FREEOWN, SIERRA LEONE ---After emerging months ago in eastern Sierra Leone, Ebola is now hitting the western edges of the country where the capital is located with dozens of people falling sick each day, the government said Tuesday. So many people are dying that removing bodies is reportedly a problem.

Forty-nine confirmed cases of Ebola emerged in just one day, Monday, in two Ebola zones in and around the capital, the National Ebola Response Center, or NERC, said. Lawmaker Claude Kamanda who represents a western area said more than 20 deaths are being reported daily.

Authorities say the uncontrolled movement of people from the interior to Waterloo which is the gateway to Freetown, the capital, has fueled the increase of Ebola cases in the west. There is a strong feeling that people are violating the quarantines elsewhere and coming to Freetown through Waterloo.

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http://abcnews.go.com/International/wireStory/ebola-cases-rise-sharply-western-sierra-leone-26339140?singlePage=true

ASSOCIATED PRESS                               Oct. 20, 2014

By Raf Casert

LUXEMBOURG (AP) — The European Union committed itself Monday to step up efforts toward getting 1 billion euros ($1.27 billion) in aid to fight Ebola in West Africa and rejected the idea of halting direct flights coming from the region.

The EU foreign ministers set off a week of continentwide action with a pledge "to play an active role in enhancing the international response" to Ebola, which so far has been late and insufficient to contain the deadly virus that has claimed at least 4,500 lives.

British Prime Minister David Cameron wants a two-day summit of the 28 EU leaders ending Friday to reach the $1.27 billion aid threshold, agreeing on a variety of topics from more financial aid to common repatriation procedures, more Ebola treatment facilities and better training for health care workers.

...So far, the overall anti-Ebola total for the EU, including EU national contributions, stands at 500 million euros ($640 million), with Britain contributing 160 million euros ($204 million). The Netherlands also promised to send a frigate to West Africa to help, matching a similar contribution from Britain.

EU ministers rejected the idea of scrapping flights from West Africa to keep the virus out of Europe.

journals.cambridge.org -  Eric Toner, Amesh Adalja and Thomas Inglesby. A Primer on Ebola for Clinicians.
Disaster Medicine and Public Health Preparedness, available on CJO2014. doi:10.1017/dmp.2014.115.

Abstract

The size of the world’s largest Ebola outbreak now ongoing in West Africa makes clear that further exportation of Ebola virus disease to other parts of the world will remain a real possibility for the indefinite future. Clinicians outside of West Africa, particularly those who work in emergency medicine, critical care, infectious diseases, and infection control, should be familiar with the fundamentals of Ebola virus disease, including its diagnosis, treatment, and control. In this article we provide basic information on the Ebola virus and its epidemiology and microbiology. We also describe previous outbreaks and draw comparisons to the current outbreak with a focus on the public health measures that have controlled past outbreaks. We review the pathophysiology and clinical features of the disease, highlighting diagnosis, treatment, and hospital infection control issues that are relevant to practicing clinicians. We reference official guidance and point out where important uncertainty or controversy exists. (Disaster Med Public Health Preparedness. 2014;0:1-5)

CDC                                                              Posted Oct. 20, 2014 from  CDC  Oct. 17 document

This document is a concise summary of published information on the current science about human-to-human transmission of Ebola virus. It is developed for use by healthcare personnel and public health professionals to use. It is a complement to the many guidance documents that CDC has issued already online at

www.cdc.gov/ebola.

It's been 42 days since the last new case

TIME MAGAZINE                                                      OCT. 20, 2014

Alexandra Sifferlin

 The World Health Organization declared Nigeria free of Ebola on Monday, a containment victory in an outbreak that has stymied other countries’ response efforts....

A school official takes a pupil's temperature using an infrared digital laser thermometer in front of the school premises, at the resumption of private schools, in Lagos, Sept. 22, 2014. Akintunde Akinleye—Reuters

“It’s possible to control Ebola. It’s possible to defeat Ebola. We’ve seen it here in Nigeria,” Nigerian Minister of Health Onyebuchi Chukwu told TIME. “If any cases emerge in the future, it will be considered—by international standards—a separate outbreak. If that happens, Nigeria will be ready and able to confront it exactly as we have done with this outbreak.”

ROUNDUP OF DEVELOPMENTS SUNDAY

REUTERS                                     Oct 19, 2014

By Erwin Seba

GALVESTON Texas --(Reuters) - The United States will issue strict new guidelines telling American health workers to cover their skin and hair when dealing with Ebola patients, a top health official said on Sunday, while some of the dozens of people being watched for possible exposure to the virus are expected to be cleared.

 A health care worker receives protocol on the proper removal of personal protection equipment from Centers for Disease Control and Prevention (CDC) instructors in preparation for the response to the current Ebola outbreak, during a CDC safety training course in Anniston, Alabama, October 6, 2014. Credit: Reuters/Tami Chappell

In Texas, a lab worker who spent much of a Caribbean holiday cruise in isolation tested negative for the deadly virus and left the Carnival Magic liner with other passengers after it docked at Galveston early on Sunday morning....

RT – Thom Hartmann - The Bigger Picture: Ebola – October 17-18, 2014

Dr. Michael D. McDonald, Robert Walker and DeAnn McEwen – A Discussion on Ebola

To stop Ebola from spreading in West Africa, Dr. Michael D. McDonald, Executive Director of Health Initiatives Foundation Inc. and the Global Resilience System talks about the need to have community strategies where we set up Resilience Capacity Zones to reduce the transmission and the translocation of Ebola. He states we need to create behavioral and social immunity around Ebola-affected areas to reduce the transmission and translocation. We need to create Ebola-resistant, and Ebola-free zones in ring-like fashion.

CLICK HERE - The Bigger Picture: Ebola

http://www.youtube.com/watch?v=FZlUp_aVgxc

Image: An experimental Ebola vaccine has been developed by the U.S. National Institutes of Health and pharmaceutical company GlaxoSmithKline. Photograph by Steve Parsons, AP

news.nationalgeographic.com - October 14th, 2014 - Karen Weintraub

Ebola vaccines are so effective in monkeys that macaques can be protected or rescued even if they're injected with a hundred times the lethal dose of the Ebola virus after vaccination. But no one knows for certain whether the vaccines will work in humans; the vaccines haven't yet been rigorously tested in people.

Just developing the vaccines to test in monkeys was a grueling, decades-long process that has killed scores of macaques since the 1990s.

(VIEW COMPLETE ARTICLE)

nejm.org - WHO Ebola Response Team

N Engl J Med 2014; 371:1481-1495 - October 16, 2014 - DOI: 10.1056/NEJMoa1411100

Conclusions

These data indicate that without drastic improvements in control measures, the numbers of cases of and deaths from EVD are expected to continue increasing from hundreds to thousands per week in the coming months.

(SEE COMPLETE NEJM ARTICLE HERE)

NEJM - Ebola Virus Disease in West Africa — The First 9 Months of the Epidemic and Forward Projections (15 page .PDF file)

USA TODAY                                                     Oct. 19, 2014

BY Gregg Zoroya and John Bacon

The Pentagon will build a 30-person, rapid-response Ebola medical support team to aid civilian health care workers should additional cases of the virus be diagnosed in the U.S., officials said Sunday.

The effort was requested by the Department of Health and Human Services "as an added prudent measure to ensure our nation is ready to respond quickly, effectively and safely in the event of additional Ebola cases," a Pentagon statement said.

http://www.defense.gov/Releases/Release.aspx?ReleaseID=16986

The Pentagon said Defense Secretary Chuck Hagel ordered his Northern Command Commander, Gen. Chuck Jacoby, to prepare and train the team. It will include 20 critical-care nurses, five doctors trained in infectious disease and five trainers in infectious-disease protocols...

Team members will remain in a "prepare to deploy" status for 30 days after training. They will not be sent to West Africa or elsewhere overseas and "will be called upon domestically only if deemed prudent by our public health professionals," the statement said.

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Four suggestions on what we need to successfully counter Ebola

A healthcare worker mixes chlorine with water at an Ebola treatment center in Hastings, Freetown, Sierra Leone, Oct. 15. Associated Press

Suggestions include:

THE INDEPENDENT                                                  OCT. 18, 2014

LONDON ---Ebola is poised to become the “definitive humanitarian disaster of our generation", Oxfam has warned, with more troops, funding and medical aid urgently needed to tackle the outbreak.

In an "extremely rare" move, the charity is calling for military intervention to provide logistical support across West Africa.

It says the world has less than two months to counter the spread of the deadly virus, which means addressing a "crippling shortfall" in military personnel.

Oxfam’s call for more troops comes after UN chief Ban Ki-Moon criticised countries he said were able to provide financial support to the crisis for not doing so.
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NEW YORK TIMES                                                 Oct. 18, 2014

By MICHAEL D. SHEAR and MARK LANDLER

WASHINGTON — Beneath the calming reassurance that President Obama has repeatedly offered during the Ebola crisis, there is a deepening frustration, even anger, with how the government has handled key elements of the response.

Those frustrations spilled over when Mr. Obama convened his top aides in the Cabinet room after canceling his schedule on Wednesday. Medical officials were providing information that later turned out to be wrong. Guidance to local health teams was not adequate. It was unclear which Ebola patients belonged in which threat categories.