Zuckerberg donates $25 million to fight Ebola

Mark and Priscilla Zuckerberg were the most generous donors in 2013, according to The Chronicle of Philanthropy.Facebook founder Mark Zuckerberg will donate $25 million to combat the outbreak of the deadly Ebola virus.

The money will go to the CDC Foundation, the charitable organization that raises and distributes funds on behalf the Centers for Disease Control and Prevention to public health organizations.

"We need to get Ebola under control in the near term so that it doesn't spread further and become a long term global health crisis that we end up fighting for decades at large scale, like HIV or polio," he said on a posting on Facebook. "We believe our grant is the quickest way to empower the CDC and the experts in this field to prevent this outcome."

The United States had its first fatality from the current Ebola outbreak last week when Thomas Eric Duncan died in a Dallas hospital last week. One of the nurses who treated him has also been diagnosed with the disease. But more than 3,000 deaths and 8,000 cases have been reported so far in the Western African nations of Guinea, Liberia and Sierra Leone.

Can pets get or spread Ebola?

Focusing on the cases of two dogs can seem trivial compared to the 4,000 people in West Africa who have died from Ebola this year.

But CNN's Anderson Cooper notes that concern about animals can have a broader impact on human health.

"We've seen this in disasters before, people not wanting to leave their homes because they couldn't bring their animals to a shelter," he said.

"The fear among health care workers and CDC officials and others is that if people are afraid that their dogs are going to be killed, they might not come forward if they're starting to show some symptoms."

"At this time, there have been no reports of dogs or cats becoming sick with Ebola or of being able to spread Ebola to people or other animals," the Centers for Disease Control and Prevention says.

Some studies have shown that dogs may experience asymptomatic Ebola infections, the CDC says -- meaning they may have the virus but don't get sick.

Also, the agency says, human infections haven't been linked to dogs.

"The risk activities that lead to human infections are direct contact with infected human body fluids, or through bats or consumption of infected wild meat."

But it's not yet clear whether a pet's body, paws or fur can pick up and spread Ebola to people or other animals.

Biology professor David Sanders said some animals, like fruit bats, can carry the virus without showing any symptoms and could infect others.

"The concept that viruses in animals can be transmitted to humans and can have potential harmful consequences, that's obvious," said Sanders who teaches at Purdue University.

"So infected animals that are not showing signs of infection can potentially be capable of transferring virus to humans."

Do we really need to worry about pets getting Ebola?

Not at all, said Dr. William Schaffner, chair of preventative medicine at Vanderbilt University.

"It is not a danger. We're not concerned," Schaffner told CNN's State of the Union with Candy Crowley.

"We know that this virus can circulate in animals, but pets have not been a feature of Ebola spread, whether in Africa and certainly not here in the developed world," he said.

"We all thought that the attention in Spain to the dog of the person who was ill was ill-advised and was a distraction."

So why did the dog in Spain have to die?

More than 400,000 people signed an online petition asking Spanish authorities to spare the life of Excalibur, the dog of nursing aide Teresa Romero Ramos. Romero is in critical condition after helping treat an infected Spanish missionary.

But Madrid health authorities insisted they had to euthanize Excalibur in case the canine had Ebola.

Critics said the dog should have been quarantined, just like Romero's husband has been.

What about the nurse's dog in Texas?

Bentley, the dog belonging to infected Texas nurse Nina Pham, is now safe with Dallas Animal Services and Adoption Center and was "on his way to an undisclosed location," the agency said Monday on Facebook.

That post was "liked" more than 1,800 times.

NBC's Nancy Snyderman apologizes for violating quarantine

NBC's medical correspondent Dr. Nancy Snyderman has issued an apology after she reportedly violated the quarantine her team was placed in when their cameraman contracted Ebola.

During the NBC Nightly News broadcast on Monday, anchor Brian Williams read out the following statement from Snyderman:

"While under voluntary quarantine guidelines, which called for our team to avoid public contact for 21 days, members of our group violated those guidelines and understand that our quarantine is now mandatory until 21 days have passed. We remain healthy and our temperatures are normal.

"As a health professional I know that we have no symptoms and pose no risk to the public, but I am deeply sorry for the concerns this episode caused. We are thrilled that Ashoka (Mukpo) is getting better and our thoughts continue to be with the thousands affected by Ebola whose stories we all went to cover."

Trip to Liberia

Snyderman and her team went into a 21-day voluntary isolation after Mukpo, their freelance cameraman, was found to have contracted Ebola. The team had been in Liberia, a hotspot for the outbreak.

Mukpo is recovering at the Nebraska Medical Center where he is receiving an experimental drug called brincidofovir, or CMX001.

Twenty one days is standard length for quarantine because that's how long the disease's incubation period is.

But the NBC crew apparently broke its word.

Takeout order

The website Planet Princeton reported that Snyderman went to a restaurant to pick up a takeout order.

Shortly after, the New Jersey Department of Health mandated the crew remain quarantined.

"Unfortunately, the NBC crew violated this agreement and so the Department of Health Friday evening issued a mandatory quarantine order to ensure that the crew will remain confined until October 22," the health department said.

"The NBC crew remains symptom-free, so there is no reason for concern of exposure to the community," it read.

Expressing appreciation

Meanwhile, Mukpo posted a status update on his Facebook page Monday, thanking everyone for their concerns.

"There have been some dark and profoundly frightening moments in this ordeal, but I want everyone to know that your good energy, love, and support was felt in a very direct way over these last two weeks," he wrote.

I won't ever know exactly when I slipped up and contracted the virus. I had been taking precautions but obviously they weren't enough."

Ebola outbreak: Are health care workers prepared, protected?

In a matter of days, they transformed from caretakers into patients.

The two women live thousands of miles apart, but the first known Ebola cases contracted outside Africa during this outbreak have one striking similarity: Both were health care workers, caring for someone infected with the deadly virus.

As a nurse in Dallas and a nurse's assistant in Madrid fight for their lives, a key question looms: Are people who are putting themselves in harm's way to care for Ebola victims receiving the training and equipment they need?

"It's really a disaster waiting to happen," she told CNN's "The Lead with Jake Tapper" on Thursday.

The union is pushing for more equipment, training and education for nurses, Cortez said. A survey of 1,900 nurses by the union found that 76% said their hospital had not communicated any policy for the potential admission of patients infected by Ebola.

It's a "startling statistic," CNN Chief Medical Correspondent Dr. Sanjay Gupta said, particularly since the Centers for Disease Control and Prevention said in May that it was distributing guidelines to hospitals around the country.

"Infectious disease protocols, universal precautions should be the same, really, in hospitals all over the country. They should apply here with regard to Ebola as well," Gupta said. "But obviously, that's not happening. These nurses who are a part of that survey just don't feel comfortable as things stand now."

CDC chief blames protocol breach

The CDC is "doubling down" on outreach and training to increase awareness of Ebola and make sure U.S. hospitals "think Ebola," CDC Director Dr. Tom Frieden said Monday.

Hospitals should be skilled at taking travel histories of people who show Ebola symptoms and should isolate those who have been to Liberia, Sierra Leone or Guinea, Frieden said. And the CDC is also planning more hands-on training at hospitals and outreach to health departments.

As authorities confirmed that the Dallas nurse had contracted Ebola, Frieden was quick to point to a breach in protocol.

Frieden said he wasn't pointing fingers, but trying to pinpoint what happened.

"Stopping Ebola is hard," he said, adding that the CDC will do anything possible to protect health care workers.

The nurse, Nina Pham, had cared for Thomas Eric Duncan, who contracted Ebola in Liberia and died of the illness at the hospital.

Frieden said he would not be surprised if there were additional cases among those who cared for Duncan, but so far, no one is showing symptoms.

On Monday morning, an official with direct knowledge of the Texas nurse's case told CNN that CDC disease detectives interviewed the nurse several times and thought there were "inconsistencies" in the type of personal protective gear she wore and with the process used to put the gear on and remove it.

Health care workers on the front lines often get sick in the early stages of an outbreak, while dealing with patients who are highly infectious, Gupta said. That's why there are guidelines for what protective gear they should wear when dealing with Ebola patients. But the Dallas case is concerning, he said.

"The patient was the most infectious," he said, "but she should have been protected."

CDC Director Tom Frieden faces rising tide of criticism

Husband of infected nurse's assistant writes scathing letter

The nurse's assistant in Spain with Ebola remains in critical condition and is having trouble breathing, authorities said. The European Centre for Disease Control and Prevention said the hospital where Teresa Romero Ramos is being treated doesn't meet all the standards set for centers capable of Ebola care.

In a scathing letter, Javier Limon, her husband, said she received only 30 minutes of training in putting on protective gear and called for the resignation of Madrid's regional health minister over how the case has been handled.

"Please explain to me how one puts on a protective suit, since unfortunately my wife doesn't have a master's degree in that," Limon wrote in a letter distributed by a family spokeswoman. "Teresa had 30 minutes or a little more to learn how to do so through a colleague."

He fired back at criticism that the family had gone on vacation.

"No one told us that we couldn't do what we did, because the protocol did not tell us that we could not do that," Limon wrote. "Now I know that in other countries they quarantine health care workers after treating an Ebola patient. Even though I am only a welder, I understand that if we had done this my wife would possibly not be battling between life and death."

Experts note ways CDC is getting it wrong

Are hospitals ready?

President Barack Obama wants federal authorities to immediately take further measures to ensure that health care workers are able to follow protocols for treating Ebola patients. He met with senior administration members at the White House on Monday afternoon for an update on its response to the Dallas case and the broader effort to make sure the country is prepared to handle an outbreak.

Of the thousands of hospitals in the United States, only four have been training for years to deal with highly infectious diseases such as Ebola: Emory University Hospital in Atlanta, the Nebraska Medical Center in Omaha, the National Institutes of Health in Maryland and Rocky Mountain Laboratories in Montana.

"They have the management, the processes, the implementation in place that if an Ebola patient comes in, just right away they know what to do," said Gavin Macgregor-Skinner, who teaches public health preparedness at Penn State University.

But if someone with symptoms of Ebola shows up at any other hospital, as Duncan did, the hospital might not be ready.

"It may not be that every single hospital is in fact prepared for this," said David Sanders, associate professor of biology at Purdue University.

"We may have to think about regional centers that are best prepared to deal with Ebola patients."

At the University of Kansas Medical Center, where a man with possible Ebola symptoms was admitted Monday, Chief Medical Officer Dr. Lee Norman said they were keeping an extra eye on protective equipment after speaking with officials at Emory and in Dallas.

While workers are putting on or taking off their gear, someone is watching to make sure they're doing it correctly, he said.

"We have trained spotters to make sure that everything is put on and taken off in the proper fashion," he told reporters, "to keep everybody safe."

9 ways travelers are handling Ebola anxiety

Fear of Ebola on airplanes is spreading faster than actual Ebola on airplanes.

STORY HIGHLIGHTS

• Our well-prepared traveler carries a face mask and wipes
• The conspiracy theorist thinks it's all Obama's fault (or the Republicans')
• Our medical adviser has read all the science websites
• Our lover of atlases understands that Africa is big

With Ebola panic traveling faster than a 787, travelers trapped in metal containers at 30,000 feet are quickly splitting into camps.

Are you canceling your flight or packing your antibacterial hand wipes and bravely going forward? Maybe you're tweeting out your stress while you wonder what to do next.

We've found nine types of travelers, almost all determined to get to their destinations with some of their sanity intact. Which one are you?

1. The provocateur

"Ebola" has become the new "bomb" in the world of flying: It's a word you don't want to use in jest unless you want to get tossed off a plane, tested for a disease you probably don't have and possibly arrested. ‏

2. The well-prepared traveler

The well-prepared traveler has a face mask, wipes and another set of clothes to change into upon arrival at her final destination. The rest of us can admire her outfit.

3. The conspiracy theorist

The paranoid traveler thinks Ebola is the newest form of terrorism against the Western world. Maybe he's right. But you'd think the terrorists would choose a virus that transmitted more easily, perhaps through the air instead of body fluids.

4. The medical adviser

This traveler has read the Centers for Disease Control and Prevention website, WebMD and the advice of CNN's own Dr. Sanjay Gupta and now knows all the problems with the current government protocols designed to keep Ebola from spreading. (And he could be right, which adds to our paranoia.)

5. The political partisan

Whatever happens with Ebola, it's President Barack Obama's fault, these people say, for not closing the borders. Or the Republicans' fault for not adequately funding the National Institutes of Health to further its quest for a viable Ebola vaccine.

6. The fatalist

While many heroic health care and travel professionals are fighting Ebola on the front lines, some travelers see evidence of lax efforts in the fight against the disease. Do you want to sit next to someone who just vomited on your flight, no matter why he or she is throwing up? Nope.

7. The comic

This person is just hilarious ... on land. Those tweets aren't so funny in the air.

8. The rational traveler

The reasonable, rational flier seeks out scientific information to address any concerns, like this useful video from a doctor, and adjusts her plans accordingly (or not). Seeking out this information calms her down.

9. The geography professor

Some travelers use their knowledge of Africa's geography to share that a) three West African countries are severely affected by Ebola; b) Africa is a very large continent, which means that c) travelers coming from South Africa aren't anywhere near West Africa. The distance between Monrovia, Liberia, and Cape Town, South Africa, is farther than the distance between Los Angeles and New York.

Ebola: Five ways the CDC got it wrong

A nurse contracts Ebola. An urgent care center in Boston shuts down when a sick man recently returned from Liberia walks in. Health care workers complain they haven't been properly trained to protect themselves against the deadly virus.

Public health experts are asking whether the U.S. Centers for Disease Control and Prevention is partly to blame.

Here are five things they say the CDC is getting wrong.

1. The CDC is telling possible Ebola patients to "call a doctor."

When passengers arrive in the United States from Liberia, Sierra Leone or Guinea, they're handed a flier instructing them to "call a doctor" if they feel ill.

Never mind how hard it is to get your doctor on the phone, but even if you could, it's quite possible she'd tell you to go to the nearest emergency room or urgent care center.

We saw how well that worked at Texas Health Presbyterian Hospital in Dallas. On September 25, the hospital sent a feverish Thomas Eric Duncan home even though he had told them he'd recently been to Liberia.

And we've seen how well that worked in Massachusetts, where an ill man recently returned from Liberia walked into an urgent care center, which then evacuated its other patients and closed for several hours.

One way to do it differently: Set up a toll free number for returning passengers that would reach a centralized office, which would then dispatch a local ambulance to get the patient to a hospital.

The hospital would be warned that a possible Ebola patient is on the way, and the patient would not be brought through the main emergency room.

That's the idea of Gavin Macgregor-Skinner, an assistant professor at Penn State's Department of Public Health Sciences.

"Do you really want someone with Ebola hopping on a bus to get to the hospital? No," he said. "And once they get there, do you want them sitting in the waiting room next to the kid with the broken arm? Again, no."

2. The CDC director says any hospital can care for Ebola patients.

"Essentially any hospital in the country can safely take care of Ebola. You don't need a special hospital to do it," Dr. Thomas Frieden said Sunday at a press conference.

"I think it's very unfortunate that he keeps re-stating that," said Macgregor-Skinner, the global projects manager for the Elizabeth R. Griffin Foundation.

He said when it comes to handling Ebola, not all hospitals are created equally. As seen at Presbyterian, using protective gear can be tricky. Plus, it's a challenge to handle infectious waste from Ebola patients, such as hospital gowns contaminated with blood or vomit.

Dr. Michael Osterholm, an infectious disease epidemiologist at the University of Minnesota, said some hospitals have more experience with infectious diseases and consistently do drills in how to deal with biohazards.

"If you were a burn unit patient, wouldn't you want to go to a burn unit?" he said.

The CDC may already be moving in that direction.

Designating certain hospitals as Ebola treatment units "is something we're exploring further," said Tom Skinner, a spokesman for the agency.

CDC 'doubling down' on Ebola training efforts

3. The CDC didn't encourage the "buddy system" for doctors and nurses.

Under this system, a doctor or nurse who is about to do a procedure on an Ebola patient has a "buddy," another health care worker, who acts as a safety supervisor, monitoring the worker from the time he puts on the gear until the time he takes it off.

The "buddy system" has been effective in stopping other kinds of infections in hospitals.

Skinner said the CDC is considering recommending such a system to hospitals.

4. CDC didn't encourage doctors to develop Ebola treatment guidelines.

Taking care of Ebola patients is tricky, because certain procedures might put doctors and nurses in contact with the patient's infectious bodily fluids.

At Sunday's press conference, Frieden hinted that Presbyterian might have performed two measures -- inserting a breathing tube and giving kidney dialysis -- that were unlikely to help Duncan. He described them as a "desperate measure" to save his life.

"Both of those procedures may spread contaminated materials and are considered high-risk procedures," he said. "I'm not familiar with any prior patient with Ebola who has undergone either intubation or dialysis."

Osterholm said CDC should coordinate with medical groups to come up with treatment guidelines.

"We could have and should have done it a few months ago," he said.

5. The CDC put too much trust in protective gear.

Once Duncan was diagnosed, health authorities started making daily visits to 48 of his contacts.

But that didn't include several dozen workers at Presbyterian who took care of Duncan after he was diagnosed. They weren't followed because they were wearing protective gear when they had contact with Duncan. Instead, they monitored themselves.

Public health experts said that was a misstep, as the CDC should have realized that putting on and taking off protective gear is often done imperfectly and one of the workers might get an infection.

"We have to recognize that our safety work tells us that breaches of protocol are the norm, not the exception in health care," said Dr. Peter Pronovost, senior vice president for patient safety and quality at Johns Hopkins Medicine. "We routinely break precautions."

Skinner said that in this case, self-monitoring worked, but that monitoring from health officials can be beneficial, too, and so health care workers who were involved in Duncan's care will now get daily visits from health authorities.

I survived Ebola, but villagers shunned me

Saa Sabas, Ebola survivor from southern Guinea: "I felt so tired and uncomfortable."

The Ebola outbreak in West Africa has hit "unprecedented" proportions, according to relief workers on the ground, with the WHO reporting 844 cases including 518 deaths since the epidemic began in March.

There is no cure or vaccine to treat Ebola, but the aid agency MSF has shown it doesn't have to be a death sentence if treated early. Ebola typically kills 90% of patients but the death rate in this outbreak has dropped to roughly 60%.

One man who survived the disease describes how the virus took hold.

How did you contract Ebola?
Map: Ebola spreads in West AfricaMap: Ebola spreads in West Africa
Inside an Ebola clinic in Guinea

I am an agronomist and I have two children, one boy and one girl. I work in the pharmacy at the health center of Gueckedou in southern Guinea. When my father was hospitalized at the health center I naturally volunteered to be at his bedside so other family members would not have to make the daily trek of tens of kilometers, traversing the trails between their village and the facility. I cleaned him when he vomited and also did his laundry. I also often gave him food and drink. He had diarrhea at least eight times per day but I did not know he was suffering from Ebola.

Five days after being hospitalized, [my father] passed away. After his death the medical staff realized he had presented Ebola symptoms and as I had close contact with him, it meant that I was at risk. So they told me that I needed to be followed up for 21 days and if ever I felt a small fever I had to come to the health center. The countdown then started for me: after nine days I got fever and this persisted until the 11th day. Finally I went to the treatment center -- where I did an Ebola test which was positive.

What were the symptoms? How did you feel while you were ill?

I first got a fever which persisted. My body temperature reached nearly 40C (104 degrees Fahrenheit). After that I had diarrhea, vomits, dysentery and hiccups [all symptoms of Ebola]. I went to the toilet several times a day and I felt so tired and uncomfortable.
Fighting Ebola through education
Ebola scientist: 'It's spectacular'

How and where were you treated?

I received medical assistance at the Ebola treatment center, put in place at the health centre of Gueckedou. The medical staff provided me with oral medications and infusions. They also provided me with food. I suffered at lot in the beginning with diarrhoea and hiccups but with the treatment I started to feel better.

What was the initial reaction in your home village after you recovered?

Joy, for my family because everyone thought that I would not survive this disease as many others people had died. However before the medical staff released me to go back to my family they tested me three times to make sure that I really had recovered. Afterwards they gave me a certificate of discharge. They also visited my family, the leaders and elders of my community to inform them that I had recovered and I was no longer contagious. Despite this, I was stigmatized. Some people avoided me in the beginning but now, over time, they have learned to accept me. Now they call me "anti-Ebola."
Some people avoided me in the beginning but now, over time, they have learned to accept me. Now they call me 'anti-Ebola'
Saa Sabas

You're now working with Red Cross volunteers in Guinea to raise awareness of the disease: what lessons are passing on?

I am part of a team of Red Cross volunteers, visiting communities, raising awareness on how to prevent the spread of the disease. One of the messages I try to pass on to the communities is to go early to the health center when sufferers first feel symptoms. The treatment is free of charge. People there will give you food and clothes and you can get a chance to survive.

What's your message for the outside world about Ebola? How can they help?

Everyone should be mobilized. We need to educate people and increase the sensitization. This is the key to stop the dangerous disease Ebola.

Many people have already died, that is why I participate in activities [to educate people]. I urge people to go the isolation and treatment centres if they experience the earliest symptoms of the disease, to increase their chance of being cured and surviving.

Questions about this new Ebola drug

Two American missionary workers infected with the deadly Ebola virus were given an experimental drug that seems to have saved their lives.

Dr. Kent Brantly was given the medication, ZMapp, shortly after telling his doctors he thought he would die, according to a source familiar with his case. Within an hour, doctors say his symptoms -- labored breathing and a widespread rash -- dramatically improved. Nancy Writebol, another missionary working with Samaritan's Purse, received two doses of the medication and has also shown significant improvement, sources say.

As there is no proven treatment and no vaccine for Ebola, this experimental drug is raising lots of questions.

Who makes the drug?
Secret serum likely saved Ebola patients
Why isn't there an Ebola vaccine?
Ebola transport team speaks to CNN
West African Ebola epidemic

The drug was developed by the biotech firm Mapp Biopharmaceutical Inc., which is based in San Diego. The company was founded in 2003 "to develop novel pharmaceuticals for the prevention and treatment of infectious diseases, focusing on unmet needs in global health and biodefense," according to its website.

Mapp Biopharmaceutical has been working with the National Institutes of Health and the Defense Threat Reduction Agency, an arm of the military responsible for weapons of mass destruction, to develop an Ebola treatment for several years.

Are there other experimental Ebola drugs out there?

Yes. In March, the NIH awarded a five-year $28 million grant to establish a collaboration between researchers from 15 institutions who were working to fight Ebola.

"A whole menu of antibodies have been identified as potentially therapeutic, and researchers are eager to figure out which combinations are most effective and why," a news release about the grant said.

Tekmira, a Vancouver-based company that has a $140 million contract with the U.S. Department of Defense to develop an Ebola drug, began Phase 1 trials with its drug in January. But the FDA recently halted the trial, asking for more information.

At least one potential Ebola vaccine has been tested in healthy human volunteers, according to Thomas Geisbert, a leading researcher at the University of Texas Medical Branch. And last week, the NIH announced a safety trial of another Ebola vaccine will start as early as September.

How does ZMapp work?

Antibodies are proteins used by the immune system to mark and destroy foreign, or harmful, cells. A monoclonal antibody is similar, except it's engineered in a lab so it will attach to specific parts of a dangerous cell, according to the Mayo Clinic, mimicking your immune system's natural response. Monoclonal antibodies are used to treat many different types of conditions.

This medicine is a three-mouse monoclonal antibody, meaning that mice were exposed to fragments of the Ebola virus and then the antibodies generated within the mice's blood were harvested to create the medicine.

Why did American missionary workers get the drug?

Many have asked why these two workers received the experimental drug when so many -- around 1,600 -- others in West Africa also have the virus.

Samaritan's Purse reached out to an NIH scientist who was on the ground in West Africa, according to the National Institute of Allergy and Infectious Diseases. "The scientist was able to informally answer some questions and referred them to appropriate company contacts to pursue their interest in obtaining experimental product," NIAID said.

The World Health Organization says it was not involved in the decision to treat Brantly and Writebol. Both patients had to give consent to receive the drug, knowing it had never been tested in humans before.

The process by which the medication was made available to the American patients may have fallen under the U.S. Food and Drug Administration's "compassionate use" regulation, which allows access to investigational drugs outside clinical trials.

Did doctors know it would work?

No. The drug had shown promise in primates, but even in those experiments, just eight monkeys received the treatment. In any case, the human immune system can react differently than primates', which is why drugs are required to undergo human clinical trials before being approved by government agencies for widespread use.

The two Americans' cases will be studied further to determine how the drug worked with their immune systems.

Will the drug be made available to other Ebola patients?
Second Ebola patient heading to U.S.
Can camera help detect Ebola?

It's unclear. Doctors "cannot start using untested drugs in the middle of an outbreak, for various reasons," World Health Organization spokesman Gregory Hartl said.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, says scientists have to be careful about assuming this drug will work in other patients as it appears to have worked in Brantly.

"Having worked with administering antibodies for people for a really long time, that would be distinctly unusual," he told CNN. "As we all know in medicine ... you have to withhold judgment."

Does the company have more vials of the drug?

The company has very few doses ready for patient use, Fauci told CNN. "Apparently the company is trying to scale up, (but) it's not easy to scale up to very large number of doses."

Who paid for the drug and how much did it cost?

We don't know. Samaritan's Purse covered the cost of Brantly and Writebol's evacuations but did not pay for the drug, according to a spokesman.

When a patient gets an experimental drug, the drug company can donate the product under compassionate use. Mapp Biopharmaceutical Inc. might have done that in this case.

Health insurance companies typically do not pick up the tab for treatments that have not been approved by the FDA. But they would usually cover the cost of any doctor fees associated with giving the drug and any costs associated with monitoring how the drug is working.

Would this drug stop the Ebola epidemic?

If it were widely available, it certainly couldn't hurt. An effective Ebola drug could help doctors treat the deadly virus, which is killing about 60% of the people infected in West Africa. But a vaccine would be a much more effective tool in stopping this, and future, epidemics.

Vaccines are given to healthy people to prevent them from ever becoming infected. One challenge with Ebola, experts say, is that companies don't believe they could make much money from developing a vaccine, so few companies show interest.


http://edition.cnn.com/2014/08/04/health/ebola-drug-questions/index.html?hpt=hp_c1

Experimental drug likely saved Ebola patients

It's a story that could have come from a cinematic medical thriller: Two American missionary workers contract Ebola. Their situation is dire. Three vials containing a highly experimental drug are flown into Liberia in a last-ditch effort to save them.

And the drug flown in last week appears to have worked, according to a source familiar with details of the treatment.

Dr. Kent Brantly's and Nancy Writebol's conditions significantly improved after receiving the medication, sources say. Brantly was able to walk into Emory University Hospital in Atlanta after being evacuated to the United States last week, and Writebol is expected to arrive in Atlanta on Tuesday.

On July 22, Brantly woke up feeling feverish. Fearing the worst, Brantly immediately isolated himself. Writebol's symptoms started three days later. A rapid field blood test confirmed the infection in both of them after they had become ill with fever, vomiting and diarrhea.
Photos: Ebola outbreak in West Africa Photos: Ebola outbreak in West Africa
Why isn't there an Ebola vaccine?
Second Ebola patient heading to U.S.
Doctors struggle to treat Ebola patients

It's believed Brantly and Writebol, who worked with the aid organization Samaritan's Purse, contracted Ebola from another health care worker at their hospital in Liberia, although the official Centers for Disease Control and Prevention case investigation has yet to be released.

As the Americans' conditions worsened, Samaritan's Purse reached out to a National Institutes of Health scientist who was on the ground in West Africa, according to the National Institute of Allergy and Infectious Diseases.

"The scientist was able to informally answer some questions and referred them to appropriate company contacts to pursue their interest in obtaining the experimental product," NIAID said.

The experimental drug, known as ZMapp, was developed by the biotech firm Mapp Biopharmaceutical Inc., which is based in San Diego. The patients were told that the treatment had never been tried before in a human being but had shown promise in small experiments with monkeys.

Questions about this new Ebola drug

According to company documents, four monkeys infected with Ebola survived after being given the therapy within 24 hours after infection. Two of four other monkeys that started therapy within 48 hours after infection also survived. One monkey that was not treated died within five days of exposure to the virus.

Brantly and Writebol were aware of the risk of taking a new, little-understood treatment and gave informed consent, according to two sources familiar with the care of the missionary workers. In the monkeys, the experimental serum had been given within 48 hours of infection. Brantly didn't receive it until he'd been sick for nine days.

The medicine is a three-mouse monoclonal antibody, meaning that mice were exposed to fragments of the Ebola virus and then the antibodies generated within the mice's blood were harvested to create the medicine. It works by preventing the virus from entering and infecting new cells.

The Ebola virus causes viral hemorrhagic fever, which refers to a group of viruses that affect multiple organ systems in the body and are often accompanied by bleeding.

Early symptoms include sudden onset of fever, weakness, muscle pain, headaches and a sore throat. They later progress to vomiting, diarrhea, impaired kidney and liver function -- and sometimes internal and external bleeding.

The ZMapp vials, stored at subzero temperatures, reached the hospital in Liberia where Brantly and Writebol were being treated Thursday morning. Doctors were instructed to allow the serum to thaw naturally without any additional heat. It was expected that it would be eight to 10 hours before the medicine could be given, according to a source familiar with the process.

Brantly asked that Writebol be given the first dose because he was younger and he thought he had a better chance of fighting it, and she agreed. However, as the first vial was still thawing, Brantly's condition took a sudden turn for the worse.

Brantly began to deteriorate and developed labored breathing. He told his doctors he thought he was dying, according to a source with firsthand knowledge of the situation.

Knowing his dose was still frozen, Brantly asked if he could have Writebol's now-thawed medication. It was brought to his room and administered through an IV. Within an hour of receiving the medication, Brantly's condition dramatically improved. He began breathing easier; the rash over his trunk faded away. One of his doctors described the events as "miraculous."

By the next morning, Brantly was able to take a shower on his own before getting on a specially designed Gulfstream air ambulance jet to be evacuated to the United States.

Writebol also received a vial of the medication. Her response was not as remarkable, according to sources familiar with the treatment. However, doctors on Sunday administered Writebol a second dose of the medication, which resulted in significant improvement.

She was stable enough to be evacuated back to the United States.

The process by which the medication was made available to Brantly and Writebol is highly unusual.

World Health Organization spokesman Gregory Hartl cautioned that health authorities "cannot start using untested drugs in the middle of an outbreak, for various reasons."

Doctors Without Borders similarly weighed in on the side of caution.

"It is important to keep in mind that a large-scale provision of treatments and vaccines that are in very early stages of development has a series of scientific and ethical implications," the organization said in a statement.

"As doctors, trying an untested drug on patients is a very difficult choice since our first priority is to do no harm, and we would not be sure that the experimental treatment would do more harm than good."

ZMapp has not been approved for human use and has not even gone through the clinical trial process, which is standard to prove the safety and efficacy of a medication. It may have been given under the U.S. Food and Drug Administration's "compassionate use" regulation, which allows access to investigational drugs outside clinical trials.

Getting approval for compassionate use is often long and laborious, but in the case of Brantly and Writebol, they received the medication within seven to 10 days of their exposure to the Ebola virus.

On July 30, the Defense Threat Reduction Agency, an arm of the military responsible for any chemical, biological, radiological, nuclear and high-yield explosive threats, allotted additional funding to MAPP Biopharmaceutical due to "promising results."

http://edition.cnn.com/2014/08/04/health/experimental-ebola-serum/index.html?hpt=hp_c1

Ebola Cure Hope

Four out of five people who get infected die

A plant has been found to halt the deadly Ebola virus in its tracks in laboratory tests, scientists have said.

The extract can be eaten or rubbed into the skin

They used a compound from Garcinia kola, a plant commonly eaten in West Africa. Compounds from the plant have also proved effective against some strains of flu. If the anti-Ebola compound proves successful in animal and human trials, it will be the first medicine to successfully treat the virus that causes Ebola haemorrhagic fever - an often-fatal condition.
The discovery was announced at the 16th International Botanical Congress in St Louis in the US.
Four deaths per five cases
The Ebola virus was first documented in 1976 after an outbreak in Zaire - now the Democratic Republic of the Congo - where 88% of the 318 human cases died.

The Ebola-Zaire virus close up

More recently, a 1995 outbreak in the same country had a death rate of 81% of the 315 infected. There are four types of the virus - Ebola-Zaire, Ebola-Sudan and Ebola-Ivory Coast all affect humans, while Ebola-Reston has so far only affected monkeys and chimpanzees.
However, doctors have been unable to stop the virus once infection has taken hold - hence the disease has gained a terrifying reputation.
Traditional origins
Dr Maurice Iwu, who set up and heads the Bioresources Development and Conservation Programme, led the research.

Dr Maurice Iwu said the discovery was a breakthrough

It started 10 years ago when researchers were led to the plant by traditional native healers who have used the plant for the treatment of infectious diseases for centuries. "This is a very exciting discovery," said Dr Iwu, who himself comes originally from a family of traditional healers.
"The same forest that yields the dreaded Ebola virus could be a source of the cure."
Fighting chance
The virus multiplies rapidly in the human body and quickly overwhelms it, and in advanced cases the patient develops high fever and severe bleeding.

Towns are quarantined following an outbreak

The Garcinia kola compound has been shown to halt multiplication of the virus in the laboratory. If repeated in humans, this would give the body a chance to fight off the virus. The active compound is what is known as a dimeric flavonoid, which is two flavonoid molecules fused together.
Flavonoids are non-toxic and can be found in orange and lemon rinds as well as the colourings of other plants.
Drug hopes
The tests are in the early stages still, but the researchers hope that if they continue to prove successful the compound the US Food and Drug Administration will put it on a fast track - making a drug available to humans within a matter of years.
"The discovery of these important properties in a simple compound - flavonoids - was very surprising," said Dr Iwu.
"The structure of this compound lends itself to modification, so it provides a template for future work. "Even if this particular drug does not succeed through the whole drug approval process, we can use it to construct a new drug for this deadly disease."

Source: BBC News

Ebola: How easily do germs spread on planes?

The Ebola outbreak is stoking fears of a deadly virus spreading across the world through air travel. We talked to experts to discover the risks of catching the disease mid-flight.

Why Ebola is so dangerous

The Ebola outbreak in West Africa is the world's deadliest to date. More than 670 people have died as health officials in Guinea, Liberia and Sierra Leone struggle to control the virus.

Are plane cabins hotbeds of disease? Frequent flyers are often on guard against sneezing or coughing co-passengers, in fear of catching what they have. And the possibility that much more serious epidemics or pandemics could spread by air travel has been a worry for years, whether it is avian flu, Sars or tuberculosis.
Now we are in the middle of one of the deadliest outbreaks of Ebola virus ever: the outbreak started in Guinea last March and soon reached Liberia, Sierra Leone and Nigeria. Concern in the West has heightened after it emerged that a man had flown on internal flights while carrying the virus, with fears growing that air travel could quickly carry the terrifying disease around the world. British Prime Minister David Cameron described Ebola as a “serious threat”.

A member of Doctors Without Borders puts on protective gear to treat patients infected by the recent Ebola outbreak in Nigeria (Getty Images)

How likely is it to catch a deadly disease mid-flight, and what might stop a sick passenger carrying it between countries? To get a sense of the risks involved, BBC Future talked to infectious disease researchers to find out what we know about transmission during air travel – and what this can tell us about the risk of Ebola spreading across the world.

Transmission problems
The risks of catching an infection from an ill passenger are not as high as you would think, says Christine Pearson, a spokesperson for the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia. “It’s not any more dangerous than any place where you are in touch with lots of people – like a shopping mall food court for example.
John Oxford, a virologist at Queen Mary University, London, agrees. He points out that the aeroplane ventilation goes from the ground to the ceiling, where the air is filtered for bacteria and viruses before it recirculates. Simulations looking at the potential spread of germs have found that they are generally confined to just a couple of rows either side of the carrier. Even then, the chances appear to be small, according to a study published in the British Medical Journal. The paper looked at a flight involving nine school children who were later found to be carrying the swine flu virus. Just two other passengers, of more than 100 questioned, later developed the illness – and they were both sitting within two rows of the ill school kids. As a result, the researchers concluded that there was just a 3.5% risk of catching the illness if you were sitting in those seats. A handful of other studies, looking at measles and TB, also suggest that in-flight transmission rates are similarly low. From studies such as these, Oxford says that “the biggest risk is not on the plane, but in the taxi on the way to the airport”.
However, John Edmunds, professor of infectious disease modelling at the London School of Hygiene and Tropical Medicine, points out that it is difficult to come to any firm conclusions, even for the more prevalent diseases. The number of studies is small, he says, meaning you can’t find absolute figures for the risk and compare that to the risk of infection in a school, say. So it is even harder to assess the risk of in-flight transmission of rare and unstudied diseases like Ebola.

How much do crowded plane cabins increase the risk of catching and spreading infectious diseases beyond national borders? (Getty Images)

Mode of transmission is clearly a factor. There are a few documented cases of norovirus spreading among passengers – probably due to people sharing the same toilet. But we know that Ebola is relatively difficult to catch: unlike respiratory diseases like colds and flu, it can only be transmitted through contact with bodily fluids like saliva, vomit, or blood, which begins to secrete out of every orifice. Although it is unlikely that someone suffering the full-blown attack would attempt to fly, it is not impossible. Patrick Sawyer, a US citizen who died from the virus last week, showed some of these symptoms on a flight from Liberia to Nigeria, raising fears for the other passengers. Airline staff and public health officials should be more aware of the dangers now, however, and should place anyone suspected of having the disease in quarantine. “Everyone is on the lookout,” says Oxford.
There is always the chance that a passenger could board a flight before they have developed the full-blown symptoms. But so far, the evidence suggests you are unlikely to catch it from someone in the early stages of the disease, before they have started vomiting and bleeding. “I wouldn’t want to be a passenger next to a guy with Ebola,” admits Edmunds. “But if they are just sitting there with a fever, I can’t imagine the situation being high risk.” Oxford points out that basic hygiene measures should further reduce the chance of infection – even if it can’t eliminate the danger completely. “The Ebola virus is very easily killed; you can kill it with hot water and soap,” he says. “Alcohol rubs get rid of it in a microsecond.”
“Small risk”
If an apparently healthy person carrying the virus lands in a country, there is still room for a second stage of contagion. This is perhaps the greater risk for a global epidemic – undetected carriers are the way that swine flu and Sars spread across the world. “The history of the spread of infectious diseases is infinitely entwined with improvements in travel,” says Edmunds. He points out that in the past, the spread of diseases was limited by the length of travel; measles develops quickly, so all the cases would have burnt out by the end of a long voyage. Since Ebola has an incubation period of up to 21 days, carriers could arrive in a country weeks before symptoms develop – potentially transmitting it to the people they know. “It is an issue,” admits Oxford, but he is optimistic that the infection could still be contained. Anyone showing the symptoms would have a rapid diagnosis before being quarantined, and health authorities would also check anyone who had been in contact with them – such as air crews, passport officials and their families. “All of that can stop it spreading – and it will be stopped.”

Thermal screens were used to identify plane passengers that may have been carrying Sars (Getty Images)

A spokesperson for the World Health Organization, Gregory Härtl, says its official stance currently is that a global epidemic is a “small risk”, although it is currently working with the International Air Transport Association to review their recommendations. Currently, it does not recommend screening passengers at airports – since the thermal scanners used to detect a fever are unlikely to find people incubating the first stages of the disease – and there are no recommended travel restrictions.
However; the situation is evolving fast and the recommendations may change in the coming days. At the moment, no one can yet predict whether other air travellers have been infected with the disease, but the hope is that heightened vigilance will help to minimise any potential risk. However, even if it is successfully contained and the outbreak peters out, Ebola shows, yet again, the fact that no disaster or epidemic is too distant in the highly-connected modern world.

Source: http://www.bbc.com/future/story/20140731-can-ebola-spread-on-planes

Why Ebola is so dangerous

Health care workers are among those most at risk of catching Ebola

Ebola crisis

The Ebola outbreak in West Africa is the world's deadliest to date. More than 670 people have died as health officials in Guinea, Liberia and Sierra Leone struggle to control the virus.

What is Ebola? Ebola is a viral illness of which the initial symptoms can include a sudden fever, intense weakness, muscle pain and a sore throat, according to the World Health Organization (WHO). And that is just the beginning: subsequent stages are vomiting, diarrhoea and - in some cases - both internal and external bleeding.

The disease infects humans through close contact with infected animals, including chimpanzees, fruit bats and forest antelope.
It then spreads between humans by direct contact with infected blood, bodily fluids or organs, or indirectly through contact with contaminated environments. Even funerals of Ebola victims can be a risk, if mourners have direct contact with the body of the deceased.

This molecular model shows the parts of the Ebola virus scientists are studying in the hopes of finding drugs that will slow the spread of the disease

The incubation period can last from two days to three weeks, and diagnosis is difficult. The human disease has so far been mostly limited to Africa, although one strain has cropped up in the Philippines.
Healthcare workers are at risk if they treat patients without taking the right precautions to avoid infection.
People are infectious as long as their blood and secretions contain the virus - in some cases, up to seven weeks after they recover.
World Health Organization guidance on Ebola
In pictures: Battling Ebola in West Africa

Where does it strike? Ebola outbreaks occur primarily in remote villages in Central and West Africa, near tropical rainforests, says the WHO.

Bushmeat - from animals such as bats, antelopes, porcupines and monkeys - is a prized delicacy in much of West Africa but can also be a source of Ebola

It was first discovered in the Democratic Republic of Congo in 1976 since when it has affected countries further east, including Uganda and Sudan. This outbreak is unusual because it started in Guinea, which has never before been affected, and is spreading to urban areas.

From Nzerekore, a remote area of south-eastern Guinea, the virus has spread to the capital, Conakry, and neighbouring Liberia and Sierra Leone.
A Liberian man who flew to Lagos in July was quarantined on his arrival and later died of Ebola - the first case in Nigeria.
The medical charity Medecins Sans Frontieres (MSF) says the outbreak is "unprecedented" in the way the cases were scattered in multiple locations across Guinea, hundreds of kilometres apart, and says it is a "race against time" to check people who come into contact with sick people.

WHO: West Africa Ebola outbreak figures as of 27 July

• Guinea - 319 deaths, 427 cases
• Liberia - 129 deaths, 249 cases
• Sierra Leone - 224 deaths, 525 cases

The virus detective who discovered Ebola

What precautions should I take? Avoid contact with Ebola patients and their bodily fluids, the WHO advises. Do not touch anything - such as shared towels - which could have become contaminated in a public place.

Washing hands and improving hygiene is one of the best ways to fight the virus

Carers should wear gloves and protective equipment, such as masks, and wash their hands regularly.
The WHO also warns against consuming raw bushmeat and any contact with infected bats or monkeys and apes. Fruit bats in particular are considered a delicacy in the area of Guinea where the outbreak started.
In March, Liberia's health minister advised people to stop having sex, in addition to existing advice not to shake hands or kiss. A BBC reporter in the Liberian capital Monrovia says that public awareness campaigns around Ebola have been stepped up following the death in July of renowned Liberian doctor Samuel Brisbane.
Liberia has now closed most of its border crossings and communities hit by an Ebola outbreak face quarantine to try to halt the spread of the virus.
Nigeria's main airliner Arik Air has suspended flights to Liberia and Sierra Leone and more stringent screening is being put in place at some airports. When the outbreak first began, Senegal closed its border with Guinea.
Fighting the fear and stigmatisation surrounding Ebola is one of the greatest challenges health workers face.

Deadliest ever outbreak of Ebola virus: What you need to know

 

It began with a just a handful of cases in Guinea in March. But it spread quickly to two other countries and is now the deadliest outbreak of Ebola virus on record.

At least 1,201 people in Guinea, Sierra Leone and Liberia have been infected by what is believed to be Ebola virus since its symptoms were first observed in March, according to the World Health Organization. 672 of them have died. That's a 55% percent mortality rate.

The WHO says "drastic action is needed" to contain Ebola, which has spread from rural areas to cities in West Africa and sparked fears that the killer virus could spread to other continents.

What's the latest?

Until recently the Ebola outbreak had been contained to three West African countries: Guinea, where it began, Liberia and Sierra Leone.

But this week a Liberian government official who had contracted the virus died in isolation at a hospital in Lagos, Nigeria.

Photos: Ebola outbreak in West Africa

Ebola outbreak kills an American

Fighting Ebola on the front lines

American doctor battling Ebola

Patrick Sawyer, a naturalized American citizen who worked in Liberia, had stopped in Nigeria for a conference but died before he could board a plane home to the U.S. He's the first American to die in the latest outbreak, though several other U.S. aid workers in Liberia have also contracted Ebola and are being treated.

Why was someone infected with Ebola allowed on a plane?

It is unknown whether Sawyer was displaying symptoms of Ebola before he flew from Monrovia, Liberia's capital, to Ghana and then to Togo to switch planes to fly to Lagos. His Minnesota-based widow, Decontee Sawyer, told CNN that he had cared for his Ebola-stricken sister in Liberia, though she said he didn't know at the time that she had the virus. When he arrived in Nigeria he told officials that he had no direct contact with anyone who had Ebola.

But since it takes between 2 and 21 days before someone infected with Ebola begins to show symptoms, there's little health officials can do to stop an infected but non-symptomatic person from flying to another country, said CNN's Chief Medical Correspondent Sanjay Gupta.

"When I left Conakry (Guinea's capital), they took my temperature at the airport and asked me to fill out a questionnaire, and that was really about it," said Gupta. "If I had been exposed for whatever reason and it was 21 days later before I got sick, there was nothing that would have prevented me from getting on that plane.

"I think it's going to happen at some point. Just from observing the whole process it's almost impossible from happening," Gupta said, before adding that he believes the virus would stand little chance of spreading very far in a developed country.

How easily could Ebola spread on a plane?

Serious viruses like Ebola may be just "a plane ride away" from reaching the developed world, according to Marty Cetron of the Centers for Disease Control and Prevention (CDC), but it is unlikely the virus would spread on a plane unless a passenger were to come into contact with a sick person's bodily fluids.

The CDC has sent guidance to American air carriers on how to identify and deal with passengers displaying Ebola symptoms -- and how they should disinfect aircraft after an infected passenger leaves a plane.

"Airline carriers, crew members, and airports can be very important partners in that front line," Cetron told CNN. "Being educated, knowing the symptoms, recognizing what to do, having a response protocol, knowing who to call -- those are really really important parts of the global containment strategies to deal with threats like this."

Health officials are also trying to track down everyone who was on any of the three flights Patrick Sawyer took to get to the heavily populated city of Lagos, in order to test them for Ebola.

What else is being done to stop the spread of the disease?

Ebola patients are being isolated by health officials in Western Africa, and those who have come into contact with them are being told to monitor their temperatures. The family of a second infected American aid worker had been living with him in Liberia, but they left before he started showing symptoms. While it's unlikely they contracted Ebola, the CDC is keeping the family on a 21-day fever watch.

The president of Liberia has closed most of the borders with neighboring countries, and the few points of entry that are still open will have Ebola testing centers. The president also placed restrictions on public gatherings and ordered hotels, restaurants and other entertainment venues to play a five-minute video on Ebola safety.

Arik Air, one of Nigeria's biggest airlines, has also suspended operations into Monrovia and Freetown, the capitals of Liberia and Sierra Leone, respectively, according to AllAfrica.com.

The UK government is also convening an emergency meeting Wednesday to discuss the threat of Ebola to Britain. There have been no cases of Ebola reported in the UK as of yet.

The CDC has also issued an alert to health workers in the U.S. to watch out for any patients who may have recently traveled to West Africa and could have contracted the virus.

Why does Ebola generate such fear?

Medecins Sans Frontieres (MSF) describes Ebola as "one of the world's most deadly diseases."

"It is a highly infectious virus that can kill up to 90% of the people who catch it, causing terror among infected communities," it says. The death rate in this outbreak has dropped to roughly 55% because of early treatment.

There is also no vaccination against it.

Of Ebola's five sub-types, the Zaire strain -- the first to be identified -- is considered the most deadly.

The WHO said preliminary tests on the Ebola virus in Guinea in March suggested that the outbreak there was this strain, although that has not been confirmed.

Tracking the Ebola virus in Nigeria

Ebola scientist: 'It's spectacular'

Ebola epidemic 'out of control'

Fighting Ebola in urban Africa

What is Ebola?

The Ebola virus causes viral hemorrhagic fever (VHF), which according to the U.S. Centers for Disease Control and Prevention (CDC), refers to a group of viruses that affect multiple organ systems in the body and are often accompanied by bleeding.

The virus is named after the Ebola River in the Democratic Republic of Congo (formerly Zaire), where one of the first outbreaks occurred in 1976. The same year there was another outbreak in Sudan.

The WHO says there are five different strains of the virus -- named after the areas they originated in. Three of these have been associated with large outbreaks of hemorrhagic fever in Africa.

These are the Bundibugyo -- an area of Uganda where the virus was discovered in 2007 -- Sudan and Zaire sub-types.

There has been a solitary case of Ivory Coast Ebola. This subtype was discovered when a researcher studying wild chimpanzees became ill in 1994 after an autopsy on one of the animals. The researcher recovered.

Finally, Reston Ebola is named after Reston in the U.S. state of Virginia, where this fifth strain of the Ebola virus was identified in monkeys imported from the Philippines.

The CDC says while humans have been infected with Ebola Reston, there have been no cases of human illness or death from this sub-type.

What are Ebola's symptoms?

Early symptoms of the Ebola virus include sudden onset of fever, weakness, muscle pain, headaches and a sore throat. These symptoms can appear two to 21 days after infection.

The WHO says these non-specific early symptoms can be mistaken for signs of diseases such as malaria, typhoid fever, meningitis or even the plague.

MSF says some patients may also develop a rash, red eyes, hiccups, chest pains and difficulty breathing and swallowing.

The early symptoms progress to vomiting, diarrhea, impaired kidney and liver function and sometimes internal and external bleeding.

Ebola can only be definitively confirmed by five different laboratory tests.

How is it treated?

There are no specific treatments for Ebola. MSF says patients are isolated and then supported by health care workers.

"This consists of hydrating the patient, maintaining their oxygen status and blood pressure and treating them for any complicating infections," it says.

There have been cases of healthcare workers contracting the virus from patients and the World Health Organization has issued guidance for dealing with confirmed or suspected cases of the virus.

Carers are advised to wear impermeable gowns and gloves and to wear facial protection such as goggles or a medical mask to prevent splashes to the nose, mouth and eyes.

MSF says it contained a 2012 outbreak in Uganda by placing a control area around its treatment center. An outbreak is considered over once 42 days -- double the incubation period of the disease -- have passed without any new cases.

How does it spread?

The WHO says it is believed that fruit bats may be the natural host of the Ebola virus in Africa, passing on the virus to other animals.

Humans contract Ebola through contact with the bodily fluids of infected animals.

The WHO says in Africa there have been documented cases of humans falling ill after contact with dead or ill chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines.

It says Ebola later spreads from human-to-human via contact with bodily fluids containing the virus. The virus can be spread through contact with an object contaminated with infected secretions.

Direct contact with the corpses of Ebola victims can also result in infection and the virus can be transmitted via infected semen up to seven weeks after clinical recovery.

MSF says while the virus is believed to be able to survive for some days in liquid outside an infected organism, it is fragile and chlorine disinfection, heat, direct sunlight, soaps and detergents can kill it.

MSF epidemiologist Kamiliny Kalahne says outbreaks usually spread in areas where hospitals have poor infection control and limited access to resources such as running water.

"People who become sick with it almost always know how they got sick: because they looked after someone in their family who was very sick -- who had diarrhea, vomiting and bleeding -- or because they were health staff who had a lot of contact with a sick patient," she says.

How many cases have there been?

The CDC estimates there have been more than 1,800 cases of Ebola and more than 1,300 deaths.

The last recorded outbreaks before the current one in Guinea were in 2012 -- in Uganda and Democratic Republic of Congo.

The Uganda outbreak involved a total of 24 probable and confirmed cases, and 17 deaths, according to the WHO, which declared it had ended in October 2012.

MSF said the Uganda outbreak had been the Sudan strain, while the virus found in DRC was the Bundibugyo sub-type.

According to the CDC, the most deadly outbreak was the 1976 outbreak in then Zaire, when 280 of 318 infected people died. In 2000, there were 425 cases of Ebola Sudan in Uganda, which resulted in 224 fatalities.

Ebola Virus Ravaging West Africa. 539 Deaths Reported & Counting [Video/Pics]

Video And Pics After The Jump
DAKAR, Senegal (Associated Press) — Deep in the forests of southern Guinea, the first victims fell ill with high fevers. People assumed it was the perennial killer malaria and had no reason to fear touching the bodies, as is the custom in traditional funerals.
Some desperate relatives brought their loved ones to the distant capital in search of better medical care, unknowingly spreading what ultimately was discovered to be Ebola, one of the world's most deadly diseases.

Ebola, a hemorrhagic fever that can cause its victims to bleed from the ears and nose, had never before been seen in this part of West Africa where medical clinics are few and far between. The disease has turned up in at least two other countries — Liberia and Sierra Leone — and 539 deaths have been attributed to the outbreak that is now the largest on record.

The key to halting Ebola is isolating the sick, but fear and panic have sent some patients into hiding, complicating efforts to stop its spread. Ebola has reached the capitals of all three countries, and the World Health Organization reported 44 new cases including 21 deaths on Friday.
There has been "a gross misjudgment across the board in gauging the severity and scale of damage the current Ebola outbreak can unleash," the aid group Plan International warned earlier this month.
"There are no cases from outside Africa to date. The threat of it spreading though is very much there," said Dr. Unni Krishnan, head of disaster preparedness and response for the aid group.
Preachers are calling for divine intervention, and panicked residents in remote areas have on multiple occasions attacked the very health workers sent to help them. In one town in Sierra Leone, residents partially burned down a treatment center over fears that the drugs given to victims were actually causing the disease.

Activists are trying to spread awareness in the countryside where literacy is low, even through a song penned about Ebola.

"It has no cure, but it can be prevented; let us fight it together. Let's protect ourselves, our families and our nation," sings the chorus.
"Do not touch people with the signs of Ebola," sings musician and activist Juli Endee. "Don't eat bush meat. Don't play with monkey and baboons. Plums that bats have bitten or half-eaten, don't eat them."
Guinea first notified WHO about the emergence of Ebola in March and soon after cases were reported in neighboring Liberia. Two months later there were hopes that the outbreak was waning, but then people began falling ill in Sierra Leone.
Doctors Without Borders says it fears the number of patients now being treated in Sierra Leone could be "just the tip of the iceberg." Nearly 40 were reported in a single village in the country's east.

"We're under massive time pressure: The longer it takes to find and follow up with people who have come in contact with sick people, the more difficult it will be to control the outbreak," said Anja Wolz, emergency coordinator for the group, also referred to by its French name Medecins Sans Frontieres.
This Ebola virus is a new strain and did not spread to West Africa from previous outbreaks in Uganda and Congo, researchers say. Many believe it is linked to the human consumption of bats carrying the virus. Many of those who have fallen ill in the current outbreak are family members of victims and the health workers who treated them.

There is no cure and no vaccine for Ebola, and those who have survived managed to do so only by receiving rehydration and other supportive treatment. Ebola's high fatality rate means many of those brought to health clinics have been merely kept as comfortable as possible in quarantine as they await death. As a result, some families have been afraid to take sick loved ones to the clinics.

"Let this warning go out: Anyone found or reported to be holding suspected Ebola cases in homes or prayer houses can be prosecuted under the law of Liberia," President Ellen Johnson Sirleaf stated recently.

Liberian President Ellen Johnson Sirleaf
Her comments came just days after Sierra Leone issued a similar warning, saying some patients had discharged themselves from the hospital and had gone into hiding.
At the airport in Guinea's capital, departing passengers must undergo temperature screening, and those with a fever are pulled aside for further evaluation. Still, the stigma of Ebola follows Guineans well outside the region.
"The police treated us like we were aliens. They said they didn't want us in their country because of the disease affecting Guinea," says Tafsir Sow, a businessman who was briefly detained at the airport in Casablanca, Morocco before continuing on to Paris. "I had tears in my eyes."
Still, WHO health officials are hopeful they will be able to get the situation under control in the next several weeks. A recent conference in the capital of Ghana brought together health authorities from across the affected areas, and the countries agreed on a common approach to fight Ebola.
"When you have it spread, of course it's moving in the wrong direction," said Dr. Keiji Fukuda, WHO's assistant director-general for health security and environment. "You want to see the number of infections going down. So we really have to redouble our efforts. But saying that it's out of control makes it sound like there are no solutions. This is a virus for which there are very clear solutions."
___
Associated Press writers John Heilprin in Geneva; Boubacar Diallo in Conakry, Guinea; Clarence Roy-Macaulay in Freetown, Sierra Leone; Jonathan Paye-Layleh in Monrovia, Liberia and Francis Kokutse in Accra, Ghana contributed to this report.

Ebola 'out of control' in West Africa

Ebola virus explained in 60 seconds