- The Washington Times - Monday, October 20, 2014

The World Health Organization declared that Nigeria has overcome its Ebola outbreak, giving Africa’s most populous country a clean bill of health even as federal officials in the U.S. still struggled to control their own outbreak, releasing new guidelines for health workers late Monday.

WHO officials said Nigeria had gone 42 days without a new case, which makes it almost a statistical certainty that its outbreak, stemming from a single Liberian man who arrived with the disease in August, has been solved.

In the U.S., meanwhile, dozens of people who came in contact with Thomas Eric Duncan, the Liberian man who carried the disease from West Africa, have been released after a three-week isolation — a period that is not as certain as the 42-day window the WHO uses to clear countries.

Officials in Dallas County, Texas, where Duncan was treated, pleaded with residents not to stigmatize those who were isolated,

“There’s zero risk that any of those people who’ve been marked off the list have Ebola,” said Dallas County Judge Clay Jenkins. “The time period for them to get Ebola has lapsed. It is over.”

But the 21-day period has been called into question, and some lawmakers are asking government officials to impose a longer isolation or quarantine period. Rep. Tulsi Gabbard, Hawaii Democrat, has said the Centers for Disease Control should follow the 42-day check the WHO uses to clear countries from the outbreak list.

“The research the CDC is basing its 21-day standard on is outdated, and therefore its policies regarding quarantine or the monitoring of individuals who have been directly exposed to Ebola patients need to be updated,” she said.

With thousands of deaths attributed to Ebola in West Africa and a small outbreak here in the U.S., the incubation and infection periods for the disease are hotly debated, and the 21- and 42-day guidelines are based on probabilities. Scientists have concluded that there’s only a 5 percent chance of an Ebola patient still being contagious after three weeks, and a 2 percent chance they’re contagious after six weeks.

The U.S. response so far has been fragmented, with the Dallas hospital that treated the Texas outbreak admitting it made mistakes, and CDC officials trying to assure Americans that the disease can be controlled.

Late Monday, the CDC released updated guidelines urging hospitals to refocus their training and prevention efforts, and stressing that health workers treating patients suspected of having Ebola should wear double gloves, fluid-resistant gowns, full-face shields and surgical hoods to ensure no skin is exposed at all.

The guidelines also call for a monitor to supervise the clothing to make sure all skin is covered.

CDC officials said they still don’t know how two nurses in Dallas contracted the disease, but said they know how to stop its spread if health workers take all recommended precautions.

President Obama late last week appointed an Ebola czar to coordinate bureaucratic efforts, naming Ron Klain, a former chief of staff to Vice President Joseph R. Biden. Mr. Klain begins work Wednesday, though the White House said he’s already getting up to speed.

Mr. Obama, meanwhile, got a briefing by video while traveling in Chicago, where he voted early ahead of November’s midterm elections.

“So far we’ve only got one person dying of Ebola, but people are understandably concerned in part because they’ve seen what’s happened in Africa,” the president said at an evening political fundraiser.

Mr. Obama said the U.S. is part of a world effort to stem the disease, but insisted Ebola is “not an outbreak or an epidemic here.”

Some have challenged that claim, saying that the cases in Texas do represent an outbreak — and one federal officials had predicted they could prevent or control.

Pressure for a travel ban continued to increase Monday, with Louisiana Gov. Bobby Jindal signing an executive order imposing restrictions on public employees and students at public colleges in his state. The order requires any of them traveling to Ebola-affected countries to alert state officials and says state agencies should be prepared to impose a 21-day monitoring plan for anyone returning from those countries.

“The federal government, to date, has failed to implement protections at the national level to prevent the entry of the Ebola virus disease into the United States of America,” Mr. Jindal wrote in the executive order.

A number of lawmakers, both in the states and on Capitol Hill, have urged Mr. Obama to stop issuing visas to citizens from Liberia, Guinea and Sierra Leone, the three countries seeing the worst of the outbreak. Others have called for a full-blown travel ban.

Mr. Obama, however, has rejected those calls, saying his health officials have told him travel restrictions could actually hurt. Those officials say if the U.S. bans entry, infected travelers will just try to sneak into the U.S., thereby avoiding the temperature-taking procedures put in place at five airports.

Duncan, the Liberian man who brought Ebola to the U.S., traveled before he showed symptoms and told screeners he hadn’t had contact with anyone infected with the disease in Africa — a claim that turned out to be untrue.

Duncan died earlier this month. Nearly four dozen individuals who had been under isolation for potential contact with him have been released from isolation, but dozens of others who had contact with the two nurses that contracted the disease from him remain under watch.

In Africa, Senegal and Nigeria have now been deemed to have beaten Ebola outbreaks after 42 days passed since the last cases were diagnosed.

Nigeria implemented some flight bans for certain air carriers but didn’t ban all travel. Senegal, whose outbreak was declared over last week, did ban flights and closed its borders — both land crossings with Guinea as well as refusing vessels from Guinea, Sierra Leone and Liberia.

WHO officials said Nigeria’s outbreak stemmed from a Liberian man who brought the disease to Lagos, Africa’s most populous city, on July 20. That man, who died five days later, set off a chain that infected a total of 19 people, seven of whom died.

Senegal had a single case.

With those two countries cleared, just Liberia, Sierra Leone, Guinea, Spain and the U.S. remain on the list of countries with cases.

International SOS, which has been tracking the disease, said 49.4 percent of the more than 9,200 suspected or confirmed cases worldwide have been fatal.

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