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FDA Warning: Phony Ebola Treatments Being Sold Online

Ebola Pills 2The US Food and Drug Administration (FDA) is warning consumers that fraudulent treatments for Ebola virus disease are being marketed online.

Although some experimental therapies and vaccines are in early phases of development, no products for treating Ebola infection have been approved by the FDA.  So far, only limited data are available about the safety and effectiveness of the products being tested, and only small supplies are available, according to the agency.  Experimental therapies were used to treat 2 US health care workers who were moved to Atlanta after they became infected by Ebola virus while caring for patients in West Africa, where there is an ongoing outbreak.

The US Center for Disease Control and Prevention says there is little threat of Ebola spreading in the United States.  But some onlineEbola Pills 1 marketers have seized on global concern about the illness to sell fraudulent products, according to the FDA.  It is illegal for companies to market unapproved products claiming to cure or prevent disease.  The FDA is asking the public to report suspect claims about Ebola-related products (http://1.usa.gov/1mS3T3P).

(JAMA)
Read more here.

The Presidential Healthcare Center’s preventative programs include emergency preparedness advice to keep you safe and healthy no matter where you travel.


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Dr. Elting Discusses Ebola Virus on News Channel 8

Dr. Elting appeared on News Channel 8 this past Wednesday, October 22nd, with Bruce Depuyt to discuss Ebola virus. Depuyt asked Dr. Elting, an infectious disease specialist, for insight into the virus; particularly focusing on ways the virus can be contracted, and how we may be at an increased risk when using air travel. Postcard Picture

From the broadcast:

Up first – Answering your questions about Ebola.  The news of late has been good.  The people who came into contact with those who cared for patient Thomas Duncan are said to be symptom-free.  And the potential cases of Ebola that we’ve seen on the news, those have turned out to be false alarms.  Nonetheless, we know there is anxiety about the Ebola virus – how it is spread, how it is treated, and whether it’s likely we’ll see more cases in the days, weeks, months ahead.

Joining us now is Dr. Jeffrey Elting.  He’s former head of infectious disease control and response for the DC Hospital Association.  He is now the Medical Director at the Presidential Healthcare Center in the National Capitol region. 

“The public health sector has stepped up its game” Dr. Elting said.  “It is important to keep everything in perspective by taking into account that someone dies every 34 seconds of a heart attack.  We have 30,000 people killed in EBOLAmotor vehicle accidents each year, and we have influenza that kills millions of people.  Comparatively, we’ve had 1 person unexpectedly come to the US with Ebola who unfortunately died from the virus, but aside from some initial missteps, the rest of the cases have been managed quite well and people are recovering.” “Ebola is a special case and more deadly than others,” he said.  “That’s why we have decontamination units, isolation rooms, stockpiles of medication, protective suits and face masks.”

Dr. Elting also spoke about how the Ebola virus is transmitted.  “The transmission
method for Ebola is generally from contaminated fluid from infected patients.  It’s not transmitted by respiratory droplets like the flu or a cold.”

He also addressed the symptoms experienced after contracting Ebola.  “The initial symptoms are going to be somewhat flu-like.  You’re going to have a fever, headache, muscle aches, irritation of the throat, and then it will progress.  Ebola is a hemorrhagic virus, therefore, it can cause bleeding into the eyes, lungs and intestinal system.  Distinguishing patients with Ebola may become more challenging as the flu season approaches.”

View the entire interview here.

The Presidential Healthcare Center’s preventative programs include emergency preparedness advice to keep you safe and healthy no matter where you go.


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Ebola: WHO Cites Cases With Longer Incubation Period of 42 Days

Ebola OctoberAs questions of how many people the second Dallas nurse infected during her journey to and from Dallas throw scary possibilities, a WHO situation assessment report gives more cause for concern by stating that the incubation period of the virus has been seen to extend to as long as 42 days in some cases.

It says that recent studies conducted in West Africa have demonstrated that 95% of confirmed cases have an incubation period in the range of 1 to 21 days; 98% have an incubation period that falls within the 1 to 42-day interval.

For WHO to declare an Ebola outbreak over, a country must pass through 42 days, with active surveillance supported by good diagnostic capacity and no new cases detected in the period.

The organization has also criticized rapid determination of infection within a few hours, noting that two separate tests 48 hours apart are required before discharging a patient or a suspected one as Ebola negative.

In assessing the situation in West Africa, WHO says fresh cases in Guinea, Liberia and Sierra Leone show that the outbreak is not showing any sign of being controlled.

On the positive side, it is all set to declare later this week that Senegal is Ebola-free, if no new cases are detected.Ebola October 2

Nigeria will also get the green signal once it passes the requisite 42 days, with active surveillance and no new cases till Monday, 20 October.

Tracing of people known to have contact with an Ebola patient reached 100% in Lagos and 98% in Port Harcourt, a crucial step in controlling the spread of the virus.

In the case of the American nurse who took a commercial flight with 132 other passengers, the risk factor is multiplied with every contact she made, beginning with the immediate co-passengers, flight attendants and airline baggage handlers to the family members she met.

The Ebola virus is believed to be able to survive outside the body for a week or more during which time anyone who comes in contact with contaminated surface can pick up the virus.

The death rate in the current Ebola outbreak has increased to 70% with the toll at 4,447. There could be up to 10,000 new cases of Ebola per week in two months, WHO has warned.

Source: International Business Times


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First Imported Case of Ebola Diagnosed in the United States

CDC confirmed on September 30, 2014, through laboratory tests, the first case of Ebola to be diagnosed in the United States in a person who had traveled to Dallas, Texas from West Africa. The patient did not have symptoms when leaving West Africa, but developed symptoms approximately five days after arriving in the United States.Ebola US

The person sought medical care at Texas Health Presbyterian Hospital of Dallas after developing symptoms consistent with Ebola. Based on the person’s travel history and symptoms, CDC recommended testing for Ebola. The medical facility isolated the patient and sent specimens for testing at CDC and at a Texas lab participating in CDC’s Laboratory Response Network. CDC and the Texas Health Department reported the laboratory test results to the medical center to inform the patient. Local public health officials have begun identifying close contacts of the person for further daily monitoring for 21 days after exposure.

The ill person did not exhibit symptoms of Ebola during the flights from West Africa and CDC does not recommend that people on the same commercial airline flights undergo monitoring, as Ebola is only contagious if the person is experiencing active symptoms. The person reported developing symptoms several days after the return flight.

CDC recognizes that even a single case of Ebola diagnosed in the United States raises concerns. Knowing the possibility exists, medical and public health professionals across the country have been preparing to respond. CDC and public health officials in Texas are taking precautions to identify people who have had close personal contact with the ill person and health care professionals have been reminded to use meticulous infection control at all times.

Quarantine stationsWe know how to stop Ebola’s further spread: thorough case finding, isolation of ill people, contacting people exposed to the ill person, and further isolation of contacts if they develop symptoms. The U.S. public health and medical systems have had prior experience with sporadic cases of diseases such as Ebola. In the past decade, the United States had 5 imported cases of Viral Hemorrhagic Fever (VHF) diseases similar to Ebola (1 Marburg, 4 Lassa). None resulted in any transmission in the United States.

Source: CDC


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Some Airports Have A New Security Routine: Taking Your Temperature

Airports in Guinea, Liberia and Sierra Leone are relying on a familiar tool to stop the spread of Ebola: the thermometer.

Airport staff are measuring the temperature of anyone trying to leave the country, looking for “unexplained febrile illness,” according to the Centers for Disease Control and Prevention, which is advising these countries on their exit screening processes.

Ebola ThermometerOther countries that are far from the infected region are screening passengers arriving from West Africa or who have a history of travel to the region. Temperature takers include Russia, Australia and India.

Travelers who exhibit an elevated fever, generally over 101.4 degrees Fahrenheit (though it varies by country), are stopped for further screening. That could mean a questionnaire or medical tests.

Critics of exit screening have pointed out the flaws in using thermometers: fever can lay dormant for two to 21 days in someone who’s been infected with Ebola, and low-grade fevers can be lowered further by simple medications like Tylenol or Advil.

While they can’t predict symptoms before they emerge, the CDC is prepared to thwart those trying to mask a fever with a pill.

“Airline and airport staff are trained to do visual checks of anyone who looks even slightly ill,” says Tai Chen, a quarantine medical officer from the CDC who returned from Liberia this past Tuesday. “And most airports are using multiple temperature checks, starting when you arrive on the airport grounds in your car until you get on the plane. Even if you take medication, your fever will likely have manifested by then.”

Here’s a look at the three methods that can be used in airport exit screening.

Ear Gun Thermometer:

Looks like: An electric toothbrush without the head.ear tests

How it works: The pointy end, covered with a plastic cap, goes in the patient’s ear while the other end is held by the airport employee six or eight inches away. After each use, the cap is discarded and replaced.

What it measures: The human ear drum’s temperature closely mimics the body’s internal temperature. The closer the thermometer can get to the ear drum without touching the fragile membrane, the more accurate the reading.

Is it accurate? The average ear gun thermometer doesn’t get close enough to the membrane to give a true reading, says Marybeth Pompeii, chief clinical scientist at Exergen, a thermometer company. Instead, it averages nearby temperatures and applies “an algorithm to produce the final temperature.” But Dr. Amesh Adalja, a public health expert for the Infectious Disease Society of America, says this margin of error won’t matter when it comes to catching Ebola patients: “Ear thermometers are accurate within a reasonable range. If you have a fever, these thermometers will register it.”

Other concerns: Because the same thermometer is used on many passengers, the device could become contaminated. All those plastic caps add to the expense. And the airport staff with the thermometer is in close proximity with potentially infectious passengers.

Also, the thermometers need to be calibrated correctly — which could explain how NPR correspondent Jason Beaubien registered a cool 91 degrees Fahrenheit in Sierra Leone last month. This temperature indicates extreme hypothermia, but was of little concern to the airport workers, who were looking for dangerously high temperatures, not low.

Full-Body Infrared Scanners

Looks like: It’s a camera, sometimes mounted on a tripod. A passenger probably wouldn’t even notice it.scanner

How it works: Its heat-sensing abilities will turn you into a heat map on a computer screen.

Bonus: The scanner can assess a group of passengers and they don’t even have to stop to be screened.

What it measures: External body temperature. Passengers who show up as green and yellow – the colors for normal body temperatures — are cleared for travel. Anyone with a red forehead is stopped for further screening.

The full-body infrared scanner depicts body temperature with colors on a computer screen. China used the device during the 2003 outbreak of the respiratory virus SARS. Some airports have turned to the scanner as part of Ebola screening.

The full-body infrared scanner depicts body temperature with colors on a computer screen. China used the device during the 2003 outbreak of the respiratory virus SARS (pictured, above). Some airports have turned to the scanner as part of Ebola screening.

Is it accurate? These machines measure skin temperature as a proxy for core body temperature, which isn’t always reliable.

“They measure the heat radiating off of someone,” says Adalja. “That’s not quite the same as internal body temperature.”

Pompeii thinks they are too easily fooled.

“You can just go to the ladies room and splash some water on your forehead. You’re going to exhibit evaporative cooling, even if you have a high fever. And you’ll just sail through,” says Pompeii. Meanwhile, she notes that rushing to catch a flight or having an alcoholic drink could raise your external temperature.

The FDA hasn’t approved full-body infrared scanners for use in the U.S., but they were popular in Asia during the SARS and Avian flu epidemics.

According to a 2011 study in the journal BMC Infectious Diseases, these machines correctly identify a passenger as febrile or non-febrile less than 70 percent of the time. This means healthy passengers could be stopped unnecessarily, and infected passengers could be getting on a plane.

Handheld Infrared Thermometer:

Looks like: A handheld ray gun.handheld

How it works: From a distance of about six inches, the airport employee points the laser at a passenger’s hand or forehead and the infrared technology can estimate the body’s internal temperature. Originally invented for industrial use to measure the temperature of extremely hot or cold items, the handheld thermometer has obvious appeal in a disease outbreak.

“You don’t have to touch anyone,” says Francisco Alvarado-Ramy, a medical officer for the Center for Disease Control. “The risk of cross-contamination and infection is less, and you spend less time worrying about disinfecting the tool.”

The process is also less invasive than the ear gun and more thorough than the full-body infrared scanners.

Is it accurate? “When you are holding something away from the individual, there is dust, air current, humidity, and these things can affect the temperature measurement,” says Pompeii. “And your inch is different than my inch, which means everyone is measuring slightly differently.”

Despite these variances, the FDA approves most handheld infrared thermometers for use in medical settings. They are also the thermometer of choice for the U.S. government, which donated 30 of these infrared scanners for use in the Nigerian airport on Aug. 24.

“The move in hospitals is toward these infrared thermometers,” says Adalja. “They are within the range of the most accurate temperatures.”

Postscript: There is one way of checking temperature that is far more reliable than the rest.

“The most accurate temperature is achieved with a rectal thermometer,” says Pompeii. “But I don’t think airlines can do that.”

Source: NPR.com


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Liberia: Doctor given experimental Ebola drug dies

Ebola C 2

A Liberian doctor who received one of the last known doses of an experimental Ebola drug has died, officials said Monday. Separately, Canada said it has yet to send out an untested vaccine that the government is donating.

Ebola has left more than 1,400 people dead across West Africa, underscoring the urgency for developing potential ways to stop and treat the disease. However, health experts warn these drugs and vaccines have not undergone the rigorous testing that usually takes place before they are used.

The experimental vaccines are at still at a Canadian laboratory, said Patrick Gaebel, spokesman for the Public Health Agency of Canada, who declined to speculate how many weeks it could be before those are given to volunteers.

‘‘We are now working with the (World Health Organization) to address complex regulatory, logistical and ethical issues so that the vaccine can be safely and ethically deployed as rapidly as possible,’’ Gaebel said.

Earlier this month, Canada said it would donate 800 to 1,000 doses of an Ebola vaccine that it developed. Likely candidates include health care workers treating Ebola patients.

The experimental drug known as ZMapp has been tried in only six people. Health experts caution that since ZMapp was never tested in humans, it is unclear whether it works. The small supply is now said to be exhausted and it is expected to be months before more can be produced.

Dr. Abraham Borbor, the deputy chief medical doctor at Liberia’s largest hospital, had received ZMapp, along with two other Liberians. He ‘‘was showing signs of improvement but yesterday he took a turn for the worse,’’ and died Sunday, Information Minister Lewis Brown told The Associated Press.

There was no update provided Monday on the other two Liberians who received the drug.

Earlier, it had been given to two Americans aid workers and a Spanish missionary priest, who died after he left Liberia. After receiving rigorous medical care in the U.S., the Americans survived the virus that has killed about half of its victims.

Ebola can cause a grisly death with bleeding from the eyes, mouth and ears. The virus can only be transmitted through direct contact with the bodily fluids of the sick or from touching victims’ bodies, leaving doctors and other health care workers most vulnerable to contracting it.

International relief efforts have included shipments of gloves, gowns, face masks and other protective equipment, although it’s not clear how many have reached health workers struggling to contain the epidemic in West Africa, where even such basics as sterile fluids can be in short supply.

But just getting enough gear isn’t the whole story: Health workers can infect themselves while taking off contaminated equipment if they don’t do it properly, a trio of infectious disease experts wrote Monday in Annals of Internal Medicine.

‘‘The physical exhaustion and emotional fatigue that come with caring for patients infected with Ebola may further increase the chance of an inadvertent exposure to bodily fluids on the outside of the’’ personal protective equipment, wrote Dr. William A. Fisher II of the University of North Carolina, Chapel Hill, along with Drs. Trish Perl and Noreen Hynes of Johns Hopkins University.

‘‘In addition, the impulse to wipe away sweat in the ever-present hot, humid environment’’ after taking off some gear, and before washing up, could be enough, they added.

Meanwhile, the family of 29-year-old William Pooley, the first British citizen confirmed to be infected with Ebola, said he is receiving excellent care at an isolation ward in London’s Royal Free Hospital after being evacuated from the capital of Sierra Leone.

‘‘We could not ask for him to be in a better place,’’ they said in a statement.

Pooley, a volunteer nurse, was flown back to Britain from Sierra Leone where he was working at an Ebola treatment center.

The WHO is also in the process of trying to evacuate a Senegalese doctor who contracted Ebola while working in Sierra Leone, said WHO Assistant Director General, Dr. Keiji Fukada on Monday.

The U.N. on Monday also spoke out against the limitations placed on flights into and out of the affected countries, saying they are slowing aid organizations’ work in sending personnel and equipment and contributing to the countries’ ‘‘economic and diplomatic isolation.’’

‘‘We shouldn’t do anything that stokes fear and stigmatization,’’ Stephane Dujarric, spokesman for the U.N. secretary-general, told reporters.

On Monday, Japan also said it is ready to provide a newly developed anti-influenza drug as a possible treatment Ebola. The drug, with the brand name Avigan, was developed by Fujifilm subsidiary Toyama Chemical Co. to treat new and re-emerging influenza viruses, and has not been proven to be effective against Ebola.

Source: Associated Press


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Americans who contracted Ebola in Liberia released from Atlanta hospital

ebola americans

American doctor Kent Brantly and North Carolina missionary Nancy Writebol, both of whom contracted Ebola while treating infected Liberian patients, have been released from an Atlanta hospital. Writebol was discharged from Emory University Hospital on Tuesday and Brantly was released on Thursday.

“Today is a miraculous day,” Brantly said at an Emory news conference. “I am thrilled to be alive, to be well and to be reunited with my family.”

Both Writebol and Brantly underwent rigorous blood and urine tests to ensure that the virus was no longer present.

“The medical staff is confident that the discharge of both patients from this hospital poses no public health threat,” said Bruce Ribner, medical director of Emory’s Infectious Disease Unit, who led the team that treated both patients.

The Texas doctor appeared near death weeks ago after contracting the disease, which has killed 1,350 people in the four African nations affected by the contagion. He was flown back to the United States from Liberia in a special transport plane that included an isolation unit and arrived at Emory on Aug. 2.

Days later, Writebol, a missionary from Charlotte, N.C., was flown to Atlanta in the same “air ambulance.” Her ride from the airport to Emory University Hospital was covered live by television news helicopters.

In a desperate effort to save them, both patients received an experimental treatment called ZMapp while they were still in Liberia. The unproven treatment appeared to help both patients.

Both Brantly and Writebol contracted Ebola while serving in the small African nation of Liberia.

Both Brantly and Writebol contracted Ebola while serving in the small African nation of Liberia.

Brantly had traveled to Liberia as part of an aid mission with Samaritan’s Purse, a Christian humanitarian organization that has treated numerous patients in the West African country hardest hit by Ebola’s spread.

“Today I join all of our Samaritan’s Purse team around the world in giving thanks to God as we celebrate Dr. Kent Brantly’s recovery from Ebola and release from the hospital,” Samaritan’s Purse president Franklin Graham said in a statement. “Over the past few weeks I have marveled at Dr. Brantly’s courageous spirit as he has fought this horrible virus with the help of the highly competent and caring staff at Emory University Hospital.”

The organization currently has 350 staff members in Liberia, many of them working to battle the growing outbreak there, the group said.

“Thank you for your prayers,” Brantly wrote in a statement last week. “Please continue to pray for and bring attention to those suffering in the ongoing Ebola crisis in West Africa. Their fight is far from over.”

Writebol was working with her husband at a hospital in Liberia through a different global ministry group, SIM. The couple reunited at Emory earlier this week after David Writebol completed a 21-day observation period.

“Nancy is free of the virus, but the lingering effects of the battle have left her in a significantly weakened condition,” Writebol’s husband, David, said in a statement released through SIM on Thursday. “Thus, we decided it would be best to leave the hospital privately to be able to give her the rest and recuperation she needs at this time.

“During the course of her fight, Nancy recalled the dark hours of fear and loneliness, but also a sense of the deep abiding peace and presence of God, giving her comfort. She was greatly encouraged knowing that there were so many people around the world lifting prayers to God for her return to health. Her departure from the hospital, free of the disease, is powerful testimony to God’s sustaining grace in time of need.”

Currently, there are no approved treatments or vaccine to treat the deadly Ebola disease, which kills 60 to 90 percent of patients who contract it.

Source: Washington Post