Ebola update: CDC moves to rarely-used highest level of alert

The NYC patient, who was thought to possibly have Ebola, does not.

The CDC said that tests show that he is not infected with the virus.  He had been isolated since it was first suspected that he might have Ebola after showing up in the ER at Mount Sinai Hospital.

The repatriated Spanish priest is now in isolation at a hospital in Spain, and is reported to be ill, but stable.

Brantly and Writebol are still in Emory University Hospital in quarantine.  Emory is prevented from releasing much information on patients’ conditions due to privacy laws.  But Nancy Writebol’s son said that he and other members of the family visited with her yesterday.  He says she is very tired and still fighting the disease. Brantly has apparently requested that no information be released about his condition.

The CDC has moved the Ebola outbreak status to its highest level of alert.  It declared the outbreak a Level 1 activation.  Level 1 activations are only rarely used. In the past, the CDC has declared such high level alerts after Hurricane Katrina and during severe flu pandemics.  This upgrade in classification will allow the CDC to increase its degree of response to the emergency.  It will be sending an additional 50 CDC staff to the area over the next 30 days.

who-logoThis move was sparked by the disease outbreak reaching Nigeria.  The World Health Organization is considering classifying the outbreak as an international public health emergency.  If it does so, that can lead to policies that could cause quarantine procedures to be enforced, halting air travel to affected areas, etc.

ZMapp, the experimental drug that was given to the two US healthcare personnel infected with Ebola, is being sought after by Nigeria and other countries involved in the outbreak.  It is in very limited supply.  More can be made, but it will take time.  In the meantime, the WHO is going to convene a panel of bioethicists to help decide how the drug should be apportioned.

A Saudi has died in Jeddah from a viral hemorrhagic fever, like Ebola.  He had recently returned from a business trip to Liberia.  He was hospitalized and quarantined, but continued to deteriorate and died. It is unknown if he did have Ebola, tests are still pending.

In the three nations most severely affected (Liberia, Guinea and Sierra Leone) there is continuing social upheaval, to a degree.  The local police and military are being used to enforce quarantine and screening policies, protect clinics and healthcare workers.  In some areas of these countries they are being used to do a house to house check to see if there may be Ebola patients being kept at  home.  In other areas, they are blockading off Ebola-infected villages to prevent further spread of the disease.

Some families have dumped the bodies of relatives who have (presumably) died from Ebola in the streets rather than calling the health ministry officials to pick them up for cremation.  In other instances, families will drop of a patient suspected of having Ebola at a clinic and then the family will leave the area.  People are afraid of being sent off to be quarantined, fearing that they will get the virus there.  Governments are doing outreach/education campaigns to get the information on the virus out to the citizens.  They have set up hotlines and are posting signs and showing videos to try to get information out to help with containment.

Nigeria, as well as the other countries hard hit with Ebola,  has publicly asked for volunteer healthcare workers to come to Nigeria to help them in case more Ebola cases appear.  Right now, there have been two deaths in Nigeria that may be due to Ebola and about 8 other patients now in quarantine with suspected Ebola.  Sierra Leone, Guinea and Liberia, are very much strapped by this outbreak.  They were poor before the disease started and are in even worse shape now.  All have appealed for help from outside sources.  The WHO will try to increase funding to these countries, or help in sending them medical supplies, food, medications and other necessary supplies.

As of yesterday, there are about 1,700 suspected or confirmed cases of Ebola in the affected regions. There have been about 932 fatalities. That means that about 56% of patients who get Ebola, and are treated in Africa, die from the disease.

Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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