TIME infectious diseases

Liberia Closes Borders to Curb Ebola Outbreak

Ebola in Liberia
Liberian health workers in protective gear on the way to bury a woman who died of the Ebola virus from the isolation unit in Foya, Lofa County, Liberia on July 2, 2014. Ahmed Jallanzo—EPA

Outbreak is already the largest on record

The Liberian government closed off most of the country’s border crossings Sunday in an effort to curb an Ebola outbreak that has already killed over 670 people across Guinea, Liberia, and Sierra Leone and become the largest outbreak of the virus on record.

President Ellen Johnson Sirleaf said the airport will remain open, but that all travelers coming in and out will be tested for the virus, Reuters reports. “All borders of Liberia will be closed with the exception of major entry points,” she said. “At these entry points, preventive and testing centers will be established, and stringent preventive measures to be announced will be scrupulously adhered to.”

Ebola kills around 90% of those who contract it, although the current outbreak has only killed around 60%. Numerous medical personnel have succumbed to the most recent outbreak, including Dr. Samuel Brisbane, one of Liberia’s most high-profile doctors, who died Saturday.

Two Americans, Dr. Kent Brantly and missionary Nancy Writebol, have contracted the virus and are currently in stable condition, NBC reports. Both worked for North Carolina-based aid group Samaritan’s Purse, and spokeswoman Melissa Strickland said that they are both “alert.”

Brantly and Writebol had followed all CDC and WHO guidelines and worn full protective equipment when treating Ebola patients, including gloves, goggles, face protection, and full body coverings, Strickland said.

Since Ebola is highly contagious, Liberia has also restricted public gatherings such as marches and demonstrations until the outbreak is brought under control. “No doubt, the Ebola virus is a national health problem,” President Sirleaf said in a statement. “And as we have also begun to see, it attacks our way of life, with serious economic and social consequences.”

TIME Liberia

Ebola Kills Liberian Doctor, 2 Americans Infected

Handout of Dr. Kent Brantly of Samitan's Purse relief organization in Monrovia
Dr. Kent Brantly, left, cares for Ebola patients at the ELWA Hospital in Monrovia, Liberia Samaritan's Purse—Reuters

(MONROVIA, Liberia) — One of Liberia’s most high-profile doctors has died of Ebola, officials said Sunday, and an American physician was being treated for the deadly virus, highlighting the risks facing health workers trying to combat an outbreak that has killed more than 670 people in West Africa — the largest ever recorded.

A second American, a missionary working in the Liberian capital, was also taken ill and was being treated in isolation there, said the pastor of a North Carolina church that sponsored her work.

Dr. Samuel Brisbane, a top Liberian health official, was treating Ebola patients at the country’s largest hospital, the John F. Kennedy Memorial Medical Center in Monrovia, when he fell ill. He died Saturday, said Tolbert Nyenswah, an assistant health minister. A Ugandan doctor died earlier this month.

The American physician, 33-year-old Dr. Kent Brantly, was in Liberia helping to respond to the outbreak that has killed 129 people nationwide when he fell ill, according to the North Carolina-based medical charity, Samaritan’s Purse.

He was receiving intensive medical care in a Monrovia hospital and was in stable condition, according to a spokeswoman for the aid group, Melissa Strickland.

“We are hopeful, but he is certainly not out of the woods yet,” she said.Early treatment improves a patient’s chances of survival, and Brantly recognized his own symptoms and began receiving care immediately, Strickland said.

The American missionary, Nancy Writebol, was gravely ill and in isolation in Monrovia, her husband, David, told a church elder via Skype, according to the Rev. John Munro, pastor of Calvary Church in Charlotte, N.C.

Munro said the couple, who had been in Liberia for about a year, insisted on staying there despite the Ebola threat. “These are real heroes — people who do things quietly behind the scenes, people with a very strong vocation and very strong faith,” Munro said.

There is no known cure for the highly contagious virus, which is one of the deadliest in the world. At least 1,201 people have been infected in Liberia, Sierra Leone and Guinea, according to the World Health Organization, and 672 have died. Besides the Liberian fatalities, 319 people have died in Guinea and 224 in Sierra Leone.

Ominously, Nigerian authorities said Friday that a Liberian man died of Ebola after flying from Monrovia to Lagos via Lome, Togo. The case underscored the difficulty of preventing Ebola victims from traveling given weak screening systems and the fact that the initial symptoms of the disease — including fever and sore throat — resemble many other illnesses.

Health workers are among those at greatest risk of contracting the disease, which spreads through contact with bodily fluids.

Photos of Brantly working in Liberia show him swathed head-to-toe in white protective coveralls, gloves and a head-and-face mask that he wore for hours a day while treating Ebola patients.

Earlier this year, the American was quoted in a posting about the dangers facing health workers trying to contain the disease. “In past Ebola outbreaks, many of the casualties have been health care workers who contracted the disease through their work caring for infected individuals,” he said.

There is no known cure for Ebola, which begins with symptoms including fever and sore throat and escalates to vomiting, diarrhea and internal and external bleeding.

The WHO says the disease is not contagious until a person begins to show symptoms. Brantly’s wife and children had been living with him in Liberia but flew home to the U.S. about a week ago, before the doctor started showing any signs of illness, Strickland said.

“They have absolutely shown no symptoms,” she said.

A woman who identified herself as Brantly’s mother said the family was declining immediate comment when reached by phone in Indiana.

Besides Brantly and the two doctors in Liberia, Sierra Leone’s top Ebola doctor and a doctor in Liberia’s central Bong County have also fallen ill.

The situation “is getting more and more scary,” said Nyenswah, the country’s assistant health minister.

Meanwhile, the fact that a sick Liberian could board a flight to Nigeria raised new fears that other passengers could take the disease beyond Africa.

Nigeria’s international airports were screening passengers arriving from foreign countries, and health officials were also working with ports and land borders to raise awareness of the disease. Togo’s government also said it was on high alert.

Security analysts were skeptical about the usefulness of these measures.

“In Nigeria’s case, the security set-up is currently bad, so I doubt it will help or have the minimum effectiveness they are hoping for,” said Yan St. Pierre, CEO of the Berlin-based security consulting firm MOSECON.

An outbreak in Lagos, a megacity where many lived in cramped conditions, could be a major public health disaster.

The West Africa outbreak is believed to have begun as far back as January in southeast Guinea, though the first cases weren’t confirmed until March.

Since then, officials have tried to contain the disease by isolating victims and educating populations on how to avoid transmission, though porous borders and widespread distrust of health workers have made the outbreak difficult to bring under control.

News of Brisbane’s death first began circulating on Saturday, a national holiday marking Liberia’s independence in 1847.

President Ellen Johnson Sirleaf used her Independence Day address to discuss a new taskforce to combat Ebola. Information Minister Lewis Brown said the taskforce would go “from community to community, from village to village, from town to town” to try to increase awareness.

In Sierra Leone, which has recorded the highest number of new cases in recent days, the first case originating in Freetown, the capital, came when a hairdresser, Saudata Koroma, fell ill. She was forcibly removed from a government hospital by her family, sparking a frantic search that ended Friday. Kargbo, the chief medical officer, said Sunday that Koroma died while being transported to a treatment center in the east of the country.

TIME Infectious Disease

Report: U.S. Citizen Tested for Ebola in Ghana

This scanning electron micrograph, SEM, depicts a number of Ebola virions. UIG/Getty Images

U.S. Embassy is working to confirm case of deadly virus

A U.S. citizen who traveled in regions of West Africa in the grip of an ebola virus outbreak is being tested for the disease in Ghana.

“He is an American and records showed that he had been to Guinea and Sierra Leone in the past few weeks,” a senior health ministry official told Reuters in an interview. The patient is reportedly quarantined in a clinic in the capital Accra and test results, which should be available later on Monday, are being examined at the Noguchi Memorial Institute of Medical Research.

According to Reuters, the U.S. embassy in Ghana has been informed of the case and is working to confirm it.

The ebola outbreak, which started in Guinea, has been declared “out of control” by the health group Doctors Without Borders, which is treating patients in Western Africa. Ebola causes fevers, vomiting, diarrhea and death, and has spread from Guinea to Sierra Leone and Liberia.

[Reuters]

TIME

Here’s What It Will Take to Contain the Worst Ebola Outbreak in History

Doctors Without Borders is calling the latest outbreak in west Africa “out of control,” and here’s why

+ READ ARTICLE

The “perfect storm” analogy is often over-used when it comes to disease outbreaks–all the elements that you don’t want to see converge to make conditions ripe for a bacteria, or, in this case, a virus, to rip through a population at lightning speed: geography, society, culture, a potent virus, reluctant politicians and a weak health care system. But all those factors are contributing to history’s largest-ever Ebola outbreak, which the World Health Organization now calls a “crisis.” Since early spring, Ebola has spread to two additional countries, Sierra Leone and Liberia, infecting 635 people and claiming nearly 400 lives.

MORE: Ebola Outbreak Beyond Our Control, Doctors Without Borders Says

The Ebola virus causes a nasty infection that triggers an inflammatory reaction so intense, patients essentially drown in their own fluids as they bleed internally and externally — victims’ bodies are overtaken with a well-intentioned defensive system run amok. Anyone who comes into contact with the infected fluids can also get infected. As of now, there are no treatments for Ebola. The only hope is for the body to remain strong enough to overcome the initial onslaught from the virus and start to develop antibodies to fight it. As patients get sick, they stop eating and drinking, becoming too weak to develop these critical antibodies. Left alone, nine out of 10 infected people die. At treatment centers, where doctors can provide supportive care with nutrients and hydration, that figure improves to seven out of 10.

Those aren’t great odds, and social and cultural practices in west Africa may be stacking the deck even further. Dr. Michel Van Herp, a physician and epidemiologist with Doctors Without Borders who traveled to Guinea when the outbreak began, says he has been confronted by hostile villagers who did not welcome the medical help.

“I have had aggressive people in front of me in the village,” Van Herp says, as he tried to bring infected patients to treatment centers. “Most villagers are denying the existence of Ebola.”

MORE: 6 Things to Know About the Latest Ebola Outbreak

That denial is fueled by a strong stigma against the disease. In other parts of central Africa where smaller outbreaks occurred, survivors of Ebola returned to their villages only to find their homes burned and their remaining family members ostracized for having been infected.

Such denial not only increases the risk that the close contacts of those infected by Ebola will be affected, but it also creates the ideal situation for the virus to gain an even broader foothold. A critical first step in containing any outbreak of infectious disease involves carefully tracing which people patients have been in contact with. Only then can scientists start to create barriers against the virus by keeping it contained to people known to have already been exposed. In Guinea, denial and stigma against Ebola means some patients who believe they are infected are fleeing to other villages or even crossing the border to another country.

“If you have a guy who runs away to a village 20 kilometers away, then you need to start from scratch in that village to trace his contacts,” says Van Herp.

MORE: What You Need to Know About the Ebola Virus

Making things worse is the fact that in the part of western Africa where the outbreak is centered, the population is particularly mobile, often traveling to nearby Sierra Leone and Liberia in search of work.

“We’ve seen kids who travel between three or four villages, and between the countries before they are too sick and weak that they aren’t able to work any more,” says Van Herp. “In the meantime they have contaminated three or four villages.”

Cultural practices mean that the potential for transmitting Ebola is also amplified if a respected elder is affected.

“If a guy like this falls sick, then more people try to cure him,” says Van Herp. “If he dies, more people are involved in the process of the funeral–in cleaning the dead body, and preparing the body. We have seen that one patient can give disease to 15 or 20 other people.”

Van Herp plans to return to Guinea in July, but he says that so far, there hasn’t been much improvement in people’s education and acceptance about Ebola, despite the rising number of deaths. The WHO has called an emergency meeting of 11 nations next week to discuss ways of containing the outbreak. Attending will be the Minister of Health from Uganda, where the government has made efforts to address the stigma associated with Ebola by creating a survivors network to educate and inform the public about the disease–and hopefully reduce fear and misperceptions about the virus.

TIME Infectious Disease

Ebola Outbreak Beyond Our Control, Doctors Without Borders Says

Doctors Without Borders/Médecins Sans Frontières staff carrying the body of a person killed by viral hemorrhagic fever at a center for victims of the Ebola virus in Gueckedou on April 1, 2014.
Doctors Without Borders/Médecins Sans Frontières staff carrying the body of a person killed by viral hemorrhagic fever at a center for victims of the Ebola virus in Gueckedou on April 1, 2014. Seyllou—AFP/Getty Images

The medical group treating Ebola patients in Africa says it can't keep up with emerging cases

Doctors Without Borders/Médecins Sans Frontières (MSF), the medical organization treating Ebola patients in West Africa, says it has reached the limit of what the group can do to fight the worsening outbreak there.

In a statement released Monday, the organization said it is the only group treating people infected with the disease in Guinea, Sierra Leone and Liberia. “We have reached our limits. Despite the human resources and equipment deployed by MSF in the three affected countries, we are no longer able to send teams to the new outbreak sites,” said Dr. Bart Janssens, MSF director of operations, in a statement.

Since the outbreak started in March in Guinea, MSF says it has treated 470 patients (215 of them confirmed cases) related to Ebola. The group has 300 international and national staff working in West Africa and has sent more than 40 tons of equipment and supplies. But with new cases emerging in new places like Sierra Leone and Liberia, the organization says it cannot keep up. Earlier, the group said the outbreak is “out of control.”

Since the disease emerged earlier this year, there have been over 520 cases and 330 deaths. Ebola is a very infectious hemorrhagic fever that has up to a 90% fatality rate. In April, Guinea’s Health Ministry said deaths from Ebola slowed and that the outbreak was close to being brought under control. But the World Health Organization reported earlier this month that in Guinea alone, there were 37 new cases and 21 new deaths between May 29 and June 1, 2014.

MSF said more groups need to help quell public anxiety over the disease, and that people are distrusting health facilities and not heeding warnings about funeral rituals that put them at risk. “Civil society and political and religious authorities are failing to acknowledge the scale of the epidemic, with few prominent figures spreading messages promoting the fight against the disease,” the organization said. In the statement, Janssens says the WHO and neighboring countries need to provide resources necessary for an epidemic.

The WHO has not released a response to the MSF statement but says it is working with local governments and is planning a regional meeting in Ghana on July 2, the Associated Press reports. The WHO does not currently recommend any restrictions to travel or trade in Guinea, Liberia or Sierra Leone.

TIME Liberia

Liberia Goes from War Zone To Surfing Mecca

Forget surfing favorites like Cape Verde and Thailand - the best kept secret in the world of riding waves is on the West African coast

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Only a few in the surfing community know about the miles of untouched golden sands, the clear waters and, most importantly, the rhythmic pounding of perfectly-formed waves that can be found in Liberia.

But Robertsport, a fishing village in north-west Africa, is building a name for itself as one of the best surf spots in Africa, the AFP reported.

“It’s picturesque! This is a little bit different from what of most people imagine when they hear Liberia,” said Sean Brody, part of the Surf Resource Project.

Indeed, while the African country has been recently known for gruesome civil wars that spanned two decades and left more than 200,000 people dead, surf tourism is slowly picking up and the country is gaining a global reputation for its spectacular beaches and waves.

In the video above, both local and foreign aficionados talk about what’s so special about Liberia’s coast.

TIME Infectious Disease

Ebola Virus Death Toll Rises to 142 in West Africa

Doctors Without Borders called the outbreak 'unprecedented', as reported deaths continue to rise in Guinea and Liberia. However, the number of new infections has slowed

A total of 142 people have now died from an Ebola outbreak in Guinea and Liberia, the World Health organization said on Wednesday. Doctors Without Borders said that the size of the outbreak is unprecedented.

The World Health Organization debunked rumors that the virus was spreading to other countries, however, in a statement on their website. They said nineteen suspected cases reported in Sierra Leone have tested negative.

Doctors in Guinea and Liberia don’t have any experience with the virus, as this is the first time it has emerged in western Africa. WHO said that Guinea has reported 208 cases, including 136 deaths. Liberia has reported 34 cases, including six deaths.

The Ebola virus kills up to 90 percent of those infected, shutting down the immune system and bringing on fever, headache, muscle pain and bleeding.

TIME Infectious Disease

Ebola Spreads from Guinea to Liberia

Medical personnel at the emergency entrance of a hospital receive suspected Ebola virus patients in Conakry, Guinea, March 29, 2014.
Medical personnel at the emergency entrance of a hospital receive suspected Ebola virus patients in Conakry, Guinea, March 29, 2014. Youssouf Bah—AP

Health officials in the West African country say the outbreak of Ebola hemorrhagic fever is suspected to have killed at least 78 people so far. Nearly six weeks had passed before authorities identifying the outbreak as Ebola, allowing it to spread

Health officials in the West African country of Guinea report that the outbreak of Ebola hemorrhagic fever has killed a suspected 78 people.

The disease, which has no cure, is thought to have come from the forests in southern Guinea. It has now spread to the densely populated capital of Conakry after an infected person traveled there, proposing a greater risk than when the virus was limited to the country’s less crowded villages. Senegal also closed its border with Guinea to prevent disease spread, and will implement sanitary checks on flights between Guinea’s capital and Dakar.

Nearly six weeks passed before authorities began to identify the outbreak as Ebola, allowing for the virus to spread. As of Friday, 24 samples have tested positive for Ebola, with two confirmed cases in Liberia, and suspected cases in Sierra Leone. The patients in both Sierra Leone and Liberia had traveled to Guinea.

When victims contract Ebola, they experience fever, weakness, muscle pain, headache, and sore throat. After that, the symptoms advance to vomiting, diarrhea rash, and poor kidney and liver function. Sometimes a patient will also experience internal and external bleeding. As TIME reported last week, there is no known cure or vaccine for Ebola; symptoms can only be managed. Typically patients are dehydrated, so they are given oral or intravenous fluid containing electrolytes. They are also quarantined so that they don’t infect others. Most of the time the virus is contained because patients die relatively quickly, making it difficult for the disease to travel too far, too quickly.

“An Ebola outbreak is always something of concern because it’s highly contagious and we don’t have a vaccine,” says WHO media spokesperson Tarik Jasarevic in Guinea. “On the other hand, we know this disease. It’s not the first time we’ve seen it so we know the measures we can take. It’s not a new disease.”

Jasarevic says clinical management is the first priority for containing the disease, followed by disease surveillance. “We need to find the people who have been infected. Incubation is a few days, so we need to check who infected people have come in contact with, find those people, and see how they feel.”

WHO is helping to coordinate outbreak control in Guinea by offering expertise, clinical care, laboratory diagnosis, and data management. They have also brought two labs to Guinea to diagnose samples. Treatments and vaccines are currently under development, but most have not been tested in humans and it could be a long time before any are proven effective.

The original host of Ebola is unknown, but it most likely came from an animal. Bats are generally considered to be the culprit. Humans become infected from contact with the blood, secretions, organs, or other bodily fluids of infected animals. Human-to-human transmission is harder, but possible through contact with bodily fluids of infected people. Health workers without proper protection, as well as people in burial ceremonies that involve direct contact with bodies, are at risk.

“We are telling the people here that, yes, this disease is dangerous and we don’t have a treatment, but you can protect yourself and we are working with health authorities to implement measures we know are effective,” says Jasarevic.

TIME Africa

Ebola Outbreak Reaches Guinea Capital

This micrograph reveals human hepatocytes infected with the Ebola virus, the cause of Ebola hemorrhagic fever.
This micrograph reveals human hepatocytes infected with the Ebola virus, the cause of Ebola hemorrhagic fever. Getty Images

Guinean officials say they have identified four cases of Ebola in the capital of 3 million people, Conakry, marking the arrival of the virus after the outbreak responsible for at least 63 deaths first began in the southern region last week

Officials in Guinea said Friday that they’ve identified four cases of Ebola in Conakry, the west African country’s capital, the first cases in the city of three million since the outbreak began in the country’s southern region last week.

At least 63 people have died of Ebola since the beginning of the outbreak, the Associated Press reports. The virus, which causes hemorrhagic fever, has a fatality rate of up to 90 percent. Officials say the four people in Conakry known to have contracted the virus were in contact with the body of an earlier victim. Anyone who took part in the burials of victims is being quarantined, the AP reports.

Liberian authorities are looking into suspected cases of Ebola in their own country, which shares a border with Guinea.

[AP]

TIME Disease

Officials: No Ebola In Canada

Ebola Virus
This micrograph reveals human hepatocytes infected with the Ebola virus, the cause of Ebola hemorrhagic fever. The Ebola pathogen is a member of the Filoviridae family of RNA viruses. It is known to be spread through close contact with an infected host. Media for Medical / UIG via Getty Images

An outbreak of the deadly hemorrhagic fever in the West African country of Guinea is causing a global scare, though Canadian authorities say that reports the virus appeared in that country aren't accurate

UPDATE 10:05am

Canadian health officials have ruled out the ebola virus as the cause of a hemorrhagic fever suffered by a man who recently traveled to Liberia.

The man, currently in medical isolation, became sick after he returned to Canada from West Africa, but officials have determined he does not have the virus, reports the Associated Press. There are no other confirmed cases of ebola in Canada.

An outbreak of the virus has killed 59 people in Guinea, on the border of Liberia, in recent days. The fever has no vaccine or specific treatment and ends in bleeding from the mouth or eyes.

[AP]

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