TIME ebola

American Freelance Cameraman Is Officially Free of Ebola

US Journalist Who Contracted Ebola In Liberia Treated At Nebraska Medical Center
An ambulance carrying an American freelance cameraman who contracted Ebola in Liberia, Ashoka Mukpo, arrives at the Nebraska Medical Center October 6, 2014 in Omaha, Nebraska. Eric Francis—Getty Images

Ashoka Mukpo was diagnosed with Ebola on Oct. 2 while working in Liberia

An American journalist who contracted Ebola while working in Liberia is officially clear of the virus, the hospital where he was treated said Tuesday.

The Nebraska Medical Center made the announcement of NBC freelance cameraman Ashoka Mukpo’s recovery after the Centers for Disease Control and Prevention confirmed his blood test no longer showed presence of the virus, according to NBC News. The 33-year-old, who arrived at the hospital on Oct. 6 after being evacuated from Liberia, will now be allowed to leave his isolation unit and return home to Rhode Island, the hospital said.

“Recovering from Ebola is a truly humbling feeling,” Mukpo told the hospital. “Too many are not as fortunate and lucky as I’ve been. I’m very happy to be alive.”

As part of his treatment, Mukpo had received a blood donation from Dr. Kent Brantly, the first American to be diagnosed with Ebola and who was also treated at the Nebraska Medical Center, in addition to an experimental drug called brincidofovir.

The photojournalist was diagnosed with Ebola on Oct. 2 in Liberia, making him the fourth American to contract the virus. That number has since risen to eight Americans who have developed the deadly disease in an outbreak that has claimed over 4,500 lives, according to the World Health Organization.

The only Ebola fatality in the U.S. thus far has been that of Thomas Eric Duncan, a Liberian who died in Dallas on Oct. 8. Meanwhile, an unnamed patient and two Dallas nurses, Amber Vinson and Nina Pham, remain in treatment, according to CNN. Pham’s condition was upgraded from “fair” to “good” Tuesday, while Vinson’s mom told ABC Tuesday that her daughter is “doing OK, just trying to get stronger.”

[NBC News]

TIME ebola

First U.S. Nurse With Ebola Upgraded to ‘Good’ Condition

Ebola patient and nurse Nina Pham is flown into Frederick Airport and transfered to NIH
Ashley King of Walkersville came out to send a positive message to Nina Pham, a nurse who treated Thomas Duncan, the Liberian man, who died of Ebola, who was flown into Frederick Airport and transferred to NIH to treat her now that she has Ebola October 16, 2014 in Frederick, Maryland. The Washington Post/Getty Images

Nina Pham was previously listed in "fair" condition

The clinical status of the first of two Dallas nurses to contract Ebola has been upgraded from “fair” to “good,” the National Institute of Health (NIH) said Tuesday.

Nina Pham, 26, had been transferred Thursday to the NIH Special Clinical Studies Unit in Maryland, where a doctor said in a statement that she was in fair condition and resting comfortably. The NIH also said that Pham has expressed gratitude for her well-wishers, but that “no additional details are available at this time.”

The unit where Pham is being treated has a staff of 50 to 60 personnel who are trained to deal with biohazards like the Ebola virus, Dr. Anthony Fauci, director of the NIH’s National Institute of Allergy and Infectious Diseases, said Friday. While Fauci did not disclose Pham’s treatment plan, he revealed that Pham had already received plasma donated from Ebola survivor Dr. Kent Brantly.

Pham, who last week released a tearful video from inside her Texas isolation unit, is the first known person to develop Ebola within the United States. Pham contracted the virus at Dallas’ Texas Health Presbyterian Hospital while treating Thomas Eric Duncan, the first person to be diagnosed with Ebola in the U.S. Duncan died of the virus Oct. 8.

A second Dallas nurse who worked alongside Pham in Duncan’s treatment was also diagnosed with Ebola two days after Pham’s diagnosis.

TIME ebola

U.S. Will Restrict Travel From Ebola-Hit West African Countries to 5 Airports

IINTERNATIONAL PASSENGERS BEING SCREENED FOR MEDICAL CONDITIONS RELATED TO EBOLA AT  THE CHICAGO INTERNATIONAL AIRPORT BY MEMBERS OF THE US CUSTOMS AND BOARDER PATROL AND A US COAST GUARD MEDICAL TEAM, BOTH PART OF THE US DEPARTMENT HOMELAND SECURITY. THE
U.S. Customs and Border Protection Officers conduct enhanced screening at JFK International Airport in New York City on October 11, 2014. Donna Burton—UPI/CBP/Landov

Fliers from Ebola-affected countries must travel to New York, Newark, Washington, Atlanta or Chicago

The Department of Homeland Security announced Tuesday that airline passengers traveling to the United States from the the countries most affected by the Ebola outbreak must travel through one of five U.S. airports, where they will undergo screening.

The new restrictions take effect Wednesday and expand on a previous requirement that passengers whose travel plans originate in Liberia, Guinea and Sierra Leone must undergo screening if they arrive at airports in New York, Newark, Washington, Atlanta or Chicago. Now, passengers must modify their itinerary to ensure they arrive at one of the five airports where they can be screened.

Though the tighter security measure is symbolically significant, it will likely only impact a small minority of travelers who arrive in the U.S. from West Africa. More than 9o% of passengers from the affected countries already arrive at those five airports via air connections in Europe or elsewhere in Africa. There are currently no direct flights from Liberia, Guinea or Sierra Leone to the U.S.

In a statement, Homeland Security Secretary Jeh Johnson said that the agency would continue monitoring the situation to determine whether additional restrictions are necessary.


Read next: Texas Tells Ebola Health Care Workers Not to Travel

TIME ebola

More Than 5,000 Health Care Workers Attend Ebola Training

CDC and Mount Sinai health workers demonstrate how to put on and off Ebola personal protective equipment at an Ebola education session in New York City Alexandra Sifferlin

"We are having a family meeting"

More than 5,000 health care and hospital infection control workers gathered at the Javits Center in New York City for an Ebola education session amid growing concern among hospital workers over Ebola preparedness.

“We are having a family meeting,” Kenneth Raske, president of the Greater New York Hospital Association (GNYHA) told TIME. “The turnout is spectacular. We may not answer every question [today], but we are committed to finding the answers.”

The event, which was streamed live nationwide, featured Centers for Disease Control (CDC) experts offering live trainings on how to safely care for patients with Ebola. It was hosted by the Healthcare Education Project from GNYHA/1199SEIU and Partnership for Quality Care.

New York governor Andrew Cuomo helped kick off the event, touting New Yorkers’ resilience and ability to always “rise to the occasion” from 9/11 to Hurricane Sandy. “We have a new challenge we must meet today,” said Cuomo. New York City Mayor Bill de Blasio also made an appearance, thanking health care workers.

“Regardless of immigration status, we will help them all,” said de Blasio, referring to the possibility of patients with Ebola coming into a New York City emergency room.

The session included a hands-on demonstration of personal protective equipment (PPE) led by Dr. Bryan Christensen of the CDC’s domestic infection control team for the Ebola response. On Oct. 20, the CDC revised its guidelines for Ebola-related care, recommending full-coverage PPE and supervision while taking PPE on and off.

Christensen supervised registered nurse Barbara Smith of Mount Sinai Health System as she demonstrated how to put on and take off all the pieces of PPE: sanitizing her hands, putting on her first set of gloves, sitting in a chair to put on her foot covers, donning her suit—and finally doing a little jig, to audience laughter, once she was completely suited. Afterward, she took off each piece, sanitized her gloves numerous times and checked for any holes. The entire process took 15 to 20 minutes, which the CDC said cannot be rushed.

Over 5,000 health care workers gather in the Javtis Center in New York City to attend an Ebola education session. Alexandra Sifferlin

CDC officials also reviewed Ebola care protocols in detail, from what to wear and how to discard linens (they can’t be washed) to the way hands should be washed and how to use an alcohol rub to clean gloves before removing them, something that is not usually part of standard procedure. For respiratory protection, the CDC recommends either a powered air purifying respirator (PAPR) or a disposable respirator like N95. Emory University Hospital uses the former; the Nebraska Medical Center uses the latter. “When we use equipment we are not used to, it makes it difficult,” said CDC’s Dr. Arjun Srinivasan. “The way we address this is practice, practice, practice.”

Massive education sessions like this have been held before over health threats like anthrax, H1N1 and smallpox. “We had to have this in a convention center to accommodate folks,” George Gresham, president of 1199SEIU United Healthcare Workers East told TIME. “Back in the 80s when the AIDS epidemic first started, I was a health care worker myself, and it was the unknown that was the mystery, and the fear, and I think that’s the same here. “

The massive number of health care workers that crowded into the conference center proves that they crave more education about caring for potential Ebola patients. Even though some states, including New York, are identifying specific hospitals that will take in any Ebola patients for actual care, all health facilities have to be prepared for the possibility that a patient like Thomas Eric Duncan could walk through their doors.

The hope is that the session was helpful and positive. “I think this is another moment we can calm the public and reassure the public of health care workers’ commitment,” Gresham said.

TIME ebola

How Ebola Hysteria Could Help Contain Flu Season

Since Ebola’s first symptoms resemble that of the flu, fears about Ebola could drive an influx of patients to doctors and emergency rooms with flu symptoms, who might otherwise have stayed home, doctors say. Each year, the Centers for Disease Control and Prevention estimates that between 5% to 20% of Americans get the flu, though most don’t see their doctor. In 2011, the last year for which data is available, 1,532 Americans died from influenza.

That number gives a sense of which disease is more dangerous to the greatest number of Americans. While only three people have been diagnosed with Ebola in the United States, nearly 40 percent of Americans say they are concerned that someone in their family will get the deadly virus within a year, a Harvard Public Health poll found last week.

While the media and polls depict an American public that is acutely fearful about Ebola, there is only modest evidence of a widespread change in behavior thus far. That could change as flu season kicks off, especially if new cases of Ebola arise in the United States. “We might expect to see an increase in people seeking health care for influenza like illness this season,” said Dr. Richard Webby, the director of a World Health Organization center studying influenza. But Webby described the flu as “background noise,” for its potential interference in efforts to contain Ebola.

For those who do see a doctor, the CDC tracks the percentage of visits in which the patients report flu-like symptoms, regardless of whether he or she actually has the flu. This figure is the best to follow to determine how fears over Ebola are influencing Americans’ response to the flu. Since March of this year, the percentage of flu related visits has been higher than the same period in 2013. This uptick approximately correlates with the rise of Ebola new coverage.

Percentage of Outpatient Visits Reporting Flu Symptoms

There is a historical precedent for fears of a pandemic raising concerns among those with the regular flu. CDC epidemiologist Lynnette Brammer, who developed the surveillance program for tracking flu cases, recounts a more dramatic trend in 2009. “During the H1N1 pandemic in 2009, we did see an increase of people going to the doctor with flu-like symptoms,” she said. “Normally they would have stayed at home, but because they were worried about H1N1, they got tested.”

Over 200 labs submit specimens tested for flu to CDC’s flu surveillance network. The number of specimens tested each week, graphed below, rises along with the increase in patients with flu symptoms. Fear over Ebola may explain this rise, though the most recent uptick in October marks the beginning of a new flu season, in which CDC added 120 new laboratories.

Number of Specimens Tested for Flu

Of course, the severity of the flu varies from year to year, which could also account for any change. Of the specimens tested above, the 2014 strain of the flu outpaced the 2013 version through May, but now appears indistinguishable.

Percent of Specimens Tested Positive for Flu

With additional reporting by Pratheek Rebala.

Methodology

Data from the Centers for Disease Control weekly influenza reports.

TIME Rwanda

Rwanda Now Screening Travelers From The U.S. And Spain for Ebola

A New Jersey elementary school recently barred entry to two transfer students from the Ebola-free country

As mass panic over Ebola sweeps over the globe, resulting in widespread stigmatization of travelers to and from Africa, one Ebola-free East African nation is stepping up its precautionary approach toward people traveling to or from America and Europe.

Rwanda Tuesday began screening people who have been in the U.S. or Spain in the last two weeks. A handful of patients have been diagnosed with Ebola in both countries. Rwanda is already denying entry to visitors who have been in Guinea, Liberia, Senegal, or Sierra Leone in the last 22 days.

Coincidence or not, Rwanda’s new policy clips on the heels of a New Jersey elementary school that barred entry to two transfer students from Rwanda, even though the country is 2,600 miles from the closest Ebola-afflicted country.

Rwanda’s protocol is laid out on the U.S. Embassy’s website.

TIME ebola

Why Ebola Isn’t Really a Threat to the U.S.

Ebola will not likely spread within the United States

Give us this—when Americans overreact, we do it all the way. Over the past week, in response to fears of Ebola, parents in Mississippi pulled their children out of a middle school after finding out that its principal had traveled to Zambia—a nation that is in Africa, but one that hasn’t recorded a single Ebola case. A college sent rejection notices to some applicants from Nigeria because the school wouldn’t accept “international students from countries with confirmed Ebola cases”—even though Nigeria has had less than 20 confirmed cases and the outbreak is effectively over.

The American public is following its leaders, who’ve come down with a bad case of Ebola hysteria. That’s how you get even-tempered politicians like New York Governor Andrew Cuomo musing that the U.S. should “seriously consider” a travel ban on West African countries hit by Ebola, while some of his less restrained colleagues raise the incredibly far-fetched possibility of a terrorist group intentionally sending Ebola-infected refugees into the U.S. It’s little surprise that a Washington Post/ABC News poll found that two-thirds of Americans are concerned about an Ebola outbreak in the U.S.

They shouldn’t be—and two events that happened on Monday show why. WHO officials declared Nigeria officially “Ebola-free.” And in Dallas, the first wave of people being monitored because they had direct contact with Thomas Eric Duncan, the first Ebola patient diagnosed in the U.S., were declared free of the diseases.

Nigeria matters because the nation’s is Africa’s most populous, with 160 million people. Its main city, Lagos, is a sprawling, densely populated metropolis of more than 20 million. Nigeria’s public health system is far from the best in the world. Epidemiologists have nightmares about Ebola spreading unchecked in a city like Lagos, where there’s enough human tinder to burn indefinitely.

Yet after a few cases connected to Sawyer, Nigeria managed to stop Ebola’s spread thanks to solid preparation before the first case, a quick move to declare an emergency, and good management of public anxiety. A country with a per-capita GDP of $2,700—19 times less than the U.S.—proved it could handle Ebola. As Dr. Faisal Shuaib of Nigeria’s Ebola Emergency Operation Center told TIME: “There is no alternative to preparedness.”

But Nigeria’s success was also a reminder of this basic fact: If caught in time, Ebola is not that difficult to control, largely because it remains very difficult to transmit outside a hospital. For all the panic in the U.S. over Ebola, there has yet to be a case transmitted in the community. The fact that two health workers who cared for Duncan contracted the disease demonstrates that something was wrong with the treatment protocol put out by the Centers for Disease Control and Prevention (CDC)—something CDC Director Dr. Tom Frieden has essentially admitted—and may indicate that the way an Ebola patient is cared for in a developed world hospital may actually put doctors and nurses at greater risk.

“You do things that are much more aggressive with patients: intubation, hemodialysis,” National Institute of Allergy and Infectious Diseases head Dr. Anthony Fauci said on CBS’s Face the Nation on Sunday. “The exposure level is a bit different, particularly because you’re keeping patients alive longer.” But now that U.S. health officials understand that additional threat, there should be less risk of further infection from the two nurses who contracted Ebola from Duncan—both of whom are being treated in specialized hospitals.

Even the risk of another Duncan doesn’t seem high. For all the demand to ban commercial travel to and from Ebola-hit West Africa, this region is barely connected to the U.S. in any case. Only about 150 people from that area of Africa come to the U.S. every day—less than a single full Boeing 757—and many airlines have already stopped flying. But there have been relatively few spillover cases even in African countries that are much more closer and more connected to Guinea, Sierra Leone and Liberia. Besides Nigeria, only Senegal has had cases connected to the West African outbreak—and that nation was declared Ebola-free today as well. (There have been cases in the Democratic Republic of Congo, but that’s considered a separate outbreak.) The worst Ebola outbreak ever is raging in three very poor nations—but it seems unable to establish itself anywhere else.

None of this is to deny the scale of the challenge facing Guinea, Sierra Leone and Liberia, where the Ebola has fully taken hold and the disease is still outpacing our efforts to stop it. But West Africa is where our fear and our efforts should be focused—not at home, where Ebola is one thing most of us really don’t have to worry about.

TIME ebola

Ebola Vaccine Testing Could Start Soon

WHO hopes for clinical trials to begin in January

An Ebola vaccine could begin testing in the next few weeks and be ready for clinical trials in West Africa by January, the World Health Organization announced Tuesday.

Still, questions remain about when the drug may be available for the public at large and how many doses will be available, according to CNN.

“It will be deployed in the form of trials,” said WHO official Marie Paule Kieny, noting the number of available trials would be in the tens of thousands, not millions.

Initial tests will be available in countries like the United States and England before moving to West Africa, CNN reported.

Currently, there is no vaccine for Ebola, which has killed more than 4,500 people, almost entirely in West Africa, in the latest outbreak. Health officials have been working on a vaccine for years, and now have expedited their efforts in the face of the current crisis.

[CNN]

TIME 2014 Election

Ebola Travel Ban Wins Support From Another Embattled Democratic Candidate

Jeanne Shaheen,Scott Brown
United States Sen. Jeanne Shaheen (D-N.H.), right, listens as her Republican rival, former Massachusetts Sen. Scott Brown speaks during their debate , Monday, Oct. 6, 2014 in Conway, N.H. Jim Cole—AP

New Hampshire Sen. Jeanne Shaheen is the latest Democrat to open up to an Ebola travel ban

Over the past several days, New Hampshire Republican Senate candidate Scott Brown has not let up hammering his Democratic opponent about Ebola.

On Thursday, he called on President Barack Obama to institute a travel ban from West Africa. On Friday, he said Democratic Sen. Jeanne Shaheen, is “rubber-stamping the President’s policy,” by opposing his position. He also told Fox News’ Brian Kilmeade that if 2012 Republican presidential candidate Mitt Romney had won, Ebola wouldn’t be a problem. The next day he wrote a letter urging Shaheen to accept a travel ban, saying that the position goes “beyond partisan politics.”

By Monday, Shaheen could take no more. “Senator Shaheen has contacted New Hampshire officials about local preparedness,” her spokesman Harrell Kirstein said Monday afternoon, just days after Shaheen said a travel ban did not make sense. “She strongly supports any and all effective measures to keep Americans safe including travel bans if they would work.”

Brown and other Republicans in tightly contested Senate races have put Democrats on their heels by following public polls that show a majority of the country wants to combat Ebola with a travel ban, even though health experts warn that such a move would make the crises in West Africa worse and ultimately increase the likelihood that the virus travels again to the United States.

Shaheen joins an ever-growing cohort of vulnerable Democrats running for Senate that have moved on the issue. Over the past week, Colorado Sen. Mark Udall, Arkansas Sen. Mark Pryor, and Georgia candidate Michelle Nunn, have announced they are in favor of some type of travel ban. On Friday, North Carolina Sen. Kay Hagan even flip-flopped in favor of a ban, saying she supported it just days after saying it would not help.

Other Senate Democratic candidates may still shift under Republican and public pressure. On Tuesday, a Washington Post-ABC poll found that two-thirds of respondents support restricting entry to the United States for people who’ve been in the West African affected countries. The next Senate Democratic candidate to support a travel ban could very well be Louisiana Sen. Mary Landrieu, who has advocated to expand airport screenings, but has faced pressure to commit to a ban from her opponent, Rep. Bill Cassidy (R-La.).

Dr. Pearson Cross, an associate political science professor at the University of Louisiana at Lafayette, says that Landrieu could face a “high,” short-term political cost otherwise. “If Landrieu doesn’t support a travel ban it may be spun that she is insufficiently concerned with protecting America and Louisiana’s health and interests in the name of political correctness,” says Cross. “That could be used in a campaign ad and on the trail where people are quite concerned about this fast-moving and often misunderstood issue.”

On Friday, Cook Political Report, the nonpartisan election handicapper, threw the race from leaning Shaheen to a “toss-up,” citing the unfavorable Democratic environment, voters finally tuning in with two weeks left in the race and Brown’s campaign abilities. “There’s been a lot of public attention to the threat of Ebola, so it’s definitely playing here,” says Dr. Dante Scala, an associate political science professor at the University of New Hampshire. “I’m sure there’s a lot more concern about that among voters than there is about the Senate race itself. I think it transcends politics in that way.”

With the political winds growing so strongly, even the White House has, at times, encouraged Democratic candidates to criticize the administration over Ebola. Last week, Iowa Democratic Rep. Bruce Braley, who is running for Senate against Republican state Sen. Joni Ernst and said he would consider the travel ban, admonished the Administration for not acting fast enough. Asked about the comments, White House Press Secretary Josh Earnest said that Braley was “somebody that has a reputation for being willing to speak truth to power, whether they’re in the same party as him or not.”

“I think this is another indication that he’s willing to do that,” Earnest added.

TIME ebola

CDC Changes Ebola Guidelines

CDC EBOLA TRAINING
Licensed clinician Hala Fawal practices drawing blood from a patient using a dummy on Monday, Oct. 6, 2014, in Anniston, Ala. Brynn Anderson—AP

Now recommending full-coverage for health care workers

Health care workers treating Ebola patients must now wear full-body coverage suits with no skin showing and must undergo significant training prior to treating patients, U.S. health officials said Monday.

“We may never know exactly how [the Dallas infections happened], but the bottom line is the guidelines didn’t work for that hospital,” Dr. Tom Frieden, director of the Centers for Disease Control and Prevention (CDC), said during a news conference announcing the new guidelines for caring for Ebola patients and wearing personal protective equipment (PPE). Prior to the three Ebola infections in Dallas, including two health care workers, the CDC did not recommend full body coverage for Ebola, but instead recommended at least gloves, a gown, eye protection and a face mask. That has changed, in light of the two health care worker infections at Texas Health Presbyterian Hospital.

The new guidelines have three additions:

1. Prior to working with Ebola patients, health care workers must be repeatedly trained and demonstrate competency in treating a patient with Ebola, especially putting on and taking off PPE. “Facilities need to ensure all healthcare providers practice numerous times to make sure they understand how to appropriately use the equipment,” the CDC said in a statement.

2. When wearing PPE, no skin can be exposed. The CDC is providing two options for the PPEs, since the University of Nebraska Medical Center and Emory University Hospital, which have both successfully treated Ebola patients, use different versions. Googles are no longer recommended. The recommendations for PPE are now the following:

  • Double gloves
  • Boot covers that are waterproof and go to at least mid-calf or leg covers
  • Single use fluid resistant or imperable gown that extends to at least mid-calf or coverall without intergraded hood.
  • Respirators, including either N95 respirators or powered air purifying respirator (PAPR)
  • Single-use, full-face shield that is disposable
  • Surgical hoods to ensure complete coverage of the head and neck
  • Apron that is waterproof and covers the torso to the level of the mid-calf should be used if Ebola patients have vomiting or diarrhea

3. Every step of putting on and taking off PPE must be supervised by a trained observer. There should also be designated areas for where PPE are taken on and off.

“It’s hard to care for Ebola, so every aspect… needs to be overseen,” said Frieden in the press conference, adding that hospitals should limit personnel in health care rooms and should limit procedures to only those that are essential.

The CDC is increasing health care worker training across the country as well as sending out training videos, but Frieden argues that there is no alternative for hands-on training, especially taking on and off PPEs. “We agree with the concern of health care workers,” said Frieden citing anxiety from health care workers nationwide that they felt unprepared for treating patients with Ebola. The new recommendations will be effective immediately, though the CDC does not have the regulatory authority to make hospitals follow the guidelines, Frieden said. The recommendations should be available online later Monday evening.

Earlier on Monday, a Dallas County Judge confirmed that 43 of 48 contacts of Thomas Eric Duncan were considered no longer at risk after the 21-day incubation period passed, and Nigeria was declared Ebola-free.

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