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October 15, 2015

Scottish Ebola nurse Pauline Cafferkey \’critically ill\’ says Royal Free Hospital

Scottish Ebola nurse Pauline Cafferkey ‘critically ill’ says Royal Free Hospital

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Thursday, October 15, 2015

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The Royal Free Hospital in London yesterday said a nurse suffering with complications after Ebola, Pauline Cafferkey, is “critically ill” after her condition deteriorated. Cafferkey, 39, was readmitted to an isolation unit at the Royal Free on the night of October 8–9 where she had spent time earlier in the year after contracting Ebola in Sierra Leone whilst treating patients with the infection.

The hospital said in a statement: “We are sad to announce that Pauline Cafferkey’s condition has deteriorated and she is now critically ill. She is being treated for Ebola in the high level isolation unit at the Royal Free Hospital.”

Royal Free Hospital, London; from file.
Image: User:Ryan4314.

Cafferkey visited an out of hours GP clinic on October 5 where her symptoms were not linked to Ebola, before deciding to go to the Queen Elizabeth University Hospital in Glasgow on October 6 where she was treated at the hospital’s infectious diseases unit. Two days later, she was flown by plane to the Royal Free. She is the only person known to suffer with Ebola in this way for a second time, which can remain in the body after an initial recovery.

Jonathan Ball of the University of Nottingham said he’d heard of nothing like this. “I am not aware from the scientific literature of a case where Ebola has been associated with what we can only assume as life-threatening complications after someone has initially recovered, and certainly not so many months after.”

Pauline’s sister Toni Cafferkey was critical of the wrong diagnosis, telling the Sunday Mail newspaper, “At that point me and my family believe they missed a big opportunity to give the right diagnosis and we feel she was let down. Instead of being taken into hospital, she spent the whole of Tuesday very ill”.

A spokesperson for NHS Glasgow and Clyde said Pauline Cafferkey did receive a diagnosis from an out of hours clinic and said: “Her management and the clinical decisions taken based on the symptoms she was displaying at the time were entirely appropriate. All appropriate infection control procedures were carried out as part of this episode of care.”

Experts say they do not believe the infection recurring within Pauline Cafferkey is contagious despite monitoring 58 people she has been in contact with. This is said to be a precaution as Ebola can only be spread through body fluids and the infection is not creating the same symptoms associated with a one-off diagnosis of Ebola.



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January 21, 2015

Priests beaten in Forecariah, Guinea over Ebola fears

Priests beaten in Forecariah, Guinea over Ebola fears

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Wednesday, January 21, 2015

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Three Baptist priests in Guinea were assaulted and held hostage yesterday by local villagers after being mistaken for campaigners promoting awareness about Ebola, the BBC has reported. They were visiting Kabac, a village in the sub-prefecture of Forécariah, to spray insecticide for the treatment of wells and pit latrines. Locals reportedly thought they were bringing Ebola and attacked the priests. After the assault they were held hostage and had their vehicle set alight.

Electron micrograph of Ebola virus.
Image: Centers for Disease Control / Dr. Frederick Murphy.

Following the attack on the priests, town council workers were forced to evacuate as their building came under assault and was set fire to. A local report, not been independently verified, alleged a council worker was killed during the incident. Police intervened to arrest a number of the local villagers involved in the attacks but were met with hostility from those trying to stop the arrested being taken away.

Such incidents have been noted by the World Health Organisation (WHO). A recent WHO report said “community resistance” is a “major barrier to control” in the countries Ebola has worst hit.

Forécariah has seen incidents like this before. In one incident, on September 23, two Red Cross volunteers buried an Ebola victim, and were then attacked. Villagers removed the corpse from the grave and hid it. This then grew into an attack on a team of epidemiologists by a mob of about 3000 armed youths. This attack had undone “weeks of persistent and effective efforts to slow the outbreak” according to the WHO, who were overseeing the team.

Although not the worst affected country, Guinea has seen 1,876 deaths from 2,871 cases of Ebola, according to WHO. This is compared to Liberia and Sierra Leone with 3,605 and 3,145 deaths each from the effects of the Ebola virus.



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October 4, 2014

Patient under evaluation with Ebola-like symptoms in Washington D.C.

Patient under evaluation with Ebola-like symptoms in Washington D.C.

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Saturday, October 4, 2014

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A patient was admitted to a hospital in Washington, D.C. after showing Ebola-like symptoms, according to a statement yesterday by hospital spokeswoman Kerry-Ann Hamilton.

Howard University Hospital
Image: AgnosticPreachersKid.

Hamilton confirmed Howard University Hospital admitted the patient in stable condition. The patient had been to Nigeria, where some cases of the Ebola virus have occurred. The hospital has followed protocol for infection control, including separating the patient from others to prevent possible infection of others.

The director of the D.C. Department of Health said they have collaborated to monitor patients with Ebola-like symptoms with Howard University Hospital and the Centers for Disease Control and Prevention.

Shady Grove Adventist Hospital in Rockville, Maryland admitted another patient with Ebola-like symptoms, but health officials there yesterday night later determined this person had malaria, not the Ebola virus.

At the peak of Ebola countermeasures in Nigeria, almost 900 people there were monitored for the virus after contacting someone who was already sick.



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September 10, 2014

WHO warns of thousands of new Ebola cases

WHO warns of thousands of new Ebola cases

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Wednesday, September 10, 2014

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Liberia is expected to see thousands of new Ebola cases within the next three weeks, the World Health Organisation (WHO) said yesterday.

The current outbreak of the virus in West Africa is believed to have killed 2,100 people, including 79 health workers. As well as Liberia, Guinea, and Sierra Leone are at the centre of the outbreak, with Nigeria, and Senegal also effected.

Cquote1.svg As soon as a new Ebola treatment facility is opened, it immediately fills to overflowing with patients Cquote2.svg

—World Health Organisation

Liberia is proving particularly vulnerable to the spread of the virus. Before the outbreak, the country had only one doctor for every 100,000 inhabitants, and a severe shortage of beds. The WHO stated that “as soon as a new Ebola treatment facility is opened, it immediately fills to overflowing with patients”.

The UK military have said they will build a 50 bed centre near Sierra Leone’s capital, with the US saying it would send a 25 bed field hospital. This falls short of the 1,000 beds an investigative team from WHO says is needed in Liberia’s capital, Monrovia, alone.

WHO says a three- to four-fold increase in the efforts of those combating the outbreak is needed.

The African Union also warned of the economic impact of the outbreak, urging a lifting of travel bans and border closures. WHO have previously warned that such travel restrictions increased the chance of food shortages. An agreement made yesterday is expected to lead to those restrictions imposed in the last few months being lifted.



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August 11, 2014

WHO declares Ebola outbreak an international emergency

WHO declares Ebola outbreak an international emergency

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Monday, August 11, 2014

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On Friday, the World Health Organisation (WHO) stated the West African Ebola outbreak is now an international health emergency.

The current ongoing outbreak of Ebola is the deadliest since the disease was first reported in humans 40 years ago, with nearly 1,000 people reported to have been killed by the disease in this outbreak. So far three countries, Sierra Leone, Liberia, and Nigeria, have declared national emergencies in response to the outbreak, with cases also reported in Guinea. The latter country was reported to have closed its borders with Sierra Leone and Liberia, but an official announcement later clarified they were taking medical precautions on border crossings.

Dr Margaret Chan, Director General of WHO
Image: January.

Director-General of WHO Dr Margaret Chan appealed for an international response to the outbreak, calling it “the largest, most severe and most complex outbreak in the nearly four-decade history of this disease”. Reports say the comparatively underdeveloped medical infrastructure in the affected countries has hampered efforts to contain the spread of the virus, with Liberia’s health system particularly under-equipped for the pressure. Medecins sans Frontieres (MSF) said the health system in Liberia was “falling apart”. Health experts and aid workers from Europe and America are already working to help bring the outbreak under control, but MSF and WHO are now calling for more help.

The announcement by WHO has international law implications, and it is expected possible cases will not be allowed to leave the countries affected until it is confirmed they are clear of the virus, with the possibility of travel being denied from any region not meeting the WHO’s guidelines. WHO have also warned all nations should prepare to bring their own nationals back to home territory for treatment if infected by the virus, with cases already returned for treatment to the US and Spain.

WHO vaccine chief Jean-Marie Okwo Bele told AFP he expected a possible vaccine against Ebola to start clinical trials next month, stating: “Since this is an emergency, we can put emergency procedures in place […] so that we can have a vaccine available by 2015”. WHO assistant director-general Marie-Paule Kieny admitted, however, to do so the bar set during the testing process would have to be lower, reflecting questions about the ethics of using comparatively untested drugs, and who they should be given to.

Meanwhile, restrictions put in place to limit the spread of the disease are reported to be causing problems among those affected in already impoverished areas. Liberia and Sierra Leone are both reported to have deployed soldiers to limit travel within these countries, with many residents reported to be worried about the effect on their trade and incomes. The Telegraph reported from interviews, there is also resistance to some measures in Liberia, where there is a strong stigma attached to the disease. This has led to many people refusing to report the deaths of family members and hand their bodies over for cremation. There have also been cases of violence towards those seeking to enforce government measures to limit the disease’s spread.



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August 2, 2014

Leading Sierra Leone doctor dies in Ebola epidemic

Leading Sierra Leone doctor dies in Ebola epidemic

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Dr. Sheik Humarr Khan died from Ebola virus on Tuesday afternoon at Kailahun treatment centre in Sierra Leone. Dr. Khan led the response in Sierra Leone to the current Ebola outbreak there and treated dozens of patients. On Thursday, Sierra Leone declared a state of emergency, quarantining Ebola epicentres.

Electron micrograph of Ebola virus.
Image: Centers for Disease Control / Dr. Frederick Murphy.

The previous Tuesday, Minister of Health and Sanitation Miatta Kargbo announced Dr. Khan had contracted Ebola. Dr. Khan was moved to the Doctors Without Borders treatment center in Kailahun. A few days before he was admitted, three other senior staff in his department at the Kenema Government Hospital died from Ebola, including one, Nurse Mbalu Fonnie, with more than two decades’ experience with hemorrhagic fever.

September 11 of this year would have been Dr. Khan’s 40th birthday. In an interview on May 20, Dr. Khan told Awareness Times his department does the only testing south of the Sahara Desert for hemorrhagic fever such as Lassa and Ebola; a decade ago, these tests would have been done in Germany. He warned about the possibility of fresh outbreaks and necessity of engaging the public in health education and prevention.



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March 6, 2009

Philippines is culling 6500 hogs after Reston ebolavirus outbreak

Philippines is culling 6500 hogs after Reston ebolavirus outbreak

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Friday, March 6, 2009

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Transmission electron micrograph of the Ebola virus.

The Philippine Department of Agriculture (DA), local health and agricultural teams Sunday have started slaughtering, burning and burying roughly 6,500 hogs at a farm in Pandi, Bulacan in Central Luzon on Sunday after three farm workers became infected with Reston ebolavirus (ERV) of the virus group Ebola, as a precautionary measure and to protect the local livestock industry.

“We culled around 300 heads—piglets and growers—in two and a half hours; we tried to start the process at 5 p.m. Sunday; after three hours we disposed of 442 hogs; that includes transporting the hogs to an area in the farm where they will be disposed of; with this rate and with some improvements in the procedure tomorrow, we expect to complete the depopulation by Wednesday,” Bureau of Animal Industry (BAI) head Davinio Catbagan said. “With the problems we encountered last night, we may go beyond Thursday,” he added.

But according to Dr. Eric Tayag, the 56-man team’s five captive bolts used in stunning the pigs malfunctioned, for which reason, they decided use instead .32 caliber pistols. “We need to finish this off because sometimes it rains,” he said. But due to other problems, 12 policemen were ordered to use instead .22 caliber guns for 80-120 kilograms pigs. The pig depopulation in the Pandi farm has reached 1,237 Tuesday amid strong rains as schedules have been set from 5 a.m. to 9 a.m. and from 4 p.m. to 9 p.m. daily, Cecilia Yacob, head of the Bulacan Provincial Public Affairs Office, said.

Monday’s culling was witnessed by representatives from the Food and Agricultural Organization (FAO), the World Health Organization (WHO), animal welfare observers, Bulacan Gov. Joselito Mendoza and Pandi Mayor Roberto Oca. The slaughter has been estimated to cost 16 million Philippine pesos (₱), which include hog farm owners’ compensation and the cost of culling for five to seven days.

“As of late Tuesday the depopulation teams have culled 2,663 pigs, compared to 442 on Sunday, 795 on Monday and 1,426 on Tuesday; as of early afternoon on Wednesday, the numbers have reached 3,482,” said Dr. Davinio Catbagan. According to Agriculture Secretary Arthur C. Yap, the culling team has slaughtered 2,078 pigs, bringing the total to 4,741 on Wednesday. The number of hogs had increased to 6,500 from 6,000 as some mother pigs gave birth amid the depopulation.

But according to Dr. Joy Gomez, provincial public health officer of Bulacan, six members of the depopulation team at the Pandi “Win Farm” have complained of fatigue, headache and dizziness, and have been closely observed by a team of doctors.

The state will compensate the farmers, however “it cannot be [100% of the market price.] A range of about 25%-50%, but it has to be discussed [with the farm owner]. At 25%-50%, the government may pay the farm owner ₱6.28 million-15.625 million, plus the cost of animal culling operations,” said Yap.

A polymerase chain reaction test to check the virus’ presence was conducted by the United States Centers for Disease Control (US-CDC) to verify ongoing transmission. “Of 160 pig blood samples that were positive for antibodies, 133 came from Bulacan and 27 from Pangasinan as reported by RITM. Those from Bulacan were traced to pigs at different age groups while those in Pangasinan were found in sows and just one piglet. This means that there is on going viral transmission in Bulacan but past infection with recovery was the case in Pangasinan,” Yap explained.

The agriculture officials earlier announced that the depopulation will be carried out in a “humane” manner, following current Office international des épizooties (OIE) procedures that ensure protection of animal welfare in the Bulacan farm. According to Philippine Department of Health (DOH) Secretary Francisco Duque, the quarantine of the hog farm in Palauig, Manaoag, Pangasinan has been lifted after finding no traces of viral transmission.

According to Yap, test results conducted by a joint mission of FAO, the World Animal Health Organization, WHO and their local counterparts, reveal that viral transmission continues to exist in Pandi hog farms, which is only 0.5% of the 13 million pigs raised throughout the country.

DOH officials also say a pig farm worker in Cabanatuan City in Nueva Ecija, who had no direct contact with sick hogs, has tested positive for Immunoglobulin G antibodies against the Reston ebolavirus, which is non-lethal, unlike the Zaïre, Bundibugyo, Côte d’Ivoire and Sudan strains, according to FAO.

“The additional positive human sample, showed signs of antibodies for Ebola Reston, was traced to a slaughterhouse male worker and was not sick during visits by the investigation team. He does not recall any direct contact with sick pigs but remembers having flu-like sickness in the past twelve months,” a DOH statement said, also confirming four pig farm workers and a butcher from Bulacan and Pangasinan tested positive for the antibodies last month.

“Ebola Reston poses a low risk to human health at this time,” said DOH Secretary Dr. Duque. “147 human samples have been tested for Ebola, but only six have tested positive. But stay away from kilawin, and half-cooked pork,” he added. The laboratory tests of 147 blood samples from workers in the affected areas were conducted by the Research Institute for Tropical Medicine (RITM) and the US-CDC. RITM has also reported that “1039 pig blood samples collected by the expert mission yielded negative results on antigen tests,” the DOH said.

The 24 other workers tested were all found negative for ERV infection. “To date, all close contacts of humans with positive anti-bodies who were tested remained anti-body-free signifying absence of illness in affected humans that can lead to possible human-to-human transmission,” Dr. Duque said. The RITM and the US-CDC also tested 160 pig blood samples: 133 of which came from the Bulacan farm and 27 from the Pangasinan farm; of the 133 blood samples from Bulacan, 19 tested positive for ERV; none of 27 samples from Pangasinan were affected.

Map of Bulacan showing the location of Pandi

Global experts said they will continue to conduct research studies of the Ebola strain to determine how it can be controlled. FAO of the United Nations has initially committed ₱10 million to buy additional kits. “We support the Bureau of Animal Industry to expand surveillance in other areas,” said Kazuyuki Tsurumi, FAO representative in the Philippines. “We have not committed any amount of money… [but] we are ready to support a wider surveillance and capacity-building for more tests,” Tsurumi explained.

“We can’t speculate. We don’t know the source of this virus, how it’s being transmitted. We’re studying that,” said Soe Nyunt-U, WHO Representative in the Philippines. “Our current issue is that the test kits are limited because we are depending on the [United States] CDC [Center for Disease Control and Prevention] to send those kits. If we are going to extend the surveillance both in the animal and human side, we need more test kits,” he added.

Both the DA and DOH officials have decided to expand the scope of the testing for the Reston ebolavirus by inspecting and monitoring hog farms in the whole of Central Luzon, Calabarzon, Southern Luzon and Pangasinan province after the culling of the 6,500 pigs.

“As a precautionary measure, while there are many questions left unanswered, these ERV-contaminated pigs should be extinguished so we can move forward and study the virus,” said BAI Director Davinio “Dave” Catbagan.

“In six months we might be finished testing Regions 3 and 4 depending on the assurance of the US Center for Disease Control and Prevention [in Atlanta Georgia, USA] to give test kits. In Region 3 alone, the government would need to test farms in 566 villages that would require around 36,000 kits, but the country only has 10,000 kits” Mr. Catbagan said. “The expanded tests will cover the provinces of Aurora, Bataan, Bulacan, Nueva Ecija, Pampanga, Tarlac and Zambales in Central Luzon, and Cavite, Laguna, Batangas, Rizal and Quezon in Calabarzon,” Mr. Catbagan added.

Mr. Catbagan has assured infected hog farm owners in Pandi they would be properly indemnified after the country’s first large-scale animal depopulation process. “We are finalizing the indemnification contract. But we will make sure the indemnification would not be open to abuse,” he said. Fatteners and piglets cost an average of ₱3,000-4,000 per head, boars cost ₱25,000-30,000, and sows cost ₱14,000-15,000.

Intensively farmed pigs in batch pens

Juan Lubroth, senior officer of the Infectious Disease Group of FAO’s Animal Health Service, has arrived on Wednesday to discuss in detail with government officials how the agency can support in the wider surveillance. The DA and DOH officials and other government agencies met last Thursday to discuss and finalize the procedure in the burning of 6,500 pigs in Pandi, Bulacan.

“The Bureau of Animal Industry and the provincial government of Bulacan, experts carrying out the ₱500,000 five-day depopulation would observe three guidelines, namely: the main disposal, water safety, and environment protection. The depopulation process will involve stunning the pigs unconscious, burning them in a 6-foot deep pit, then burying them at the site. We want to make sure that our means would not violate the Animal Welfare Act. We are also ensuring that there would be no seepage,” Governor Mendoza explained.

“Local authorities have decided to use electric prods and a ₱70,000 captive bolt pistol with a blunt rod to stun the 6,000 pigs in Pandi, prior to slaughter burning using rice hulls before burying them in a pit dug inside the hog farm,” said Dr. Davinio Catbagan.

“About 40 health workers — clad in special hog mask suits and are tasked to facilitate the depopulation — would then dump the pigs into 10 30×30-foot pits that can accommodate 600 pigs each. The pits are located some 30 feet from the infected pig farm,” said Mr Eric Tayag, head of the National Epidemiology Centre. “The cull could take up to seven days to complete,” Mr Tayag added. A truckload of disinfectants was prepared amid rice husks to be used in the burning.

The Pandi culling will be the first large-scale depopulation because of a disease, according to Samuel B. Animas, chief of BAI’s animal health division. “Only one to three pigs are slaughtered at a time in backyard farms during the foot and mouth disease infection [in the 1990s],” he added.

Meanwhile, at the 18th hog farmers convention, which was launched on Monday at Club Filipino, the president of the National Federation of Hog Farmers, Albert R. T. Lim, Jr., said hog farmers have feared the effects of Reston ebolavirus virus on industry, since hog exports were banned due to the outbreak. “We are also apprehensive that if we keep on talking about this thing, some people might just misconstrue or misunderstand what they are talking about and people might get scared,” Lim said.

The government has spent about ₱10 million to maintain the two quarantined hog farms in Bulacan and Pangasinan. “Anyway, we always have our hog producers in Mindanao to supply Luzon if necessary. I am more concerned about our exports although the Ebola scare also somewhat affected local demand,” Lim said.

Amid the nationwide ERV scare and probe, local authorities have seized more than 200 kilograms of rotten pork meat at a local market in Pasay City Wednesday. Barangay officials in Maricaban district have intercepted the banned ‘hot meat’ and arrested Roberto Clet and Rafael Fruelda, who were indicted under the “Consumer Act of the Philippines.” The statute punishes the illegal sale of unsafe products like double-dead meat with penalty of ₱1,000 to ₱10,000 and not less than six-months but not more than five years of imprisonment.

Transmission electron micrograph of the Ebola virus.

Local police has also arrested four vendors and seized their 3,000 kilos of “botcha” (rotten pork meat or “double dead meat”) at MC Market in Balintawak, Quezon City Wednesday evening, and allegedly delivered from Bulacan. The four suspects were charged for violation of the Consumer Act of the Philippines and Republic Act 9296 or the Meat Inspection Code.

In December, international experts initially probed outbreak among Philippine pigs, wherein about 6,000 pigs at Pandi and Talavera farms were tested for the Reston ebolavirus.

“There is no salmonella outbreak in Eastern Visayas, Region 8, said Dr. Archie Lluz, Chief of Regional Animal Disease and Diagnostic Laboratory of the Department of Agriculture in the region. But hog specimens from Leyte and Babatngon, where 270 swine deaths and cases of sick pigs were reported, were examined by lab tests. The results revealed cutaneous “Pasteurella hemolytica”, a type of bacterial infection which causes swine deaths due to loss of appetite, dehydration, fever and diarrhea.

According to the DA, sick pigs had been culled from Babatngon, Tacloban City, Alangalang, Santa Fe, Palo, Pastrana, Dagami, Burauen, Tabontabon, Lapaz, Mayorga, and Abuyog in Leyte; Sogod in Southern Leyte; Catbalogan, Calbiga, Daram, and Santa Rita in Samar; and Lope de Vega in Northern Samar. Swine infections have spread to 18 towns and one city in Eastern Visayas.

The Reston ebolavirus is suspected to be a subtype of the Ebola virus or a new filovirus of Asian origin. It was first discovered in crab-eating macaques from the Philippines at a laboratory in Reston, Virginia. The same lab then recorded an outbreak of viral hemorrhagic fever among monkeys imported from the Philippines in 1990. The Reston ebolavirus strain was discovered among monkeys in the Philippines in 1996, and in Italy in 1992.

African strains of the virus caused deaths of about 50 percent to 90 percent of those infected with prior symptoms of lethal bleeding and organ failure, the WHO said. “Since the 1970s, scientists, veterinarians, microbiologists and physicians have been looking at thousands of species to see if they can find this elusive reservoir, and we have been pretty much empty-handed,” Juan Lubroth, head of infectious diseases in the animal health unit of the Food and Agriculture Organization in Rome, explained.

“Unlike the three subtypes, Zaire, Sudan and Ivory Coast, which can cause hemorrhagic symptoms, Reston does not. There has been no evidence that Reston can cause significant illness in humans. When Reston was previously found in monkeys, few animal handlers were infected but only one had very mild symptoms,” the DOH’s official website announced.

In January 1997, the Philippines Department of Environment and Natural Resources ordered the immediate slaughter of some 600 monkeys in Ferlite, a breeding farm in Laguna, to prevent an outbreak of Reston ebolavirus.



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January 8, 2009

International experts probe deadly Ebola Reston virus outbreak in Philippine pigs

International experts probe deadly Ebola Reston virus outbreak in Philippine pigs

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Thursday, January 8, 2009

Transmission Electron Micrograph of the Ebola Virus. Hemorrhagic Fever, RNA Virus.

Global animal and health authorities’ emergency mission to the Philippines is investigating whether the strain of deadly Ebola Reston virus, recently discovered in dead pigs, poses a threat to human health. Unlike more-deadly strains of Ebola virus, Philippine health officials say this particular strain, known as the Reston ebolavirus, has never caused human illness or death, and it’s not immediately clear there is a public-health issue.

A 22-member team of experts from three United Nations agencies arrived in Manila on Tuesday for a joint risk assessment on the virus contamination of local swine, to help the government contain the outbreak. The mission will coordinate with the Philippine counterparts – the Departments of Agriculture and Health. According to chief veterinary officer, Davinio P. Catbagan, six of 28 swine samples tested positive for Ebola-Reston by the U.S. Department of Agriculture laboratory. The infected pigs came from two commercial and two backyard farms in three provinces north of Manila. Both Ebola and related Marburg hemorrhagic fever, are considered to infect humans via primates.

The Straits Times reported that as of December, about 6,000 pigs at Pandi, Bulacan and Talavera farms had tested positive for the Ebola-Reston virus. “Eating pork remained safe as long as it is handled and cooked properly (at a minimum of 70 degrees Celsius or 158 degrees Fahrenheit) and bought in outlets accredited by the government’s National Meat Inspection Service,” said a joint statement by the World Health Organisation (WHO), World Organisation for Animal Health (OIE) and Food and Agriculture Organisation (FAO). “Our teams are doing field and laboratory investigation to determine where the Ebola-Reston virus came from and how it was transmitted,” Caroline-Anne Coulombe, WHO risk communications officer, explained.

Crab-eating macaque (Macaca fascicularis) in Lopburi, Thailand.

According to FAO team leader, Juan Lubroth, it was the first time that the Ebola-Reston virus strain had infected animals other than monkeys and the first recorded worldwide in swine. The U.N. mission is scheduled to perform 10 days scientific tests, on two hog farms in Manaoag, Pangasinan and Pandi, Bulacan, but it would take months to publish evaluation reports on the virus.

As early as May, a high incidence of swine sickness and death in three provinces caused Philippine authorities in August to send samples from the dead pigs to the NY Plum Island Animal Disease Center. The results found the presence of several diseases, including Ebola Reston virus and PRRS.

In late October laboratory tests confirmed that pigs in Nueva Ecija and Bulacan farms were infected with the Ebola-Reston virus and the highly virulent strain of Porcine Reproductive and Respiratory Syndrome Virus (PRRS). In early 2007 pigs on those farms died at a faster rate than usual amid the conducted lab tests. PRRSV, or Blue-Ear Pig Disease (zhū láněr bìng 豬藍耳病), is a viral and economically important pandemic disease which causes reproductive failure in breeding stock and respiratory tract illness in young pigs. Initially referred to as ‘mystery swine disease’ or ‘mystery reproductive syndrome’, it was first reported in 1987 in North America and Central Europe. The disease costs the United States swine industry around $600 million annually.

In December, the Philippine health authorities conducted testing of about 10,000 swine in two northern Luzon quarantined farms. Reuters reported that “the Ebola-Reston virus in some pigs in two commercial farms and two backyard farms in the Philippines were discovered by accident in United States laboratory tests in September, when samples were sent to test another disease.”

Ebola virus is one of at least 18 known viruses capable of causing the viral hemorrhagic fever syndrome. It is the common term for a group of viruses belonging to genus Ebolavirus, family Filoviridae, and for the disease which they cause, Ebola hemorrhagic fever. The virus is named after the Ebola River where the first recognized outbreak of Ebola hemorrhagic fever occurred in 1976. The viruses are characterized by long filaments and have a similar shape to the Marburg virus, also in the family Filoviridae, and share similar disease symptoms. Since its discovery, Ebolavirus has been responsible for a number of deaths.

In the central Democratic Republic of Congo (DRC), the highly contagious Ebola virus was first detected in September, according to Medecins Sans Frontieres. “As of Tuesday January 7, a total of 42 patients have been reported with suspected Ebola haemorrhagic fever in the province of Western Kasai… 13 of these 42 patients suspected of having Ebola have died,” it said.

Transmission Electron Micrograph of the Ebola Virus.

The Reston ebolavirus is suspected of being either another subtype of the Ebola or a new filovirus of Asian origin. It was first discovered in crab-eating macaques originating in the Philippines, from Hazleton Laboratories (now Covance) in 1989. This discovery attracted significant media attention and led to the publication of The Hot Zone. There was then, an outbreak of viral hemorrhagic fever among monkeys imported from the Philippines to Reston, Virginia. The Ebola-Reston strain was discovered among Philippine monkeys in the U.S. again in 1990 and 1996, and in Italy in 1992.

According to the World Health Organization, African strains kill 50 percent to 90 percent of those infected through lethal bleeding and organ failure. “Since the 1970s, scientists, veterinarians, microbiologists and physicians have been looking at thousands of species to see if they can find this elusive reservoir, and we have been pretty much empty-handed,” Juan Lubroth, head of infectious diseases in the animal health unit of the Food and Agriculture Organization in Rome, explained.

Despite its status as a Level-4 organism, the Reston ebolavirus is non-pathogenic to humans and is only mildly fatal to monkeys; the perception of its lethality was skewed due to the monkey’s coinfection with Simian hemorrhagic fever virus (SHFV). During the incident in which it was discovered, six animal handlers eventually became seroconverted, one of whom had cut himself while performing a necropsy on the liver of an infected monkey. When the handler failed to become ill, it was concluded that the virus had a very low pathogenicity to humans.

In January 1997, The Philippines Department of Environment and Natural Resources had ordered the immediate slaughter of some 600 monkeys in Ferlite, a breeding farm in Laguna, to prevent an outbreak of the deadly Ebola Reston strain virus.

The US Centers for Disease Control and Prevention had donated 8,000 test kits to diagnose the ebola reston strain. “I am more concerned in the international community because we have proven in our December sales that this ebola did not affect consumer confidence,” Albert R. T. Lim, president of the National Federation of Hog Farmers, Inc., warned. The Philippines Department of Agriculture (DA) has directed the Bureau of Animal Industry (BAI) and the National Meat Inspection Commission (NMIC) to conduct swine tests in South Cotabato using the US test kits for the Ebola Reston virus, before approval of the “Meat in a Box” shipment to Singapore. The initial export of the meat for December was deferred pending outcome of the ERV tests.

Meanwhile, in eight Barangays of Santa Maria, Davao del Sur, in Mindanao, at least 50 pigs died since December due to viral and bacterial infections. Dr. Nestor Barroga, provincial veterinarian, said that he could not however detect yet the type of the infecting virus. The village of Pong-pong had the largest number of casualties. Mercy Olalo, a hog raiser, said their pigs would suddenly become weak and eventually die. “The pigs developed red skins and they salivate excessively,” she said.



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October 5, 2007

Biohazard lab supervision an issue says US investigation

Biohazard lab supervision an issue says US investigation

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Friday, October 5, 2007

An electron micrograph of the Ebola virus.

According to recent investigations by the Associated Press and Congressional investigations, the United States federal government is not properly handling serious biohazards such as Ebola in labs. Since the September 11, 2001 attacks the United States has increased by a factor of over 40 the funding for research related to potential biological weapons as well as other virulent infectious diseases, such as Anthrax, Ebola and Smallpox. Since 2003, there have been at least 100 incidents involving United States laboratories. These incidents have ranged from missing shipments of deadly viruses and bacteria to accidents in which lab workers have become infected. According to the Congressional panel even where research is going on is not precisely known.

The recent investigations were prompted in part by the suspension of research at Texas A&M University after repeated laboratory accidents and failure to report serious breaches to the Center for Disease Control including an incident in which someone was infected with brucellosis, a disease which can infect humans and a variety of domesticated animals and is generally not fatal in humans. Concern about safety and security procedures focus primarily on two risks: terrorists obtaining biological agents from laboratories or labs accidentally releasing infectious agents into the general population.

Critics have questioned the influx of new research as being unnecessary, unguided and dangerous both to workers and to the people around them and have pointed to the case of Janet Parker who was the last recorded case of someone dying from smallpox and had contracted the disease by working in a building with poor containment systems.

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September 16, 2007

Health organisations respond to Ebola outbreak in Democratic Republic of the Congo

Health organisations respond to Ebola outbreak in Democratic Republic of the Congo

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Sunday, September 16, 2007

Location of DRC within Africa.
Image: Rei-artur..

The World Health Organization (WHO), non-governmental aid organisation Médecins Sans Frontières (MSF), and the U.S. Centers for Disease Control and Prevention (CDC) have sent experts to the Democratic Republic of the Congo (DRC) to assist local health authorities with a recent outbreak of Ebola haemorrhagic fever in Kasai Occidental province of DRC. The illness had been unidentified until laboratory test results confirmed the presence of the virus.

DRC President Joseph Kabila described the situation as being contained. “The village of Kampungu has been quarantined to prevent population movement towards Kananga,” Kabila said on Thursday. Kananga is the provincial capital. “The situation is at the moment, I cannot say under control, but at least the problem has been contained very well in the area,” he continued. “There is no risk that the whole country will be affected.”

WHO is working closely with officials from the DRC Ministry of Health and MSF to improve local facilities in order to better contain the virus. A mobile field laboratory is to be established in order to provide rapid sample analysis and, subsequently, diagnosis of patients. There are concurrent outbreaks of other diseases, such as dysentery (Shigellosis), that have been complicating diagnoses and need to be identified as well.

Ebola haemorrhagic fever generates mortality rates in the range of 50 to 90 percent, typically. There is currently no vaccine or effective treatment for Ebola. WHO describes the symptoms of Ebola as being “characterized by the sudden onset of fever, intense weakness, muscle pain, headache and sore throat. This is often followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. Laboratory findings show low counts of white blood cells and platelets as well as elevated liver enzymes.”

MSF, who now have 14 experts in DRC, arranged for eighteen tons of supplies, such as medical and sanitation material, to be delivered to the province of West Kasai. MSF indicated that the transportation of supplies from the airport to the affected areas has been a challenge, due to poor road conditions. It has taken up to three days to travel the 250 km to the outbreak area from the provincial capital city, Kananga.

A patient (non-Ebola) in a public hospital in DRC, May 2006.
Image: IRIN.

MSF experts will provide advice on sanitary burial procedures, which would include the use of body bags and spraying. Both the WHO and MSF will disseminate information to the local population regarding the transmission of the virus and measures that could be taken to reduce the spread of the disease.

The MSF emergency team coordinator in Kampungu, Rosa Crestani, described the isolation ward set up at Kampungu’s health centre. “Our isolation centre is basically divided in three parts. One is completely isolated, where the sick patients are; another is where the staff dresses with the complete protection uniform and then undresses after having been in contact with the patients; and the third part is a space for disinfection in between,” said Crestani. “In the coming days, we will decide with the Ministry of Health and the WHO whether we set up isolation structures in other locations of the health zone.”

Neighbouring countries, such as Rwanda and Zambia have issued alerts to their citizens, warning of travel to and from DRC. Zambian Health Minister Brian Chituwo stated that all people coming into Zambia from DRC will be watched for symptoms of Ebola for up to eight hours. Chituwo noted, however that it would be unlikely for an infected person to travel into the country, as the time between onset and death is very rapid and that the symptoms are severe.

There has been a minimum of 395 people affected by haemorrhagic fever, including 160 deaths, in DRC in the past few months. Since arriving in Kampungu in early September, MSF have seen 25 patients admitted with suspected Ebola haemorrhagic fever, of which eight have died.

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  • “WHO investigates outbreak of unidentified illness in Democratic Republic of the Congo” — Wikinews, September 2, 2007

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