[stem-ebola] PRO/AH/EDR> Ebola virus disease - ex Africa (25): Norway do

[alex@xxxxxxxxxxxxxx]

EBOLA VIRUS DISEASE - ex AFRICA (25): NORWAY DOCTOR, USA QUARANTINE,
VACCINES
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In this update:
[1] Norway: MSF doctor recovered
[2] USA: quarantine controversy
[3] Rapid diagnostic test
[4] EU: 24.4 million euros to develop vaccine against Ebola
[5] Russia: vaccine trials
[6] Insurance increase

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[1] Norway: MSF doctor recovered
Date: 22 Oct 2014
Source: MSF [excerpted, edited]
<http://www.doctorswithoutborders.org/article/norwegian-aid-worker-recovers-ebola>


On Mon 20 Oct 2014, SLM, a medical doctor working with Doctors Without
Borders/Medecins Sans Frontieres (MSF) was discharged from Oslo
University Hospital, Ulleval. She was treated for Ebola hemorrhagic
fever after having contracted the disease on Sat 4 Oct 2014, after
working 2 weeks at an Ebola center in Bo, Sierra Leone... After
testing positive for Ebola on Sun 5 Oct 2014, she was flown to Oslo in
an incubator of sorts [sic], which was airtight and infection proof,
and then transferred to Ulleval Hospital... She has now recovered and
is no longer infectious...

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******
[2] USA: quarantine controversy
Date: 26 Oct 2014
Source: Reuters [edited]
<http://www.reuters.com/article/2014/10/26/us-health-ebola-usa-idUSKBN0IF03L20141026>


Quarantines imposed on travelers coming from Ebola-affected countries
in West Africa could discourage American health workers from going
there to help fight the epidemic, a senior U.S. medical official said
on Sun [26 Oct 2014]...

New York, New Jersey and Illinois imposed 21-day mandatory quarantines
in the last 2 days for anyone arriving with a risk of having
contracted Ebola in Sierra Leone, Liberia and Guinea. They are the 3
West African countries that have borne the brunt of an epidemic that
has killed nearly 5000 people. But critics worry the policies, going
beyond federal regulations and intended to ease public concern over
the spread of the disease, will just make matters worse. "I don't want
to be directly criticizing the decision that was made, but we have to
be careful that there are unintended consequences," said Anthony
Fauci, director of the National Institute of Allergy and Infectious
Diseases. "The best way to stop this epidemic is to help the people in
West Africa, we do that by sending people over there, not only from
the U.S.A. but from other places," Fauci told NBC's "Meet the Press."
He called such quarantines "a little bit draconian."

The states' policies were abruptly imposed after a New York City
doctor was diagnosed with the disease on Thu [23 Oct 2014] after
coming home from treating patients in Guinea. A nurse who returned on
Fri [24 Oct 2014] through New Jersey's Newark airport after working in
Sierra Leone with Ebola patients strongly criticized the quarantine
policy on Sat [25 Oct 2014], describing hours of questioning and then
transfer to a hospital isolation tent. She called her treatment a
"frenzy of disorganization."

Fauci reiterated what the medical officials have been stressing as
Americans worry about Ebola: that it is spread only by contact with
bodily fluids of people with symptoms. "The science tells us that
people who are not sick, if you do not come into contact with body
fluid, if someone comes back from wherever, Liberia, and they're well,
they are no danger to anyone," Fauci said. But New Jersey Governor
Chris Christie, asked to respond to Fauci's comment that it is not
good science to quarantine people who are not symptomatic, said, "I
don't believe that when you're dealing with something as serious as
this that we can count on a voluntary system."

"This is government's job. If anything else, the government's job is
to protect the safety and health of our citizens," he told the "Fox
News Sunday" program. Asked whether the new rules would discourage
health workers from going to West Africa, Christie added, "Folks that
are willing to take that step and willing to volunteer also understand
that it's in their interest and in the public health's interest to
have a 21-day period thereafter if they've been directly exposed to
people with the virus."... The governor is considered a likely
candidate for the Republican presidential nomination...

[Byline: Douwe Miedema & Jonathan Allen]

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******
[3] Rapid diagnostic test
Date: 22 Oct 2014
Source: UT San Diego [edited]
<http://www.utsandiego.com/news/2014/oct/22/genalyte-ebola-test/?>


Sprinting into the race to commercialize an Ebola diagnostic, San
Diego's Genalyte says it has developed a 10-minute Ebola test. The
company said its test uses one drop of blood from a finger prick and
offers results in as fast as 10 minutes on its diagnostic platform.
The test detects Ebola proteins, even at an early stage of infection
before the person is showing obvious symptoms [This last feature could
be a game changer - Mod.JW].

Genalyte says validation of the test "is only weeks away," and it
wants to work with the federal government to make the test available
as rapidly as possible. The test is based on a proprietary silicon
chip technology and run on Genalyte's Maverick Detection System
testing platform. The platform is being used now to test for immune
system rejection of biologic drugs, such as monoclonal antibodies...
For the Ebola test, the chip is coated with antibodies that bind to
the viral proteins. Blood flows directly over the chip, Gunn said...
The Maverick system can process up to 100 tests per hour per
instrument. Each instrument costs around USD 120 000, and the chips
will cost about USD 10 each, Gunn said. The system requires standard
electrical power. But the power ... can come from a generator, he
said...

[Byline: Bradley J. Fikes]

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[Cost will be a serious limitation. Also, if deployed in West Africa,
experience with expensive electronic equipment in the tropics, even
inside air-conditioned premises, shows short operational life and
difficulty, time and expense of repairing and replacing parts; they
have to be flown out with a repair technician, who will need salary,
airfare and per diem, a visa and yellow fever vaccination certificate
dated at least 10 days earlier, clear customs, etc. - Mod.JW]

******
[4] EU: 24.4 million euros to develop vaccine against Ebola
Date: 24 Oct 2014
Source: Tass [edited]
<http://en.itar-tass.com/world/756177>


The European Union provides EUR 24.4 million euros [USD 31 million,
GBP 19 million] for research to develop a vaccine against Ebola,
outgoing European Commission President Jose Manuel Barroso said after
the 1st day of the EU summit. The research will be aimed at containing
the epidemic and protecting medical personnel, 1st of all developing
vaccine, he said...

Smaller EU countries have said they are ready to send healthcare
workers to West Africa but lack the resources to evacuate them if they
caught the disease. The EU addressed this problem this week by
providing a guarantee to international health workers that they would
either be flown to Europe or receive high-quality treatment on the
spot if they caught the disease in West Africa...

[Byline: Dennis M. Sabangan]

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Communicated by:
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[The high-quality treatment facilities on the spot are still under
construction. - Mod.JW]

******
[5] Russia: vaccine trials
Date: 24 Oct 2014
Source: Tass [edited]
<http://en.itar-tass.com/world/756252>


Russia has launched the production of a trial batch of the Ebola
vaccine Triazavirin that will be sent to Africa in the coming days for
efficiency tests, head of the vaccine producer Yunona (Juno)
pharmaceutical holding Alexander Petrov said on Fri [24 Oct 2014]. EU
provides EUR 24.4 million [USD 31 million] to develop vaccine against
Ebola. The vaccine was created by the Ural Biopharmaceutical
Technology Center.

Triazavirin has been approved by the Russian Health Ministry, Petrov
said. "Studies have confirmed the medicine's high efficiency against a
number of viral infections, influenza, tick-borne encephalitis and
exotic viruses that are common in Africa and Asia," the scientist
said. Tests of Triazavirin have shown the vaccine's high efficiency
(70-90 percent) against various kinds of haemorrhagic fevers,
including Marburg fever, which has a close relation to Ebola...

Russia and Guinea will ink a memorandum on the fight with the Ebola
virus outbreak in the coming week, Golodets said on Fri [24 Oct
2014]...

[Byline: Dennis M. Sabangan]

--
Communicated by:
ProMED-mail
<promed@xxxxxxxxxxxxxx>

[Presumably, this is to be tested in Guinea. A field trial will have
the same problems mentioned before: unknown infection/incubating
status of subjects unless isolated for at least 21 days before
vaccination; unknown dose of subjects virus positive before even
starting, risk of serious or even fatal side-effects discrediting the
vaccine, all leading to allegations that the vaccine is transmitting
the virus. Then, how would the research team know the date vaccinated
persons were subsequently exposed to infection? There would be ethical
constraints against requiring them to work in an Ebola Treatment Unit
without PPE. - Mod.JW]

******
[6] Insurance increase
Date: 23 Oct 2014
Source: Reuters [edited]
<http://www.reuters.com/article/2014/10/22/health-ebola-insurance-idUSL3N0SG69X20141022>
and
Date: 22 Oct 2014
Source: Business Insider [edited]
<http://www.businessinsider.com/insurance-now-has-ebola-exclusions-2014-10>


As fear of Ebola infections spreads to developed economies, U.S. and
British insurance companies have begun writing Ebola exclusions into
standard policies to cover hospitals, event organisers and other
businesses vulnerable to local disruptions. As a result, new policies
and renewals will become costlier for companies opting to insure
business travel to West Africa or to cover the risk of losses from
quarantine shutdowns at home, industry officials told Reuters...

ACE Ltd said on Wed [22 Oct 2014] that its global casualty unit, which
offers coverage for U.S.-based companies whose employees travel or
that have operations abroad, was using a policy endorsement to exclude
Ebola on a "case-by-case basis" during the underwriting process on new
policies and renewals. "Probably the biggest issue coming up is
business interruption," said Tony DeFelice, managing director of Aon
Risk Solutions' national casualty practice in the United States. A
business interruption could be anything from the loss of key employees
to sickness to the quarantine of an airliner or cruise ship used by a
suspected patient suffering from Ebola or any other serious infectious
disease.

[Byline: Carolyn Cohn, Richa Naidu & Avik Das]

--
Communicated by:
Roger Feldman <promedrf@xxxxxxxxx>

[This will drive up prices for all cargo destined for West Africa and
further exacerbate their precarious financial situations. - Mod.JW

A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/promed/p/107>.]

[See Also:
Ebola virus disease - ex Africa (24): USA nurse better, China, USA
troops 20141025.2899189
Ebola virus disease - ex Africa (23): USA (NYC) MSF doctor ex Guinea
20141024.2895748
Ebola virus disease - ex Africa (22): Canada, China, France, UK, USA,
guidelines 20141022.2891397
Ebola virus disease - ex Africa (21): USA, TX free, control, ebook
20141021.2884364
Ebola virus disease - ex Africa (20): Spain negative, India, USA,
China 20141019.2880692
Ebola virus disease - ex Africa (19): Spain, USA, travel bans,
prevention 20141018.2875795
Ebola virus disease - ex Africa (18): Ethiopia NOT, USA nurses,
prevention 20141016.2872362
Ebola virus disease - ex Africa (17): USA (Texas) 2nd nurse update
20141015.2868385
Ebola virus disease - ex Africa (16): USA (TX) 2nd nurse case
20141015.2866172
Ebola virus disease - ex Africa (15): USA (Texas) 2nd nurse case
20141015.2866172
Ebola virus disease - ex Africa (14): UN doctor dies, USA, prevention
20141014.2863794
Ebola virus disease - ex Africa (13): Ethiopia susp., USA (TX)
prevention 20141013.2859164
Ebola virus disease - ex Africa (12): USA new case, Spain, more
quarantined 20141012.2856660
Ebola virus disease - ex Africa (11): Europe, threat to N. America,
recurrence 20141011.2854247
Ebola virus disease - ex Africa (10): WHO, UN, Liberia, medevac, S.
Leone, USA 20141010.2851248
Ebola virus disease - ex Africa (09): WHO, Spain, Australia, Canada,
USA 20141009.2848352
Ebola virus disease - ex Africa (08): US death, concern re. spread,
travel ban 20141008.2843902
Ebola virus disease - ex Africa (07): Europe cases, USA quarantine
stations 20141007.2840925
Ebola virus disease - ex Africa (06): Spain case, USA case, US case
medevaced 20141006.2837374
Ebola virus disease - ex Africa (05): USA ex Liberia, prevention
20141005.2834301
Ebola virus disease - ex Africa (04): USA ex Liberia, prevention
20141004.2832236
Ebola virus disease - ex Africa (03): USA ex Liberia, Germany case ex
S. Leone 20141003.2830392
Ebola virus disease - ex Africa (02): USA ex Liberia, prevention,
false alarms 20141002.2827166
Ebola virus disease - ex Africa: USA ex Liberia, WHO 20141001.2823539
Ebola virus disease - West Africa (184): USA (TX) first case ex
Liberia 20140930.2819341]
.................................................sb/jw/msp
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