Health

Ebola crisis: DHS to limit entry into US from West Africa to 5 airports

A plane arrives at New York's John F. Kennedy Airport (JFK ) airport on October 11, 2014 in New York City. Ebola screenings began on Saturday at JFK for travelers arriving from West African countries that have been afftected by the disease. On Tuesday, October 21, 2014, the Department of Homeland Security announced a new requirement that travelers from West African countries impacted by the Ebola outbreak will be required to enter the U.S. through JFK and four other airports that have implemented enhanced screening procedures.
A plane arrives at New York's John F. Kennedy Airport (JFK ) airport on October 11, 2014 in New York City. Ebola screenings began on Saturday at JFK for travelers arriving from West African countries that have been afftected by the disease. On Tuesday, October 21, 2014, the Department of Homeland Security announced a new requirement that travelers from West African countries impacted by the Ebola outbreak will be required to enter the U.S. through JFK and four other airports that have implemented enhanced screening procedures.
Spencer Platt/Getty Images

Everyone coming to the United States from the three West African countries at the center of theEbola outbreak will now be screened for the deadly disease at one of five airports, the Homeland Security Department said Tuesday.

Earlier this month, Customs and Border Protection officers at New York's Kennedy, Newark Liberty, Washington's Dulles, Chicago's O'Hare and Hartsfield-Jackson Atlanta airports started screening people arriving from West Africa. The screening includes using no-touch thermometers to determine if travelers have a temperature, one symptom of a possible Ebolainfection. The Centers for Disease Control and Prevention is also working with DHS on the screening.

There are no direct flights to the United States from West Africa. About 94 percent of the roughly 150 people traveling daily from West Africa to the U.S. arrive at the one of the five airports. Homeland Security Secretary Jeh Johnson said Tuesday that now everyone traveling from Liberia, Sierra Leone or Guinea will have to land in the U.S. at one of the five airports and then fly on to their destination.

The new requirement means that people traveling from the region who were not originally passing through one of those five airports will have to rebook their flights.

Johnson said DHS now has "measures to identify and screen anyone at all land, sea and air ports of entry into the United States who we have reason to believe has been present in Liberia, Sierra Leone or Guinea in the preceding 21 days."

Concerns about travelers infected with Ebola have risen since a Liberian man traveled from the region to Dallas last month. Thomas Eric Duncan became the first person in the United States diagnosed with Ebola, a few days after arriving from West Africa. He died on Oct. 8.

Since then, two nurses who helped care for him have also been diagnosed with Ebola.

Some members of Congress have urged President Barack Obama to ban all travel from West Africa. Tuesday, House Judiciary Committee Chairman Bob Goodlatte, R-Va., praised the expansion of airport screening but again urged Obama to halt all travel from the region.

"President Obama has a real solution at his disposal under current law and can use it at any time to temporarily ban foreign nationals from entering the United States from Ebola-ravaged countries," Goodlatte said.

Sen. Chuck Schumer, D-N.Y., described the move as an "added layer of protection against Ebola entering our country."

Meanwhile, here are some updates on efforts to combat the virus around the globe...

WHO: Ebola vaccine trials in W. Africa in January

Tens of thousands of doses of experimental Ebola vaccines could be available for "real-world" testing in West Africa as soon as January as long as they are deemed safe, a top World Health Organization official said Tuesday.

Dr Marie Paule Kieny, an assistant director general for WHO, said clinical trials that are either underway or planned in Europe, Africa and the U.S. are expected to produce preliminary safety data on two vaccines by December.

If the vaccines are declared safe, she said they will be used in trials in West Africa beginning in January to test their effectiveness among tens of thousands — but not millions — of people.

"I'm not suggesting at this moment that there would be mass vaccination campaigns at population levels starting in 2015," she said, adding that none of the volunteers who take part in the trials could accidentally contract Ebola from the testing.

The Ebola outbreak in West Africa has already killed over 4,500 people, mostly in Liberia, Guinea and Sierra Leone, since it emerged 10 months ago. Experts have said the world could face 10,000 new cases a week in two months if authorities don't take stronger steps to fight the deadly virus.

One of the two vaccines that Kieny mentioned was developed by the U.S. National Institutes of Health and GlaxoSmithKline from a modified chimpanzee cold virus and an Ebola protein. It is in clinical trials now in the U.K. and in Mali and will be used in trials in Lausanne, Switzerland, by the start of February.

The second front-runner, developed by the Public Health Agency of Canada and known as VSV-EBOV, has been sent to the U.S. Walter Reed Army Institute of Research in Maryland for testing on healthy volunteers, with preliminary results about its safety expected by December. The next stage would be to test it more broadly, including among those directly handlingEbola cases in West Africa.

Canada has donated 800 vials of the experimental vaccine to WHO but the shipment was delayed by a Lufthansa pilots' strike. Those are now expected to arrive in Switzerland on Wednesday for testing coordinated by the U.N. health agency among volunteers at the University Hospital of Geneva, and volunteers in Hamburg, Germany, and in Gabon and Kenya, Kieny said.

"These data are absolutely crucial to allow decision-making on what dose level should go in the efficacy testing in Africa," Kieny said. "We expect, we hope, to have a go-ahead by the end of the month."

That would allow the vaccine to be shipped for use in Africa immediately afterward.

Kieny said decisions about "which strategy to use and how and where and who" regarding the vaccines will be made in the next few weeks. Then vaccines will be given to health workers and select segments of the general population "early in 2015, in January."

At a separate news conference, WHO spokeswoman Fadela Chaib promised a thorough public audit of the agency's early missteps — and those by countries and partner organizations — in responding to the Ebola crisis.

"There is certainly a wish and a will to have this review," she said. "We know many elements need to be explained in the future. ... WHO will do that, but in the future; now our focus is on the response."

The U.N.'s emergency committee on Ebola plans to meet later this week in Geneva to study the outbreak further and decide what more should be done.

— Associated Press reporter John Heilprin

Ebola cases rise sharply in western Sierra Leone 

After emerging months ago in eastern Sierra Leone, Ebola is now hitting the western edges of the country where the capital is located with dozens of people falling sick each day, the government said Tuesday. So many people are dying that removing bodies is reportedly a problem.

Forty-nine confirmed cases of Ebola emerged in just one day, Monday, in two Ebola zones in and around the capital, the National Ebola Response Center, or NERC, said. Lawmaker Claude Kamanda who represents a western area said more than 20 deaths are being reported daily.

Kamanda told the local Politico newspaper that authorities are experiencing challenges collecting corpses from both quarantined and non-quarantined homes.

Authorities say the uncontrolled movement of people from the interior to Waterloo which is the gateway to Freetown, the capital, has fueled the increase of Ebola cases in the west. There is a strong feeling that people are violating the quarantines elsewhere and coming to Freetown through Waterloo.

There are 851 total confirmed Ebola cases in the two zones, called Western Area Urban and Western Area Rural, the NERC said. In numbers of cases, they may soon surpass a former epicenter of the outbreak in the country, the eastern districts of Kenema and Kailahun where there have been a total of 1,012 confirmed cases.

No new cases were reported Monday in Kenema and Kailahun but a World Health Organization spokeswoman said it is too early to declare that the epidemic has burned itself out in the east.

"There was a drop in new cases in Kenema and Kailahun and fingers were crossed but there has been a bit of a flare up thanks to a couple of unsafe burials," said Margaret Harris, WHO's spokeswoman in Sierra Leone. "So it's too early to say we have a real decline ... definitely too early to say it's been beaten there."

A local newspaper suggested Tuesday that authorities quarantine Waterloo. The World Food Program over the weekend delivered emergency food rations to people there.

"The growing fear has left the public with no choice but to call on the Government for Waterloo to be quarantined as was done to other places including Kailahun, Kenema, Bombali, Port Loko and Moyamba Districts," the Exclusive newspaper said.

Many residents of the capital note that Ebola has followed the same route across the country as rebels who in 1991 started a savage war in Kailahun district. The war ended in Freetown a decade later where the final battle was fought. Now the enemy is a disease, and the president is putting in place a more military-style response.

President Ernest Bai Koroma last week appointed Defense Minister Alfred Palo Conteh as CEO of the National Ebola Response Center, whose headquarters are being placed at the former War Crimes Tribunal for Sierra Leone in the west end of Freetown together with the United Nations Mission for Ebola Emergency Response.

The west African nations of Sierra Leone, Liberia and Guinea — where the outbreak first emerged 10 months ago — have been hit hard by Ebola with more than 4,500 deaths, according to WHO estimates. A few cases have also emerged in the United States and Spain, and on Tuesday the east African nation of Rwanda was singling out travelers from the U.S. and Spain for special screening. A Rwandan Ministry of Health document says all passengers from the U.S. and Spain will have their temperatures taken upon arrival. If the passenger has a fever he or she is denied entry. If there is no fever, the visitors still must report their health condition daily to authorities.

The U.S. Embassy in Rwanda on Tuesday urged Americans who may have a fever or who have traveled to Ebola countries "to weigh carefully whether travel to Rwanda at this time is prudent."

"Please note neither the Department of State's Bureau of Consular Affairs nor the U.S. Embassy have authority over quarantine issues and cannot prevent a U.S. citizen from being quarantined should local health authorities require it," the embassy said.

No Ebola cases have emerged in Rwanda.

— Associated Press writer Clarence Roy-Macaulay and reporters Maria Cheng in London contributed to this report.

California nurses press governor on Ebola safety

Gov. Jerry Brown is scheduled to meet with the state's largest nurses union to discuss Ebola preparedness at hospitals and other health facilities.

Leaders of the California Nurses Association will meet with him Tuesday as the union presses for more training and protective gear for health workers.

The governor's office says Brown and state public health officials also are meeting this week with hospital executives, physicians, local health officials and emergency responders.

RoseAnn DeMoro, executive director of the statewide union and National Nurses United, says hospitals have been slow in responding to the Ebola threat. The union wants the type of gear used at premiere institutions and practice taking it off.

Also Tuesday, nurses will rally in Oakland urging the state Department of Industrial Relations to adopt stronger safety standards.

Rwanda requires US, Spain visitor health reports

Rwanda's Ministry of Health is requiring visitors who have been in the United States or Spain during the previous 22 days to report their medical condition to health authorities upon arrival in Rwanda, the U.S. Embassy in Rwanda said Tuesday.

A Ministry of Health document says all passengers from the U.S. and Spain - two countries that have seen cases of Ebola - will have temperatures taken upon arrival. Passengers with fevers will be denied entry, and those without fevers will still be required to report daily health conditions.

Dr. Agnes Binagwaho, Rwanda's health minister, said Tuesday that travelers from the U.S. and Spain will be required to fill a detailed form upon arrival at border entry points.

"It is definitely extra work for us. We have to ensure that all citizens or any other travelers arriving from the above mentioned countries including the U.S have to be screened in an extra careful manner and follow up on them during their stay," Bingwaho said.

No Ebola cases have been reported in Rwanda. The U.S. Embassy said that Rwanda is not allowing visitors who have recently traveled to Guinea, Liberia, Senegal, or Sierra Leone, though the incoming health form advises those traveling from those countries must also report health conditions daily.

Rwanda has quarantined 30 people since the Ebola outbreak. No U.S. citizens have been quarantined. One German national has been quarantined.

Spanish woman free of Ebola, final tests shows

Conclusive tests show a Spanish nursing assistant infected with Ebola is completely clear of the virus, doctors said Tuesday, signaling a positive outcome in her 15-day battle to survive.

Four blood tests over the past four days showed Teresa Romero's system had eliminated the virus, Dr. Jose Ramon Arribas, of the Carlos III hospital said.

"World Health Organization criteria for curation have been completed," said Arribas, the hospital's chief for infectious diseases.

He added that she would no longer have to be kept in isolation although he warned she would have to be monitored for after effects of the virus.

Romero, 44, tested positive Oct. 6 and was admitted to the Madrid hospital. She received plasma from a recovered Ebolapatient, but health authorities have disclosed no more treatment details.

Doctors said she began to show signs of recovery last week.

Romero was the first known person to contract the disease outside of West Africa in the latest outbreak. Romero had treated two Spanish missionaries who died of Ebola at the hospital after they were flown back from West Africa.

She told doctors she remembered touching a glove to her face after leaving the hospital room of missionary Miguel Pajares, who died Sept. 25.

A spokeswoman for Romero said she is expected to remain at the hospital about two more weeks.

Romero still doesn't know that Spanish health authorities approved the killing of the couple's mixed breed dog named Excalibur on Oct. 8 instead of isolating the pet.

This story has been updated.