014, the PAHO said. EFE. –Fox News Latino
Epidemic declared in Virgin Islands: ST. THOMAS – While the V.I. Health Department stood up to public criticism of its mitigation plan for the spread of chikungunya, a debilitating mosquito-borne virus, the department also declared that the territorial outbreak is officially an epidemic. In fact, it has been an epidemic since May. “As soon as we knew of the first case, it was an outbreak,” said the Health Department’s territorial epidemiologist, Dr. Esther Ellis. An outbreak, Ellis said, is when more cases of a health concern occur than is expected at any one time. An epidemic, on the other hand, is when a doubling of cases occurs in a period of three weeks or less, she said. The first confirmation of the virus in the U.S. Virgin Islands was May 20, according to health officials, who said that the person had traveled to Dominica, which reported confirmed cases prior. “It’s really the humans that move the virus,” Ellis said.
Currently, the DOH has counted 514 suspected cases on St. Thomas, with 41 confirmed or probable; 25 suspected cases on St. Croix, with three confirmed or probable; and 13 suspected are on St. John, with two confirmed or probable. In the Americas altogether, 706,093 cases were suspected and 8,651 were confirmed as of Sept. 12, according to the Pan American Health Organization. In total, 113 deaths have resulted from the disease, according to the organization. -VID
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TEP Radio – Special Report: Ebola, the next global crisis

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Deep 6.7 magnitude earthquake strikes 25 miles from Guam

Guam 7.1 Sept 17, 2014
September 2014GUAM - A magnitude 7.1 earthquake struck 25 miles northwest of Guam on Wednesday, the U.S. Geological Survey said. The earthquake was later downgraded to a 6.7 by the USGS. The quake struck at more than 100 miles deep, it said, after originally putting the magnitude at 6.9. The Pacific Tsunami Warning Center said no tsunami had been generated because the quake was too deep.
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U.N. sees emergency need for $1 billion to fight Ebola outbreak

September 2014GENEVA — The Ebola virus outbreak in West Africa risks ballooning into a humanitarian catastrophe without a major surge in international efforts to contain it, senior United Nations officials said Tuesday, estimating the cost of this effort at $1 billion. The number of people affected by the disease is still rising at an “almost exponential” rate, Bruce Aylward, an assistant director general of the World Health Organization, said at a news conference in Geneva. He said the number of reported cases had climbed to 4,985, including 2,461 deaths. Half of the infections and deaths occurred in the past 21 days, he said, underscoring the acceleration of the outbreak. “We don’t really know where the numbers are going with this,” Mr. Aylward said. A road map he announced nearly three weeks ago to guide the international response had called for the capacity to manage 20,000 cases, but “that does not seem like a lot today,” he said. “The numbers can be kept in the tens of thousands,” he said, “but that is going to require a much faster escalation of the response if we are to beat the escalation of the virus.” Mr. Aylward appeared with Valerie Amos, the United Nations’ emergency relief coordinator, and Dr. David Nabarro, the United Nations’ senior system coordinator for Ebola, spelling out the devastating impact of the outbreak on the fragile economies of Guinea, Liberia and Sierra Leone, the countries at the center of the crisis. “Looking forward,” Mr. Aylward said, “we risk a humanitarian catastrophe if we do not see a rapid scale-up not just of the Ebola response but also the provision of essential services.”
The Ebola outbreak is “much more than a health crisis,” Ms. Amos said, warning that the three countries’ capacity to deliver food and other necessities of daily life was “on the brink of collapse.” Dr. Nabarro said the funding the United Nations estimated was needed to tackle the crisis had jumped tenfold from $100 million a month ago. He justified the increase with the somber assessment that the outbreak would “go on doubling in that sort of frequency if we don’t deal with it.” So far, he said, the appeal has raised about 30 percent of what is needed. Offers of assistance are coming in all the time, he said, but it will take “something quite exceptional” to turn the situation around. The first priority is increasing the number of treatment centers to isolate those infected with disease, Mr. Aylward said, noting that in some areas, infected people are still walking around their communities, and generating more infection. In Liberia, which had three treatment centers with a total capacity of 314 beds last week, Mr. Aylward said, the United Nations now has firm commitments of 500 new beds and expects more in the coming weeks.
Their remarks came in advance of a speech on Tuesday by President Obama announcing an expansion of military and medical resources to combat the spread of Ebola. The American response will focus on Liberia, the worst hit of the three countries. The initiative will include opening a joint command center in Monrovia, the capital, and sending up to 3,000 military officers to train national workers and to build 17 treatment centers, adding about 1,700 beds. Among the latest international contributions to fighting the epidemic, China is sending Sierra Leone a mobile laboratory consisting of 59 clinicians, epidemiologists and nurses from its Center for Disease Control and Prevention, who will join 115 medical staff members it already has working in the country. Throwing money or sending troops at the Ebola problem will not make the Ebola go away. There has to be a comprehensive global plan…It is our responsibility to help the less fortunate. This is one war that we should be fighting. We need our troops to save lives…
“The most urgent immediate need in the Ebola response is for more medical staff,” Dr. Margaret Chan, director general of the World Health Organization, said in a statement welcoming China’s move as “a huge boost, morally and operationally.” The International Federation of Red Cross and Red Crescent Societies said Monday that it had opened a 60-bed treatment center in Kenema, one of the most badly affected cities in Sierra Leone. Letting up new treatment centers requires weeks, however, so one of the main initiatives to “take the heat out of the outbreak” is developing small Ebola “care units” in the community to try to get sick people out of their homes. Despite the scale of the threat, Mr. Aylward saw hope of progress in some areas. “You definitely want to get Nigeria and Senegal, obviously, done quickly,” he said after the news conference. Sierra Leone’s capital, Freetown, and Guinea’s capital, Conakry, should be freed of the disease soon, he said, and “Guinea should be able to get most of the country free in the very near term as well.” Monrovia still poses a particular challenge, he said. –NY Times
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Carcasses float on flooded roads, town in Kashmir faces epidemic outbreak

September 2014KASHMIR - An epidemic threat is looming large over flood hit Srinagar with thousands of carcasses of livestock lying dead in the streets of the summer capital. In Army’s largest dairy farm at Bemina on the Srinagar-Baramulla highway, bodies of hundreds of Jersy cows and buffaloes are lying unattended for the past eight days after the flood hit the city. The farm opposite to the Army’s cantonment, Toto Ground, is spread over hundreds of kanals of land in the middle of residential area. Doctors termed the situation as “very threatening” saying if the dead animals were not removed and buried along with decomposing agents, the situation could lead to an epidemic outbreak. “This situation is a breeding ground for deadly diseases like cholera, hepatitis and typhoid,” said a known doctor at SMHS hospital. A young boy who identified himself as Saifullah Gulzar of Al-Shakir colony, Bemina said there were 370 cows and buffaloes in the Army run farm. He said the farm got submerged on Sunday (September 7). “The main gate of the farm was closed which led to the death of the animals. Only seven cows could be saved while they were being washed away by floods,” said Gulzar. While most of the carcasses have got stuck in the mud and flood water in the farm, many of them which were washed away by the flood were lying on the roadside, on the Srinagar-Baramulla highway.
With water level receding and sun shining bright, hundreds of dogs and vultures are preying on these carcasses. The whole area stinks and people moving on the road by foot or in vehicles cover their mouths to avoid the stinking smell. “It is becoming very dangerous day-by-day to return to our homes due to this stink and there are chances of deadly diseases taking places due to these unattended carcasses,” said another local Shabir Ahmad. “Some of the families which had returned went back due to the epidemic threat in the area. We are not allowing our children to enter this entire area.” In posh Raj Bagh area which is one of the areas worst hit by floods, carcasses of dogs were floating on the flood water. Groups of crows and other carnivore birds were feeding on these dead dogs at many places along the Jawahar Nagar-Raj Bagh road. “If you move into the interiors of Rajbagh, you will find scores of dead dogs floating around.
They have become a source of disease,” said Hashim Ahmad, member of a volunteer group from Ikhrajpora, carrying rescue and relief operations in the inundated Raj Bagh and Jawahar Nagar. The situation is equally worse in Lasjan on the Srinagar outskirts which remained completely submerged for many days as the area is located on the Jhelum River embankment. A foul smell is emanating from the locality as people walking along the bund cover their mouth. “First the flood ravaged us and now the government has abandoned us. The entire area has become a death trap,” said a local Mubashir Hussain. The bodies of dead animals like dogs and cows and poultry birds were floating on inundated roads at many places in the city on Monday including Hyderpora-Tengpora road, Iqbal Park-LD road. Another senior doctor said the government should remove the carcasses from the roads at the war-footing and bury them as soon as possible. “They can be even burnt also,” the doctor said. None of the ministers or government officials concerned could be reached at for their comment over the situation due to poor telecommunication network in Kashmir. –Greater Kashmir
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