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California-Trained Doctor Helps Keep Liberian Hospital Open During Ebola Crisis

While many run from the Ebola outbreak in West Africa, some brave souls are running toward the region to help. Dr. James Appel is one of those. Trained in the Inland Empire at the Loma Linda University School of Medicine, he's been working for Adventist Health International at hospitals in Chad for the last decade. Last week, Dr. Appel flew to Liberia to keep the doors open at Cooper Adventist, a small hospital in the capitol, Monrovia.

PBS NewsHour

Ebola’s spread hastens preparations for vaccine testing

Local residents gather around a very sick Saah Exco, 10, in a back alley of the West Point slum on August
         19, 2014 in Monrovia, Liberia. The boy was one of the patients that was pulled out of a holding center for suspected Ebola
         patients when the facility was overrun by a mob on Saturday. A local clinic Tuesday refused to treat the boy, according to
         residents, because of the danger of infection, although the boy was never tested for Ebola. Photo by John Moore/Getty Images

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GWEN IFILL: Adding to the difficulty, a different strain of Ebola has appeared in the Democratic Republic of Congo, causing 13 deaths so far. 

Here at home, the National Institutes of Health announced today it will start testing an experimental Ebola vaccine next week.

For more on that development, I’m joined by Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at NIH.  He will oversee those trials.

Dr. Fauci, thanks for joining us again.

What would trials like this look like?

DR. ANTHONY FAUCI, Director, National Institute of Allergy and Infectious Diseases: Well, first of all, it’s an early phase one trial.

And by phase one, we mean this is the first time this vaccine has been put in humans.  So safety is paramount, so you take a very small number of people, 20 in total, three at a time, and you use the vaccine to determine if there are untoward effects, any inflammation, any idiosyncratic or hypersensitivity reactions, pain or anything that might be a red flag about safety.

And also you learn whether it induces the kind of response in a person that you would hope would be protective against Ebola infection.  The reason why we chose this vaccine is that it showed very favorable results in an animal model, a monkey model, in which it protected monkeys very well against a challenge with lethal Ebola.

So this is a first, because it’s the first time this has been in a human, in now what will be a series of steps to ultimately develop it to determine if, in fact, it is effective.

GWEN IFILL: This has been in development for some time.  You called this an uncontrolled outbreak in West Africa.  Dr. Tom Frieden for the CDC said it will get worse before it gets better.  Is it this West African outbreak which is moving this from development to trial?

DR. ANTHONY FAUCI: We have been working on an Ebola vaccine for a number of years now.  This has been one of the priorities of the hemorrhagic fevers, of which Ebola is actually the worst of those.

This is kind of the culmination of an iterative process of developing it.  It was certainly accelerated by what we’re seeing now with this extraordinary outbreak in certain West African countries.  So we were on the track of an Ebola vaccine, but we accelerated it.  We didn’t cut corners, but we really put the afterburners on to get things done much more quickly, so that we could get to the point where, next week, we will put this first time in a human, in a normal volunteer right here in our clinical center in Bethesda.

GWEN IFILL: We have spent a lot of time trying to figure out ZMapp, the small dosage which has been experimented on humans in this latest outbreak.

This plan that you’re talking about developing would be working with a large drug company, GlaxoSmithKline.  Does that make a difference in the timetable, how quickly we would see it come to market if it worked?

DR. ANTHONY FAUCI: Gwen, it makes an extraordinary amount of difference.  It really is the game-changer in that.

When you have a company like GlaxoSmithKline, who partners fully with the NIH, with our science and their capability of producing this, that’s how you get things done.  And, in fact, one of the reasons why we had not gotten the vaccine up to now or even drugs is that there was relatively little interest on the part of many pharmaceutical companies for either drugs or vaccines.

And I think the extraordinary, dramatic situation which we’re going through right now is going to really get people’s attention and we will see a lot more interest in that, which I’m very pleased about because we really do need a vaccine and some therapeutics.

GWEN IFILL: Because Ebola is such a dangerous virus, how do you ensure the safety not only for those taking it in the trial, but also for those handling the virus?

DR. ANTHONY FAUCI: Well, that’s a good question, Gwen.

And it’s important to point out there’s no chance at all of the vaccine giving Ebola to anyone, because we’re not giving them the Ebola virus.  We’re giving them a vaccine that has a very small component of the genetic material from Ebola that will make a protein that is again an important component of the virus, but not a virus that can actually replicate.

So there’s no chance.  When we say safety, which is the first part of phase one, we’re not talking about safety of giving someone Ebola.  We’re talking about safety of an adverse reaction to the vaccine itself.  That’s an important difference.

GWEN IFILL: If we’re talking about the possibility of 20,000 cases before this thing begins to subside, how do we know the vaccines are the right solution, or even are they the right solution?

DR. ANTHONY FAUCI: Well, again a great question, because the solution, right now, is what we know can stop an outbreak, and that is the ability and the infrastructure to deliver infection control by isolation, by quarantine, by contact tracing, and by protecting the health care workers with proper personal protective equipment.

The difficulty in those West African countries is, they don’t have that kind of infrastructure in place, and it’s truly a struggle to be able to do that kind of infection control.  Historically, under other circumstances, there have been now about 24 outbreaks of Ebola, usually in geographically-restricted areas, where it was much easier to contain it.

You can contain it with good hospital and infection control capabilities.

GWEN IFILL: Dr. Anthony Fauci at the National Institutes of Health, thank you very much.

DR. ANTHONY FAUCI: You’re quite welcome.

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WHO announces $490 million plan for fighting Ebola


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GWEN IFILL: There were new numbers and a bleak projection today on the Ebola outbreak in West Africa.  At the same time, it appears human trials will begin for a possible vaccine as soon as next week.

The ominous forecast came from the World Health Organization:  Ebola cases could top 20,000 as the outbreak continues to spread.

DR. BRUCE AYLWARD, World Health Organization: It is now not just remote isolated areas where you can rapidly contain, but we are dealing with this disease in large urban environments and over large geographic areas.  This is very unique.

GWEN IFILL: So far, the U.N. agency has confirmed more than 3,000 cases.  Of that number, more than half have died in Liberia, Sierra Leone, Guinea and Nigeria.  But the WHO says the outbreak could spread to 10 other countries.

To contain the virus, the agency announced a $490 million strategic plan for the next nine months.

DR. BRUCE AYLWARD: When we look at the numbers of people, to make this work, we are going to need 750 internationals at least and 12,000 nationals.  That is very difficult in the current — current environment, but that is the scale of manpower needed to do this.

GWEN IFILL: The current environment includes a sizable fear factor, especially in Liberia, the country with the most Ebola cases and deaths.  Doctors Without Borders opened a treatment facility in the Liberian capital, Monrovia, two weeks ago, but its 120 beds are already full.

LINDIS HURUM, Doctors Without Borders: The health care system has more or less broken down.  Hospitals have closed, clinics are closed.  Some of them have reopened, but the staff is afraid to go back because they are afraid to get the disease.

GWEN IFILL: In desperation, Liberian officials quarantined Monrovia’s West Point neighborhood, and armed police have used live ammunition to stop residents from getting out.  The medical emergency has also placed a heavy economic strain on affected countries.  The African Development Bank is urging an end to trade and travel restrictions.

DONALD KABERUKA, President, African Development Bank: Markets are not functioning, airlines are not coming in, projects are being canceled, businesspeople have left.  That is very, very damaging.

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Ebola outbreak could affect 20,000 people before it’s over

This undated handout photo provided by National Institute of Allergy and Infectious Diseases and GlaxoSmithKline (NIAID/GSK)
         shows a vaccine candidate, in a vial, that will be used in the upcoming human Ebola trials. Photo from GlaxoSmithKline

This undated handout photo provided by National Institute of Allergy and Infectious Diseases and GlaxoSmithKline (NIAID/GSK) shows a vaccine candidate, in a vial, that will be used in the upcoming human Ebola trials. Photo from GlaxoSmithKline

It will take six to nine months to stop the Ebola outbreak in West Africa according to a road map released today by the World Health Organization. During those months more than 20,000 people may become infected with the disease.

Controlling the epidemic could cost $490 million and will need the help of thousands of local health workers and hundreds of international experts.

So far, 1,552 people had been confirmed dead in Sierra Leone, Liberia, Guinea and Nigeria, while 3,062 had been infected. Almost 40 percent of all the cases have been reported in the past three weeks which shows the virus is accelerating.

Health officials in Nigeria confirmed the country’s sixth Ebola related death on Thursday. The victim died in the southeastern oil city of Port Harcourt, located just outside of Lagos — Nigeria’s main international transit hub. Nigeria is Africa’s most populous nation.

In response to the epidemic, the U.S. announced that they will begin testing Ebola vaccines on humans next week — much sooner than previously planned.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at NIH said the Ebola outbreak “is a public health emergency that demands an all-hands-on-deck response.”

He added that results from this initial round of testing won’t be available until the end of the year, and the success of the vaccine was not guaranteed.

Health care workers will be the first to take the vaccine if it works, given the fact that more than 240 workers have contracted the virus, so far. However, Fauci said that residents in affected areas could be eligible to receive the vaccine.

Dr. Anthony Fauci will be on PBS NewsHour tonight to discuss the upcoming trials.

The post Ebola outbreak could affect 20,000 people before it’s over appeared first on PBS NewsHour.

Brain-eating amoeba found in Louisiana parish drinking water

A deadly amoeba known to fatally infect human brains has been discovered within a water system in Louisiana.

Louisiana health officials said a deadly amoeba has been detected in the water system of a parish that serves more than
         12,000 people in three towns. Photo courtesy of the Centers for Disease Control and Prevention

Louisiana health officials said a deadly amoeba has been detected in the water system of a parish that serves more than 12,000 people in three towns. Photo courtesy of the Centers for Disease Control and Prevention

Officials from the Department of Health and Hospitals said Wednesday that the Naegleria fowleri, or “brain-eating” amoeba, was detected within the St. John Water District 1 water system, which serves 12,577 people through three towns within the St. John the Baptist Parish. The department said the water system did not maintain the state-required “minimum disinfectant residual level,” mandated after the same amoeba killed two people in two separate parishes in 2013.

According to the Centers for Disease Control and Prevention, infections occur when amoeba-contaminated water enters through the nose. The CDC notes, however, that humans can not be infected by drinking water contaminated by the amoeba.

The department said there have been no reported incidents relating to the amoeba. The water system will be put through a chlorine burn today.

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