World fears mount that Ebola battle being lost

GENEVA - The World Bank warned Friday the fight to stop Ebola was being lost, as the UN pleaded for more money to combat the escalating epidemic and global travel fears mounted.

As the death toll from the world's worst-ever outbreak of the virus shot past 4,500, a glimmer of hope came from Senegal, which was declared Ebola-free by the World Health Organization.

The United States, meanwhile, named an "Ebola czar" to coordinate its response, after criticism of how a Texas hospital handled a Liberian victim, with two nurses who treated him now infected.

And a researcher at British pharmaceuticals giant GlaxoSmithKline said a vaccine may not be ready for commercial use until late 2016.

"We are losing the battle," World Bank chief Jim Yong Kim warned, blaming a lack of international solidarity in efforts to stem the epidemic.

"Certain countries are only worried about their own borders," he told reporters in Paris.

As of October 14, 4,555 people have died from Ebola out of a total of 9,216 cases registered in seven countries, the WHO says.

Most of the dead are in three West African nations at the centre of the outbreak: Guinea, Liberia and Sierra Leone.

Experts warn that the infection rate could hit 10,000 a week by early December.

- 'Very serious problem' -

The United Nations has warned that it has received less than 40 percent of the nearly $1 billion it asked for to fight Ebola.

So far, just $377 million has come in, and another $217 million has been pledged, the UN Office for the Coordination of Humanitarian Affairs (OCHA) said.

"But that's not money in the bank," OCHA spokesman Jens Laerke told reporters in Geneva.

And a UN trust fund for Ebola has just $100,000, despite $20 million in pledges -- a situation UN Secretary General Ban Ki-moon said had left the world body with a "very serious problem."

"We need to turn pledges into action. We need more doctors, nurses, equipment, treatment centres and medical evacuation capacities," he said.

- Travel fears -

Despite enhanced health checks at airports in several countries, fears mounted, and Air France flight attendants called for an end to flights to Guinea, one of the three hardest-hit nations in West Africa.

The daily Air France Paris-Conakry flight "carries a serious risk of spreading the epidemic, particularly in our country," read a statement from the two unions of flight crew and commercial staff.

France will on Saturday start carrying out health checks on travellers arriving from Guinea. The United States, Britain and Canada have already launched screenings at airports for passengers from Ebola-hit zones. The EU is reviewing the matter.

In the United States, health authorities were still facing questions about how the disease -- which kills around 70 percent of those it infects in West Africa -- had spread at a Texas hospital.

Other questions surfaced about the safety protocols in place for those who came in contact either with a Liberian man who died of Ebola at the hospital, or the two infected nurses who treated him.

The Centers for Disease Control and Prevention (CDC) has expanded the number of airline passengers it wants to interview after the second nurse, Amber Vinson, flew from Dallas to Cleveland and back before being diagnosed.

And another Texas health care worker who may have come in contact with samples from the Liberian Ebola victim has voluntarily quarantined herself aboard a cruise ship in the Caribbean.

Although that woman is considered at "very low risk" of infection, according to Carnival Cruise Lines, the ship was apparently denied entry at ports in Belize and Mexico, and was headed back to the US.

The US State Department deputy spokeswoman, Marie Harf, told reporters at a briefing that the ship, now en route to Galveston, Texas, is due to dock on Sunday.

Symptoms of Ebola include fever, headache, diarrhoea, vomiting and in some cases bleeding.

Even if a person is infected, the virus can only be passed on once symptoms appear and only through direct contact with their bodily fluids, such as mucus, semen, saliva, vomit, stool or blood.

- Influx of doctors -

The WHO is ramping up its efforts to help 15 African countries defend themselves against Ebola -- notably with measures to better protect health workers, who are paying a heavy price, with 236 deaths out of 427 cases across the affected countries.

The East African Community bloc comprising Burundi, Kenya, Rwanda, Uganda and Tanzania announced it was sending more than 600 health workers to Guinea, Liberia and Sierra Leone.

And US Secretary of State John Kerry offered a rare praise to Cuba, which has sent 165 health care workers and plans to send 300 more to battle the outbreak.

A string of health workers have been evacuated back to Europe from Africa with Ebola, but the only confirmed case of transmission on the continent so far is a Spanish nurse in Madrid.

- Glimmers of hope -

Health authorities held up Senegal as a shining example of success in an otherwise dire global outlook on Ebola.

"Senegal's response is a good example of what to do when faced with an imported case of Ebola," the WHO said, lauding the government for having "reacted quickly to stop the disease from spreading".

Nigeria, where 20 people were infected and eight died, is expected to be declared Ebola-free on Monday. But neither is out of danger.

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Ebola victim dies in US hospital

DALLAS - The first person diagnosed with Ebola in the United States, Liberian national Thomas Eric Duncan, died on Wednesday morning at a Dallas hospital, a hospital spokesman said.

"It is with profound sadness and heartfelt disappointment that we must inform you of the death of Thomas Eric Duncan this morning at 7:51 am," hospital spokesman Wendell Watson said in an emailed statement.

Duncan became ill after arriving in the Texas city from Liberia on Sept. 20 to visit family, heightening concerns the world's worst Ebola outbreak on record could spread outside of the three worst-hit West African countries. About 48 people with whom Duncan had been in contact are being monitored.

Ebola has killed more than 3,400 people in Liberia, Sierra Leone and Guinea since the outbreak began in March, nearly half of all those infected, according to the World Health Organization. While several American patients have been flown to the United States from West Africa for treatment, Duncan was the first person to start showing symptoms of the disease on U.S. soil.

A Spanish nurse who treated a priest who worked in the region is also infected.

Duncan was able to fly to the United States from Liberia's capital Monrovia, which is at the epicenter of the Ebola outbreak, because he did not have a fever when screened at the airport and filled out a questionnaire saying he had not been in contact with anyone infected with Ebola.

Liberian officials have since said that he lied on the questionnaire and had been in contact with a pregnant woman who later died of the disease. Ebola can take as long as three weeks before its victims show symptoms, at which point the disease becomes contagious. Ebola, which can cause fever, vomiting and diarrhea, spreads through contact with bodily fluids such as blood or saliva.

Duncan began feeling ill shortly after his arrival in Texas. He went to Texas Health Presbyterian Hospital in Dallas on Sept. 25, but was initially sent home with antibiotics. His condition worsened, he returned Sept. 28 by ambulance and was diagnosed with the disease.

"The past week has been an enormous test of our health system, but for one family it has been far more personal. Today they lost a dear member of their family. They have our sincere condolences, and we are keeping them in our thoughts," David Lakey, commissioner of the Texas Department of State Health Services said in a statement.

Officials have said as many as 48 people may have been exposed to the disease by Duncan, and that the 10 people at highest risk are cooperating with public health authorities by staying in quarantine voluntarily. The other 38 people who may have been exposed are being checked routinely for fever.

U.S. Centers for Disease Control and Prevention (CDC) Director Dr. Thomas Frieden said he was confident the disease would not spread widely within the United States. U.S. officials are also expanding their response in West Africa.

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Texas Ebola patient gets experimental drug

WASHINGTON - A Liberian man diagnosed with Ebola in Texas was given an experimental drug for the first time, officials said Monday as the White House mulled tougher airport screening at home and abroad.

Thomas Eric Duncan was given the investigational medication, brincidofovir, on Saturday, the day his condition worsened from serious to critical, said Texas Health Presbyterian Hospital Dallas.

The medication is made by the North Carolina-based pharmaceutical company Chimerix, and until now had never been tried in humans with Ebola, the company said.

However, it has been tested in about 1,000 people against adenovirus and cytomegalovirus.

The drug "works by keeping viruses from creating additional copies of themselves," Chimerix said.

Duncan is the first person to be diagnosed with Ebola in the United States, and he is believed to have become infected while in Liberia.

West Africa is currently battling the largest outbreak of Ebola in history, with more than 3,400 dead from the hemorrhagic virus since the start of the year.

Meanwhile, President Barack Obama was briefed by senior health and security advisors about the situation in Texas and US preparedness against Ebola.

Obama said the chances of a US Ebola outbreak were "extraordinarily low" but vowed to press world leaders to step up the global fight against the deadly epidemic in West Africa.

"We have not seen other countries step up as aggressively as they need to," Obama said.

"I'm going to be putting a lot of pressure on my fellow heads of state and government around the world to make sure that they are doing everything that they can to join us in this effort."

He said the United States is considering tougher airport screening to ward against the spread of cases by airline travelers.

"We're also going to be working on protocols to do additional passenger screening both at the source and here in the United States," Obama told reporters.

In Nebraska, a US photojournalist who tested positive for Ebola in Liberia arrived at a hospital and was able to walk off the airplane that carried him.

"We are really happy that his symptoms are not extreme yet," Ashoka Mukpo's mother, Diana, told reporters, adding that he was feverish and nauseous.

He is being treated at the Nebraska Medical Center, the same facility that treated American missionary doctor Rick Sacra last month.

Sacra also came down with Ebola in Liberia and was treated with the Canadian firm Tekmira's Ebola drug, TKM-Ebola, as well as serum from another doctor, Kent Brantly, who had Ebola and recovered.

Brantly was treated with a drug called ZMapp, which is hard to make, and there are no doses left.

There is no market-approved drug for treating Ebola yet, and no vaccine to prevent it.

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Ebola hits 5th W. African state as Senegal confirms 1st case

DAKAR - The Ebola epidemic that has killed more than 1,500 people across West Africa spread to a fifth country in the region on Friday with the first confirmed case of the deadly virus in Senegal.

The case marks the first time a new country has been hit by the outbreak since July and comes a day after the World Health Organization warned the number of infections was increasing rapidly.

Scientists meanwhile said the first human trials of a potential vaccine would start next week using a product made by pharmaceuticals giant GlaxoSmithKline and the US government.

On Friday, scientists writing in the journal Nature said 18 lab monkeys given high doses of the Ebola virus fully recovered after being given the prototype drug ZMapp, which reversed bleeding in the animals.

ZMapp has been given to a handful of frontline health workers who have contracted Ebola, two of whom have recovered, and two of whom have died. Three others are still receiving the treatment.

Senegal's health ministry said the country's first Ebola patient was a young Guinean man who was immediately quarantined at a Dakar hospital, where he was in a "satisfactory condition".

The man is believed to have been infected in Guinea's capital Conakry, and may have travelled to Senegal before Dakar closed its land border with Guinea on August 21.

Authorities are now scrabbling to piece together where he went and who he encountered, in a bid to halt the spread of the deadly virus.

New figures released by the WHO on Thursday revealed the massive scale of the crisis, which it said indicated a "rapid increase still in the intensity of transmission" that could cost at least $490 million (370 million euros) to tackle.

In a sign that affected countries are struggling to stop its spread, the UN agency said the number of cases could exceed 20,000 before the epidemic is brought under control.

- Under surveillance -

Never before has there been an Ebola outbreak so large, nor has the virus -- which was first detected in 1976 -- ever infected people in West Africa until now.

As of August 26, 1,552 people had been confirmed dead from Ebola in four countries -- Sierra Leone, Liberia, Guinea and Nigeria.

Liberia was the worst affected with 694 deaths; 422 people have died in Sierra Leone; and 430 in Guinea, where the virus emerged at the start of the year. Nigeria has now recorded six deaths.

The Democratic Republic of Congo has also confirmed two cases of Ebola, but officials there insist it is unconnected to the current outbreak in West Africa.

Sierra Leone President Ernest Koroma on Friday sacked health minister Miatta Kargbo.

A presidential statement read on state television said the decision was made "in order to create a conducive environment for more efficient and effective handling of the Ebola outbreak."

Nigeria's latest death -- in the southeastern oil city of Port Harcourt -- was the first outside its biggest city, Lagos, and dashed hopes that the country had successfully contained the virus.

The victim, a doctor named Ikyke Samuel Enuemo, is believed to have caught the virus from a patient he treated who travelled to the city after coming into contact with an infected Liberian-American man.

Some 160 people are now under surveillance in Port Harcourt following the doctor's death, the local government said on Friday.

Meanwhile a curfew was imposed in N'Zerekore, Guinea's second-largest city, a day after 20 people were injured during a protest by market stall holders against a team of health workers sent, without notice, to spray their market with disinfectant.

- A shield around the region -

In a bid to stop the spread of the virus, many African governments have sought to ringfence Sierra Leone, Guinea and Liberia.

But member states of the West African regional bloc ECOWAS complained Thursday that some of the security measures taken by other countries, including travel bans, had unfairly hit the region.

A number of airlines, including Air France and British Airways, have suspended their services to Freetown and Monrovia, the capitals of Sierra Leone and Liberia respectively.

Bruce Aylward, the WHO's head of emergency programmes, said it was "absolutely vital" that airlines resume flights because bans were hindering the emergency response.

The outbreak has also caused sporting chaos, with Sierra Leone having to field all players for the qualifying games for the African Cup of Nations from outside the country over a growing quarantine.

Morocco, which will host the tournament next year, said on Friday it was launching a national commission tasked with drawing up a health plan to deal with the risk from Ebola.

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Ebola-hit Liberia fires absentee ministers

MONROVIA - Liberia's leader has sacked ministers and senior government officials who defied an order to return to the west African nation to lead the fight against the deadly Ebola outbreak, her office said on Tuesday.

President Ellen Johnson Sirleaf had told overseas ministers to return within a week as part of a state-of-emergency announcement on August 6, warning that extraordinary measures were needed "for the very survival of our state".

Sirleaf "directed that all officials occupying ministerial level positions or equivalent -- senior and junior -- managing directors, deputy/assistant directors or equivalent, commissioners et cetera who violated the orders are hereby relieved of their positions," her office said in a statement.

It did not say how many ministers were affected or which ones had been fired.

But a government insider clarified that only deputy ministers and senior officials were involved in the dismissal, and not cabinet-level ministers.

United Nations officials have pledged to step up efforts against the lethal tropical virus, which has infected more than 2,600 and killed 1,427 since the start of the year.

The World Health Organization said on Monday more than 120 health workers across west Africa have died during the "unprecedented" outbreak, and more than 240 had been infected.

In Sierra Leone, the WHO has temporarily pulled back its health workers from the Kailahun post after one of them was infected and an investigation is under way to prevent further infections before sending a team back there.

"This was the responsible thing to do. The field team has been through a traumatic time through this incident," said Dr Daniel Kertesz, WHO representative in Sierra Leone, in a statement.

Also Tuesday the African Development Bank warned the epidemic could cut economic output in the three worst-hit countries, as well as neighbouring Ivory Coast, by between one and 1.5 percent of gross economic product.

"If people don't start worrying about agriculture, there is going to be a food crisis. That will be the first direct impact on farmers in this region," said president Donald Kaberuka.

Second Ebola front
Meanwhile a second front has opened up in Africa's struggle with Ebola, after the Democratic Republic of Congo said on Tuesday it was preparing for a "battle of at least three months" after 13 people died after contracting the virus in the remote northeast.

Congolese authorities said the outbreak concerned Zaire Ebola, the species that is ravaging west Africa, but said the two outbreaks were not linked.

The United Nations' Ebola envoy David Nabarro, in Guinea's capital Conakry on Tuesday on the third leg of a tour of the region, has described the fight against the epidemic as a "war" which could take six more months.

"I understand that the situation is more or less stable in Guinea," he said.

"But with the surge of new outbreaks of the epidemic in recent weeks, there is an urgent need to consider a regional humanitarian rapid large-scale operation to stop the epidemic in a maximum period of six months."

Guinea, where the disease was first discovered, has reported 406 deaths, Sierra Leone 392 and Nigeria five, the WHO said on Friday.

- Deaths likely underestimated -

Liberia has suffered the worst effects of the outbreak, registering 624 deaths.

Sirleaf's office said she met a delegation of the United States Centers for Disease Control and Prevention, including its global head Tom Frieden, on Monday to discuss combatting the epidemic.

Frieden was quoted as saying there was an urgent need for more treatment facilities.

The WHO has echoed Nabarro's warning that it could take several months to bring the epidemic under control.

The agency estimates its count of the infected and dead is likely far too low, due in part to community resistance to outside medical staff and a lack of access to infected areas.

Meanwhile in Nigeria, the health ministry said Tuesday that two more people had been released from isolation after recovering from Ebola, leaving only one living patient with the disease in the country.

Elsewhere in the region, the Ivory Coast has closed its borders with Guinea and Liberia, just days after Senegal did the same with Guinea, while South Africa has banned entry for non-citizens arriving from Sierra Leone, Guinea and Liberia.

Ivorian Health Minister Raymonde Goudou Coffie told a press conference in Abidjan that it was "uncanny' that the country has so far no reported cases of Ebola which is ravaging neighbouring Guinea and Liberia.

Peter Piot, the Belgian scientist who co-discovered the Ebola virus in 1976, said on Tuesday a "perfect storm" in west Africa had given the disease a chance to spread unchecked.

"We have never seen an (Ebola) epidemic on this scale," Piot was quoted by the French daily Liberation as saying.

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Ebola outbreak moving fast, experts warn

GENEVA - The Ebola epidemic is moving faster than the authorities can handle and could take six months to bring under control, the medical charity MSF said Friday.

The warning came a day after the World Health Organization said the scale of the epidemic had been vastly underestimated and that "extraordinary measures" were needed to contain the killer disease.

The UN health agency said the death toll from the worst outbreak of Ebola in four decades had now climbed to 1,069 in the four afflicted West African countries -- Guinea, Liberia, Nigeria and Sierra Leone.

"It is deteriorating faster, and moving faster, than we can respond to," Joanne Liu, the chief of Doctors without Borders, known by its French acronym MSF, told reporters in Geneva.

She added that it could take six months to get the upper hand.

"It is like wartime," she said a day after returning from the region. "I don't think we should focus on numbers. To really get a reality check, we're not talking in terms of weeks, but months" to control the epidemic."

WHO said Thursday it was coordinating "a massive scaling up of the international response" to the epidemic.

"Staff at the outbreak sites see evidence that the numbers of reported cases and deaths vastly underestimate the magnitude of the outbreak," it said.

The epidemic erupted in the forested zone straddling the borders of Guinea, Sierra Leone and Liberia earlier this year, and later spread to Nigeria.

WHO declared a global health emergency last week -- far too late, according to MSF, which months ago warned that the outbreak was out of control.

Liu said while Guinea was the initial epicentre of the disease, the pace there has slowed, with fears now focused on the other countries.

"If we don't stabilise Liberia, we'll never stabilise the region," Liu said.

Concerns have also centred on the Nigerian cases, which are in Lagos, sub-Saharan Africa's largest city.

"Right now we have no past experience of Ebola within an urban setting," said Liu.

Athletes barred

As countries around the world stepped up measures to contain the disease, the International Olympics Committee said athletes from Ebola-hit countries had been barred from competing in pool events and combat sports at the Youth Olympics opening in China on Saturday.

The decision, which affects three unidentified athletes, was made "to ensure the safety of all those participating" in the Games in the city of Nanjing, the IOC and Chinese organisers said.

No cure or vaccine is currently available for Ebola, with the WHO authorising the use of largely untested treatments in efforts to combat the disease.

Hard-hit nations are awaiting consignments of up to 1,000 doses of the barely tested drug ZMapp from the United States, which has raised hopes of saving hundreds.

Canada says between 800 and 1,000 doses of a vaccine called VSV-EBOV, which has shown promise in animal research but never been tested on humans, would also be distributed through the WHO.

MSF's Liu warned against focusing on drugs.

"In the short term, they're not going to help that much, because we don't have many drugs available. We need to a get a reality check on how this could impact the curve of the epidemic," she said.

The last days of an Ebola victim can be grim, characterised by agonising muscular pain, vomiting, diarrhoea and catastrophic haemorrhaging described as "bleeding out" as vital organs break down.

The cost of tackling the virus is also threatening to take a severe toll on the already impoverished West African nations hit by the epidemic.

In Nigeria, in particular, a more serious outbreak could severely disrupt its oil and gas industry if international companies are forced to evacuate staff and shut operations, rating agency Moody's has warned.

'Hostility to health workers'

Sierra Leone's chief medical officer Brima Kargbo this week spoke of the risks facing health workers fighting the epidemic, which has killed 32 nurses since May as well as an eminent doctor, a tenth of the country's fatalties.

"We still have to break the chain of transmission to separate the infected from the uninfected," Kargbo said.

Nigerian sex workers also reported suspicion from customers, with business down drastically. One woman in Lagos who gave her name as Bright told AFP that Ebola was "worse than HIV/AIDS. You can prevent HIV by using condoms but you can't do the same with Ebola."

Across the region, draconian travel restrictions have been imposed and a number of airlines have cancelled flights in and out of West Africa.

Guinea, where at least 377 people have died, became the latest country to declare a health emergency, ordering strict controls at border points and a ban on moving bodies from one town to another.

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Asia on alert with thermal cameras, doctors as Ebola declared global risk

BANGKOK - Asian nations are using thermal imaging cameras and posting doctors at airports to screen out sick travellers as health authorities scramble to avert any outbreak of the Ebola virus that has killed almost 1,000 people in West Africa.

The four nations of Guinea, Liberia, Nigeria and Sierra Leone are struggling to combat the world's worst outbreak of Ebola, which has a fatality rate of up to 90 percent, with no known vaccine or cure.

The World Health Organisation declared the West Africa epidemic an "extraordinary event" and an international public health emergency on Friday.

There have been no confirmed cases of the virus in Asia, but health authorities who have battled deadly viruses, such as bird flu and the Severe Acute Respiratory Syndrome (SARS) in recent years, were dusting off the drills used for those outbreaks.

Their measures included infra-red thermal imaging cameras to screen air passengers with fevers and public awareness campaigns. Most countries have told citizens to consider postponing travel to affected areas.

Asia's efforts to screen visitors were adequate, said Tarik Jasarevic, a WHO spokesman based in Geneva.

"As long as a person is not visibly sick we think it's fine for them to be in public," he told Reuters by telephone. "We consider the risk for international spread quite low. The measures countries in Asia have taken are appropriate."

Health officials in Thailand, which received a record 26.5 million tourists last year, are monitoring 21 visitors from Sierra Leone, Liberia and Guinea. The officials said they had no plans to quarantine the visitors.

"They are free to move but we are checking in on them frequently," said Opart Karnkawinpong, a disease control official at Thailand's Ministry of Public Health.

"We have surveillance cameras in place at major entry points and doctors at international airports to supplement existing teams."

MEASURES IN PLACE

The Ebola virus is only transmitted through contact with the body fluids of someone with symptoms, which initially include muscle pains and joint aches, then worsen to vomiting, diarrhoea and internal and external bleeding in the final stages.

In China, there were no reports of Ebola cases but hospitals have been told to report any suspected cases.

India, which has nearly 45,000 citizens living and working in the four affected countries, said it would screen travellers passing through, or starting journeys there, when they returned.

"The surveillance system would be geared up to track these travellers for four weeks and detect them early, in case they develop symptoms," Health Minister Harsh Vardhan told parliament on Wednesday.

Japan is ready to send suspected Ebola victims to special isolation hospitals, Chief Cabinet Secretary Yoshihide Suga told a news conference.

In Australia, authorities said they had not taken extra steps but airports were on alert for sick travellers, saying the risk of the disease reaching the country was "very low".

Officials in Singapore said the city state, praised for its tough measures against the SARS outbreak that claimed 33 lives in 2003, also faced only a low threat from the Ebola virus.

"Measures are already in place to carry out contact tracing and quarantine all close contacts if there is a case," the health ministry said.

In Thailand, health official Opart said the 21 travellers would stay under observation for the entire incubation period, which can last up to 21 days.

"Even though Ebola is only a small risk to Thailand we are not taking any chances," he said.

(Additional reporting by Thuy Ong in SYDNEY, Rachel Armstrong in SINGAPORE, Aung Hla Tun in YANGON, Kaori Kaneko in TOKYO and Nita Bhalla of the Thomson Reuters Foundation in NEW DELHI; Editing by Clarence Fernandez)

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Saudi suspects case of Ebola infection

RIYADH - Doctors in Saudi Arabia are testing a patient suspected of having contracted Ebola during a trip to West Africa, hit by an epidemic of the virus, the health ministry said Tuesday.

The Saudi man was admitted to hospital in the Red Sea city of Jeddah after showing symptoms of haemorrhagic fever upon his return from Sierra Leone.

The patient, in his 40s, is in critical condition and has symptoms "similar to that of Ebola infection."

Ebola-like symptoms include fever, vomiting, severe headaches and muscular pain and, in the final stages, profuse bleeding.

The UN World Health Organisation said Monday that at least 887 people have died from Ebola since the beginning of the year, after the virus spread across Guinea, Liberia and Sierra Leone.

In April, Saudi Arabia announced a ban on visas for Muslims in the three West African nations wishing to perform the pilgrimage to the Muslim holy sites there.

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