Skip to main content

[Date Prev][Date Next][Thread Prev][Thread Next][Date Index][Thread Index] [List Home]
Re: [stem-ebola] PRO/AH/EDR> Ebola virus disease - Africa, Europe cases, USA quarantine stations

That's really unfortunate. May he rest in peace. I was hoping the brincidofovir would help, but I think Duncan was probably too sick to recover.

In animal models, an RdRp (RNA-Dependent Polymerase Inhibitor) called Favipiravir only works in mice if administered within the first 6 to 8 days after infection. Probably the same in humans... need to get the nucleoside antivirals within 5-7 days of symptom onset.

I think in Duncan's case he got the antivirals too late... And the vascular and organ dysfunction (Severe Sepsis / DIC) was just too severe... Even if the viral replication were slowed or stopped, there is still circulatory system and organ damage to deal with 14+ days into a severe Ebola infection.

I read Ebola up-regulates some really damaging host genes... one of them is called MMP-3 , a host gene which is up-regulated only in lethal Ebola infections (matrix metalloproteinase 3).

"Proteins of the matrix metalloproteinase (MMP) family are involved in the breakdown of extracellular matrix and during tissue remodeling"

"Of particular relevance is our finding that metalloproteinase genes were upregulated only in lethal [Ebola] infections and not in response to the nonlethal wild-type or single-mutant viruses. Furthermore, the metalloproteinase gene MMP3 was one of 7 genes associated with lethality that was induced by the double mutant but not by the virus carrying the VP24 mutation. Metalloproteinases control chemokine activity (14, 34, 37, 43) and can regulate inflammation by controlling the activity of chemokines (13, 28), and MMP3-deficient mice are prone to severe inflammation "


On 2014-10-08 10:36, James Kaufman wrote:
sad news

Best Regards,

 IBM Almaden Research Center, 650 Harry Rd.
 San Jose, CA 95120-6099
 email: jhkauf@xxxxxxxxxx
 phone: (408) 927-2477 (tie 457-2477)

 From: alex@xxxxxxxxxxxxxx
 To: stem-ebola@xxxxxxxxxxx,
 Date: 10/08/2014 09:35 AM
 Subject: [stem-ebola] PRO/AH/EDR> Ebola virus disease - Africa,
Europe cases, USA quarantine stations
 Sent by: stem-ebola-bounces@xxxxxxxxxxx


ProMED-Mail Update on Ebola Outbreak. Tues. Sep 8th 10:30AM.

 *Includes what went wrong in Spain; how a Spanish nurse was infected

 -------- Original Message --------
 Subject: PRO/AH/EDR> Ebola virus disease - ex Africa (07): Europe
 USA quarantine stations
 Date: 2014-10-07 21:44
 From: promed@xxxxxxxxxxxxxx
 To: promed-post@xxxxxxxxxxxxxx, promed-edr-post@xxxxxxxxxxxxxx,
 Reply-To: promedNOREPLY@xxxxxxxxxxxxxx

 A ProMED-mail post
 ProMED-mail is a program of the
 International Society for Infectious Diseases

 In this update:
 [1] Spain: nurse's Ebola infection blamed on substandard equipment
 [2] Norway case
 [3] USA: quarantine stations
 [4] Where to find non-sensational Ebola coverage

 [1] Spain: nurse's Ebola infection blamed on substandard equipment
 Date: 7 Oct 2014
 Source: The Guardian [edited]


 Health professionals in Madrid have blamed substandard equipment and
 failure to follow protocol for the 1st case of Ebola to be contracted
 outside West Africa. Health authorities announced on Mon [6 Oct 2014]
 that a Spanish nurse at Madrid's Carlos III hospital who treated a
 patient repatriated from Sierra Leone had twice tested positive for

 Her husband had also been admitted to hospital and was in isolation,
 and a 2nd nurse from the same team that treated both repatriated
 victims was also being tested. In this case, the nurse contacted the
 authorities on Mon [6 Oct 2014] complaining of a fever. She was in
 isolation in the Carlos III Hospital while authorities waited for the
 test results, a spokesperson for the Madrid regional government said.

 Staff at the hospital told El Pais that the protective suits they
 given did not meet World Health Organization (WHO) standards, which
 specify that suits must be impermeable and include breathing
 apparatus. Staff also pointed to latex gloves secured with adhesive
 tape as an example of how the suits were not impermeable and noted
 that they did not have their own breathing equipment.

 The nurse was part of a team attending to missionary MGV, 69, who
 4 days after being brought to Carlos III hospital on 20 Sep 2014. The
 same team, including the nurse, also treated missionary MP, 75, who
 was repatriated from Liberia in August 2014 and died 5 days later.
 Staff at the hospital said waste from the rooms of both patients was
 carried out in the same elevator used by all personnel and, in the
 case of the 2nd patient, the hospital was not evacuated.

 The European commission said on Tue [7 Oct 2014] it had written to
 Spanish health minister "to obtain some clarification" on how the
 nurse had become infected when all EU member states were supposed to
 have taken measures to prevent transmission. There is obviously a
 problem somewhere," the commission spokesman Frederic Vincent said.

 Spanish health authorities have said that professionals treating
 patients in Spain always follow WHO protocols. The nurse would have
 entered GV's room just twice, said Antonio Alemany, from the regional
 government of Madrid, both times wearing protective equipment. "We
 don't know yet what failed," Alemany said. "We are investigating the
 mechanism of infection."

 The nurse was in a stable condition. She had alerted the ministry of
 slight fever on 30 Sep 2014 and been checked into a hospital in
 Alcorcon, on the outskirts of Madrid, with a high fever on Mon [6 Oct
 2014]. The nurse, who is married with no children, was transferred to
 Carlos III hospital early on Tuesday morning [7 Oct 2014]. El Mundo
 reported that it was the nurse who asked to be tested for Ebola,
 having to insist repeatedly on being tested before it was done on
 Monday [6 Oct 2014].

 While staff at the Alcorcon hospital were waiting for the test
 results, the nurse remained in a bed in the emergency room, separated
 only by curtains from other patients, hospital staff told El Mundo.
 Their version of events clashes with that of health authorities, who
 have said the patient was isolated from the 1st moment.

 The woman was on holiday at an unknown location when she began
 symptoms. "We are drawing up a list of all the people she may have
 been in contact with, including with health professionals at the
 Alcorcon hospital," said Alemany, estimating that more than 30 people
 were being monitored for any sign of symptoms.

 In August 2014, Spain became the 1st European country in the current,
 fast-spreading outbreak to evacuate patients for treatment. The
 decision prompted concern among health professionals, who said
 hospitals were not adequately equipped to handle Ebola.

 [Byline: Ashifa Kassam]

 Communicated by:
 ProMED-mail Rapporteur Kunihiko Iizuka

 Spain: contacts quarantined
 7 Oct 2014: (BBC) Three other people, including the nurse's husband,
 have been quarantined. The nurse had twice gone into the room where
 Mr. GV had been treated to be directly involved in his care and to
 disinfect the room after his death. Both times, she was wearing
 protective clothing. Madrid healthcare director Antonia Alemany told
 reporters that according to the information available: "The nurse
 into the room wearing the individual protection gear, and there's no
 knowledge of an accidental exposure to risk."... The hospital was
 reported to have had extreme protective measures in place including 2
 sets of overalls, gloves and goggles.

 However, health workers told El Pais newspaper that the clothing did
 not have level-4 biological security, which is fully waterproof and
 with independent breathing apparatus. Instead, it was level 2, the
 paper says, as photographs provided by staff indicated that the
 overalls did not allow for ventilation, and the gloves were made of
 latex and bound with adhesive tape.

 Doctors are also monitoring 22 people with whom the nurse had contact
 at Alcorcon hospital and 30 people working at Carlos III, according
 health sources quoted by Spanish newspaper El Pais. They include an
 ambulance crew and doctors and nurses, and all have been contacted by
 the health authorities.
 < [3]>

 [The] case highlighted the dangers that health care workers face
 caring for Ebola patients; officials said she had changed a diaper
 the priest and collected material from his room after he died. Dead
 Ebola victims are highly infectious, and in West Africa, their bodies
 are collected by workers in hazmat outfits.

 [This posting from the Washington Post originally cited an AP report
 that said a Nigerian has been hospitalized in Spain. The AP has
 updated its reporting to say that the man is Spanish and had recently
 traveled to Nigeria. This post has been updated as well. - Mod.JW]

 News of the quarantines hit Spain's stock market Tuesday [7 Oct
 Spain is one of Europe's biggest tourist destinations, and stocks in
 tourism-related companies such as airlines and hotel chains fell on
 the Madrid stock exchange as investors feared the consequences of the
 Ebola case. Shares in International Airlines Group, formed in early
 2011 by the merger of British Airways and Iberia, dropped more than 6
 percent, while those of NH Hotel Group and Melia Hotels were down 4
 percent. The Ibex 35 stock market index was 1.7 percent lower.

 The nurse, who did not leave Madrid during her vacation, was
 being treated with drip using antibodies from previous infected
 patients... [presumably plasma from the 2 missionaries who died in
 hospital. - Mod.JW]


 [Byline: Inmaculada Sanz]

 Ryan McGinnis

 [2] Norway case
 Date: 7 Oct 2014
 Source: The Local, Norway [edited]


 The Norwegian woman infected by Ebola [ebolavirus] in Sierra Leone
 currently receiving treatment in Oslo, will get the last dose of the
 virus treatment medicine ZMapp available in the world. The news was
 released by the Norwegian Medicines Agency on Tue [7 Oct 2014],
 according to NTB. Steinar Madsen, medical director of the Norwegian
 Medicines Agency, said to Dagens Medisin: "It looks like we could get
 the last available dose of ZMapp to Norway. The medicine is now in

 According to the professional medic's magazine, the agency has given
 Oslo University hospital the authorisation to import Ebola medicines
 not approved of in Norway. Madsen said: "When there are patients with
 an acute need for medicine, we allow import of medicines that are not

 While the medicine Avigan came to Norway already on Tue [7 Oct 2014],
 TKM-Ebola will arrive on Wed [8 Oct 2014]. Madsen reported that ZMapp
 has been the most difficult to get. "It must be said it is lucky that
 Norway will get the last dose of ZMapp. There are no more doses in
 world, and it takes a long time to produce. It is the hospital
 pharmacy that gets the medicine through contact networks all over the
 world, while the Norwegian Medicines Agency gives the necessary
 approval," said Madsen.

 Madsen explained further the medicine will be imported to the Ebola
 patient only. It has been tried on only a small number of patients,
 and the effect of the medicine is, therefore, not fully known. Madsen
 said: "Of those who have taken ZMapp, the majority have survived.
 Another person has survived with TKM-Ebola, but the medicines are
 on a small number of patients."

 It has been revealed that at least 27 Norwegians are still currently
 working in Ebola-ridden areas and include:
 - Medecins Sans Frontiers: Around 20 Norwegians take part in the
 effort in Liberia, Sierra Leone and Guinea.
 - Red Cross: 7 Norwegian employees in areas struck by Ebola.
 - NORCAP: A Norwegian health logistics worker will travel to Liberia
 on Fri [10 Oct 2014]. Other Norwegians are also on NORCAP's
 preparedness lists.

 Ryan McGinnis

 [3] USA: quarantine stations
 Date: 6 Oct 2014
 Source: Washington Post [edited]


 Public health officials say Ebola is extremely unlikely to spread in
 the United States, but the Centers for Disease Control and Prevention
 is on the lookout for international travelers who might be carrying
 the deadly virus. The agency operates a network of 20 quarantine
 stations where health officers can "decide whether ill persons can
 enter the United States and what measures should be taken to prevent
 the spread of contagious diseases."

 The locations of all 20 U.S. quarantine stations (Courtesy of CDC):
 < [8]>.

 On Sun [5 Oct 2014], one of those stations sprang to action after a
 passenger began vomiting on board an international flight headed from
 Brussels to New Jersey's Newark Liberty International Airport,
 according to a CNN report. Most of the 255 passengers on the flight
 were released to go through customs after about an hour and 35
 minutes. The sick traveler was allowed to leave after the New Jersey
 Department of Health, in coordination with federal officials,
 determined that his condition was "consistent with another, minor
 treatable condition unrelated to Ebola."

 The CDC has the authority to deny entry to the United States for ill
 people if they have one of 9 types of "quarantinable diseases," as
 defined by executive order. The agency can also admit patients to
 specialized hospitals for treatment. The list of quarantinable
 diseases, which was last updated by President Obama in July [2014],
 includes cholera, diphtheria, infectious tuberculosis, plague,
 smallpox, yellow fever, viral hemorrhagic fevers, severe acute
 respiratory syndromes, and new types of flu that could cause a
 pandemic. Ebola counts as a viral hemorrhagic fever.

 CDC quarantine centers are staffed by personnel who assess the health
 of travelers on board landed aircraft when passengers become ill.
 individuals can be moved to isolation rooms at the quarantine
 facilities, or the agency can send them for care at hospitals. To be
 clear, the CDC considers "quarantine" to be different from
 "isolation." Quarantines apply to individuals who have been exposed
 diseases but feel well and need monitoring, while isolation applies
 those who are actually ill...

 [Byline: Josh Hicks]

 Communicated by:

 [4] Where to find non-sensational Ebola coverage
 Date: 4 Oct 2014
 Source: US4 [edited]


 We talked to medical reporter Helen Branswell of The Canadian Press
 about where she goes to find reliable news about Ebola.

 Your Sanity Guide To Ebola
 "A case of #Ebola in Dallas shows the risk this virus poses the
 But the fight needs to go to the source, West Africa. #containment,"
 tweeted Helen Branswell, the longtime medical reporter for The
 Canadian Press, this week. She keeps us from going completely nutso
 with fear every day, so we asked her where she goes for her most
 reliable and up-to-date info.
 - The World Health Organization is crucial for up-to-date
 "I don't think anybody trusts the Ebola numbers, but the best ones
 that are available are the ones WHO is generating."

 - "It's hard to say that one thing is more important than the other,
 but ProMED-mail is critical for trying to keep on top of things."
 a push service and aggregator that sends out tailored email updates
 several times a day with context added in by infectious disease

 - The Journal of Science has "some of the best English language
 science writers on the planet, and they are particularly strong on
 infectious diseases." The full stories appear weekly in the journal,
 but they put things up quickly on Science Insider.

 - Dr. Richard Besser was an acting director of the CDC at one time
 is now Chief Health and Medical Editor at ABC News. He's currently in
 Monrovia, and he's a good source of informative, non-hyped Ebola

 - Follow Kai Kupferschmidt, a science writer, on Twitter; he's
 phenomenal. It's hard to follow Ebola on Twitter right now because
 it's moving so fast, but this is a good place to start.

 Communicated by:

 [ProMED thanks Helen, a good friend and contributor to our list, for
 her kind mention. - Mod.JW

 A HealthMap/ProMED-mail map can be accessed at:

 [See Also:
 Ebola virus disease - ex Africa (06): Spain case, USA case, US case
 medevaced 20141006.2837374
 Ebola virus disease - ex Africa (05): USA ex Liberia, prevention
 Ebola virus disease - ex Africa (04): USA ex Liberia, prevention
 Ebola virus disease - ex Africa (03): USA ex Liberia, Germany case ex
 S. Leone 20141003.2830392
 Ebola virus disease - ex Africa (02): USA ex Liberia, prevention,
 false alarms 20141002.2827166
 Ebola virus disease - ex Africa: USA ex Liberia, WHO 20141001.2823539
 Ebola virus disease - West Africa (184): USA (TX) first case ex
 Liberia 20140930.2819341]
 ProMED-mail makes every effort to verify the reports that
 are posted, but the accuracy and completeness of the
 information, and of any statements or opinions based
 thereon, are not guaranteed. The reader assumes all risks in
 using information posted or archived by ProMED-mail. ISID
 and its associated service providers shall not be held
 responsible for errors or omissions or held liable for any
 damages incurred as a result of use or reliance upon posted
 or archived material.
 Donate to ProMED-mail. Details available at:
 Visit ProMED-mail's web site at <>.
 Send all items for posting to: promed@xxxxxxxxxxxxxx (NOT to
 an individual moderator). If you do not give your full name
 name and affiliation, it may not be posted. You may unsub-
 scribe at <>.
 For assistance from a human being, send mail to:

 stem-ebola mailing list
 To change your delivery options, retrieve your password, or
unsubscribe from this list, visit [10]


stem-ebola mailing list
To change your delivery options, retrieve your password, or
unsubscribe from this list, visit

Back to the top