Update: Reverse engineered Spanish flu; Ebola “out of control”

(News & Editorial/Update: US has reverse engineered Spanish influenza; Ebola “out of control”)

A.  A Flu Virus That Killed Millions in 1918 Has Now Been Recreated
13 June  2014, Vice News, by Olivia Becker
Excerpt pasted from; https://news.vice.com/article/a-flu-virus-that-killed-millions-in-1918-has-now-been-recreated

Scientists have recreated a nearly exact replicate of the deadly flu virus that killed an estimated 50 million in the 1918 Spanish flu pandemic. But don’t worry, they say it’s totally safe.

 Researchers at the University of Wisconsin-Madison reverse engineered an influenza virus from a similar one found in birds, combining several strains to create one that is nearly identical to the one that caused the 1918 outbreak. They then mutated the genes to make it airborne, and to study how it spreads between animals.

“Our research indicates the risks inherent in circulating avian influenza viruses,” Yoshihiro Kawaoka, the scientist who led the research team, told VICE News. “Continued surveillance of avian influenza viruses — and not only viruses that we know pose risks for humans, such as H5N1 and H7N9 influenza viruses, and attention to pandemic preparedness measures is important.”

According to the statement summarizing the project published this week, the “analyses revealed the global prevalence of avian influenza virus genes whose proteins differ only a few amino acids from the 1918 pandemic influenza virus, suggesting that 1918-like pandemic viruses may emerge in the future.”

In other words, a common avian flu virus that has been circulating in wild ducks is pretty much the exact same one that infected humans a century ago. And now is in a lab.

But many scientists disagree and have condemned research that recreates virus’ such this, stating that if released accidentally, a virus could spread to humans and cause a pandemic.

Marc Lipsitch, an epidemiologist at Harvard, has criticized research such as Kawaoka’s as unnecessarily risky.

“There is a quantifiable possibility that these novel pathogens could be accidentally or deliberately released. Exacerbating the immunological vulnerability of human populations to PPPs is the potential for rapid global dissemination via ever-increasing human mobility,” Lipsitch said in a paper about experiments with transmissible virus’. “The dangers are not just hypothetical.”

Lipsitch points out that many of the H1N1 flu outbreaks that have occurred between 1977 and 2009 were a result of a lab accident.

Kawaoka disagrees, saying, “We maintain that it is better to know as much as possible about the risk posed by these viruses so we may be able to identify the risk when viruses with pandemic potential emerge, and have effective countermeasures on-hand or ready for development.”

B.  Outbreak of Ebola in Guinea, Liberia, and Sierra Leone
Centers for Disease Control and Prevention
Pasted from: http://www.cdc.gov/vhf/ebola/outbreaks/guinea/

[Tracing the outbreak back  2-1/2 months to it roots-lfp]
June 5, 2014 Outbreak Update

  • As of June 3, 2014, Guinea’s Ministry of Health was reporting 344 cumulative cases of Ebola hemorrhagic fever (EHF), including 215 deaths and 207 laboratory confirmed cases. Cases are currently being reported from the Conakry, Télimélé, Boffa, Boke, and Dubreka districts in the west, and the Guéckédou and Macenta districts in the south (see map below).
  • The Ministry of Health and Sanitation of Sierra Leone reported on June 5, 2014 that 81 suspect cases are under investigation, 31 cases have been laboratory confirmed, and 7 deaths have been reported. Suspect cases are now being reported from eight districts including Kailahun, Kenema, Koinadugu, Bo, Moyamba, Bombali, Western area urban, and Port Loko. Laboratory testing is being conducted in Kenema. Sierra Leone and WHO has sent experts to aid in the response and investigation. 

ebola map

May 28, 2014, Outbreak Update

  • The World Health Organization (WHO) reported on May 27, 2014, 14 new suspect cases of Ebola hemorrhagic fever (EHF) and 5 deaths occurring in western Guinea from May 23-27. For the first time, cases are being reported from Boffa, Boke, and Dubreka counties. Additional cases are still being reported in Télimélé, Guékédou, Macenta, and Conakry. The cumulative total of EHF cases as reported by Guinea’s Minisitry of Health, stands at 281 (163 laboratory confirmed) with 186 deaths.
  • In Sierra Leone, WHO states that 7 EHF cases have been laboratory confirmed with an additional 9 suspect cases and 5 community deaths under investigation. All suspect cases are reported to be from the Kailahun district of Sierra Leone which neighbors the current EHF hotspot in Guekedou, Guinea. Laboratory testing was conducted in Kenema, Sierra Leone and WHO has sent experts to aid in the response and investigation.
  • No cases have been reported in Liberia since April 9, 2014.

April 30, 2014, Outbreak Update

  • On April 29, 2014, the Ministry of Health (MoH) of Guinea’s reported 221 suspect and confirmed cases of Ebola hemorrhagic fever (EHF), including 146 deaths. Of these suspect cases, 126 have been laboratory confirmed positive cases of Ebola hemorrhagic fever (EHF). The number of health care workers reported among the suspect and confirmed cases remains at 25, including 16 deaths. Other districts reporting suspect and confirmed cases remain Guekedou, Macenta, Kissidougou, Dabola, and Djingaraye.
  • The Ministry of Health and Social Welfare (MOHSW) of Liberia, together with CDC and WHO, reviewed suspect and confirmed EHF case definitions for Liberia. As of April 30, 2014, the newly revised number of suspect and confirmed cases of EHF in Liberia is 13. Six (6) samples have tested positive for Ebola virus. Samples from Mali and Sierra Leone have, thus far, been negative for Ebola virus though investigations and monitoring of reports of suspect cases is ongoing.

April 17, 2014, Outbreak Update

  • On April 16, 2014, the Ministry of Health of Guinea reported 197 probable and suspect cases of Ebola hemorrhagic fever (EHF), including 122 deaths, according to the World Health Organization (WHO). Of these suspect cases, 101 have been laboratory confirmed positive cases of Ebola hemorrhagic fever (EHF). 24 health care workers have been reported among the suspect and confirmed cases, including 13 deaths. Other districts reporting suspect and confirmed cases remain Guekedou, Macenta, Kissidougou, Dabola, and Djingaraye.
  • According to WHO and the Ministry of Health and Social Welfare (MOHSW) of Liberia, the cumulative total of probable and suspect cases of EHF is 27, with 13 deaths as of April 16, 2014. Samples from Mali and Sierra Leone have, thus far, been negative for Ebola virus though investigations and monitoring on reports of suspect cases is ongoing.
  • MSF/Doctors without Borders is helping the Ministry of Health of Guinea in establishing Ebola treatment centers in the epicenter of the outbreak. In Liberia, several international organizations including the International Red Cross (IRC), Pentecostal Mission Unlimited (PMU)-Liberia, and Samaritan’s Purse (SP) Liberia are aiding the MOHSW of Liberia by supporting awareness campaigns and providing personal protective equipment (PPE) for healthcare workers. The Institute Pasteur in Lyon, France, the Institut Pasteur in Dakar, Senegal, the European Consortium mobile laboratory, and the Metabiota/Tulane University laboratory in Kenema, Sierra Leone, and CDC Atlanta are some of the laboratories collaborating to test samples. CDC is in regular communication with its international partners, WHO, and MSF regarding the outbreak. Currently CDC has and a 6 person team in Guinea and a 3 person team in Liberia assisting the respective MOHs and the WHO-led international response to this Ebola outbreak.

April 2, 2014, Outbreak Update

  • According to the World Health Organization (WHO), the Ministry of Health (MoH) of Guinea reported an increased total of 127 probable and suspect cases, including 83 deaths (case fatality ratio: 65%), as of April 1, 2014. Of these suspect cases, 35 have been laboratory confirmed positive cases of Ebola hemorrhagic fever (EHF), including 14 health care workers and 11 cases in Conakry, the capitol. Liberia has reported 8 suspect cases, which include 5 deaths and 2 laboratory-confirmed cases of EHF from persons with recent travel history to Guinea. Additional reports of suspect cases in Liberia and Sierra Leone are under investigation.
  • Doctors without Borders) is helping the Ministry of Health of Guinea in establishing Ebola treatment centers in the epicenter of the outbreak. In Liberia, several international organizations including the International Red Cross (IRC), Pentecostal Mission Unlimited (PMU)-Liberia, and Samaritan’s Purse (SP) Liberia are aiding the Ministry of Health of Liberia by supporting awareness campaigns and providing personal protective equipment (PPE) for healthcare workers. The Institut Pasteur in Lyon, France, and the Institut Pasteur in Dakar, Senegal are a few of the laboratories collaborating to test samples. To date, 37 cases from Guinea and Liberia have been laboratory confirmed by PCR for Ebola virus. CDC is in regular communication with its international partners WHO and MSF regarding the outbreak, and has sent a 5 person team to Guinea to assist Guinea MOH and WHO led international response to the Ebola outbreak.

March 25, 2014, Initial Announcement

  • According to the World Health Organization (WHO), the Ministry of Health (MoH) of Guinea has reported an outbreak of Ebola hemorrhagic fever in four southeastern districts: Guekedou, Macenta, Nzerekore and Kissidougou. Reports of suspected cases in the neighboring countries of Liberia and Sierra Leone are being investigated. In Guinea, a total of 86 suspected cases, including 59 deaths (case fatality ratio: 68.5%), had been reported as of March 24, 2014. Preliminary results from the Pasteur Institute in Lyon, France suggest Zaire ebolavirus as the causative agent. Médecins sans Frontières (MSF/Doctors without Borders) is helping the Ministry of Health of Guinea in establishing Ebola treatment centers in the epicenter of the outbreak. CDC is in regular communication with its international partners WHO and MSF regarding the outbreak, to identify areas where CDC subject matter experts can contribute to the response.

C. Doctors Without Borders: Ebola ‘out of control’
20 June 2014, Associated Press, by SARAH DiLORENZO
Pasted from: http://www.boston.com/health/2014/06/20/ebola-out-control-doctors-without-borders/gxjq53wYl4CVS9QFh73ALI/story.html

ebola dr wo borders

[FILE – In this file photo provide by Medecins Sans Frontieres (Doctors without Borders), taken on Friday, March 28, 2014, healthcare workers from the organization, prepare isolation and treatment areas for their Ebola, hemorrhagic fever operations, in Gueckedou, Guinea. One preacher advocated fasting and prayer to spare people from a virus that usually leads to a horrible death. Some people pray that the Ebola virus stays confined to a rural district. Others are unruffled and say the outbreak will blow over. AP Photo/Kjell Gunnar Beraas, MSF, File]

DAKAR, Senegal (AP) — The Ebola outbreak ravaging West Africa is ‘‘totally out of control,’’ according to a senior official for Doctors Without Borders, who says the medical group is stretched to the limit in responding.

The outbreak has caused more deaths than any other of the disease, said another official with the medical charity. Ebola has been linked to more than 330 deaths in Guinea, Sierra Leone and Liberia, according to the World Health

International organizations and the governments involved need to send in more health experts and increase public education messages about how to stop the spread of the disease, Bart Janssens, the director of operations for the medical group in Brussels, told The Associated Press on Friday.

‘‘The reality is clear that the epidemic is now in a second wave,’’ Janssens said. ‘‘And, for me, it is totally out of control.’’

The Ebola virus, which causes internal bleeding and organ failure, spreads through direct contact with infected people. There is no cure or vaccine, so containing an outbreak focuses on supportive care for the ill and isolating them to limit the spread of the virus.

The current outbreak, which began in Guinea either late last year or early this year, had appeared to slow before picking up pace again in recent weeks, including spreading to the Liberian capital for the first time.

‘‘This is the highest outbreak on record and has the highest number of deaths, so this is unprecedented so far,’’ said Armand Sprecher, a public health specialist with Doctors Without Borders.

According to the WHO, the highest previous death toll was in the first recorded Ebola outbreak in Congo in 1976, when 280 deaths were reported. Because Ebola often touches remote areas and the first cases sometimes go unrecognized, it is likely that there are deaths that go uncounted during outbreaks.

The multiple locations of the current outbreak and its movement across borders make it one of the ‘‘most challenging Ebola outbreaks ever,’’ Fadela Chaib, a spokeswoman for the World Health Organization, said earlier in the week.

But Janssens’ description of the Ebola outbreak was even more alarming, and he warned that the countries involved had not recognized the gravity of the situation. He criticized WHO for not doing enough to prod local leaders; the U.N. health agency did not immediately respond to requests for comment.

‘‘There needs to be a real political commitment that this is a very big emergency,’’ he said. ‘‘Otherwise, it will continue to spread, and for sure it will spread to more countries.’’

But Tolbert Nyenswah, Liberia’s deputy minister of health, said the highest levels of government are working to contain the outbreak, noting that Liberia had a long period with no new cases before this second wave.

Governments and international agencies are definitely struggling to keep up with the outbreak, said Unni Krishnan of Plan International, which is providing equipment to the three countries. But he noted that the disease is striking in one of the world’s poorest regions, where public health systems are already fragile.

With more than 40 international staff currently on the ground and four treatment centers, Doctors Without Borders has reached its limit to respond, Janssens said. It is unclear, for instance, if the group will be able to set up a treatment center in Liberia, like the ones it is running in in Guinea and Sierra Leone, he said.

Janssens said the only way to stop the disease’s spread is to persuade people to come forward when symptoms occur and to avoid touching the sick and dead.

He said this outbreak is particularly challenging because it began in an area where people are very mobile and has spread to even more densely populated areas, like the capitals of Guinea and Liberia. The disease typically strikes sparsely populated areas in central or eastern Africa, where it spreads less easily, he said.

By contrast, the epicenter of this outbreak is near a major regional transport hub, the Guinean city of Gueckedou.

 D.  What Happens to Your Body When You Get Ebola?
18 June 2014, By Derek Gatherer, Lancaster University
Pased from: http://www.livescience.com/46379-what-happens-to-your-body-when-you-get-ebola.html

This article was originally published at The Conversation. The publication contributed the article to Live Science’s Expert Voices: Op-Ed & Insights.

ebolaThis morning you woke up feeling a little unwell. You have no appetite, your head is aching, your throat is sore and you think you might be slightly feverish. You don’t know it yet, but Ebola virus has started to attack your immune system, wiping out the T-lymphocyte cells that are crucial to its proper function.

These are the same cells that the AIDS virus (HIV-1) attacks, but Ebola virus kills them far more aggressively. Exactly when and where you caught Ebola virus is unclear, it can take anything between two and 21 days from initial infection to the first symptoms. What is more certain is that you are now infectious yourself. Your family, friends and anyone in close contact with you are all in mortal danger.

The next week or so will determine if you are one of the lucky minority who survive. In the 24 Ebola virus outbreaks prior to the present one, a cumulative total of 1,590 people, two-thirds of all cases, have died.

The current outbreak, which began in the village of Meliandou in eastern Guinea in early December 2013, and which has now spread across Guinea and into the neighbouring countries of Sierra Leone and Liberia, has killed 251 people as of June 5, nearly half of the identified cases.

The west African Ebola epidemic is now the largest outbreak seen since Ebola virus was discovered in 1976. The World Health Organisation issued its first communiqué on the situation on March 23, and since then has been producing regular reports.

Over the next few days your condition deteriorates. Your body aches all over, you have chronic abdominal pain, the fever intensifies and you start to vomit and develop diarrhoea. After anything between a couple of days and a week of misery, you will have reached the crisis point – now the symptoms will either gradually recede or you will progress to the horrors of “cytokine storm”, a convulsion of your ravaged immune system that will plunge you into the terminal phase of Ebola virus disease known as haemorrhagic fever.

Cytokine storm releases a torrent of inflammatory molecules into your circulatory system. Your own immune system, now completely out of control, attacks every organ in your body. Tiny blood vessels burst everywhere and you begin slowly to bleed to death. The whites of your eyes turn red, your vomit and diarrhoea are now charged with blood and large blood blisters develop under your skin. You are now at the peak of infectiousness as Ebola virus particles, ready to find their next victim, pour out of your body along with your blood.

Fortunately, however, it seems you have survived. Rehydration therapy kept you strong in the initial phase and pure luck saved you from haemorrhagic fever. Understanding why some Ebola virus patients avoid the terminal phase is an active area of research, and one possible answer is that those whose T-lymphocytes survive the initial attack of the virus possibly retain sufficiently intact immune systems. Even when you are merely in the first phase of feeling vaguely unwell, it may be possible to determine if you will live or die.

Even though you are feeling much improved, and perhaps even ready to return to work, you will remain infectious for a while. All your bodily fluids will still contain virus. In particular, the virus can be sexually transmitted, especially if you are a man, up to 40 days after recovery.

Epidemiological modelling studies have shown that Ebola virus is about as infectious as influenza or very slightly more so – each infected person will probably infect two to four others. That’s not tremendously infectious compared to some of the super-infectious viruses such as measles or polio, which have corresponding numbers of five to 18, but it is nevertheless enough to sustain a pandemic. The question of why we haven’t seen a worldwide pandemic of Ebola in pre-modern times therefore becomes rather perplexing.

Where did it come from?
A briefly popular theory of a few years ago, that the Black Death of the 14th century was caused by Ebola virus, and that the famous mediaeval descriptions of buboes were actually haemorrhagic fever blood blisters, has now been convincingly excluded by DNA analyses that have proved beyond doubt that the Black Death was, after all, bubonic plague as originally thought.

Ebola may well be a purely modern disease and, since Ebola virus made its first known appearance in 1976, a whole generation of African medical workers have been drilled to be alert to the symptoms of haemorrhagic fever. Consequently, the World Health Organisation and its partners have been able to suffocate outbreaks before they spread more generally. However, the latest outbreak is proving rather more recalcitrant than expected and the story is not yet over.

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