who ebola sitrep

WHO | Ebola Response Roadmap Situation Report 15 October 2014

A total of 8997 confirmed, probable, and suspected cases of Ebola virus disease (EVD) have been reported in seven affected countries (Guinea, Liberia, Nigeria, Senegal, Sierra Leone, Spain, and the United States of America) up to the end of 12 October. There have been 4493 deaths.

Data for epidemiological week 41 are incomplete, with missing data for 12 October from Liberia. This reflects the challenging nature of data gathering in countries with widespread and intense EVD transmission. These challenges remain particularly acute in Liberia, where there continues to be a mismatch between the relatively low numbers of new cases reported through official clinical surveillance systems on one hand, and reports from laboratory staff and first responders of large numbers of new cases on the other. Efforts are ongoing to reconcile different sources of data, and to rapidly scale-up capacity for epidemiological data gathering throughout each country with widespread and intense transmission.

It is clear, however, that the situation in Guinea, Liberia, and Sierra Leone is deteriorating, with widespread and persistent transmission of EVD. An increase in new cases in Guinea is being driven by a spike in confirmed and suspected cases in the capital, Conakry, and the nearby district of Coyah. In Liberia, problems with data gathering make it hard to draw any firm conclusions from recent data.

There is almost certainly significant under-reporting of cases from the capital Monrovia. There does appear to have been a genuine fall in the number of cases in Lofa district, but a concerted effort will be required to sustain that drop in cases and translate it into an elimination of EVD in that area. In Sierra Leone, intense transmission is still occurring in the capital Freetown and the surrounding districts.

Of the countries with localized transmission, Nigeria and Senegal are now approaching 42 days since the date of last potential contact with a probable or confirmed case. Both Spain and the United States continue to monitor potential contacts.

the ebola done partying in december

motherboard | Part of the allure of epidemiology is being able to describe and predict highly dynamic outbreaks with simple, clean mathematical models. But how close can models really get to perfectly mapping the spread of disease? 

Modeling how disease spreads early in an outbreak is a major challenge as sample sizes remain low and variables high. But a recently-developed method of making short-term outbreak projections called the IDEA model has shown promise, and is even doing an excellent job of tracking the current Ebola outbreak.

"If validated, the implications of such a finding may be profound," wrote the model's creators in an open-access 2013 paper in PLOS One, "e.g., the ability to project, with a high degree of accuracy, the final size and duration of a seasonal influenza outbreak within 2 weeks of onset."

The graph above shows how the model is faring with the current Ebola outbreak. So far, it's nearly perfect. If the IDEA model continues to predict the epidemic with the same accuracy, we can expect Ebola to start burning out in December, with a total of 14,000 cases. Currently, according to the CDC there are or have been 8,400. We have a ways to go

the ebola: flying the friendly skies

WSJ | While a number of researchers are modeling the spread of Ebola in West African countries besieged by the deadly virus, a group led by Alessandro Vespignani at Boston’s Northeastern University has used air traffic connections to explore how the disease might spread to the rest of the world.

The study, published last month in PLOS Currents: Outbreaks, simulated the number of passengers traveling daily from West Africa to other parts of the world in an effort to quantify the risk of the disease spreading Ebola internationally.

The short-term probability of the virus spreading to countries outside of Africa, the researchers concluded, is small; however, if the current outbreak isn’t contained, the chances of it spreading internationally will increase.

strict texas law protects medical-industrial egregores from patients and employees...,

observer |  One of the unexpected lessons from the Ebola cases in Dallas may well be how thoroughly Texas protects hospitals—and their insurance companies—from answering for critical lapses in care.

When Thomas Eric Duncan entered the Texas Health Presbyterian Hospital’s emergency room on Sept. 25 with a fever and complaining of stomach pain, there’s a chance that proper treatment might have saved him from the Ebola virus that would kill him 13 days later. Instead, the Liberian man was sent home with only painkillers and antibiotics. Duncan’s family and his fiancée are haunted by the question of whether Duncan might have survived had he been properly diagnosed. Executives at Texas Health Presbyterian Hospital have admitted to mistakes and apologized to Duncan’s family.

But should Duncan’s family members seek more than an apology, and ask the courts to hold the hospital accountable for its missteps, they won’t find much recourse under Texas law. Neither will the nurses who contracted Ebola while treating Duncan, apparently for a time without sufficient safety gear, nor will anyone who might have contracted the virus from them later.

Thanks to a number of Texas court decisions and laws—including a sweeping 2003 Republican-led tort reform effort—lawyers say it’s unlikely that Presbyterian faces serious legal risk from the Ebola cases or others like them. Even if the hospital were found liable in court, the damages would be limited. Without the threat of expensive litigation, critics of tort reform argue, hospitals face little consequence for turning away sick, uninsured patients, even ones with Ebola.

The Dallas Morning News has reported that Duncan’s family members are considering a lawsuit against the hospital. The first challenge they would face is probably the greatest: proving that Duncan ever had a better-than-even chance of survival once he’d contracted the virus. With Ebola’s global mortality rate estimated recently at 70 percent, doctors and hospitals are probably safe from ever answering for even the most blatant malpractice against an Ebola patient. That’s not necessarily true in states where courts have adopted what’s known as a “loss of chance” doctrine allowing lawsuits even when the chance of survival is under 50 percent. But Texas’ courts have consistently shut the door to that possibility, ruling that if a patient was likely to die, then the hospital can’t be held liable for malpractice.

If there were a way past that barrier, Duncan’s family would face the same obstacles any other patient has since Texas’ 2003 tort reform law took effect. The law requires emergency room patients to prove not just negligence on the part of hospital staff but “willful and wanton” negligence. That “emergency room standard” is one of a few changes introduced in the tort reform law that raised the standard for lawsuits against hospitals. Another section of the law, related to hospitals’ responsibility for credentialing dangerous doctors, has protected another Dallas-area hospital from litigation over a dangerous Dallas neurosurgeon who killed two patients and paralyzed four others in a series of botched surgeries.

u.s. hospitals weigh withholding care to ebola patients...,

reuters |  The Ebola crisis is forcing the American healthcare system to consider the previously unthinkable: withholding some medical interventions because they are too dangerous to doctors and nurses and unlikely to help a patient.

U.S. hospitals have over the years come under criticism for undertaking measures that prolong dying rather than improve patients' quality of life.

But the care of the first Ebola patient diagnosed in the United States, who received dialysis and intubation and infected two nurses caring for him, is spurring hospitals and medical associations to develop the first guidelines for what can reasonably be done and what should be withheld.

Officials from at least three hospital systems interviewed by Reuters said they were considering whether to withhold individual procedures or leave it up to individual doctors to determine whether an intervention would be performed.

Ethics experts say they are also fielding more calls from doctors asking what their professional obligations are to patients if healthcare workers could be at risk.

U.S. health officials meanwhile are trying to establish a network of about 20 hospitals nationwide that would be fully equipped to handle all aspects of Ebola care.

Their concern is that poorly trained or poorly equipped hospitals that perform invasive procedures will expose staff to bodily fluids of a patient when they are most infectious. The U.S. Centers for Disease Control and Prevention is working with kidney specialists on clinical guidelines for delivering dialysis to Ebola patients. The recommendations could come as early as this week.   
The possibility of withholding care represents a departure from the "do everything" philosophy in most American hospitals and a return to a view that held sway a century ago, when doctors were at greater risk of becoming infected by treating dying patients.

"This is another example of how this 21st century viral threat has pulled us back into the 19th century," said medical historian Dr. Howard Markel of the University of Michigan.

that magic orange grease though....,

farmingpathogens |   There’s something fishy about the bushmeat narrative of Ebola.

In August we explored the way the story internalizes the outbreak to local West Africans. It’s part of the ooga booga epidemiology that detracts from the circuits of capital, originating in New York, London and elsewhere, that fund the development and deforestation driving the emergence of new diseases in the global South.

But in addition, and not unconnected, there’s something missing from the model’s purported etiology. Indeed, Ebola may have almost nothing, or only something tangentially, to do with the bushmeat trade.

In this new commentary just published in Environment and Planning A, a team of ecohealth scientists of which I’m a part proposes Ebola emerged out of a phase change in West Africa’s agroecology brought about by neoliberal development.

We hypothesize more specifically that the pathogen arose as oil palm, to which Ebola-bearing bats are attracted, underwent a classic case of creeping consolidation, enclosure, commoditization, and proletarianization that at one and the same time curtailed artisanal production and expanded the human-bat interface over which Ebola traffic likely increased.

Explorations of such structural causes, the heart of the matter, have largely been shelved before they’ve begun. The emergency response, or lack thereof, has moved front and center. Both eminently understandable and opportunistically convenient. The failure to address upstream causes produces the crisis that becomes another way of avoiding such a discussion.

The tension manifests in some striking ways, with many veiled allusions to structural sources of the outbreak but few open declarations. It’s as if scientists and first responders are expected to talk about the outbreak’s origins without using anything more than generalities, careful euphemisms and pointed ellipses, avoiding offending funding sources whose capital accumulation helped drive the outbreak in the first place.

surprise, surprise..., the firestone rubber plantation stopped ebola in its tracks

CDC |  On March 30, 2014, the Ministry of Health and Social Welfare (MOHSW) of Liberia alerted health officials at Firestone Liberia, Inc. (Firestone) of the first known case of Ebola virus disease (Ebola) inside the Firestone rubber tree plantation of Liberia. The patient, who was the wife of a Firestone employee, had cared for a family member with confirmed Ebola in Lofa County, the epicenter of the Ebola outbreak in Liberia during March–April 2014. To prevent a large outbreak among Firestone's 8,500 employees, their dependents, and the surrounding population, the company responded by 1) establishing an incident management system, 2) instituting procedures for the early recognition and isolation of Ebola patients, 3) enforcing adherence to standard Ebola infection control guidelines, and 4) providing differing levels of management for contacts depending on their exposure, including options for voluntary quarantine in the home or in dedicated facilities. In addition, Firestone created multidisciplinary teams to oversee the outbreak response, address case detection, manage cases in a dedicated unit, and reintegrate convalescent patients into the community. The company also created a robust risk communication, prevention, and social mobilization campaign to boost community awareness of Ebola and how to prevent transmission. During August 1–September 23, a period of intense Ebola transmission in the surrounding areas, 71 cases of Ebola were diagnosed among the approximately 80,000 Liberians for whom Firestone provides health care (cumulative incidence = 0.09%). Fifty-seven (80%) of the cases were laboratory confirmed; 39 (68%) of these cases were fatal. Aspects of Firestone's response appear to have minimized the spread of Ebola in the local population and might be successfully implemented elsewhere to limit the spread of Ebola and prevent transmission to health care workers (HCWs). 

Firestone Liberia, Inc. is an affiliate of Firestone Natural Rubber Company, LLC, a division of Bridgestone Americas, Inc., that operates rubber tree plantations in Liberia. The original plantation was established in 1926 by the Firestone Tire & Rubber Company. The company harvests natural rubber and wood from a plantation area of approximately 120,000 acres (185 square miles) in the Firestone District of Margibi County (Figure 1). The populations of Margibi County and Firestone District are 238,000 and 69,000, respectively (Government of Liberia 2014 population estimates). Employees and their dependents reside within 121 communities inside the Firestone plantation. Nearly 16,000 students matriculate at 27 schools operated by Firestone. Although Firestone manages the plantation, the area is accessible to non-company residents from surrounding communities and includes roadways permitting passage of people and commerce.

Firestone operates a referral hospital, two clinics, and seven health posts, with 181 health care providers within the plantation area. The main hospital has an emergency department, labor and delivery department, intensive care unit, and 170-bed routine inpatient capacity with an additional 130-bed surge capacity for both adult and pediatric patients. Health posts are located within housing communities and staffed by non-physician primary care providers who reside in those communities. Firestone also operates a mobile medical unit that follows a daily route through the plantation area and surrounding communities. Firestone's reported health care catchment population of roughly 80,000 includes employees, retirees, dependents, and the residents of the densely populated surrounding communities in Margibi and Montserrado counties. Firestone provides perinatal care (representing 70% of all deliveries at Firestone's main hospital), routine vaccinations, primary care through the mobile medical unit, and emergency care for members of the communities surrounding Firestone's plantation area. The total number of patient visits to Firestone facilities averages nearly 5,500 per month.

trust issues: u.s. biowarfare laboratories in west africa are the origin of the ebola epidemic in west africa

ICH |  Could Ebola Have Escaped From US Bio-warfare Labs? American law professor Francis A. Boyle, answers questions for tvxs.gr and reveals that USA have been using West Africa as an offshore to circumvent the Convention on Biological Weapons and do bio-warfare work. Is Ebola just a result of health crisis in Africa - because of the large gaps in personnel, equipment and medicines - as some experts suggest?

That isn’t true at all. This is just propaganda being put out by everyone. It seems to me, that what we are dealing with here is a biological warfare work that was conducted at the bio-warfare laboratories set up by the USA on the west coast of Africa. And if you look at a map produced by the Center of  Disease Control you can see where these laboratories are located. And they are across the heart of  Ebola epidemic, at the west coast of Africa. So, I think these laboratories, one or more of them, are the origins of the Ebola epidemic.

US government agencies are supposed to do defensive biological warfare research in these labs. Is there any information about what are they working on?

Well, that’s what they tell you. But if you study what the CDC and the Pentagon do… They say it is defensive, but this is just for public relation purposes than anything. It’s a trick. What it means is what they decide at these bio-warfare labs. They say, “well we have to develop a vaccine”, so that’s their defensive argument. Then what they do is to develop the bio-warfare agent itself. Usually by means of  DNA genetic engineering. And then they say, “well to get the vaccine we have to develop the bio-warfare agent” - usually by DNA genetic engineering - and then they try to work on the vaccine. So it’s two uses type of work. I haven’t read all these bio-warfare contracts but that’s typical of the way the Pentagon CDC has been doing this since at least the 1980’s. I have absolute proof from a Pentagon document that the Center of Disease Control was doing bio-warfare work for the Pentagon in Sierra Leone, the heart of the outbreak, as early as 1988. And indeed it was probably before then because they would have had to construct the lab and that would have taken some time. So we know that Fort Detrick and the Center for Disease Control are over there, Tulane University, which is a well-known bio-warfare center here in USA - I would say notorious for it - is there. They all have been over there.

In addition, USA government made sure that Liberia, a former colony of  the USA, never became a party to the Biological Weapons Convention, so they were able to do bio – warfare work over there - going back to 1980’s - the USA government, in order to circumvent the Biological Weapons Convention. Likewise, Guinea the third state affected here - and there is an increase now – didn’t even sign the Biological Weapons Convention. So, it seems to me, that the different agencies of the US government have been always there try to circumvent the Biological Weapons Convention and engage bio-warfare work. Indeed, we had one of these two lab bio-warriors admit in the NY Times that they were not over there for the purpose of either screening or treating people. That’s not what these labs are about. These labs are there in my opinion to do bio-warfare work for different agencies of the US government. Indeed, many of them were set up by USAID. And everyone knows that USAID is penetrated all up and down by the CIA and CIA has been involved in bio-warfare work as well.

Are we being told the truth about Ebola? Is that big outbreak began all of a sudden? How does it spread so quickly?

The whole outbreak that we see in the west coast of Africa, this is Zaire/Ebola. The most dangerous of five subtypes of Ebola. Zaire/Ebola originated 3500 km from the west coast of Africa. There is absolutely no way that it could have been transmitted 3500 km. And if you read the recently published Harvard study on the DNA analysis of the west Africas’ Zaire/Ebola there is no explanation about how the virus moved there. And indeed, it’s been reported in the NY Times that the Zaire/Ebola was found there in 1976, and then WHO ordered to be set to Porton Down in Britain, which is the British equivalent to Fort Detrick, where they manufacture all the biological weapons for Britain. And then Britain sent it to the US Center for Disease Control. And we know for a fact that the Center for Disease Control has been involved in biological warfare work. And then it appears, at least from whatever I’ve been able to put together in a public record, that the CDC and several others US bio-warriors exported Zaire/Ebola to west Africa, to their labs there, where they were doing bio-warfare work on it. So, I believe this is the origins of the Zaire/Ebola pandemic we are seeing now in west Africa.

Why would they do that?

Why would they do that? As I suggested to try to circumvent the Biological Weapons Convention to which the US government is a party. So, always bio-warriors do use offensive and defensive bio-warfare work, violating the Biological Weapons Convention. So effectively they try to offshore it into west Africa where Liberia is not a party and Guinea is not a party. Sierra Leone is a party. But in Sierra Leone and Liberia there were disturbances which kept the world from really paying attention of what was going on in these labs.

USA sent troops to «fight» Ebola. What do you think about that move?

The US military just invaded Liberia. They send in the 101st Airborne Division to Liberia. That’s an elite division of combat and they have no training to provide medical treatment to anyone. They are there to establish a military base in Liberia. And the British are doing the same in Sierra Leone. The French are already in Mali and Senegal. So, they’re not sending military people there to treat these people. No, I’m sorry.

trust issues: um, er, ah..., why the pentagon deploying domestically, redundantly, to address these "issues"?

zerohedge |  President Obama may have been busy golfing this weekend, and his brand new Ebola Czar may have had more pressing matters to attend than the White House's Saturday evening meeting on the US "response to domestic Ebola cases" (because clearly the Ebola Czar is superfluous at such Ebola-related events), but that doesn't mean that the administration will once again be caught with its pants down the next time an Ebola index patient is unveiled on US soil. Nope. 

In taking a page right out of America's response to the Ebola pandemic in... West Africa, where the US has dispatched several thousands troops to do, something, unclear what, earlier today, it was revealed that the U.S. military is forming a 30-person "quick-strike team", which according to CNN is "equipped to provide direct treatment to Ebola patients inside the United States, a Defense Department official told CNN's Barbara Starr on Sunday."

From CNN:

The team will be under orders to deploy within 72 hours at any time over the next month, the official said.  The Department of Health and Human Services requested the military team, and the Pentagon has given verbal approval, the official said.

The team will include five doctors, 20 nurses and five trainers, Pentagon press secretary Rear Adm. John Kirby said in a statement.

The Pentagon has been working to determine what assistance it could offer the civilian health care sector following a White House meeting last week during which President Barack Obama said he wanted a more aggressive response, according to two Defense officials.

Defense Secretary Chuck Hagel ordered chief of the Northern Command, Gen. Chuck Jacoby, "to prepare and train a 30-person expeditionary medical support team that could, if required, provide short-notice assistance to civilian medical professionals in the United States," Kirby said.

Jacoby is already working with the military on the joint team, Kirby said, and once formed, it will head to Fort Sam Houston in Texas for up to seven days of training in infection control and personal protective equipment. The training, provided by the U.S. Army Medical Research Institute of Infectious Diseases, will begin "within the next week or so," Kirby said.

The team will remain in "prepare-to-deploy" status for 30 days, he said. It will be able to respond anywhere in the U.S. if "deemed prudent by our public health professionals," he said.

To summarize: the Pentagon, as in the US army, will provide direct treatment to Ebola patients.

So just how exactly is the US army's crack 30-person "SWAT" team which has a whopping 5 doctors, more competent to deal to deal with what is, at last check, a medical situation than, say, America's medical professionals? Or is, in the parlance of our times, where an "Iraq military advisor" really means crack commando fighting Syrian troops on the ground on behalf of Qatar and Saudi Arabia, "direct treatment" merely a euphemism for something far less enjoyable? 

For the partial answer to some of these questions, please read "Public Health Emergency Declared In Connecticut Over Ebola: Civil Rights Suspended Indefinitely, and also "Obama Mobilizes National Guard, Army Reserves To Fight Ebola" - they serve as a good starting point for where all of this is ultimately headed.

trust issues: u.s. army withheld promise from germany that ebola and marburg wouldn't be weaponized...,

rt |  The United States has withheld assurances from Germany that the Ebola virus - among other related diseases - would not be weaponized in the event of Germany exporting it to the US Army Medical Research Institute for Infectious Diseases.

German MFA Deputy Head of Division for Export Control Markus Klinger provided a paper to the US consulate's Economics Office (Econoff), "seeking additional assurances related to a proposed export of extremely dangerous pathogens."

Germany subsequently made two follow-up requests and clarifications to the Army, according to the unclassified Wikileaks cable.

"This matter concerns the complete genome of viruses such as the Zaire Ebola virus, the Lake Victoria Marburg virus, the Machupo virus and the Lassa virus, which are absolutely among the most dangerous pathogens in the world," the request notes.

The Zaire Ebola virus was the same strain of Ebola virus which has been rampaging through West Africa in recent months.

"The delivery would place the recipient in the position of being able to create replicating recombinant infectious species of these viruses," the cable notes.

However, it also points out that Germany has in place an "exceptionally restrictive policy," adding that approval would not be granted to the export until US assurance was provided.

"A decision about the export has not yet been made. Given the foregoing, we would appreciate confirmation that the end use certificate really is from the Department of the Army and of the accuracy of the data contained therein," the document stated.

There is no follow-up document available to confirm whether the US Army eventually provided Germany with the necessary guarantees.

Bioweapons were outlawed in the Biological Weapons Convention of 1972 and was signed and ratified by 179 signatories, including Germany, the US and Russia.

It dictates that signatories, "under all circumstances the use of bacteriological (biological) and toxin weapons is effectively prohibited by the Convention" and "the determination of States parties to condemn any use of biological agents or toxins other than for peaceful purposes, by anyone at any time."

the systemic roots of a global pandemic

collapseofindustrialcivilization |  Over the ages, a number of empires have exploited and looted the resource-rich lands of Africa. At its height, the Roman Empire stretched from Scotland in the northern hemisphere to the deserts of Africa in the south. The Romans stripped their North African territory of its trees, making it their breadbasket of grain production. Originating in central Africa, malaria was likely spread to the center of the Roman Empire on their cargo ships. Passengers on their boats could have carried malaria in their bloodstream before becoming symptomatic, and water barrels on board could have harbored mosquito larvae. In fact, the DNA work of Dr. Robert Sallares has proven that the most lethal form of malaria helped topple ancient Rome. Fast forwarding to today, the blow-back from industrial agriculture and transnational corporate land grabs in Africa has now reached the shores of the hegemonic American Empire in the form of a deadly tropical disease called Ebola.

The Roman Empire seized fertile African land by brute force, but in modern times capitalist industrial civilization takes over Third World countries with the stroke of a pen. Structural adjustment loans by such tools of western power as the IMF and World Bank are signed requiring privatization of the economy and government cuts in social spending. Vast tracks of forests are cleared for mining or monoculture crop production such as palm oil. Subsistence farmers are dispossessed of their ancestral lands and forced to migrate to cities in search of work. Deprived of adequate healthcare and the opportunity to earn a livable wage, these urban poor live in squalor and are driven to hunt in the surrounding forests for a cheap source of protein known as bushmeat. Fruit bats, a keystone environmental species, have been identified as an Ebola virus host that has spread the disease through bushmeat consumption, habitat destruction, and human encroachment. Thus the neoliberal agenda of ‘developed’ nations has acted to create the atmosphere from which this pandemic arose.

Due to the long history of exploitation by outside powers, native Africans are justifiably wary and prone to conspiracy theories involving intervention by Western institutions as well as their own governments which have been, to a great degree, corrupted by the resource curse. These unpleasant facts are, of course, never mentioned by the MSM because it might spark a flicker of moral compunction in the ‘developed’ world which has ended up with so much of Africa’s wealth in the form of rare earth minerals used inside electronic devices, gold and diamonds in jewelry, or petrol pumped into vehicles. The horrific realities behind conflict minerals are always kept out of sight and out of mind by the next consumer diversion.

the political economy of ebola

farmingpathogens |  In spite of writing a long book on diseases spilling over from animals to humans, well-regarded author David Quammen can’t seem to get his mind wrapped around the possibility Ebola has likely evolved a new ecotype, for the first time spreading into a major urban area.

The first outbreak of Flaviviridae Filoviridae Ebola in West Africa apparently began in forest villages across four districts in southeastern Guinea as early as December 2013 before spreading to Conakry and the outskirts of Monrovia, the capitals of Guinea and Liberia respectively.

The number of deaths across West Africa presently stands at 149 killed out of 242 infected. According to the WHO, with a three-week incubation period cases are likely to continue to accumulate for months.

To date, researchers have identified five ebolavirus types. A new clade of Zaire ebolavirus characterizes the present outbreak.

Many of the human outbreaks since 1976, until now limited to Central and East Africa, began with the ingestion of an infected monkey or fruit bat of the Pteropodidae family or some such combinatorial of ecological pathways. In short, one of Quammen’s spillovers.

A human infection typically leads to fever, diarrhea, vomiting, hemorrhage, and death.

Ebola is difficult to contract from another human, however. Much like HIV it spreads by bodily fluid, including, alongside ingestion and accidental cuts, sexually. Its virulence, producing case fatality rates as high as 91%, usually burn out outbreaks. Patients die faster than susceptibles are infected.

And yet this new strain has found the geographic momentum and multiple transmission chains associated with a virus experimenting with evolutionary possibilities, including a more widespread epidemiology.

*

History offers multiple examples of pathogens successfully making such sociospatial transitions.

For most of its evolutionary history the cholera bacterium ate plankton in the Ganges delta. Only once humanity urbanized and by the 19th century became spatially integrated by new modes of transport was cholera able to make its way to the world’s cities. There, in a kind of microbial Bildungsroman, the bacterium transformed from a marginal bug into a roaring success when municipalities began drawing drinking water from the same place they dumped their shit.

The simian immunodeficiency viruses that would evolve into HIV likely emerged from Cameroonian forests when colonial logging broadened the wildlife-human interface.

For eons influenza cycled across waterfowl populations that summered on the Arctic Circle. Influenza expanded into humans once we became farmers and our population densities and connections grew enough to support such an acute infection. After WWII influenza entered  its Industrial Revolution. Billions of livestock monoculture are now pressed up against each other, permitting a new phase in influenza evolution and spread.

In the guise of a liberal paternalism, Quammen errs on the side of an essentialist Ebola instead, denying the virus its capacity to evolve new identities under new circumstances,

Other work documents West Africa is undergoing massive changes in food production and forestry driven by the neoliberal program. “In West Africa,” writes William Moseley and colleagues,

the resulting neoliberal economic policies sought to promote growth and prosperity through structural adjustment programs (SAPs) that generally involved contraction of government services, renewed export orientation on crops or goods deemed to have a comparative advantage, privatization of parastatal organizations, removal or reduction of many subsidies and tariffs, and currency devaluations.

The area is part of the larger Guinea Savannah Zone the World Bank describes as “one of the largest underused agricultural land reserves in the world” that the Bank sees best developed by market commercialization, if not solely on the agribusiness model.

Indeed, the initial outbreaks appear within the cycle migration range–about 120 miles–of recent land deals pursued by the newly democratized government of Guinea.

architects of death and chickens coming home to roost...,

newpol |  To understand the gravity of the situation in Liberia, in Sierra Leone and in the south of Guinea, it’s necessary to look carefully at the particularities of this sub-region. I note here four characteristics that constitute an explosive cocktail.

1. At the end of the 1980s, Liberia, Sierra Leone, and the south of Guinea were at the center of armed conflicts for the control of natural resources.
2. After the reestablishment of relative peace in the early 2000s, there was a surge of foreign investments, accompanied by land-grabbing and the expropriation of the small farmers who had been weakened by war.
3. The increasingly rapid destruction of the forests endangered many animal species and pushed their microbial parasites to search for new hosts at the margins of their traditional ecosystem.
4. The collapse of the state institutions that had been established when these countries became independent led to the transfer of their tasks to outside and local non-governmental organizations, private companies, and even to Western powers.

It is the combination and interaction of these four characteristics that has made these countries an ideal terrain for the diffusion of the Ebola virus.

Wars for the Control of Natural Resources

The civil wars that bloodied Liberia and Sierra Leone starting at the end of the 1980s had largely been carried on by groups—whether those in power or those in rebellion—struggling over the control of natural resources, in particular diamonds (which because of these circumstances came to be called blood diamonds) as well as lumber, with the complicity of large multinational corporations. Those wars were the cause of the death of some 200,000 people, not to mention the thousands of wounded, mutilated, raped women, orphaned children, and those displaced and turned into refugees. The vast forests where Liberia, Sierra Leone, and Guinea touch have been particularly ravaged by the battles in which the Guinean army confronted the Liberian forces, which were allied to the rebels of Sierra Leone.[1] In addition, this remote area where the capitals of the three countries are found has continued to be the scene of repeated violence, almost to this day, either in the district of Kolahun (Lofa County) in Liberia, or in that of Guéckédou, Guinea. It is in the latter that the Ebola epidemic broke out in December 2013.

Liberia and Sierra Leone recovered from their civil wars and attained a relative stability, supported by the diplomats and the special forces of Great Britain and the United States, whose action has been continued by United Nations peace-keeping missions there, so that by 2005 in Liberia and 2005-07 in Sierra Leone there had been put in place a semblance of representative democracy and business-as-usual resumed. The international index of “economic freedom” (of the Heritage Foundation and the Wall Street Journal) showed a continual improvement in commercial freedom, in the monetary and tax systems and in investments in the two countries, and only the rights of workers and public services have worsened.

No doubt about it: the international competition for the control and exploitation of natural resources has returned with a vengeance, dispensing with the mediation of costly armed bands, as part of the new scramble for Africa. During the last five years, from 2009 to 2013, according to the World Bank, the GDP of Liberia has grown on average by 11.1 percent per year, and Sierra Leone by 10 percent. Overall, Guinea remains behind, with a growth rate of 2.5 percent, though it is true that is has not suffered a destructive conflict in the whole country.

to keep ebola at bay - big don say - "schmoke weed everyday"

mtlblog |  Not a day has gone by in the last few weeks without a mention of Ebola. Having made its way into North America, Ebola has become reached the top of the “to fear” list, making many worry that it will only be a matter of time before the disease dominates the continent. Effective vaccines and treatments for Ebola have yet to be discovered, though one may be hiding in plain sight: cannabis.

Cannabinoids in marijuana have gained more and more of a reputation as a way to control and aid one’s immune systems, specifically with diseases that target a body’s natural defense measures against viruses, like HIV. Dr. David B. Allen, medical director of Cannabis Sativa, Inc, and Brad Morehouse, founder of NewCure.org, both believe cannabis can combat Ebola in the same way.

First, a rundown on what Ebola is and does, so everyone understands the argument. Ebola is a virus that targets the RNA (which creates proteins) in cells, takes over, then begins to replicate itself. The virus is able to hide itself from virus killing cells by creating indivisibility cloak-like surface proteins, which makes fighting Ebola especially difficult for the body.

Another consequence of Ebola being an RNA virus is that it makes each strain unique to the individual infected, thus making the creation of a widely applicable vaccine incredibly difficult.

What makes Ebola deadly is the way in which one’s immune system reacts as time goes on. Aside from creating hemorrhaging and leaking between cells, Ebola primarily kills when a person’s body releases a massive amount of enzymes (a cytokine storm) and an overabundant, and fatal amount, of immune cells being activated.

That’s where marijuana comes in as a potential saving grace to those afflicted with Ebola. As Joe Martin points out, cannabis is contains natural antiretrovirals and is also an anti-inflammatory able to reduce the harm to the body caused by a cytokine storm.

Dr. Allen also notes that cannabis has already become a legitimate regulator of immune system processes for those infected with HIV, with the same processes being applicable to Ebola. Being a natural virus killer, Allen also notes how cannabis can prevent the other harmful consequences of Ebola, namely hemorrhaging and cell leaking. Fist tap Big Don.

belize gots to say the nayno...,

belizean |  Update: Channel 7 news anchor Indira Craig has posted on her Facebook page that Belize Prime Minister Dean Barrow in a callous move in view of very close Belize-U.S. relations, has denied entry into Belize for the stricken U.S. nationals to be air lifted to the U.S.A. for treatment:

“Talks have concluded with the PM and The US State Department officials. Belize WILL NOT BE GRANTING ACCESS to the suspected passengers to have entry onto our shores. An official release will be sent out shortly by government followed by a press conference to be held tomorrow.Passports have been returned so this scare has ended.”

In a late night official press release issued by the Belize Press Office, the Belize government offered its version of the Belize Ebola Incident.It stresses that while the patient did not disembark in Belize, it does not address the question that thousands of cruise ship passengers that may have had contact with the patient(s) did in fact disembark and tour Belize City today:

Belmopan. October 16, 2014. The Government of Belize was contacted today by officers of the U.S. Government and made aware of a cruise ship passenger considered of very low risk for Ebola. The passenger had voluntarily entered quarantine on board the ship and remains free of any fever or other symptoms of illness. The Ebola virus may only be spread by patients who are experiencing fever and symptoms of illness and so the US Government had emphasized the very low risk category in this case. Nonetheless, out of an abundance of caution, the Government of Belize decided not to facilitate a U.S. request for assistance in evacuating the passenger through the Phillip Goldson International Airport.

The GOB reassures the public that the passenger never set foot in Belize and while we remain in close contact with US officials we have maintained the position that when even the smallest doubt remains, we will ensure the health and safety of the Belizean people. The Prime Minister has called a press conference tomorrow morning to further address any concerns that may arise from this event.

Update From Carnival Cruise Lines: John Head, Carnival Senior Cruise Director wrote on his FaceBook Page:

“Late afternoon on Wednesday, Oct. 15., we were made aware by the U.S. CDC of a guest sailing this week on board Carnival Magic who is a lab supervisor at Texas Health Presbyterian Hospital. At no point in time has the individual exhibited any symptoms or signs of infection and it has been 19 days since she was in the lab with the testing samples. She is deemed by CDC to be very low risk. At this time, the guest remains in isolation on board the ship and is not deemed to be a risk to any guests or crew. It is important to reiterate that the individual has no symptoms and has been isolated in an extreme abundance of caution. We are in close contact with the CDC and at this time it has been determined that the appropriate course of action is to simply keep the guest in isolation on board.”

peter piot: outbreak out of hand, won't end without clipboards...,

guardian |  The Ebola epidemic, which is out of control in three countries and directly threatening 15 others, may not end until the world has a vaccine against the disease, according to one of the scientists who discovered the virus.

Professor Peter Piot, director of the London School of Hygiene and Tropical Medicine, said it would not have been difficult to contain the outbreak if those on the ground and the UN had acted promptly earlier this year. “Something that is easy to control got completely out of hand,” said Piot, who was part of a team that identified the causes of the first outbreak of Ebola in Zaire, now the Democratic Republic of Congo, in 1976 and helped bring it to an end.

The scale of the epidemic in Sierra Leone, Liberia and Guinea means that isolation, care and tracing and monitoring contacts, which have worked before, will not halt the spread. “It may be that we have to wait for a vaccine to stop the epidemic,” he said.

On Thursday night, a Downing Street spokesman said a meeting of the government’s emergency response committee, Cobra, was told the chief medical officer still believed the risk to the UK remained low.

“There was a discussion over the need for the international community to do much more to support the fight against the disease in the region,” the spokesman said. “This included greater coordination of the international effort, an increase in the amount of spending and more support for international workers who were, or who were considering, working in the region. The prime minister set out that he wanted to make progress on these issues at the European council next week.”

Dr Tom Frieden, director of the Centers for Disease Control (CDC), in evidence to Congress, said he was confident the outbreak would be checked in the US, but stressed the need to halt the raging west African epidemic.

“There are no shortcuts in the control of Ebola and it is not easy to control it. To protect the United States we need to stop it at its source,” he said.

ebolavirus in west africa, and the use of experimental therapies or vaccines

biomedcentral |  Abstract - Response to the current ebolavirus outbreak based on traditional control measures has so far been insufficient to prevent the virus from spreading rapidly. This has led to urgent discussions on the use of experimental therapies and vaccines untested in humans and existing in limited quantities, raising political, strategic, technical and ethical questions.

Ebolavirus outbreaks and disease - The ongoing outbreak in West Africa of ebolavirus hemorrhagic fever (EHF) [1], lately also referred to as Ebola virus disease (EVD), has led to a surge in public interest and concern regarding this virus, which was first discovered in 1976 during simultaneous outbreaks in Zaire (now the Democratic Republic of the Congo) and Sudan [2]. Humans initially contract the virus either through contact with the infected reservoir, which is thought to be fruit bats, or by hunting and butchering of infected wildlife, particularly great apes. Since their discovery, ebolaviruses have caused frequent outbreaks almost exclusively in Central Africa. However, the recent emergence of Zaire ebolavirus in West Africa, resulting in what is the largest outbreak to date (Figure 1), with 4,390 cases and 2,226 deaths as of 7 September 2014, shows that ebolaviruses are more widely distributed than previously thought. While EHF is commonly associated with high case fatality rates (up to 90% for Zaire ebolavirus, approximately 50% for Sudan ebolavirus, and approximately 35% for Bundibugyo ebolavirus), the pathogenicity of Taï Forest ebolavirus, which was discovered in the mid-1990s in Ivory Coast, is unknown because only a single case has been reported, and Reston ebolavirus, which is found in the Philippines, is considered apathogenic for humans. Outbreaks are usually driven by human-to-human transmission as a result of direct contact with live or deceased patients and their body fluids, mainly during patient management and care, and participation in traditional local burial practices. Basic hygiene measures and barrier nursing techniques are usually sufficient to disrupt ebolavirus transmission and spread in the community. Nevertheless, because of its high case fatality rate and the absence of licensed vaccines or treatments, this virus is considered of the highest biosafety concern, restricting work on infectious virus to a few maximum containment laboratories worldwide. Despite the restricted and highly regulated handling of the pathogen, there have been considerable scientific achievements over the past years; however, many challenges remain in the public health sector in relation to identifying and managing cases and interrupting virus spread.

but I bet they got some clipboards though....,

WaPo |  Attention in the United States is squarely focused on containing the spread of the Ebola virus from the Dallas hospital ward where a patient with the disease died last week.

But across the Atlantic, the devastating effects of the outbreak continue. Liberia, one of the three West African countries at the heart of the Ebola epidemic, has been tragically ill-prepared to deal with the spread of the deadly virus. An inventory released by the country's health ministry this week shows how stark the situation is, beginning with Liberia's acute shortage of body bags.

i want me one of these anti-ebola clipboards!!!

abcnews |  The man seen not wearing a hazmat suit while standing just feet away from the second nurse with Ebola as she was transported to Emory University hospital did not need to wear the protective gear, the medical airline said. 

The nurse, identified Wednesday as Amber Vinson, was flown from Dallas to Atlanta on medical airline Phoenix Air. 

She was seen being transported to and from the ambulance by three people in full body hazmat suits, but the fourth person by her stretcher was wearing plainclothes and holding a clipboard. 

The airline confirmed to ABC News that the man was their medical protocol supervisor who was purposefully not wearing protective gear. 

"Our medical professionals in the biohazard suits have limited vision and mobility and it is the protocol supervisor’s job to watch each person carefully and give them verbal directions to insure no close contact protocols are violated," a spokesperson from Phoenix Air told ABC News said. 

"There is absolutely no problem with this and in fact insures an even higher level of safety for all involved," the spokesperson said.

how depressed does the ebola make you?

LiverTox Introduction

Imipramine is a tricyclic antidepressant that continues to be widely used in the therapy of depression.  Imipramine can cause mild and transient serum enzyme elevations and is rare cause of clinically apparent acute cholestatic liver injury.

Background

Imipramine (im ip' ra meen) is a dibenzazepine derived tricyclic antidepressant which acts by inhibition of serotonin and norepinephrine reuptake within synaptic clefts in the central nervous system, thus increasing brain levels of these neurotransmitters.  Imipramine is indicated for therapy of depression and was approved for this indication in the United States in 1959; it is still widely used, with more than 1 million prescriptions being filled yearly.  Imipramine is also used for childhood enuresis.  Imipramine is available in generic forms and under the brand names of Tofranil in 10, 25, and 50 mg tablets and as capsules of 75, 100, 125 and 150 mg for nighttime dosing.  The typical recommended dose for depression in adults is 75 to 100 mg daily in divided doses, increasing gradually to a maximum of 200 mg daily.  Imipramine can also be given as a single nighttime dose.  The recommended dose in children (ages 6 years or above) is 25 to 75 mg daily 1 hour before bedtime.  Common side effects include dizziness, headache, drowsiness, restlessness, confusion, gastrointestinal upset, increased appetite, weight gain, blurred vision, dry mouth and urinary retention.