Ebola's sobering toll on uninfected children
Ebola isn't just ravaging the thousands infected with the virus in Guinea, Sierra Leone and Liberia. It's also wrecking the lives of the victims' survivors -- especially children. UNICEF estimates Ebola has created more than 3,700 orphans in West Africa, CNN's Christiane Amanpour reports:
An eye on bordering nations
Dr. Isabelle Nuttall, the World Health Organization's director of global capacity, alert and response, said that while the Ebola cases in the United States and Spain are a concern, they are less of a concern because they have high-quality health care systems and "good infection control."
Of more concern, she said, are Mali, Ivory Coast, Senegal and Guinea-Bissau, countries that border the three African nations with widespread transmission -- Guinea, Liberia and Sierra Leone -- because of the trade and travel among those countries.
"They really need to be better prepared," she said, adding that WHO has been working with African nations for years to control outbreaks -- any outbreaks -- and handling Ebola involves the same steps: "Be ready, detect, inform, assess, respond."
Nuttall also said it could take months before the Ebola outbreak can be stopped, blaming the increasing number of Ebola cases and deaths on the “persistent transmission” of the virus. There has been an increase of new cases in Guinea, difficulties in gathering data in Liberia and an “intense transmission is still taking place” in Sierra Leone, Nuttall told reporters in Geneva.
Looking beyond affected countries
Wider preparedness plan
Dr. Isabelle Nuttall, the World Health Organization's director of global capacity, alert and response, told reporters in Geneva that while the countries bordering Guinea, Sierra Leone and Liberia are of particular concern, the larger preparedness plan involves a total of 15 African nations.
They are: Central African Republic, Democratic Republic of Congo, Gambia, Ghana, Mauritania, Nigeria, South Sudan, Togo, Ivory Coast, Guinea-Bissau, Mali, Senegal, Benin, Burkina Faso and Cameroon.
Patient in Nebraska improving
Ashoka Mukpo, the freelance cameraman for NBC News who tested positive for Ebola in Monrovia, Liberia, and is now being treated in Nebraska, is "doing well, getting better every day and continues to trend in the right direction," said Taylor Wilson, spokesman for Nebraska Medicine.
Border protection statement
U.S. Customs and Border Protection has released a statement about its work with the CDC and how its agents are at all U.S. points of entry to "observe all travelers entering the United States for general overt signs of illnesses":
CBP and the CDC have closely coordinated to develop policies, procedures, and protocols to identify travelers at all ports of entry who are potentially infected with a communicable disease and to minimize the risk to the traveling public. These procedures have been utilized collaboratively by both agencies on a number of occasions with positive results. CBP personnel review all travelers entering the United States for general overt signs of illnesses (visual observation, questioning, and notification of CDC as appropriate) at all U.S. ports of entry, including all federal inspection services areas at U.S. airports that service international flights, land-border crossings and seaports.
In addition to the measures already in place at all ports of entry, CBP and CDC have developed enhanced passenger screening for travelers entering the United States from or through an Ebola-affected country. These measures will be in place at the five U.S. airports where about 94 percent of travelers from Guinea, Liberia, and Sierra Leone arrive. JFK implemented enhanced screening Saturday, Oct. 11. On Thursday, Oct. 16, enhanced screening begins at Chicago's O'Hare International Airport, Dulles International Airport in Virginia, Hartsfield Jackson International Airport in Atlanta and Newark International Airport in New Jersey. The enhanced screening includes isolating the traveler from the traveling public while the individual completes a questionnaire and contact information form and medically trained personnel take the traveler's temperature. If the traveler has a fever or other symptoms or may have been exposed to Ebola, CBP will refer the traveler to CDC for a public health assessment. CDC will then determine whether the traveler can continue to travel, is taken to a hospital for further evaluation, or referred to a local health department for further monitoring.
CBP personnel at all U.S. ports of entry, including all U.S. airports that service international flights, continue to observe all travelers entering the United States for general overt signs of illnesses (visual observation, questioning, and notification of CDC as appropriate) and continues to distribute a CDC health notice to travelers entering the U.S. that have traveled from or transited through the affected countries informing travelers to watch their health and what they need to do if they become ill in the future. When a traveler is identified with a possible communicable disease or identified from information that is received from the CDC, CBP personnel will take the appropriate safety measures by donning personal protective equipment (PPE), to include gloves and surgical masks, which are readily available for use in the course of their duties.
CBP personnel receive training in illness recognition, but if they identify an individual believed to be infected, CBP will contact CDC along with local public health authorities to help with further medical evaluation. The traveler would be isolated from the traveling public while the CDC and local public health authorities conduct an evaluation.
A three-point plan
Calling West Africa's Ebola outbreak one of the "deadliest challenges of modern times," Randi Weingarten, president of American Federation of Teachers, the second-largest nurses union, called for a three-point plan to handle the situation in the United States:
1 -- All public and private health care facilities should implement "infection control protocol and worker preparedness."
2 -- Health care facilities need "dedicated teams of willing staff" -- including doctors, nurses and lab workers -- to be trained to care for any patient suspected of having Ebola.
3 -- Front-line health care providers, "who are key to containing Ebola," need to have input in how plans are implemented at health care facilities.
White House working to educate
Health workers could be placed on 'do not board' list
The CDC is considering putting 76 health care workers on the "do not board" list, which is a list the CDC operates with the Department of Homeland Security.
This shouldn't be confused with the "no fly" list, which is reserved for people who might have ties to terrorism.
Lack of surgeon general political?
Randi Weingarten, president of American Federation of Teachers, the second-largest nurses union, had some sharp words about the United States having no surgeon general in her remarks earlier today.
"This should be a wake-up call to make public health care investment a priority in the USA," she said. "We have had years of cuts and cuts and cuts and cuts, leaving many states without the public health infrastructure necessary to provide the education and services on a wide range of health care issues, including this one, and frankly, partisan politics have left us without a Surgeon General and that has to change too.
In a quarterly earnings call, Delta COO Gil West said Ebola isn't the first communicable disease the airline industry has faced and Delta is "well versed at managing these type of events and ensuring the safety of our customers and crews."
He added, "There are CDC screening portfolios in place in and out of the West African countries as well as into the U.S. and the EU to prevent a person with symptoms from flying. We've also got well-established hygienic cleaning procedures and use disinfectants" as part of every flight.
"I continue to point out there's virtually no risk to all air travelers no matter where you're traveling," he said. As for his employees, "We have ongoing dialogue with flight crews and educational campaign as well as provisioning the aircraft with preventative kits in case they do encounter anything unusual."
On the same call, Joanne Smith, chief human resources officer, said the airline isn't seeing requests from pilots and flight attendants that they be taken off West Africa flights.
Nurse: Ebola a wake-up call
Ebola patient headed to Maryland
Dallas nurse and Ebola patient Nina Pham is being moved to a National Institutes of Health facility in Maryland, according to two sources familiar with the situation.
Ban Ki-moon calls for $1 billion response
In New York, U.N. Secretary General Ban Ki-moon demanded an urgent response to the Ebola crisis. From his remarks:
The people and governments of West Africa are demonstrating significant resilience, but they have asked for our help.
Dozens of countries are showing their solidarity, but we need to turn pledges into action. We need more doctors, nurses, equipment, treatment centers and Medevac capacities. I appeal to the international community to provide the $1 billion launch that will enable us to get ahead of the curve and meet our target of reducing the rate of transmission by December 1.
The United Nations system has mobilized to meet this monumental task. We have established UNMEER – the UN Mission for Ebola Emergency Response -- to coordinate and scale up action. I have also formed a Global Ebola Response Coalition.
Ebola can be beaten if we work together effectively. We all have a responsibility to act.
Condolences for U.N. worker from Sudan
Secretary-General Ban Ki-moon offered condolences to the second U.N. worker in Liberia to die from Ebola, saying, "I salute the courage of the medical and support personnel working on the front-lines. I offer condolences to the family of Abdel Fadeel Mohammed Basheer, a
laboratory technician and member of the United Nations family from Sudan
who died this week from Ebola. He was the second person from the U.N. Mission in Liberia to succumb to this unforgiving disease.
Dr. Daniel Varga, chief clinical officer for Texas Health Resources, will issue an apology regarding the handling of Thomas Eric Duncan, the first person in the United States to be diagnosed with Ebola, during his remarks to a congressional committee today.
"Unfortunately, in our initial treatment of Mr. Duncan, despite our best intentions and a highly skilled medical team, we made mistakes. We did not correctly diagnose his symptoms as those of Ebola. We are deeply sorry," his prepared remarks say.
"Also, in our effort to communicate to the public quickly and transparently, we inadvertently provided some information that was inaccurate and had to be corrected. No doubt that was unsettling to a community that was already concerned and confused, and we have learned from that experience as well."
Congressman blasts response
The chairman of a House subcommittee holding a hearing on Ebola response says he's troubled that the country isn't taking more steps to restrict the travel of people from Ebola-ravaged African countries to the United States. Current screening plans and self-reporting have been a "demonstrated failure," Rep. Tim Murphy said.
Threat could become extended one
To protect the U.S. from Ebola, the virus needs to be stopped at the source, and if Ebola spreads more widely in Africa, Ebola could become a threat to the U.S. health system "for a long time to come," CDC Director Dr. Tom Frieden says in testimony to a House Energy and Commerce subcommittee.
Nina Pham transfer confirmed
Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told the subcommittee that Nina Pham, one of the Dallas nurses who contracted Ebola, is headed to an National Institutes of Health facility where she will receive "state-of-the-art care in our high-level containment facilities."
In northeast Ohio, one person has been quarantined and six others have quarantined and are monitoring themselves for Ebola after coming into contact or being in the vicinity of Ebola-stricken Texas nurse Amber Vinson, said Ohio Department of Health spokesman Jay Carey.
CDC director 'fears' spread of Ebola in Africa
'Overwhelming' demand for vaccines
Luciana Borio, assistant commissioner for counterterrorism policy at the U.S. Food and Drug Administration, tells the subcommittee that the desire for safe and effective Ebola vaccines is "overwhelming" and stresses the importance of testing the efficacy of all products.
Ebola case mishandled
Dr. Daniel Varga, chief clinical officer for Texas Health Resources, apologized during his testimony to a House subcommittee, saying his staff mishandled the case of Thomas Eric Duncan: "We made mistakes. We did not correctly diagnose his symptoms as those of Ebola, and we are deeply sorry."
When Duncan succumbed to the disease, he said, "It was devastating to the nurses, doctors and team who tried so hard to save his life, and we keep his family in our thoughts and prayers."
More on Ebola drugs
Every Ebola patient in the United States has been treated with "at least one investigational product" -- Ebola treatments whose safety and efficacy still are being determined -- Luciana Borio, assistant commissioner for counterterrorism policy at the U.S. Food and Drug Administration, told a House Energy and Commerce subcommittee hearing.
The FDA works to approve the use of such treatments outside clinical trials when it's estimated that the benefits outweigh the risks, she said.
Student in Connecticut undergoing tests
A Yale doctoral student who recently returned to Connecticut from Liberia and has a fever is in isolation at Yale-New Haven Hospital and is being tested for Ebola, officials at the hospital said Thursday. Results should be available within 24 hours, they said.
Nina Pham doing "reasonably well"
Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, says that he has not seen Ebola patient Nina Pham, who is being transferred to a National Institutes of Health facility in Maryland today, but he has heard reports that she is "stable and she seems to be doing reasonably well, but I have to verify that myself."
Asked if the CDC might change its stance and put in place travel restrictions on countries facing the Ebola outbreak, CDC Director Tom Frieden told a House subcommittee, "We will consider any options to better protect Americans."
'Deeply sorry' for mistakes
CDC: Travel bans problematic
Addressing questions on why the U.S. doesn't ban certain people from entering the country, CDC Director Tom Frieden said travel restrictions are not wise because borders in West Africa are porous and it could result in people coming to the U.S. from other countries or over land.
This would prevent health officials from: checking them for fever when they leave and arrive, obtaining a detailed history to determine their potential for exposure, quarantining people deemed to be high risk and gathering contact and identifying information that allows officials to presently track them after they land.
In short, travel bans might prevent U.S. health officials from imposing "conditional release on them or actively monitoring" them. "Right now, we know who's coming in," Frieden said.