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Ebola declared a global emergency

GENEVA, Aug 8, (Agencies): The World Health Organization on Friday declared the killer Ebola epidemic ravaging parts of west Africa an international health emergency and appealed for global aid to help afflicted countries. The decision came after a rare meeting of the UN health body’s emergency committee, which urged screening of all people flying out of affected countries, where nearly 1,000 people have died The WHO stopped short of calling for global travel restrictions, urging airlines to take strict precautions but to continue flying to the west African countries hit by the outbreak.

And it called on countries around the globe to be prepared to “detect, investigate and manage” Ebola cases if they should arise. WHO director-general Dr Margaret Chan appealed for greater help for those worst hit by the “largest, most severe and most complex outbreak in the nearly four-decade history of this disease”. “I am declaring the current outbreak a public health emergency of international concern,” Chan said, warning of the “serious and unusual nature of the outbreak and the potential for further international spread”.

Investigating
States of emergency have been declared in the hardest hit countries of Guinea, Liberia, Nigeria and Sierra Leone, while two people have died in Nigeria and Benin is investigating a suspect patient. In the first European case, Spain is treating an elderly priest who contracted the disease while helping patients in Liberia. US health authorities have also said the symptoms of Ebola would “inevitably” spread beyond west Africa, and medical charity Doctors Without Borders (MSF) has warned the tropical virus is “out of control”.

Defining the epidemic a public health emergency of international concern — a label only used twice before, during the H1N1 swine flu pandemic in 2009 and last May for the reemergence of polio — “alerts the world to the need for high vigilance,” Chan said. MSF head of operations Bart Janssens hailed the move, but said there needed to be immediate action on the ground. “Lives are being lost because the response is too slow,” he said. Chan said only a small part of Africa had been affected so there was little reason to fear that all countries would see Ebola cases”.

Ebola had by Wednesday claimed at least 961 lives and infected nearly 1,800 people since breaking out in Guinea earlier this year, with 29 people dying in just two days, the WHO said. “The likelihood is that it will get worse before it gets better,” WHO health security chief Keiji Fukuda said, with the outbreak likely to last for months. In Liberia, soldiers in Grand Cape Mount province — one of the worst-affected areas — have set up road blocks to limit travel to the capital Monrovia, as bodies reportedly lay unburied in the streets.

In Sierra Leone, which has the most confirmed infections, 800 troops were sent to guard hospitals treating Ebola patients and two towns in the east were put under quarantine. In Nigeria, which so far has seen two dead and five others infected, doctors suspended a nearly five-week strike to help prevent the virus taking hold in sub-Saharan Africa’s most populous country. As African nations struggled with the scale of the epidemic, the scientists who discovered the virus in 1976 have called for an experimental drug being used on two infected Americans to also be made available for African victims. The two Americans, who worked for aid agencies in Liberia, have shown signs of improvement since being given ZMapp, made by US company Mapp Pharmaceuticals. There is no proven treatment or cure for Ebola and the use of the experimental drug has sparked an ethical debate, and WHO is planning a special meeting next week to discuss the issue.

Regulators
US regulators meanwhile loosened restrictions on another experimental drug which may allow it to be tried on infected patients in Africa. Ebola causes severe fever and, in the worst cases, unstoppable bleeding. It is transmitted through contact with bodily fluids, and people who live with or care for patients are most at risk. Fatality rates can approach 90 percent, but the latest outbreak has killed around 55-60 percent of those infected. The earlier the virus is discovered, the better the chances are of survival. Although Ebola cases could easily appear far beyond the epicentre of the crisis due to the nature of global air travel, Fukuda told AFP that large outbreaks further afield were unlikely. “If you have health systems, you have awareness, you are ready for it, this is something that you can stop,” he said. The strength of the current outbreak can largely be attributed to the dismal state of the health systems in the affected countries, which have far from enough doctors, nurses, laboratory technicians and equipment to face the onslaught. Charity Save the Children warning that people with the virus, particularly children, were slipping through the cracks. “This outbreak really underscores the importance of having strong health systems,” Fukuda said.

The US State Department is ordering all eligible family members of US personnel to leave the American Embassy in Liberia’s capital city because of the Ebola outbreak. In a statement issued Thursday night, the State Department says it’s taking the action for those not employed by the embassy in Monrovia out of an abundance of caution. A State Department spokeswoman says its medical office has determined that there is a lack of options for routine health care services at major medical facilities due to the Ebola outbreak.

The deadly virus has been reported in Liberia and three other countries in West Africa. Nearly 1,000 people have died since the outbreak appeared in March. The Obama administration is forming a special Ebola working group to consider setting policy for the potential use of experimental drugs to help the hundreds infected by the deadly disease in West Africa, US officials said on Thursday.

The group is being formed under Dr Nicole Lurie, Assistant Secretary for Preparedness and Response at the Department of Health and Human Services, an administration official said. The action follows mounting international pressure as the death toll mounts to consider using untested treatments. The World Health Organization (WHO) is due to consider next week the ethics of administering such drugs. Ebola has claimed at least 932 lives, according to the WHO.

The US group will include scientists and officials from such agencies as the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), according to Dr Anthony Fauci, director of NIH’s National Institute of Allergy and Infectious Diseases (NIAID). Calls to consider making unapproved drugs available to Ebola patients have grown since two US aid workers infected with the deadly virus received an experimental treatment that may have helped them.

The drug, from California-based Mapp Biopharmaceutical Inc, had only been tested on monkeys. It is one of several being considered for use by people infected with Ebola. Early human clinical trials for a drug from Canada’s Tekmira Pharmaceutical Corp had been put on hold by US regulators. On Thursday, the company said the hold had been partially lifted to enable its potential use by infected patients. Fauci said in an interview that he was not certain when the group would have its first meeting or who would be there, but he said, “I’m sure they’ll tap people from NIAID with competence in clinical trials.” Expertise in clinical trials, in which patients receive an experimental drug under scientifically rigorous conditions, is crucial, Fauci said. “You need to balance compassion with the need to figure out if something actually works,” he said. Countless experimental drugs have cured lab animals but failed to work in people or even caused harm. For that reason, Fauci said, “You can’t just willy-nilly give out a drug. You have a responsibility to at least rule out that it is harming people and to make some effort to find out if it works.”

Patients
If compassion dictates providing experimental compounds to Ebola patients in West Africa, he said, then the way to meet the ethical obligation to determine safety and efficacy is through a clinical trial, such as by giving a drug to 50 Ebola patients in a hospital in Liberia and comparing them to 50 patients who do not get it. That requires adequate supplies of a drug. “There is an extremely limited supply and in some cases no supply of these drugs that people are reading about,” Fauci said, referring to media reports about the experimental drugs. Policymakers need to determine whether there is a way to identify the experimental compounds most likely to help, presumably via lab animal studies, and which could undergo “accelerated production to introduce in controlled sites and at least begin doing something,” said J. Stephen Morrison, a global health expert who worked for the US State Department during the Clinton administration. Separate from the Ebola working group, the administration official said the CDC was pursuing a short-term strategy to control the spread of the outbreak by establishing and supporting medical infrastructure in affected countries. The CDC’s long-term strategy is aimed at preventing future outbreaks.

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