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WHO says Ebola team arrives in Congo

FILE PHOTO: Medecins Sans Frontieres (MSF) workers talk to a worker at an isolation facility, prepared to receive suspected Ebola cases, at the Mbandaka General Hospital, in Mbandaka, Democratic Republic of Congo May 20, 2018. REUTERS/Kenny Katombe

By Tom Miles and Fiston Mahamba

GENEVA/GOMA (Reuters) – An international delegation has arrived in the town of Beni in Democratic Republic of Congo, 30 km (18 miles) from where an Ebola outbreak was declared, the World Health Organization and Congolese officials said on Thursday.

Officials from the United Nations, the World Bank, the WHO and Democratic Republic of Congo’s Ministry of Health, including Health Minister Oly Ilunga, will support a team already on the ground.

Congo declared the new outbreak on Wednesday, just days after another outbreak that had killed 33 people in the northwest was declared over.

Twenty people have died from haemorrhagic fevers in and around Mangina, a densely populated town in North Kivu province about 30 km (18 miles) southwest of the city of Beni and 100 km from the Ugandan border.

The ministry has not made public when the deaths occurred. Another six who are still living are showing signs of fever, of which four tested positive.

“The Government-Partner delegation is holding its first meeting to organize the response,” North Kivu governor Julien Paluku tweeted. “Already a … team from Kinshasa is installing a laboratory and a single coordination center.”

But eastern Congo is a tinderbox of conflicts over land and ethnicity stoked by decades of on-off war and this could hamper efforts to contain the virus.

About 1,000 civilians have been killed by armed groups and government soldiers around Beni since 2014, and the wider region of North Kivu holds over 1 million displaced people.

(Writing by Tim Cocks; editing by Matthew Mpoke Bigg)

First Ebola vaccines given as WHO seeks to beat Congo outbreak

FILE PHOTO: A Congolese child washes her hands as a preventive measure against Ebola at the Church of Christ in Mbandaka, Democratic Republic of Congo May 20, 2018. REUTERS/Kenny Katombe/File Photo

By Kate Kelland

LONDON, (Reuters) – A vaccination campaign aimed at beating an outbreak of Ebola in Congo began on Monday in the port city of Mbandaka, where four cases of the deadly disease have been confirmed.

Use of the VSV-EBOV shot – an experimental vaccine developed by Merck – marks a “paradigm shift” in how to fight Ebola, said the World Health Organization’s head of emergency response, and means regions with Ebola outbreaks can in future expect more than just containment of an outbreak with basic public health measures such as isolation and hygiene.

The shot is designed for use in so-called ring vaccination plans. When a new Ebola case is diagnosed, all people who might have been in recent contact with the patient are traced and vaccinated to keep the disease from spreading.

“It’s the first time in the midst of an outbreak … that we’re using this as a way to stem transmission,” WHO’s Peter Salama said in a telephone interview. “It’s an important moment that changes the way we’ve seen Ebola for 40 years.”

The same strategy was used to test Merck’s vaccine in Guinea in late 2015, towards the end of an Ebola outbreak in West Africa from 2013 to 2016. The trial results showed it was safe and gave very high levels of protection against Ebola.

Around 30 Guinean health workers who were directly involved in that 2015 vaccine trial have travelled to Congo and will help with the immunizations there, Salama said.

Ebola causes hemorrhagic fever, vomiting and diarrhea and spreads through contact with the bodily fluids of an infected person. More than 11,300 people died in the West Africa epidemic.

This latest outbreak has killed 25 people since early April, according to the WHO. It is Congo’s ninth since the disease made its first known appearance near the country’s Ebola river in the 1970s.

Cases in Mbandaka, a port city on the Congo river, have raised concern that the virus could spread downstream to the capital, Kinshasa, which has a population of 10 million.

Salama, who visited Congo after the Ebola outbreak was first reported on May 8, said up to 1,000 people – first in Mbandaka and then in Bikoro and other affected areas -could be vaccinated within the next week.

Some 7,300 doses are already in Congo, and hundreds of thousands more are available in a stockpile built up by Merck.

“If we need any more we can ship it within days,” he said. “We’re fine for vaccine supply; that’s not an issue. The issue is going to be making sure we find every contact, track them down and get them vaccinated if they agree.”

Congolese health ministry data show four cases of Ebola confirmed in Mbandaka’s Wangata neighborhood and two suspected cases. One patient has died. For every case, up to 150 contacts will be offered the vaccine.

Salama said he was particularly concerned about the “unknowns” of the outbreak – namely the potential numbers of cases in the village of Ikobo, where no roads go and even helicopters have trouble landing.

“I’m actually very worried about Ikobo because we have four new suspected cases there and it’s very, very remote. We’ve tried to land helicopters there several times, but we need the community to clear the airstrip, and they haven’t fully cleared it yet,” Salama said.

“And when you haven’t got people on the ground, it’s very hard to assess the extent of the outbreak. I’m worried there are many more cases than we’ve been able to identify so far.”

(Reporting by Kate Kelland; Editing by Larry King)

Exclusive: U.S. needs to improve oversight of labs handling dangerous pathogens – report

By Julie Steenhuysen

CHICAGO (Reuters) – A year-long audit of the program overseeing U.S. labs that handle lethal pathogens such as Ebola and anthrax found overworked safety inspectors, an absence of independent review and weak biosafety protections that could expose lab workers and the public to harm, a government report will say on Tuesday.

The report by the Government Accountability Office to Congress followed a series of mishaps in which dangerous pathogens were inadvertently released. The report, seen by Reuters, concluded that the Federal Select Agent Program needs an overhaul.

The GAO audited laboratory safety oversight following errors that could have exposed dozens of people to live anthrax bacteria and the deadly toxin ricin. Its report will guide questioning of officials before the House Energy and Commerce Committee’s oversight subcommittee on Thursday.

The Federal Select Agent Program is jointly run by the U.S. Centers for Disease Control and Prevention (CDC) and the Animal and Plant Health Inspection Service (APHIS) of the U.S. Department of Agriculture.

According to the report, a chief concern is that the program is too focused on physical security measures, such as preventing theft from labs, and needs to focus more on biosafety issues that could protect researchers and the wider public from errors.

The GAO report also noted that many of the labs using high-risk pathogens for research belong to either CDC or the USDA, and recommended that Congress consider setting up a fully independent oversight body to remove potential conflicts of interest.

“The Select Agent Program does not fully meet our key elements of effective oversight,” the report stated.

Safety lapses in CDC labs captured headlines in 2014 when scientists at a high-level biosecurity lab did not properly inactivate anthrax bacteria before sending the material to labs with fewer safeguards. More than 80 scientists were exposed to potentially live anthrax, though no one fell ill.

In the months that followed, the Food and Drug Administration disclosed the discovery of decades-old vials of smallpox in a storage closet, while a U.S. Army lab erroneously shipped live anthrax to nearly 200 labs worldwide.

To address concerns of conflict of interest, CDC and APHIS have made structural changes to increase the program’s independence, but according to the GAO report, the program has not undergone a comprehensive risk management review, even as problems with lab safety continue to come to light.

As recently as last November, the Department of Homeland Security found a private lab inadvertently shipped ricin – a lethal poison – to one of its training centers on multiple occasions in 2011.

“Considering the type of research we’re talking about, we should have a much more robust, systematic oversight approach. That seems to be lacking,” said an aide to the House committee who declined to be identified.

To avoid conflicts of interest, inspections of APHIS laboratories are supposed to be carried out by the CDC, and inspections of CDC labs are to be carried out by APHIS. But the report revealed that at least three times in 2015, APHIS inspected its own laboratories, partly because there is no process in place to ensure compliance.

The report also cited excessive workloads for inspectors, which delay inspection reports and make it harder to retain personnel. In some cases, inspectors have been assigned to tasks outside of their expertise. For example, the GAO found that an APHIS physical security expert was asked to inspect ventilation systems – a critical protection against the accidental release of dangerous pathogens.

Short of a move by Congress to create an independent oversight agency, GAO recommended that CDC and APHIS officials conduct a risk assessment of the Select Agent Program and how it handles conflicts of interest. It also recommended that program officials shift inspection priorities to focus on high-risk activities in labs and develop a joint plan to train and hire inspectors.

The Health and Human Services Department, which oversees CDC, and the USDA, which runs APHIS, agreed with many of these recommendations, according to the report. Officials from the CDC and APHIS will testify at the Thursday hearing.

(Reporting by Julie Steenhuysen; Editing by Michele Gershberg)

WHO confirms second Ebola case in Congo outbreak

FILE PHOTO: A health worker sprays a colleague with disinfectant during a training session for Congolese health workers to deal with Ebola virus in Kinshasa October 21, 2014. REUTERS/Media Coulibaly

By Aaron Ross

KINSHASA (Reuters) – The World Health Organization (WHO) confirmed on Sunday a second case of Ebola in Democratic Republic of Congo after an outbreak this week of 17 other suspected cases.

Health officials are trying to trace 125 people thought to be linked to the cases identified in the remote northeastern province of Bas-Uele province in northeastern Congo near the border with Central African Republic, WHO’s Congo spokesman Eugene Kabambi said.

Three people have so far died among the 19 suspected and confirmed cases, he added.

It was not immediately clear how the first victim, a deceased male, caught the virus, although past outbreaks have been linked to contact with infected bush meat such as apes.

The outbreak comes just a year after the end of an epidemic in West Africa killed more than 11,300 people mostly in Guinea, Sierra Leone and Liberia.

However, Congo, whose dense forests contain the River Ebola near where the disease was first detected in 1976, has experienced many outbreaks and has mostly succeeded in containing them without large-scale loss of life.

The GAVI global vaccine alliance said on Friday some 300,000 emergency doses of an Ebola vaccine developed by Merck <MRK.N> could be available in case of a large-scale outbreak and that it stood ready to support the Congo government on the matter.

(Reporting by Aaron Ross; Writing by Emma Farge; Editing by Louise Ireland and Gareth Jones)

Scottish nurse who had Ebola cleared of hiding symptoms

Pauline Cafferkey a nurse who volunteered volunteered to treat Ebola patients in West Africa, then survived the disease herself, leaves a hearing after being cleared of misconduct charges in Edinburgh, Scotland

EDINBURGH (Reuters) – A Scottish nurse who contracted Ebola while caring for patients in Sierra Leone was cleared on Wednesday of allegations that she had put the public at risk by hiding the fact that she had a raised temperature when she returned to Britain.

Pauline Cafferkey, 40, was infected in 2014, during an outbreak of the highly contagious disease that killed more than 11,300 people in three West African countries.

The Nursing and Midwifery Council, which regulates the professions in Britain, held a two-day hearing in Edinburgh to investigate allegations that Cafferkey had allowed a wrong temperature to be recorded at London’s Heathrow Airport on her return.

She was also accused of failing to flag up her true temperature to medical staff at a screening area in the airport.

The panel dismissed both charges of professional misconduct after hearing that she had been impaired by illness as she went through the screening area, described in evidence as chaotic and under-staffed.

“Throughout her career Pauline has been motivated by a genuine desire to help other people even if this meant putting her own life at risk. She would never have knowingly put anyone in danger,” her lawyer, Joyce Cullen, told reporters.

Having been given the green light to leave the screening area and fly onwards to Glasgow, Cafferkey then became extremely unwell and was flown back to London to be treated in a special isolation unit at the Royal Free Hospital.

She spent close to a month there before she was discharged. She has continued to suffer from ill health linked to the consequences of her Ebola infection and was twice hospitalized again.

Cullen told reporters after the end of the disciplinary hearing that it had been upsetting and stressful for Cafferkey, who would now continue with her nursing career in Scotland.

(Reporting by Russell Cheyne in Edinburgh and Estelle Shirbon in London; editing by Michael Holden)

Republican lawmakers approve $1.1 billion in new Zika funds

By Susan Cornwell

WASHINGTON (Reuters) – The U.S. House of Representatives on Thursday agreed to $1.1 billion to fight the Zika virus, short-changing President Barack Obama’s $1.9 billion funding request and angering Democrats by making other cuts to pay for it.

The House approved a funding deal that had been agreed to on Wednesday by Republicans from both the House and Senate. But the bill’s future was uncertain in the Senate, where the Democratic minority has more power to stop legislation, and Democratic leader Harry Reid has declared his opposition.

“It is a responsible plan that assures the administration will continue to have the needed resources to protect the public,” Republican House Speaker Paul Ryan said. Republicans said the deal included funding for fiscal years 2016 and 2017.

But the White House said the allocation fell short.

“This plan from congressional Republicans is four months late and nearly a billion dollars short of what our public health experts have said is necessary to do everything possible to fight the Zika virus, and steals funding from other health priorities,” White House press secretary Josh Earnest said in a statement before the House voted.

Earnest said the Republican plan would limit needed birth control services for women seeking to prevent Zika, which can be spread through unprotected sex — “a clear indication they don’t take seriously the threat from the Zika virus.”

Democrats have been urging Republicans for months to agree to more Zika funding, and the Obama administration has already reprogrammed nearly $600 million that had been set aside to fight Ebola.

House Democrats said they could not go along with the deal because of $750 million in budget cuts elsewhere that the Republicans want to use to pay for the Zika spending.

Senate Democrats also voiced displeasure, clouding the outlook for it passing.

“A narrowly partisan proposal that cuts off women’s access to birth control, shortchanges veterans and rescinds Obamacare funds to cover the cost is not a serious response to the threat from the Zika virus,” Reid said.

Still, Ryan urged the Senate to move on the bill.

According to House Appropriations Committee Chairman Hal Rogers, $543 million of the $1.1 billion would come from unspent funds set aside for implementing Obamacare in U.S. territories, while $107 million would come from unused funds to fight another virus, Ebola. Another $100 million would come from unused administrative funds at the Department of Health and Human Services, he said.

(Reporting by Susan Cornwell and Susan Heavey; Editing by Toby Chopra)

Scientists use climate, population change to predict disease

A mosquito is seen under a microscope at the Greater Los Angeles County Vector Control District in Santa Fe Springs

By Kate Kelland

LONDON (Reuters) – British scientists say they have developed a model that can predict outbreaks of zoonotic diseases – those such as Ebola and Zika that jump from animals to humans – based on changes in climate.

Describing their model as “a major improvement in our understanding of the spread of diseases from animals to people”, the researchers said it could help governments prepare for and respond to disease outbreaks, and to factor in their risk when making policies that might affect the environment.

“Our model can help decision-makers assess the likely impact (on zoonotic disease) of any interventions or change in national or international government policies, such as the conversion of grasslands to agricultural lands,” said Kate Jones, a professor who co-led the study at University College London’s genetics, evolution and environment department.

The model also has the potential to look at the impact of global change on many diseases at once, she said.

Around 60 to 75 percent of emerging infectious diseases are so-called “zoonotic events”, where animal diseases jump into people. Bats in particular are known to carry many zoonotic viruses.

The Ebola and Zika viruses, now well known, both originated in wild animals, as did many others including Rift Valley fever and Lassa fever that affect thousands already and are predicted to spread with changing environmental factors.

Jones’ team used the locations of 408 known Lassa fever outbreaks in West Africa between 1967 and 2012 and the changes in land use and crop yields, temperature and rainfall, behavior and access to health care.

They also identified the sub-species of the multimammate rat that transmits Lassa virus to humans, to map its location against ecological factors.

The model was then developed using this information along with forecasts of climate change, future population density and land-use change.

“Our approach successfully predicts outbreaks of individual diseases by pairing the changes in the host’s distribution as the environment changes with the mechanics of how that disease spreads from animals to people,” said David Redding, who co-led the study.

“It allows us to calculate how often people are likely to come into contact with disease-carrying animals and their risk of the virus spilling over.”

The team tested their new model using Lassa fever, a disease that is endemic across West Africa and is caused by a virus passing to people from rats. Like Ebola, Lassa causes hemorrhagic fever and can be fatal.

The study, published in the journal Methods in Ecology and Evolution, tested the model with Lassa and found the number of infected people will double to 406,000 by 2070 from some 195,000 due to climate change and a growing human population.

(Reporting by Kate Kelland; editing by Andrew Roche)

Senate negotiators zero in on Zika virus funding

An anti Zika virus kit, including a bug net, mosquito repellent, condoms, literature and anti mosquito dunks,

WASHINGTON (Reuters) – U.S. Senate negotiators on Wednesday tried to reach a deal to provide more than $1 billion to battle the Zika virus that is feared will creep north into the United States with the onset of warmer weather, which breeds mosquitoes that could carry the disease.

Senior Senate Democratic aides said details were still being worked out, but votes could come by next week on whether to approve the new money.

In February, President Barack Obama requested $1.9 billion in emergency funds, but Republicans balked, with some arguing that $1.1 billion is more in line with what is needed. Many Republicans also want any Zika funds to be offset with spending cuts elsewhere.

These are among the details that still have to be worked out, according to aides.

Republican Senator Roy Blunt from Missouri and Democratic Senator Patty Murray from Washington, the two senior senators on an appropriations panel that oversees healthcare spending, have been trying to hammer out a deal.

An aide to Murray said in a statement: “Senator Murray is having conversations with Chairman Blunt and others about the path forward on emergency funding to respond to Zika.”

The aide said Murray still supports Obama’s $1.9 billion request.

Amid congressional inaction, the Obama administration shifted $589 million to help federal agencies prepare for Zika. Most of that money came from a fund to fight the Ebola virus and will have to be replenished, according to officials.

Senator Marco Rubio, however, is one Republican pushing for both immediate, emergency funding and longer-term money to be made available starting on Oct. 1 to battle the disease that can cause severe brain deformities in babies born of infected mothers and other illnesses.

“This is going to be an ongoing issue beyond this year,” Rubio said, adding, “We need to jump on it now.”

There are fears that Rubio’s home state of Florida could be the first place in the continental United States to get hit hard by Zika because of its tropical climate.

“For the first time, I’ve seen high-level conversations about a way forward here in the Senate and that’s a positive development,” Rubio said in a brief hallway interview with Reuters.

Republicans in the House of Representatives are still deeply divided over new funding for Zika, according to two senior aides.

(Reporting By Richard Cowan; Editing by Bernard Orr)

Fifth person dies in Guinea Ebola flare-up

CONAKRY (Reuters) – A fifth person has died of Ebola in southeast Guinea since March 17, a health official told Reuters on Tuesday, raising concerns that a recent flare-up of the deadly virus could spread.

The latest case was detected in Macenta prefecture, about 200 kilometers from the village of Korokpara where the four other recent Ebola-related deaths occurred, said Fode Sylla Tass, spokesman for National Coordination of the Fight against Ebola in Guinea.

The man, who has not been identified, had recently visited Korokpara and had been in direct contact with the first patients, Tass said. He was buried in the village of Makoidou without any sanitary precautions.

Burials, where bodies of the deceased are often washed, have been a main cause of transmission of Ebola, which has killed at least 11,300 people in West Africa since 2013 in the worst outbreak on record.

Guinea, one of the worst hit countries, was declared Ebola free in December, but the World Health Organization warned about possible flare-ups.

It was not immediately clear how the people from Korokpara had contracted the disease but the area had previously resisted efforts to fight the illness in the initial epidemic.

Guinea’s Ebola coordination unit has traced an estimated 816 people who may have come into contact with the first four recent victims.

Liberia closed its border with Guinea on Tuesday as a precaution against the latest outbreak.

In Makoidou, news of the latest test was met with panic.

“When the villagers realized that the test conducted by our health teams on the man were positive, they all fled into the bush,” Tass said.

(Reporting by Saliou Samb; Writing by Edward McAllister; Editing by Catherine Evans)

U.S. doctor with Lassa fever en route to Atlanta from West Africa

ATLANTA (Reuters) – An American doctor who was working with missionaries in West Africa is being moved to an isolation ward at an Atlanta hospital on Friday with a suspected case of Lassa fever, a deadly hemorrhagic disease similar to Ebola, officials said.

The patient, who has not been identified publicly, was being flown in a specially equipped aircraft from Togo and was expected to arrive at Emory University Hospital sometime Friday or this weekend, officials said.

The isolation ward is where Emory successfully treated four Ebola patients in 2014, said Dr. Bruce Ribner, director of Emory’s Serious Communicable Disease Unit.

“The take-away from this for the public, is that there is absolutely no risk to anyone,” he said. “We’ve shown that we can handle Ebola and this is a lot less communicable.”

Lassa fever has been endemic in Africa for many years, with up to 300,000 infections annually. Only about 3 percent presenting symptoms severe enough need hospitalization, Ribner said.

Of those hospitalized, about 20 percent of the cases are fatal, compared with a 70 percent rate for all patients who catch Ebola, which is transmitted through blood and bodily fluids.

“With Lassa, most of the people who get it never even know it,” Ribner said.

The worst Ebola outbreak in recorded history began in West Africa in December 2013, spreading to at least 11 countries on the continent before petering out. In all, more than 11,300 people died, almost all in the three worst-affected countries.

At its height, the Ebola outbreak sparked fear around the world, prompting governments and businesses to take emergency precautions.

An outbreak of Lassa fever is now underway in Nigeria, according to the World Health Organization, and it is starting to spread to nearby countries including Togo.

According to a WHO statement, 159 suspected cases of Lassa fever and 82 deaths were reported between August 2015 and January 2016. Some media reports have said as many as 101 people have died as of February.

Like Ebola, Lassa causes a severe fever with bleeding, Ribner said. It is most commonly transmitted to people from rodent excrement, and it can be transmitted from person to person by contact with blood or bodily fluids, Ribner said.

He said the hospital will take every precaution and that the public should not be alarmed.

“You can’t catch it like you get the common cold,” he said. “We can handle this.”

(Editing By Frank McGurty, Bernard Orr)

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