Ebola Outbreak 2014

Chronology of Events

 

March 2014

 

-22: Guinea identifies the Ebola virus as the source of a highly contagious epidemic raging through its southern forests, as the death toll rises to 59.

 

Experts had been unable to identify the disease, whose symptoms were first observed six weeks ago, but scientists studying samples in the French city of Lyon confirmed it was Ebola.

 

-27: Ebola spreads to Guinea's capital Conakry.

 

-31: Liberia confirms two cases of the virus.

 

April

 

-5: West African countries mobilise against an epidemic of haemorrhagic fevers, including Ebola. The measures include the deployment of medical teams at Conakry airport.

 

-8: The UN's health agency, the World Health Organisation, says the Ebola outbreak is among the "most challenging" for health workers since the deadly disease emerged elsewhere in Africa four decades ago.

 

-10: International aid organisations launch a series of emergency measures across west Africa in a bid to contain the outbreak.

 

May

 

-26: Sierra Leone confirms its first death from Ebola and said it is restricting travel in some areas to stop the fever from claiming more lives.

 

June

 

-18: Fresh data from the WHO confirms the outbreak to be the deadliest ever, with 337 deaths since January, a 60 percent increase in two weeks.

 

-21: The WHO says the recent rapid spread of Ebola in the three countries has come in part because efforts to contain the deadly virus have been relaxed.

 

-23: The outbreak is now "out of control" with more than 60 outbreak hotspots in Guinea, Liberia and Sierra Leone, the medical charity Doctors Without Borders says.

 

July

 

-3: The WHO says at the close of a regional summit of health ministers on the crisis it expects the Ebola outbreak to continue for at least "several months".

 

-25: The virus spreads to Africa's most populous country Nigeria, as a Liberian national dies in quarantine in Lagos. A day later the country places its ports and airports on alert.

 

-27: A woman suffering from the first confirmed case of Ebola in Sierra Leone's capital, Freetown, dies.

 

-29: After Nigeria's main airline Arik, pan-African airline ASKY suspends all flights to and from the capitals of Liberia and Sierra Leone.

 

-30: Doctors Without Borders warns there is a risk of Ebola spreading to other countries.

 

Liberia announces it is shutting all schools and placing "non-essential" government workers on 30 days' leave.

 

-31: Countries across the world announce stringent new security measures to contain the epidemic. 

 

Sierra Leone declares a State of Emergency.

 

The WHO raises the death toll to 729. 

 

The United States, Germany and France issue warnings against travel to Guinea, Liberia and Sierra Leone, while Paris also includes Nigeria.

 

August

 

-1: The head of the WHO and Presidents of the countries involved meet in Guinea to launch a $100 million emergency response, involving the deployment of hundreds of medical personnel to help overstretched workers and facilities. 

 

WHO chief Margaret Chan tells the leaders the outbreak is "moving faster than our efforts to control it".

 

Dubai's Emirates airline says it is suspending flights to Guinea.

 

-2: First of two Americans with Ebola virus lands in U.S. having been treated with experimental vaccine ZMapp  prior to leaving West Africa.

 

-3: Emirates becomes the first major airline to suspend flights to the region.

 

-4: Spain to repatriate Priest infected.

 

-5: Liberia declares a State of Emergency.

 

-6:  The WHO raises the death toll to 932. British Airways and regional West African airlines suspend flights.

 

-7: The CDC (Centre for Disease Control and Prevention) raises its alert level to 'Level 1 Activation' following the spread of the disease to Nigeria.

 

Liberia declares a 'State of Emergency' to be in effect for 90 days.

 

-8: The World Health Organization (WHO) declares an 'International Public Health Emergency' in relation to the Ebola outbreak in West Africa.

 

-11: Nigeria declares a 'State of Emergency' following the confirmed transmission of the disease within that country.

 

Zambia bans the entry of any traveler from an Ebola affected country until further notice.

 

Guinea closes its border with Liberia and Sierra Leone.

 

-12: The Liberian government says Liberia will receive an untested experimental drug, Zmapp, to treat people infected with Ebola.

 

Ivory Coast bans all passenger flights from three countries hit by Ebola in an attempt to prevent the spread of the deadly virus.

 

-13: Germany orders all its citizens, except health workers, to leave Guinea, Sierra Leone and Liberia due to the risk posed by the Ebola outbreak in West Africa.

 

Guinea-Bissau shuts its border with Guinea.

 

World Health Organization (WHO) classifies Kenya as a "high-risk" country for the spread of the deadly Ebola virus.

 

A panel of medical ethicists convened by WHO has approved use of experimental medications/vaccines for the Ebola outbreak. Following this announcement Canadian Health Minister Rona Ambrose announced Tuesday her government will donate between 800 and 1,000 doses of an experimental Ebola vaccine (VSV-EBOV) to WHO.

 

-15: Guinea declares a national health emergency in an effort to curb the spread of the Ebola virus.

 

Joanne Liu, the head of Médecins Sans Frontières (MSF) says that it will take six months to get the upper hand on the epidemic. Her comments came after a 10-day trip to the region.

 

-18: An Ebola quarantine center in Monrovia, Liberia is attacked and looted by an unidentified group of assailants. Some infected patients fled the facility and 17 patients were missing.

 

Cameroon closes its border with Nigeria on Sunday over Ebola concerns and suspends all flights between the countries.

 

-19: The seventeen patients who fled from a health center in Liberia after it was attacked were found. The Liberian information minister says the patients were at a newly opened treatment center in the capital, Monrovia.

 

Three African doctors who had received the experimental drug, Zmapp, show remarkable improvement, say Liberian officials.

 

Zmapp also helped two American aid workers infected in July. However, according to the drug's manufacturer, Mapp Biopharmaceuticals, the available supply has been exhausted.

 

-20: Researchers at the National Institutes of Health accelerate human clinical trials for a new Ebola vaccine with hopes to finish Phase 1 of testing by the end of November 2014 as opposed to January 2015, as originally scheduled.

 

Liberia's president declares a curfew and orders security forces to ensure no one goes in or out of West Point, an area of the capital attacked over the weekend, in hopes of curbing the spread of the virus.

 

A patient in Sacramento, California, USA is tested for potential exposure to the Ebola virus. 

 

-21: Dr. Kent Brantly, one of two American Ebola patients repatriated back to the US for treatment, is scheduled to be discharged from Emory University Hospital today. His blood tests came back negative for the virus. 

 

-22: The two American aid workers, Dr. Kent Brantly and Nancy Writebol, recovered and were released from Emory University Hospital. Both were treated with the experimental drug ZMapp.

 

Health officials announced that the patient in Sacramento, California, USA who had possibly been infected with the Ebola virus tested negative. The patient had recently traveled to West Africa but blood tests confirmed the person did not have the disease.

 

Clinicians in Liberia informed the World Health Organization that two doctors and one nurse received ZMapp, the experimental Ebola therapy. All three have shown a marked improvement yet the supply of ZMapp, according to its producer Mapp Biopharmaceutical Inc, is now exhausted.

 

-24: A British health worker infected with Ebola in Sierra Leone was flown back to the UK on a Royal Air Force jet. It is the first confirmed case of a Briton contracting the virus during the current outbreak.

 

-25: Democratic Republic of Congo authorities confirm Ebola in two of the thirteen suspicious deaths reported late last week in the remote northern province of Equateur. The disease appears to be a different strain than West Africa's outbreak and authorities are setting up a quarantine zone within a 100-km (62 mile) radius of Boende, where the cases had been registered.

 

Nigeria reports two new cases, infected by their medical worker spouses who had cared for Liberia-American Patrick Sawyer, who flew into Nigeria from Liberia and Togo and infected 11 others before he died in July.

 

Ivory Coast closes its land borders with Liberia and Guinea and banded flights from the two countries and Sierra Leone. Gabon also announces it is barring all flights and ships from any of the stricken countries in West Africa.

 

Japan's Chief Cabinet Secretary Yoshihide Suga says Tokyo can offer an untested drug developed by Toyama Chemical, a Fujifilm subsidiary, to help treat Ebola. The tablet, known as favipiravir, is in stock to treat more than 20,000 patients and was approved by Japanese health ministry in March to treat novel and re-emerging influenza viruses. Japan is waiting for more information from the World Health Organization regarding the use of untested drugs, although WHO did say earlier this month that given the severity of the Ebola outbreak it is ethical to treat patients with untested drugs.  

 

-26: Upon arriving at Delhi airport from Liberia, six passengers were immediately isolated and taken for Ebola tests. Both Mumbai and Delhi airports are equipped with thermal scanners to detect fever in passengers.

 

Liberian doctor Abraham Borbor, who was given the experimental drug ZMapp, dies. The deputy chief medical doctor at Liberia's largest hospital was treated with the same drug as two infected American patients, both of whom survived.

 

To date, more than 240 health workers have been infected with the Ebola virus in Guinea, Liberia, Nigeria, and Sierra Leone, killing more than 120.

 

-27: Nigeria closes all its schools until 13 October to avoid spreading the Ebola virus. The academic year was to commence Monday, 1 September but the education minister ordered the closures to allow staff time to be educated and trained to handle potential cases.

 

British Airways announces they will extend the suspension of flights to Liberia and Sierra Leone through the end of 2014.

 

The World Health Organization removes its team from Kailahun, a region hit hardest in Sierra Leone near the Guinean border. Among others, three Canadian public health workers running a mobile laboratory testing for the virus and three WHO employees coordinating the tracing of victims' contacts were pulled from the area. The aid group Doctors Without Borders will remain operating in Kailahun.

 

-29: Doctors find the Ebola virus is accumulating new mutations as it spreads. In June 2014, an international team of researchers sequenced 99 Ebola genomes from 78 diagnosed patients in Sierra Leone. The simple genome, made of only seven genes, is rapidly mutating as it spreads across West Africa, meaning it may become harder to both detect and treat.

 

Nigeria confirms the first death outside of Lagos, the county's main international transit hub. The doctor who died was located in Port Harcourt, Nigeria's oil hub.

 

September

 

-2:  The only clinical trial data on the experimental drug ZMapp has shown it is effective 100% in monkey studies, even in the later stages of infection, according to a study to be published in the journal Nature. The limited supplies of ZMapp, reported to be exhausted at the present time and produced in small volumes, means it is unlikely to be of much benefit in the current outbreak in West Africa. Additionally two of seven infected patients treated with ZMapp later died from the disease.

 

Adding to the misery of West Africa, the current Ebola outbreak is placing the West Africa crop harvest at "serious risk." Basic staple crops of rice and maize are likely to be particularly affected and food shortages are expected to worsen in the coming months.

 

The director of the US Centers for Disease Control (CDC), Dr. Tom Frieden, recently returned from a visit to West Africa to see firsthand how the Ebola outbreak is unfolding. In media interviews this morning he warns the outbreak is likely to infect 20,000 people over the next six months and the window of opportunity to "tamp down the outbreak" is closing. Dr. Frieden has suggested increased resources and coordination to combat the outbreak.

 

-4: The United Nations estimates containing the Ebola virus will cost $600 million, up from the $490 million estimate from the World Health Organization (WHO) last week.

 

The President of Ghana announces he will allow an airbridge, or route, through the country to allow affected regions to quickly obtain supplies and move people. Ivory Coast, which closed its borders with Liberia and Guinea in August, has modified its ruling and said the nation will allow humanitarian and economic corridors to the bordering countries.

 

The National Institutes of Health begins testing a new Ebola vaccine in a human safety trial. The experimental vaccine, developed by the National Institute of Allergy and Infectious Diseases (NIAID) and the pharmaceutical company GlaxoSmithKline (GSK), will first be administered to three healthy humans to see if they experience any adverse effects. The GSK/NIAID vaccine did very well when tested on chimpanzees and funding will allow GSK to begin manufacturing up to 10,000 doses while trials are ongoing.

 

The second leading candidate vaccine was developed by the Public Health Agency of Canada. The Canadian government is willing to ship 800 to 1,000 doses yet is still uncertain how they can be transported safely. In addition to regulatory and logistic issues, the vaccine must be kept cool enough to remain potent.

 

Dr. Rick Sacra, the second doctor from the United States infected with Ebola while on serving a humanitarian mission in Liberia, could be evacuated back to the US as early as today. Dr. Sacra had been delivering babies in Liberia and was not in direct contact with Ebola patients, which raised concerns over how he was infected since it is transmitted by contact with bodily fluids of the ill. Suspected cases of airborne infection in monkeys in laboratories have been reported but it remains undetermined how Dr. Sacra contracted the virus.

 

After sequencing samples of the Ebola virus, WHO released a report confirming the Democratic Republic of Congo Ebola cases are genetically unrelated to the West Africa outbreak.

 

Nurses at Liberia's largest hospital, Monrovia's John F. Kennedy, go on strike, saying they will not return to work until they are provided with the hazmat-like suits known as personal protective equipment, or PPEs, that protect against the spread of the virus.

 

The Minister of Health in Port Harcourt, Nigeria's oil hub, reports three confirmed cases of EVD in the area, following a death last week. These are the only confirmed cases outside of the country's main transit hub, Lagos, but hundreds more are being investigated.

 

Scientists fast-track a third Ebola vaccine from Johnson & Johnson. Testing will begin in early 2015. Human tests are not expected to commence until later that year or possibly even 2016.

 

Médecins Sans Frontières (MSF) suggests wealthy countries should immediately dispatch available specialized biological disaster response teams immediately to West Africa. Senior US government officials have indicated the US is focusing on rapidly increasing the number of Ebola treatment centers in the region, providing personal protective equipment, and training local staff.

 

-9:  United States President Barack Obama says the US military will begin providing aid to West Africa by providing equipment and other assistance for international health workers. This comes after a plea from Médecins Sans Frontières (MSF) that wealthy nations take action to help control the Ebola virus.

 

The Sierra Leone government imposes a four-day lockdown in a bid to contain the virus. From 18 to 21 September people in the nation will not be allowed to leave their homes.

 

Over 200 people are under surveillance in Port Harcourt related to the Nigerian physician who contracted Ebola and continued to interact and operate on patients for several days following the appearance of symptoms in mid-August. Of those under watch, 60 patients are considered to have had high-risk or very high-risk exposure.

 

-11: The Gates Foundation, set up by Microsoft founder Bill Gates and his wife Melinda, is immediately releasing $50m in "flexible funds" to the United Nations and other aid agencies to fight the Ebola virus. The Gates Foundation also announced they will work with partners to expedite drug and vaccine developments. The UK has committed $40m in support and the European Union has offered $180m in aid with the US offering $100m thus far.

 

A male United States health worker who contracted the virus in Sierra Leone arrives in Atlanta, Georgia, US via air ambulance.

 

-16: The President of the United States, Barack Obama, is scheduled to announce today that the US will send up to 3,000 troops to help fight Ebola in Liberia. The US will also aid in the construction of 17 treatment centers with about 1,700 beds, with an additional 1,000 beds provided by the US Agency for International Development. In the interim, the US is sending 5000 body bags, training burial teams and sending testing kids and 40,000 Ebola home health and treatment kits to Liberia.

 

Canada is donating $2.5 million worth of specialized medical equipment to the World Health Organization to protect healthcare workers.

 

-18: A black market for the blood of Ebola survivors is emerging, despite warning from the World Health Organization (WHO). The protein base of blood from survivors, known as convalescent serum, is said to be rich in antibodies that can fight the virus. Studies have suggested blood transfusions from survivors may help prevent and treat Ebola but more research is needed. The dangers of obtaining convalescent serum illicitly are extensive and include the spread of other diseases like HIV and allergic reactions to the transfusions resulting in anaphylactic shock.

 

A British nurse who survived the virus, Will Pooley, is said to have traveled to the United States to donate his blood to a patient. It is believed the two worked together Sierra Leone. Pooley was discharged from the Royal Free Hospital in north-west London two weeks ago and had all his belongings burned as a precaution against spreading the disease.

 

A World Bank Group analysis of the Ebola epidemic warns the economic impact on Guinea, Liberia and Sierra Leone could grow eight-fold if the disease continues to surge. The three countries were in fragile economic condition before the epidemic but were experiencing some growth. The outlook for them is uncertain and the World Bank urges a swift international reaction to lessen overall economic costs.

 

The three-day lockdown in Sierra Leone began today and will be enforced until Sunday. Residents are prohibited from leaving their homes and health workers will travel from house to house identifying cases; suspected cases will be taken to holding centers. Roughly 21,000 people were recruited to bolster the police forces and soldiers helping to enforce the quarantine. The Sierra Leone government expects to identify up to 20% in the next three days.

 

-19: Eight bodies have been found after a group of people with intentions to educate locals on Ebola prevention were assailed in Wome, Guinea, near the city of Nzerekore. The team, including medical officers and journalists, were attacked with stones and beaten with clubs then later found in the village latrine. These are believed to be the first deaths resulting from resistance to international efforts to curb the Ebola outbreak in the region.

 

The United Nations Security council has deemed the Ebola outbreak in West Africa "a threat to international peace and security." UN Secretary General Ban Ki-moon announced an emergency mission in which the United Nations will work with the World Health Organization to combat the virus. This was the first time the UN Security Council has met to confront a public health crisis.

 

The lockdown in Sierra Leone will continue until Sunday in efforts to curb the spread of Ebola.

 

-22: Authorities declare the three-day lockdown in Sierra Leone a success and that it will not be extended. The head of Sierra Leone's Emergency Operations Centre, Stephen Gaojia, said 130 new cases were confirmed and 39 more are still being tested.

 

Spanish priest, Manuel García Viejo, will repatriate from Sierra Leone to be treated for EVD. He worked at the same hospital as a Spanish priest infected in August. Doctor García Viejo will not be treated with the experimental serum ZMapp due to low stock.

 

Schools in most of Nigeria's 36 states reopen today after an extended summer break in efforts to control the spread of the virus. Schools in Niger, Kebbi, Zamfara, Jigawa, Osun, Rivers and Lagos will continue to postpone the commencement of their school year to ensure required preventative measures are in place until at least the first week of October.

 

-23: The UK government announces that more than 160 United Kingdom National Health Service staff have volunteered to help in the Ebola outbreak in West Africa.

 

The WHO warns the number of infections will triple to 20,000 by November if efforts are not stepped up. The forecast comes amid concerns that Ebola could become an endemic problem in West Africa for the next several years, or even on a permanent basis similar to diseases like Malaria.

 

The UK's Wellcome Trust charity announces that experimental drugs will be tested in West Africa for the first time, with the first trials as early as November. Several drugs are under development around the globe, but none been fully tested and all are in very short supply.

 

Research published in the New England Journal of Medicine has found Ebola death rates in West Africa hospitals reached 70% of cases, higher than the 50% figure previously reported.

 

In a just-released six month situation assessment report on the outbreak the WHO indicated that "countries with well-developed health systems and services are unlikely to see much--if any--onward transmission of Ebola virus disease following an imported case."

 

-24: The CDC issues a report warning that if not contained the Ebola virus could infect between 550,000 and 1.4 million people in the next four months. This represents a worst-case scenario. The CDC's modeling also indicates a best-case scenario of the outbreak "almost ended" by January 20, which would require significant improvement to the handling and care of patients and the remains of the deceased. They estimate that while the reported number of cases is approximately 5,800 the actual number is likely closer to 20,000.

 

The Health Minister of Nigeria announces the country is free of active Ebola cases and all suspected cases have been released from surveillance.

 

-25:  Following a nationwide three-day lockdown, Sierra Leone expands its quarantine to include three districts in addition to two eastern districts isolated since August. Port Loko and Bombali in the north and Moyamba in the south will be quarantined effective immediately. Only individuals delivering essential services will be permitted to enter.

 

The International Crisis Group, an independent conflict-prevention non-profit, releases a statement saying, "the worst-hit countries now face widespread chaos and, potentially, collapse." The outbreak could undo years of economic and social development in West African nations and possibly lead to failed states.

 

Six Red Cross workers in Guinea were attacked while collecting the body of man infected with Ebola. The group of attackers are believed to be relatives of the deceased. Security is increasingly a concern in Ebola-infected areas and this incident occurs only a week after eight health workers educating people on the virus were found dead in Guinea. 

 

-30: An adult male patient being treated at a Dallas, Texas hospital is the first person diagnosed with Ebola in the United States, say the Centers for Disease Control and Prevention (CDC). The unidentified patient arrived into the US from Liberia on September 20th, first experienced symptoms and sought care on the 24th, then sought further treatment on the 28th and the laboratory confirmed him infected with Ebola today, September 30th. The patient reportedly stayed with family members in the community from the 24th to the 28th, while symptomatic and infectious. The patient is hospitalized at Texas Health Presbyterian Hospital in Dallas and is expected to remain at the hospital for treatment. The CDC indicates the hospital's isolation capability is fully capable to safely treat Ebola. The CDC, local and State health authorities are conducting "contact tracing" to identify any other individuals the patient may have come into contact with while infectious.  

 

October

 

-3: Up to 100 people in Dallas, Texas, US are being monitored for Ebola after possible contact with Thomas Eric Duncan, who was diagnosed Tuesday. Four of Duncan's relatives are under quarantine in their home and being monitored for signs of infection.

 

A second man has arrived in Germany to be treated for Ebola. The Ugandan doctor was flown from West Africa to Frankfurt University Hospital and is currently isolation. He worked directly with Ebola patients in Sierra Leone. The second patient in Germany is still undergoing treatment in Hamburg.

 

The United Nations is reporting that number of Ebola cases in West Africa is doubling every 20 days.

 

The NGO Save the Children is reporting five new Ebola cases every hour in Sierra Leone for a total of 765 new cases last week alone, in context of a only 327 available hospital beds. The organization states that it believes case numbers are being "massively under-reported."  

 

-7: A nurse in Spain who treated two repatriated Ebola patients in Madrid is the first person during the current outbreak to be infected outside of West Africa. She is being treated at Carlos III hospital and is currently in stable condition. Three people are in the hospital after being in close contact with her. Madrid health officials say 22 people additional people who had contact with the nurse are being monitored.

 

Scientists at Northeastern University say there is a 50% chance Ebola will reach the UK by 24 October. They used viral spread patterns and airline traffic data to estimate when a traveller will bring the disease to various locations. The team says there is a 75% chance the virus will reach France by the same date.

 

The man diagnosed in Dallas, Texas, US last week will be treated with the experimental drug brincidofovir, manufactured by Chimerix. The drug has shown promise in test tubes and is just now being tested on animals. The Food and Drug Administration gave special permission to administer the drug at the request of the patient's medical team. He remains in critical condition.

 

Doctor Richard Sacra, who contracted Ebola in Liberia and has been treated in Nebraska, US tested negative for the virus and will be removed from isolation.

 

A freelance cameraman working for NBC has contracted Ebola in Liberia and will be the second person to receive treatment in Nebraska, US at the Nebraska Medical Center. He was diagnosed on Thursday and flown to the United States on Sunday.

 

-8: The first person diagnosed with Ebola in the US, Thomas Eric Duncan, dies. His fiancé, her child and two other men remain under quarantine in a home for the remainder of the virus' incubation period, 21 days, to ensure they have not been infected and spread the virus to others.

 

-9: Five major international airports in the United States require temperature checks from any traveler coming from Sierra Leone, Guinea or Liberia. The airports are: John F Kennedy International in New York (JFK), New Jersey's Newark (EWR), Chicago's O'Hare (ORD), Washington Dulles (IAD) and Atlanta's Hartsfield airport (ATL). White House Press Secretary Josh Earnest says these five airports handle 94 percent of the travelers coming from the three West African countries hit hardest by the outbreak.

 

World Bank President Jim Kim says the international community has "failed miserably" in its response to the outbreak. The Bank released a statement estimating that if the virus spreads to neighboring countries with larger economies the financial impact could reach US$32.6 billion by the end of 2015.

 

The UK will send 750 troops to Sierra Leone next week to build an Ebola treatment center and training academy.

 

The Spanish nurse who contracted Ebola while treating a patient in Spain is reportedly left waiting in an emergency room in an infectious disease hospital in Madrid for up to eight hours after positively testing for Ebola, increasing the chances of additional infections of Spanish healthcare workers and fellow patients. Five other patients related to her case, including two doctors and a nurse, are currently hospitalized and being monitored. They have not yet tested positive for Ebola.

 

Spanish authorities report a total of 52 people from the hospitals involved with the Spanish nurse's care, plus their family members, are being monitored.

 

The WHO warns that more Ebola cases can be expected among medical staff, even in developed countries.

 

-10: Hospital staff in Madrid, Spain at the Carlos III hospital have resigned or refused to treat certain patients due to concerns of contracting the Ebola virus. Fourteen people are in quarantine at the hospital, including the first person to contract Ebola outside of West Africa. Carlos III hospital is now understaffed and has been forced to seek out help from unemployed health workers in order to care for the patients, even among concerns over inadequate training and safety standards.

 

Travelers arriving at Heathrow, Gatwick and Eurostar terminals in the UK from West Africa will face what officials are calling an enhanced screening. This entails a series of questions with a possible medical assessment by trained medical workers instead of border patrol.

 

At yesterday's annual meeting of the World Bank and International Monetary Fund (IMF) the presidents of Sierra Leone, Guinea and Liberia plead with world leaders to increase their support in fighting Ebola. No new money was offered but the European Commission and United States promised medical evacuation services for health workers deploying to West Africa. This assurance will increase the flow of skilled medical professionals to the region.

 

A third patient from West Africa arrived in Germany yesterday. He is an unidentified United Nations medical officer who was working in Liberia. He will be treated at a local clinic with specialist facilities in the eastern city of Leipzig.

 

Studies have shown even after a patient has recovered from Ebola certain bodily fluids remain infectious long after they have been clear of the disease. Semen can carry the virus months after recovery. WHO released a statement saying the Ebola can persist in a survivor's semen for up to 90 days, with some research showing it could be longer. Using condoms during this time is crucial to prevent its spread. Breast milk can also carry the virus after it is no longer in the bloodstream. It is advised that mothers avoid breastfeeding a few weeks after recovery.

 

-13:  A second person in the United States tests positive for Ebola. The nurse had helped treat the first patient, Thomas Eric Duncan, in Dallas, Texas, who died last week. The woman, who has not been publicly identified, is the first person to contract Ebola in the United States. The CDC has indicated the transmission to the nurse was due to a failure to follow protocol; however, they have not yet identified the exact chain of events. They are reviewing whether the it occurred during intubation or dialysis, high-risk procedures that were performed in a last ditch effort to save the patient, or during the removal of contaminated Personal Protective Equipment by the nurse.

 

The Attorney General for the US state of Louisiana, Buddy Caldwell, is seeking a temporary restraining order to block the disposal of incinerated waste that included Mr. Duncan's personal items at a Louisiana landfill. "There are too many unknowns at this point, and it is absurd to transport potentially hazardous Ebola waste across state lines," Caldwell said Sunday.

 

An ill passenger with flu-like symptoms on a United Airlines flight from New York to Los Angeles on Sunday triggered Ebola concerns. Upon landing the plan was directed to a remote gate at LAX and held for several hours. There appeared to have been some miscommunication regarding the passenger's recent travel to the African continent, which turned out to be specifically South Africa. Once health officials determined the female passenger did not have Ebola, she and the other passengers were allowed to leave.

 

Temperature screening of arriving passengers from the Sierra Leone, Guinea and Liberia began Saturday at New York's JFK International Airport. Washington's Dulles, Newark (New Jersey), Chicago's O'Hare and Atlanta's international airport will begin screening Thursday.

 

European countries are not following the US example regarding screening of arriving passengers, health authorities in Europe view such screening as ineffective and disruptive - a view that is backed by the World Health Organization. Instead European countries appear to be relying on their own health systems to identify and isolate the spread of Ebola as and when it appears.

 

Thousands of members of the National Health Workers Association in Liberia have planned a strike starting today, wanting an increase in the monthly risk fee paid to anyone treating Ebola cases. They also want protective equipment and insurance. Their current pay is US$200 to $300 a month with a risk fee of $500. The health workers are asking for the fee to be increased to $700 per month but the government says due to the scale of the outbreak it cannot afford the original risk fee.

 

-15: A second healthcare worker who cared for Thomas Eric Duncan in Dallas, Texas, US tests positive for Ebola. Preliminary testing was done at a lab in Austin, Texas late last night and the CDC will conduct additional testing in Atlanta, Georgia, US to confirm the positive results. An unidentified government official has told reporters that in hindsight Mr. Duncan should have been moved to one of the four specialty biocontainment hospitals in the US following confirmation of his diagnosis.

 

Head of the United Nations Mission for Ebola Emergency Response (UNMEER), Anthony Banbury, says we are losing the race against the virus. He urged the UN Security Council to expand on-the-ground efforts in West Africa to control Ebola. "It is far ahead of us, it is running faster than us, and it is winning the race," said Banbury.

 

The WHO says the outbreaks in Nigeria and Senegal are not officially over yet. If no new cases occur and the active surveillance that is currently in place continues, WHO will declare the outbreak over in Senegal on 17 October. This is after the requisite 42 days, twice the virus' maximum incubation period of 21 days, have passed with no new cases. The same will be declared for Nigeria on 20 October barring no new cases.

 

Heathrow airport in the UK began screening passengers for Ebola yesterday, starting with Terminal 1. Health Secretary Jeremy Hunt said screening at Gatwick and Eurostar terminals will start next week. Nurses and consultants from Public Health England will conduct the screenings. As of now, no other airports in Europe are screening passengers coming from Ebola-affected areas.

 

The WHO warns there could be up to 10,000 new cases a week in Liberia, Sierra Leone and Guinea by the end of this year as the rate Ebola is spreading.  

 

-16: The second infected healthcare worker in Dallas, Texas, US flew the day before testing positive for Ebola. Prior to flying, the nurse had called the CDC and reported that she had an elevated temperature but no other symptoms. Since she did not meet the temperature threshold for fever she was told she could fly commercially. The woman flew Frontier Airlines flight (number 1143) from Cleveland, Ohio back to Texas. The CDC is now asking all passengers on that flight to contact them at 1-800-CDC-INFO. The lack of other symptoms, such as vomiting or diarrhea, means the risk of transmission to fellow passengers on Frontier flight 1143 and passengers on subsequent flights on the same aircraft is quite low.

 

In a response proportionally greater than its wealthier counterparts, Cuba sends 165 healthcare workers to Sierra Leone and another 296 are going to Liberia to help contain the virus. Cuba also has professionals on the ground in Guinea.

 

British army medics will run a hospital in Sierra Leone to treat infected healthcare workers. A total deployment of 750 military personnel is planned to be sent to West Africa. 

 

-21: A team of scientists from the University of Toronto in Canada estimate that on average three Ebola-infected travellers may board international flights each month. The prediction is based on a model that the study's author Doctor Isaac Bogoch used. He says the likelihood of someone with Ebola travelling from Guinea, Liberia or Sierra Leone to the UK or France is roughly eight times greater than flying to the United States, based on past flight data.

 

43 people who had contact with Dallas Ebola patient Thomas Eric Duncan, who died last week, are declared free of Ebola. They were in isolation for 21 days, which is the virus' maximum incubation period. Some of the isolations were self-imposed while others were mandated by the state of Texas.  

 

In December 2014, preliminary safety data will be released on two vaccines being tested in Europe, the US and Africa, said World Health Organization's Doctor Marie Paule Kieny. If the vaccines are found to be safe they will be tested on tens of thousands of West Africans in trials beginning January 2015.

 

Four blood tests on Spanish Ebola patient Teresa Romero come back negative and doctors at Madrid's Carlos III hospital confirm she is now free of the virus. She was treated with plasma from an Ebola survivor but no other details on her treatment have been released.

 

Nigeria and Senegal are both officially free of Ebola after no new cases are reported for 42 days, or twice the incubation period of the virus.

 

United States President Barack Obama selects Ron Klain, former chief of staff for Vice Presidents Al Gore and Joseph R. Biden Jr., as the White House's Ebola response coordinator. He has a background in crisis response operations and will be in charge of containing the virus now that it has spread to the US. 

 

-23: The United States will monitor every traveller coming into the country from Sierra Leone, Liberia and Guinea. For three weeks after entering the US, the maximum incubation period of the Ebola virus, the CDC requires that individuals report their temperature daily along with any other potential symptoms like vomiting, unusual bleeding or bruising.

 

Robotics scientists are looking into the possibility of robots performing the lifesaving tasks that healthcare workers currently do to contain the spread of Ebola. Waste removal and burying bodies bring humans in close contact with the virus; if robots could perform these tasks humans would have less exposure and more time to carry out tasks that require the dexterity robots are currently incapable of. Other possible uses scientists are discussing are robotic diagnosis and virtual family visits for patients in quarantine.

 

Amber Joy Vinson, a nurse who was infected after she treated Dallas patient Thomas Eric Duncan, is now clear of Ebola. A second nurse who was in contact with Duncan and caught the virus, Nina Pham, has had her condition upgraded from fair to good. The hospital where all three were treated, Texas Health Presbyterian, will no longer admit additional cases. This is likely due to the extreme criticism they received from the handling of the first patient, Duncan, who died 8 October. Texas health officials will create two new Ebola treatment centers in the event that any new cases occur.

 

North Korea said beginning Friday 24 October it will no longer allow foreign tourists into the country due to fears of bringing the Ebola virus in. It has not been stated whether the ban includes diplomats and business travellers. 

 

-24: The first case in Mali is reported in a 2-year-old girl who had recently traveled from Guinea. Mali is the sixth West African country to confirm a case during this outbreak. The young girl is in isolation in a hospital near the Senegal border.

 

New York City in the United States has its first confirmed case of Ebola. Doctor Craig Spencer tested positive for the virus Thursday evening and is being treated at Bellevue Hospital. Spencer left Guinea on 14 October after treating patients in Guinea. According to New York City officials he had reported no symptoms until Thursday. At least three people Spencer had contact with are in isolation. Bellevue Hospital reports he has not treated patients since his return from Guinea on the 17th. Additionally, the doctor's widely reported bowling alley outing in Brooklyn and jog through Central Park occurred before he began experiencing symptoms and was infectious. 

 

-27:  The United States military is developing mobile isolation units that can transport up to 12 patients on planes. The prototypes will be tested next month and deployed January 2015 in West Africa.

 

The Governors of New York, New Jersey and Illinois in the United States imposemandatory 21-day quarantines for all medical workers who had contact with Ebola patients. While the quarantines are still in effect, health workers are no longer required to be in isolation at a hospital and can remain in their homes unless symptomatic. Asymptomatic individuals are not contagious.

 

-28:  The government of Australia announces new immigration controls intended to protect public health, which include: no longer approving visa applications from the West Africa Ebola-affected countries; mandatory three week quarantine process prior to travel to Australia of holders of permanent Australia visas; and additional screening and follow-up checks upon arrival in Australia. The announcement has been met with surprise from the Australian Medical Association, which views the risk of the disease entering Australia through a migrant from the region as very low. The Immigration Minister, Scott Morrison, also announced Australia is suspending its humanitarian program.

 

The CDC issues a new system for categorizing risk using four levels: high risk, some risk, low (but not zero) risk and no identifiable risk. For each risk level there are details on exposure, clinical criteria and public health actions. The table can be viewed in full here. In the US, the state government has primary responsibility for public health enforcement, but typically look to the CDC and National Institutes of Health for baseline recommendations and guidance. The recent policies and subsequent modifications by governors of Illinois, New Jersey and New York have underscored the differences that may emerge between US federal and state governments when attempting to address the threat of infectious diseases.

 

The US Army places several asymptomatic members returning from the medical support mission in Liberia into quarantine at their base in Italy, including the former commanding general. None of the members reportedly had any contact with Ebola patients. This reflects differences of opinion even within the US federal government and may further cause erosion of public confidence on the risk of transmission. The US Army's actions with the returning soldiers is counter to existing Department of Defense policies. The current DOD policy on monitoring returning troops says, "as long as individuals remain asymptomatic, they may return to work and routine daily activities with family members."

 

The New England Journal of Medicine (NEJM) writes a forceful editorial criticizing the recent public health policies issued by governors of Illinois, New Jersey and New York. The editorial suggests the governors are taking the wrong approach and that the potential threat posed by asymptomatic travelers returning from West Africa is misunderstood. NEJM indicates that the sensitive blood polymerase-chain-reaction (PCR) test for Ebola is often negative on the day when fever or other symptoms appear and only becomes reliable 2 to 3 days after symptoms appear. Those infected may not be contagious during this period because the levels of the virus in their blood are still very low. NEJM indicate this is supported by the fact that the family members of US patient Thomas Eric Duncan cared for him and lived in close proximity to him during the first several days of his symptoms and did not contract Ebola. To date all confirmed cases of transmission outside Africa have been to healthcare workers caring for hospitalized Ebola patients. 

 

-29:  Kaci Hickox, the nurse who was quarantined at a New Jersey hospital upon arriving in the United States from West Africa, was allowed to leave the hospital and finish her 21-day quarantine at her home in Maine. Hickox has announced that she will take legal action against the state of Maine if they do not lift these restrictions. She is still completely asymptomatic.

 

A 2-year-old in southern Guinea is believed to be "Patient Zero" for the current Ebola outbreak. Over a year ago the toddler contracted the disease, which eventually spread to his mother, 4-year-old sister and grandmother, killing all of them. Officials are uncertain how the boy was infected. The family lived in the village of Meliandou.

 

The two-year-old girl from Mali who died after being infected during a trip to Guinea had taken a bus to return home. According to a report from the World Health Organization, she had contact with 57 people, 10 of whom are healthcare workers. 116 people in Mali are now under observation for symptoms.

 

World Bank President Jim Yong Kim says more than 5,000 health workers are needed to fight Ebola in Sierra Leone, Guinea and Liberia, where the virus is tearing apart communities and killing thousands. Kim spoke in Ethiopia with U.N. Secretary-General Ban Ki-moon who added that the virus continues to outpace the international community's response. Both urged African Union members not to close their borders or impose travel restrictions as these precautions actually slow the containment of the disease by diminishing the number of medical professionals in the field. 

 

-30:  WHO reports the rate of new Ebola infections in Liberia is declining. The decrease is likely due to the increase in safe burials, isolations of the infected and public awareness campaigns. WHO warns that this trend may not continue. The decline may by cyclical and any let-up in the response could cause the virus to surge again. Ebola continues to spread rapidly in Sierra Leone, specifically in western areas near the capital.

 

Since last week the number of Ebola cases has risen more than 3,000 to over 13,700 globally. Dr. Bruce Aylward, the WHO's assistant director general, said this is due to data being updated with numbers from old cases. Total reported deaths stand just under 5,000 for this outbreak, as of yesterday's data from the CDC.

 

-31: Researchers at the University of Washington found that in a study on mice the effect of the Ebola virus may be determined by genes. They identified two genes that were crucial in whether the mice contracted the virus and died or whether they became ill at all. The researchers began their work three years ago. This is the first time scientists have been able to breed mice that developed Ebola infections similar to humans, including the hemorrhages that appear a few days before death in one-third of humans infected. The study has shown that the mice who hemorrhage do so because their immune systems overreact resulting in an inflammatory response leading to cells seeping fluids and breaks down white blood cells, tissue and organs. If the patient survives long enough blood begins to leak out of the vessels. The study has implications for humans and researchers will continue to study the mice and the specific genes that lead to different outcomes after infection.

 

Kaci Hickox, a nurse in Maine who had treated Ebola patients on behalf of MSF, defies state-ordered home quarantine restrictions and takes a bike ride. She is still asymptomatic and her public protest goes against the measures the US government is taking in hopes of containing the virus.

 

Medecins Sans Frontieres (MSF) warns that the new United States quarantine measures are having a "chilling effect" on the charity's work. The state restrictions may shorten assignments to West Africa and some volunteers are delaying their return to the US for 21 days by remaining in Europe in order to avoid being quarantined at home. Others are being discouraged by their families to go into the field, depleting the most needed resource to fight the virus, real healthcare workers on the ground.

 

China will dispatch an elite army unit of the People's Liberation Army (PLA) to build a 100-bed treatment center in Liberia. The squad has experience from the 2002 Severe Acute Respiratory Syndrome (SARS) outbreak. The center will open in one month and China will send 480 PLA medical professionals to treat patients.

 

November

 

-3: Canada is suspending visa applications from residents and passport-holders from the West African countries involved in the Ebola outbreak (described as countries with "widespread and persistent-intense transmission, according to authorities). The decision follows similar actions by Australia. The WHO is highly critical of such bans, believing them to be counter-productive to the global response to the outbreak.

 

Starting Wednesday, citizens of Sierra Leone, Guinea and Liberia will require a visa to enter Singapore. The city-state is a major transportation hub and was affected by the SARS virus in 2003. Singapore's health ministry said the visa requirement will allow for better tracing and oversight.

 

A UN healthcare worker who contracted Ebola while working in Sierra Leone is evacuated to a biocontainment unit at a French Army teaching hospital outside Paris.

 

Teresa Romero Ramos, the Spanish nurse's aide who contracted Ebola while caring for another patient is moved out of isolation at Hospital Carlos III in Madrid, after tests showed Ramos no longer has the virus. She will be discharged pending additional tests.

 

A state court judge in the US state of Maine lifts portions of his own temporary order restricting the movement of US nurse Kaci Hickox, who recently returned from treating Ebola patients in West Africa and who has stood up to quarantine requirements in New Jersey and Maine. The judge went further and sided with Ms. Hickox against the Governor and Maine's Department of Health in reducing limitations on her movement. The nurse, who is asymptomatic, clears the 21-day incubation milestone on November 10th.

 

-4: In a speech in Benin yesterday, World Health Organization (WHO) director Dr. Margaret Chan denounced the pharmaceutical industry, saying the industry's profit-seeking motives are the reason no vaccine for Ebola has been found. She reproached the lack of effective public health systems in Sierra Leone, Guinea and Liberia.

 

The Africa Governance Initiative (AGI) finds that in rural parts of Sierra Leone Ebola is spreading nine times faster than it was two months ago. Near the capital of Freetown the rate of new cases reported is six times higher than two months ago. This is in contrast to Liberia, where data shows the rate of cases spreading has slowed recently.

 

The first inhalable Ebola treatment is proving highly effective in animal studies. A team at the University of Texas confirmed that a respiratory vaccine is showing long-term protection in non-human primates against the virus. The benefits of a breathable vaccine are numerous; storing, transport and administration of injectable vaccines create a sea of logistical problems for drug makers. The respiratory formula has been in development for seven years and is found to improve survival rates of non-human primates from 67% to 100% when in contact with Ebola 150 days after the vaccine has been administered.

 

The government of Senegal helped contain the spread of Ebola in part through a successful SMS warning message campaign. The mobile phone message system was originally developed to help people manage diabetes but was key in educating citizens when the first and only case of Ebola was confirmed on August 29th. 

 

-5: Thousands violate home quarantines in Sierra Leone because their food deliveries are not reaching them. Individuals being monitored for signs of Ebola are forced to leave their homes to find food at markets, possibly spreading the virus while simply trying to survive. It is difficult for the government and the UN's World Food Program to keep up with the deliveries as the number of cases increases exponentially.

 

The first of six British-run Ebola facilities opens in Sierra Leone, near the capital of Freetown. The 92-bed center has a blood-testing laboratory and will be run by the UK's Disasters Emergency Committee, the Department for International Development (DfID) and charity Save the Children.

 

Ebola screenings begin at Manchester and Birmingham airports in the UK for any passenger arriving from Sierra Leone, Liberia or Guinea. Last month screenings commences at Heathrow, Gatwick and Eurostar airports. 

 

-6: The WHO reports it is continuing to see a slowdown in new Ebola cases in Liberia, although it is still increasing for Sierra Leone and is "stable" in Guinea.

 

New York state health authorities report the number of people under active monitoring has more than tripled this week to 357. Most of the increase is made up of persons newly arrived from Sierra Leone, Liberia and Guinea; however, some are related to Dr. Craig Spencer's case, the Ebola-infected physician currently hospitalized in Bellevue Hospital, New York City.

 

US officials indicate President Barack Obama will ask Congress for $6.2 billion to fight Ebola in West Africa with the intent to avoid it spreading into the US. $4.5 billion will be for immediate response needs and $1.7 billion will be for a contingency fund.

 

The US government announces that approximately 70 uniformed US Public Health Service Commissioned Corps healthcare professionals will staff a clinic opening this weekend in the Liberian capital, Monrovia. The clinic was built by US military personnel. The 25-bed facility will focus on caring for infected healthcare workers. The Public Health Service workers have all volunteered for the direct patient care. Up to this point all US government personnel have served in construction and logistical support roles.

 

A journalist is Sierra Leone, David Tam Baryoh, who has been critical of the Sierra Leone government's response, is allegedly beaten and jailed by government officials following his interview with an opposition party spokesman. The government is apparently using emergency laws meant to contain the spread of Ebola for his incarceration. Local journalists have expressed concern over a government crackdown as the media seeks to keep on top of hundreds of millions of dollars in aid coming into the country.

 

The WHO lowers the Ebola total death toll estimate for the second week in a row, with 440 fewer deaths reported in Sierra Leone than in its data published on October 31st. The WHO indicates this is a result of improving the quality of its data.

 

The head of the UN mission to fight Ebola, Tony Banbury, tells the BBC they do not have the resources to fight Ebola even with major contributions from the UK, US, Cuba and China. Banbury remains confident that by December they will achieve 70% bed space for new cases in West Africa and 70% safe burials. 

 

-7: Texas, United States reaches the 21-day incubation limit without any new Ebola cases from persons who may have been exposed to the virus. This effectively ends the outbreak in Texas.

 

One person in Iowa, United States is under quarantine and will be closely monitored. They were among 13 travelers in Iowa who have recently returned from Sierra Leone, Liberia or Guinea. The one individual was deemed to have some risk of exposure to Ebola while the others have been determined to be low risk. The 12 other travelers are required to self-monitor and report their health status to public health officials.

 

The UN's Ebola chief, Dr. David Nabarro, expresses optimism that the outbreak could end in 2015, based on the extraordinary global response made over the past month. Nabarro indicated there are now five times the number of treatment beds in the three affected countries than there were two months ago. 

 

-11: New York City doctor Craig Spencer, who was diagnosed with Ebola last month, is free of the virus and is released today.

 

Fujufilm's pharmaceuticals division says it expects international government bodies to approve its influenza drug, Avigan, to treat Ebola as early as the end of this year. Fujifilm said it has stock to treat 20,000 patients and enough ingredients to make Avigan for 300,000 people. Patients in Spain, France, Norway and Germany have already been treated with the drug. Four patients have survived after taking Avigan. France and Guinea will conduct clinical trials beginning this month.

 

A hunger strike in Guinea launches to protest military presence in the village of Wome where a team of Ebola awareness workers were killed this September. So far 20 village leaders are camping outside of parliament to show their opposition.

 

The Sierra Leone government announces it will give $5,000 USD (£3,000) to the family of any health worker who dies fighting the Ebola virus.

 

-13: Despite initial success in containing a potential Ebola outbreak related to a two-year-old traveler, Mali is now facing an increased likelihood of new cases related to the recent death of a Guinean citizen who received care in Mali. Shortly after passing away from an undiagnosed condition the patient received a traditional Muslim burial ceremony without any precautions regarding Ebola. At least one member of the man's family has now tested positive for Ebola. Mali has placed quarantine on 90 people and has closed a mosque and private clinic.

 

New Ebola cases in Guinea have begun moderating, following a similar pattern of improvement seen in Liberia. In a recent report from WHO the moderation has begun in parts of Guinea and Liberia, though transmission of the virus "remains strong." Some districts in both countries are still experiencing "consistently high transmission," and Sierra Leone continues to report "steep increases" in the disease.

 

Government officials in both the US and Liberia appear to be reassessing the strategy to combat the spread of Ebola in Liberia, where earlier plans called for the construction of 17 Ebola treatment centers. The US completed the first of its 100-bed centers on Monday. Two additional centers will be completed by the end of November and seven additional units across Liberia are in various stages of construction. The original commitment to 17 treatment centers came at the height of the epidemic in Liberia, which has since experienced a moderation of the outbreak. Several treatment centers currently in operation around the country have for more than a month reported empty beds. Some advocates are calling for more of the earmarked funds to go towards other healthcare needs within the country, including detection and rapid response to future outbreaks.

 

Medical charity MSF has announced clinical trials of three separate experimental treatments will commence at three of its treatment centers in Guinea beginning next month. The trials will include two antiviral drugs (brincidofovir and favipiravir) and convalescent blood and plasma therapy.

 

Hundreds of health workers involved in treating Ebola patients at a clinic in hard-hit Sierra Leone have gone on strike to protest the government's failure to pay an agreed weekly $100 "hazard payment" for such work. The Bandajuma clinic is run by medical charity MSF, which said it would be forced to close the facility if the strike continued. About 60 patients have been left unattended due to the strike.

 

The family of Thomas Eric Duncan, the Ebola patient who passed away in Texas, has reached a financial settlement with Texas Health Presbyterian of Dallas. The hospital initially failed to identify Mr. Duncan's risk for Ebola when he sought care for symptoms following arrival from Liberia. The settlement includes creating a charitable foundation to improve Ebola treatment in Africa.

 

Thousands of nurses reportedly took part in rallies, protests and strikes across the US on Wednesday over what they say are insufficient safeguards for health workers treating patients possibly infected with Ebola. The action was coordinated by the California-based National Nurses United, which is currently in contentious contract talks with operators of nearly 90 California hospitals and clinics. Healthcare provider Kaiser Permanente, which operates many of the facilities involved in the labor negotiations, accused the union of using Ebola as a pretext to justify labor action. 

 

-14:  Liberia's President, Ellen Johnson Sirleaf, announces an end to a national state of emergency. Ms. Johnson Sirleaf said the announcement came "not because the fight against Ebola is over," but because enough progress has been made to keep fighting the virus until it is eradicated in Liberia.

 

A surgeon treating Ebola patients in Sierra Leone is being repatriated to Omaha, Nebraska, United States. Martin Salia will be treated at the special Biocontainment Unit at the Nebraska Medical Center.

 

-18: The government of the Democratic Republic of the Congo (DRC) declares their Ebola outbreak is over. The outbreak, unrelated to the Ebola outbreak in West Africa, claimed a total of 49 lives. The last confirmed case was on October 4th and the 42-day period (twice the 21-day incubation period of the virus) with no new cases has been met. Treatment teams still remain but have begun to withdraw.

 

Dr. Martin Salia dies on Monday at the Nebraska Medical Center in the United States. He contracted Ebola while treating patients in Sierra Leone. Dr. Salia was already in critical condition when he arrived in the United States on Saturday. He was treated with blood serum from a surviving Ebola patient and received a rare dose of the experimental treatment ZMapp. 

 

-19: A Cuban doctor has contracted Ebola in Sierra Leone. Felix Baez is a member of the 165-person Cuban medical team in Sierra Leone and tested positive on Monday. He will be treated in Geneva.

 

An Indian Ebola survivor who has not had the virus in his blood stream since testing negative on September 30th is now in quarantine in New Delhi. Upon returning from Liberia on November 10th, Indian officials tested all of his bodily fluids and found the virus still in his semen. Research has shown Ebola can survive in semen up to 90 days after bloods tests are negative. The man, an Indian national, is not showing any symptoms of the disease but health authorities say they will hold him in isolation in a special health facility inside the Delhi Airport Health Organization until all of his bodily fluids test negative. India appears to be the first country to continue to quarantine recovered male patients until every trace of the virus is no longer detectable in the semen.

 

A new study will test the effectiveness of using the blood of Ebola survivors to treat patients. Plasma from those who have beaten the disease contains antibodies that fight the virus and some patients who have been treated with it have survived. The study will begin within a month and funding has been bolstered by a $5.7M donation from the Bill & Melinda Gates Foundation. 

 

-24: An Italian doctor has contracted Ebola in Sierra Leone and will be flown to Rome for treatment. The Italian Health Ministry has said the doctor will be transported late today to Rome's National Institute for Infective Diseases on a military plane.  

 

The United States' Food and Drug Administration (FDA) announced it is stockpiling plasma from Ebola survivors to treat future patients. The plasma will be treated with a pathogen inactivation system, Cerus Corporation's Intercept system, to ensure no other harmful diseases, such as malaria, are transmitted to the patient. 

December

 

-1:  According to the World Health Organization (WHO), only 23% of Ebola cases are being isolated in Liberia and 40% in Sierra Leone and neither country has enough burial teams to reach the United Nations' goal of safely burying 70% of the dead.

 

Doctors Without Borders (Médecins Sans Frontières or MSF) will open a new treatment center in Freetown, the capital of Sierra Leone, within the next two weeks. Ebola is raging in Sierra Leone and is set to surpass Liberia in the number of cases in the coming days.

 

Mali's President, Ibrahim Boubacar Keita, declared his country free of Ebola on Saturday. The last remaining case has been resolved and no one is currently under treatment though 285 people who had contact with those infected are being monitored. 

 

-10: Sierra Leone will launch a two-week lockdown in the Eastern district of Kono to control the rapid spread ofEbola. People will be allowed to move about within the district but not enter or leave until December 23rd.

 

Junior doctors in Sierra Leone have gone on strike seeking the promise of better medical care should they contract the virus. Senior doctors have not gone on strike and the government's chief medical officer, Dr.Brima Kargbo, said he saw no disruption in medical service after a tour of the main government hospitals in the capital of Freetown.

 

The rate of new cases reported in Liberia has decreased since mid-September but the country still records12 new cases a day. Liberian President Ellen Johnson-Sirleaf has announced a new campaign entitled "EbolaMust Go," which focuses on the community's role in ending the outbreak by observing health protocols and helping care for children whose caregivers have died. Kevin De Cock, the doctor leading the Centers forDisease Control and Prevention's Ebola effort in Liberia stresses that just because the rate of new cases is on the decline, the fight to contain the virus is not over yet.

 

-30:  A healthcare worker returned to Glasgow, Scotland this Sunday from Sierra Leone and has been diagnosedwith Ebola. The patient has been transferred to a specialized care unit at the Royal Free Hospital in London.

 

A new Ebola test named LightMix Ebola Zaire rRT-PCR, made by the company Roche, has been approvedby the U.S. Food and Drug Administration and can generate results in three hours. The current test called RTPCR,which stands for reverse transcriptase polymerase chain reaction, takes six hours. LightMix testing hasnot been approved for general use yet.

  

For the latest updates, please see Healix's Ebola Updates