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'Merciless' Ebola virus spreading, CDC chief says

Travel restricted as dead top 700


This article was published August 1, 2014 at 3:08 a.m.


A man washes his hands Thursday before entering a public building in Monrovia, Liberia, as part of a drive to prevent further spread of the deadly Ebola virus.

FREETOWN, Sierra Leone -- Security forces went house-to-house in Sierra Leone's capital Thursday looking for Ebola patients and others exposed to the disease as the death toll from the worst recorded outbreak in history surpassed 700 in West Africa.

Fears grew as the United States warned against travel to three countries -- Guinea, Sierra Leone and Liberia -- experiencing outbreaks.

"The bottom line is Ebola is worsening in West Africa," said Dr. Tom Frieden, director of the Centers for Disease Control and Prevention, who announced the travel warning. He called Ebola "a tragic, dreadful and merciless virus."

The purpose of the travel warning is to not only protect U.S. travelers but also limit their use of overburdened clinics and hospitals for injuries or other illnesses, he said.

Little Rock-based nonprofit Heifer International, which works to address world hunger, has staff members in West Africa. Heifer spokesman Tina Hall said the organization has two employees in Sierra Leone but none in Liberia or Guinea.

"We have had contact with them, and they are well," she said. "They're based there, so they're not really traveling back and forth."

Hall said the travel advisory would not affect Heifer's work, because it does not have current or forthcoming projects in the three countries covered by the travel notice.

As their countries struggle to deal with the Ebola outbreak, the presidents of Liberia and Sierra Leone said Thursday that they will not attend President Barack Obama's U.S.-Africa Leaders Summit in Washington next week. The event was planned to discuss investment, regional stability and U.S. ties to the region.

The president of Guinea is still debating whether to attend the conference, said a State Department official who wasn't authorized to comment publicly. The three countries will be represented by high-level delegations in any case, the official said.

Linda Thomas-Greenfield, U.S. assistant secretary of state for African affairs, said Thursday that meetings on how to respond to the Ebola crisis will be held during the conference with staff members from the CDC and the Department of Health and Human Services.

Almost half of the 57 new deaths reported by the World Health Organization on Thursday occurred in Liberia, where two Americans -- Dr. Kent Brantly of Texas and Nancy Writebol, a North Carolina-based missionary -- also are sick with Ebola.

At the White House, press secretary Josh Earnest said the U.S. is looking into options to bring them back to the U.S. Officials at Atlanta's Emory University Hospital said they expected one of the Americans to be transferred there "within the next several days." The hospital declined to identify which aid worker, citing privacy laws.

Officials said in a statement Thursday that the hospital has a special isolation unit that was built in collaboration with the CDC that is used to treat people with certain serious infectious diseases.

Writebol was in stable but serious condition Thursday and was receiving an experimental treatment, according to a statement released by SIM, a Christian missions organization.

"There was only enough [of the experimental serum] for one person. Dr. Brantly asked that it be given to Nancy Writebol," said Franklin Graham, president of Samaritan's Purse, another aid organization that has been working in Liberia during the Ebola crisis.

Brantly, who works for Samaritan's Purse, did receive a unit of blood from a 14-year-old boy who had survived Ebola because of the doctor's care, Graham said.

"The young boy and his family wanted to be able to help the doctor who saved his life," he said.

Giving a survivor's blood to a patient might be aimed at seeing whether any antibodies the survivor made to the virus could help someone else fight off the infection. This approach has been tried in previous Ebola outbreaks with mixed results.

"I remain hopeful and believing that Kent will be healed from this dreadful disease," Brantly's wife, Amber, said in a statement released by Samaritan's Purse. She and the couple's two young children left Liberia for Texas before her husband was infected, and she said they are fine.

There is currently no licensed drug or vaccine for Ebola. There are a handful of experimental drug and vaccine candidates for Ebola, some of which have had promising results in animals including monkeys.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Thursday that U.S. officials are working to fast-track the development of a vaccine and hope to begin human trials in September.

"We're trying to go as quickly as we can given the emerging nature of the situation," Fauci said.

While Ebola has historically killed as many as 90 percent of those who contract it, the current outbreak has seen a fatality rate of 60 percent, probably because of early treatment efforts, officials have said.

But containing the spread of the disease has been complicated by local beliefs that the disease doesn't exist, suspicion of medical workers and a lack of basic health care services. Many families have kept relatives at home to pray for their survival instead of taking them to clinics.

In Sierra Leone, which borders Liberia to the northwest, authorities are vowing to quarantine all those at home who have refused to go to isolation centers.

Rosa Crestani, Ebola emergency coordinator for Doctors Without Borders, said it is "crucial" to gain the trust of communities that have been afraid to let health workers in.

"The declaration of a state of emergency in Sierra Leone shows a recognition of the gravity of the situation, but we do not yet know what this will mean on the ground. What we can say is that it will be difficult to implement due to the fact that the cases are dispersed over such a large area, and that we currently do not have a clear picture of where all the hot spots are," she said.

Liberia's president on Wednesday also instituted new measures aimed at halting the spread of Ebola, including shutting down schools and ordering most public servants to stay home from work.

"It could be helpful for the government to have powers to isolate and quarantine people, and it's certainly better than what's been done so far," said Dr. Heinz Feldmann, chief of virology at U.S. National Institute of Allergy and Infectious Diseases. "Whether it works, we will have to wait and see."

Peace Corps exits

The U.S. Peace Corps on Thursday was evacuating hundreds of its volunteers in the affected countries. Two Peace Corps workers are under isolation outside the U.S. after having contact with a person who later died from the Ebola virus, a State Department official said.

In Moberly, Mo., Liz Sosniecki said she got a call from her 25-year-old son, Dane, a Peace Corps volunteer in Liberia. He had not been exposed to Ebola and expressed disappointment about leaving just six weeks after he arrived.

"He said, 'I'm coming home,'" she said, beginning to cry. "Sorry. I'm a little emotional. It's a relief."

Ebola now has been blamed for 729 deaths in four West African countries this year: 339 in Guinea, 233 in Sierra Leone, 156 in Liberia and one in Nigeria.

The WHO is launching a $100 million response plan calling for the deployment of several hundred more health workers to help the strained resources in deeply impoverished West Africa, where hospital and clinics are ill-equipped to cope with routine health threats let alone the outbreak of a virulent disease like Ebola.

The current outbreak is now the largest since the virus first emerged in 1976, and it has shown up in three African capitals with international airports. Officials are trying to step up screening of passengers, though an American man was able to fly from Liberia to Nigeria, where authorities said he died days later from Ebola.

Experts say the risk of travelers contracting the virus is low because it requires direct contact with bodily fluids or secretions such as urine, blood, sweat or saliva. Those in the throes of death can bleed from their eyes, mouth and ears.

Patients are contagious once the disease has progressed to the point that they show symptoms, according to the WHO.

The most vulnerable are health care workers and relatives who come in close contact with the sick. In Liberia, authorities say 28 out of the 45 health workers who have contracted the disease so far have died.

The CDC has about two dozen staff members in West Africa working to control the outbreak. Frieden, the agency's director, said Thursday that the CDC will send 50 more in the next month. CDC employees in Africa also are helping to screen passengers at airports, he said.

The CDC has said that the risk of the Ebola virus emerging in the United States remains small. On Monday, the agency sent a health alert to U.S. doctors, updating them about the outbreak. The alert stressed that they should ask about foreign travel in patients who come down with Ebola-like symptoms, including fever, headache, nausea and diarrhea.

Even if someone infected with Ebola came to the U.S., the risk of an outbreak is considered very low, Frieden said. U.S. hospitals are well equipped to isolate cases and control spread of the virus.

Frieden also noted that relatively few people travel from West Africa to the United States. He said about 10,000 travelers from those countries come to the United States in an average three- or four-month period, and most do not arrive on direct flights.

The CDC has staff members at 20 U.S. airports and border crossings. They evaluate any travelers with signs of dangerous infectious diseases and isolate them when necessary. The agency is prepared to increase that staffing if needed, he said.

Frieden said a widespread Ebola outbreak in the United States "is not in the cards."

But fears of travelers spreading the virus persist elsewhere. Seychelles on Thursday forfeited an African Cup qualifying game and withdrew from the competition rather than allow Sierra Leone's soccer team to travel to the Indian Ocean nation.

"We have taken the decision because of the advice sent to us by the Seychelles Ministry of Health," Seychelles Football Federation President Elvis Chetty said, according to the BBC. "We also received a letter from the Ministry of Immigration saying it would not allow the Sierra Leone team to enter our jurisdiction."

The Ebola outbreak also led the Liberia Football Association to call off all games indefinitely in that country this week.

"Whenever there is a game, a lot of people come together, and we want to discourage gathering at this point," said Hassan Bility, president of the association.

Information for this article was contributed by Clarence Roy-Macaulay, Krista Larson, Maria Cheng, Jonathan Paye-Layleh, Carla K. Johnson, Gerald Imray, Josh Lederman and Mike Stobbe of The Associated Press; by Nicole Gaouette, Silas Gbandia, Elise Zoker, Marie French, Cynthia Koons, Makiko Kitamura, Simeon Bennett and Olivier Monnier of Bloomberg News; by Brady Dennis of The Washington Post; and by Cammie Bellamy of the Arkansas Democrat-Gazette.

A Section on 08/01/2014

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