Vectors, Hosts, Fomites and Food….The challenge of controlling Ebola in West Africa

John T. Hoffman

Colonel, USA, Retired

Senior Research Fellow

National Center for Food Protection and Defense

University of Minnesota

September 29, 2014

Control of VHF Ebola in West Africa is complicated by the fact that we know so little as to the mechanisms for the spread of the disease other than direct contact with infected persons or their bodily fluids, which local wildlife and rodents actually serve as hosts for the virus and the actual survivability of viable Ebola virus on fomites.   Given these knowledge gaps, modeling the spread and control of the disease with any probability of being close to reality is unlikely.    Potentially, these gaps suggest that the current focus on treatment and traditional control protocols have be insufficient to stop the outbreak and produce an Ebola free West Africa. 

A C-17 U.S. military aircraft arrived in Liberia on Sept. 18, 2014, with the first shipment of U.S. military equipment and personnel for the anti-Ebola fight, which was promised by President Barack Obama in a speech September 16, 2014, at the Centers for Disease Control and Prevention in Atlanta, Georgia.

stripes.com -Associated Press - September 29, 2014

The U.N. mission to combat Ebola is opening its headquarters in Ghana, where it will coordinate aid for the West African crisis.

The head of the mission, Anthony Banbury, and his team are expected to arrive Monday in Ghana's capital, Accra. The United Nations Mission for Ebola Emergency Response, also known as UNMEER, will work to identify the biggest needs during this outbreak, especially in the three hardest-hit countries of Liberia, Sierra Leone and Guinea.

(READ COMPLETE ARTICLE)

Update

New York Times           Sept. 30, 2024

By DONALD G. McNEIL Jr

Lagos --With quick and coordinated action by some of its top doctors, Nigeria, Africa’s most populous country, appears to have contained its first Ebola outbreak, the United States Centers for Disease Control and Prevention said Tuesday.

As the epidemic rages out of control in three nations only a few hundred miles away, Nigeria is the only country to have beaten back an outbreak with the potential to harm many victims in a city with vast, teeming slums.

“For those who say it’s hopeless, this is an antidote — you can control Ebola,” said Dr. Thomas R. Frieden, director of the C.D.C.   ....

By Michael Gerson - September 15 2014 - washingtonpost.com

The nation of Liberia — founded by liberated American slaves with support from Henry Clay, Daniel Webster and James Monroe — is not unacquainted with suffering. Two civil wars in the period from 1989 to 2003 and decades of economic mismanagement caused an 80 percent decline in per capita GDP — perhaps worse than any country since World War II. Warlords reduced Liberia’s infrastructure to rubble. In the 15 years following 1991, there was no electricity in the country except for private generators.

Thomson Reuters Foundation

By Stella Dawson

Mon Sep 29, 2014 

WASHINGTON - The rainy season in West Africa is compounding difficulties in getting supplies delivered and new treatment centers built as donors rush to isolate people infected with the deadly Ebola virus and stop its rapid spread, U.S. officials said.

Nancy Powell, newly appointed as the U.S. State Department's envoy to coordinate its Ebola response, said the top priority is to isolate as many people as quickly as possible. But that faces significant logistical hurdles.

"Infrastructure challenges in the rainy season is one of the biggest difficulties. And you add the rain and getting materials out of the capital and it is very difficult," Powell said in a news briefing last week.

The July to September rainy season is coming toward its end, but October is known for heavy thunderstorms that can drench the region and turn roads to mud.

Eric Talbert, executive director of Emergency USA which has opened a 22-bed Ebola treatment center in Goderich, outside the capital of Freetown in Sierra Leone, said the downpours complicate getting supplies along unpaved single track roads that are washed out by the heavy rains..

Local workers look on as a team or U.S. Navy engineers prepares the ground for a 25-beds medical facility they are building next to the airport in Monrovia, Liberia, Sept. 27, 2014.

voanews.com - by Benno Muchler - September 29, 2014

MONROVIA—Over the past two weeks, one world leader after the other has called for immediate action in the fight against Ebola in West Africa.

The United States has made the largest contribution and is sending 3,000 troops to Liberia to assist with healthcare logistics. It is the biggest military operation for America in Africa since withdrawing forces from Somalia in 1993.

(READ COMPLETE ARTICLE)

Wall Street Journal     Sept. 28, 2014 8:10 PM

By Drew Hinshaw in Robertsville, Liberia, and Betsy McKay in Atlanta

The American military effort against history's deadliest Ebola outbreak is taking shape in West Africa, but concerns are mounting that the pace isn't fast enough to check a virus that is spreading at a terrifying clip.

On Saturday, a handful of troops from the Navy's 133rd Mobile Construction Battalion led a bulldozer through thigh-high grass outside Liberia's main airport, bottles of hand sanitizer dangling from their belt loops.

They had been digging a parking lot in the East African nation of Djibouti this month when they received a call to build the first of a dozen or more tent hospitals the U.S intends to construct in this region. The soldiers started by giving the land a downward slope for water runoff—"to keep out any unwanted reptiles," said Petty Officer Second Class Justin Holsinger.

While this team levels the earth, superiors hash out the still-uncertain details of the American intervention here.

Bulk of promised global aid has yet to materialize on the ground

 The Associated Press Posted: Sep 28,  Updated: Sep 28, 2014 1:10 PM ET

  Doctors are in short supply. So are beds for patients. Six months after the Ebola outbreak emerged for the first time in an unprepared West Africa and eventually became the worst-ever outbreak, the gap between what has been sent by other countries and private groups and what is needed is huge.

Even as countries try to marshal more resources, those needs threaten to become much greater, and possibly even insurmountable....

Beds are filling up as fast as clinics can be built. Ambulance sirens blare through standstill traffic. Often, there is nowhere to take the sick except to "holding centres" where they await a bed at an Ebola treatment facility.

The virus has killed almost 3,000 people and infected more than 6,200 in Liberia, Sierra Leone, Guinea, Nigeria and Senegal.

Her trash bag protection method is being taught to others in West Africa who can't get personal protective equipment.
John Bonifield / CNN

cnn.com - by Elizabeth Cohen - September 26, 2014

. . . imagine how 22-year-old Fatu Kekula felt nursing her entire family through Ebola. . .

. . . Three out of her four patients survived. . .

. . . Fatu, who's in her final year of nursing school, invented her own equipment. International aid workers heard about Fatu's "trash bag method" and are now teaching it to other West Africans who can't get into hospitals and don't have protective gear of their own.

(READ COMPLETE ARTICLE)

By Cheryl Pellerin

DoD News, Defense Media Activity

WASHINGTON, Sept. 26, 2014 – The Defense Department has made critical contributions to the fight against the deadly Ebola outbreak in West Africa, and today Defense Secretary Chuck Hagel described additional ways the Pentagon is helping in the broader battle against infectious disease outbreaks of the future.

He spoke at a gathering of top government and military officials and infectious disease experts from 44 countries here to attend the Global Health Security Agenda, or GHSA, Summit hosted by President Barack Obama.

Hagel said ...the department also is accelerating the manufacture of potential treatments and starting clinical trials for a vaccine candidate and it has received approval to begin safety testing for one [Ebola] vaccine candidate that will be conducted at the Walter Reed Army Institute of Research.”

...The DoD Cooperative Threat Reduction Program is providing unique resources and expertise to enhance detection and surveillance, Hagel said, and all department assets will help civilian responders contain Ebola's spread and mitigate its economic, social and political fallout.

For fuller description of the Defense Department's activities to counter Ebola see link to the full article:

The Washington Post Follow-up to the original CNN report        Oct. 2, 2014

Since the original CNN interview, Logan has been in contact with Dr. Fauci. "I can't say it's a good idea or bad idea," Fauci told The Post this week. "It's one of those things where you're in a situation where you have no therapy, so you look for things that might be available."

Fauci said National Institutes of Health researchers have tested lamivudine's reaction to Ebola in test tubes. There was no response; but Fauci said researchers will adjust some levels and try it again "to see if there's even slight activity against Ebola."

If there is, he said, NIH would consider going to the trial stage.

It makes sense to consider lamivudine as a potential Ebola treatment: It belongs to a group of drugs known as nucleoside analogs, which interfere with the replication processes of certain viruses, Fauci explained.

See Washington Post report

http://www.washingtonpost.com/news/to-your-health/wp/2014/10/02/a-liberian-doctor-is-using-hiv-drugs-to-treat-ebola-victims-the-nih-is-intrigued/

uschamberfoundation.org

Event: Corporate Citizenship Center - Ebola Outbreak Coordination Conference Call
Friday, September 26, 2014 - 2:00pm

The U.S. Chamber of Commerce Foundation Corporate Citizenship Center (CCC) hosted a conference call on Friday, September 26 at 2:00 p.m. Eastern Time to discuss the Ebola outbreak in West Africa.

Over the past six months, an Ebola outbreak has affected five countries in West Africa (Guinea, Liberia, Nigeria, Senegal, and Sierra Leone).  The current outbreak is unprecedented in scale and geographical reach: the present West Africa outbreak has a higher caseload than all other previous Ebola crises combined.  Worse yet, the United Nations reports that the outbreak continues to accelerate, with almost 40% of the total cases occurring in the past 21 days.

CCC’s Ebola coordination conference call will provide updated information on the humanitarian response and the efforts to contain the disease.  It will also detail ways that the business community can help.

CLICK HERE - Listen to the Call Archive

ASSOCIATED PRESS  SEPTEMBER 27, 2014

MONROVIA, Liberia (AP) — Liberia's chief medical officer is placing herself under quarantine for 21 days after her office assistant died of Ebola.

Bernice Dahn, a deputy health minister who has represented Liberia at regional conferences intended to combat the ongoing epidemic, told The Associated Press on Saturday that she did not have any Ebola symptoms but wanted to ensure she was not infected.

...

"Of course we made the rule, so I am home for 21 days," Dahn said Saturday. "I did it on my own. I told my office staff to stay at home for the 21 days. That's what we need to do."

...

Meanwhile, Senegal was expected on Saturday to receive a flight carrying humanitarian staff from Guinea — the first time aid workers from one of the three most-affected countries were allowed in Senegal since the corridor was opened, said Alexis Masciarelli, spokesman for the World Food Program.

LINK TO FULL STORY

submitted by Sarah Slaughter

The Field Deployable Hydrolysis System was designed, developed and fabricated by a government team to provide a transportable, high throughput neutralization system designed to convert chemical warfare materiel into compounds not usable as weapons.

defense.gov

The Field Deployable Hydrolysis System (FDHS) is a transportable, high-throughput modular demilitarization system designed to render chemical warfare materiel into compounds not usable as weapons. The system uses neutralization technology to destroy bulk chemical warfare agents and their precursors by heating and mixing with reagents, such as water, sodium hydroxide and sodium hypochlorite to facilitate chemical degradation resulting in a destruction efficiency of 99.9 percent. The neutralization process generates hazardous waste in volumes of five to 14 times the volume of chemical warfare materiel treated. This hazardous waste can then be commercially disposed of in accordance with host-nation environmental laws.