Here’s what you need to know about Ebola

NYC EBOLA CLEANUP CREW USING ‘HOSPITAL GRADE’ CHEMICAL SPRAY

NEW YORK — A cleanup specialist at the home of a Manhattan Ebola patient says the process includes the use of a “hospital grade” chemical spray.

Patrick Borges (BOHR’-juhs) was one of two team members certified to enter the apartment of Dr. Craig Spencer on Friday.

Borges said no other apartments would have to be evacuated.

After the chemical spray takes effect, they set up a safety zone in the home.

Borges says he wears a swimsuit beneath his protective gear. A breathing device is part of their protocol, even though Ebola is not airborne.

The team removes clothing and other fabric from the home and wipes down hard surfaces like game consoles.

Borges said Spencer and his fiancee have no pets.

He estimated the cleanup would take five or six hours.

—

NYC EBOLA CASE BRINGS DEMANDS FOR QUARANTINES

NEW YORK — The case of the U.S. doctor stricken with Ebola left lawmakers on Capitol Hill, scientists and ordinary New Yorkers wondering why he was out on the town in the week after his return from West Africa — and why stronger steps aren’t being taken to quarantine medical workers.

Dr. Craig Spencer rode the subway, took a cab, went bowling, visited a coffee shop and ate at a restaurant in the days after he came back to New York City from Guinea, where he had been treating Ebola victims.

Health officials said he followed U.S. and international protocols in checking his temperature every day and watching for symptoms, and put no one at risk. But others think he should have been quarantined — voluntarily or by the government — during Ebola’s 21-day incubation period.

Doctors Without Borders, the group Spencer was working for, said in a statement that that would be going too far. People with Ebola aren’t contagious until symptoms begin, and even then it requires close contact with body fluids.

“As long as a returned staff member does not experience any symptoms, normal life can proceed,” the organization said in a statement.

But even some prominent scientists disagreed.

A three-week quarantine makes sense for anyone “with a clear exposure” to Ebola, said Dr. Richard Wenzel, a Virginia Commonwealth University scientist who formerly led the International Society for Infectious Diseases.

Some health workers could “have a kind of denial there are any exposures,” and an automatic quarantine would address that, Wenzel said.

At the same time, he conceded health workers might be leery of volunteering if they knew they would be confined to their homes for three weeks after they got back.

On the streets of New York, Michael Anderson was critical of the government and Spencer.

“He’s stupid, a complete idiot” for moving about in public, the longtime Manhattan resident said at Grand Central Station. “It’s his responsibility when you come back from Africa” not to put people at risk, he said.

Spencer, a 33-year-old emergency room doctor, returned from Guinea on Oct. 17 and sought treatment Thursday after suffering diarrhea and a 100.3-degree fever. He was listed in stable condition at a special isolation unit at Bellevue Hospital Center, and a decontamination company was sent to his Harlem home. His fiancee, who was not showing symptoms, was being watched in a quarantine ward at Bellevue.

The idea of broader quarantine is a topic “actively being discussed. It’s going to be something that will be discussed at federal level,” said Dr. Mary Bassett, New York City’s health commissioner.

Lawmakers from both parties criticized the federal government’s Ebola response.

Rep. Stephen Lynch, D-Mass., said anyone coming from West Africa should be quarantined for 21 days abroad before even boarding a plane to this country.

“This can’t just be about ideology and happy talk,” Lynch said. “We need to be very deliberate, take it much more seriously than I’m hearing today.”

The World Health Organization is not recommending the quarantine of returning aid workers without symptoms, according to spokeswoman Sona Bari.

“Health care workers are generally self-monitoring and are aware of the need to report any symptoms, as this patient did,” she wrote in an email.

Bruce Johnson, president of SIM USA, a Christian organization based in North Carolina, said its staffers are told to follow guidelines established by the federal Centers for Disease Control and Prevention for their first 21 days in the U.S. Beyond that, he said, they are told to avoid crowded public areas.

Johnson said his staff members would not be deterred from serving in Ebola-stricken countries if they were required to remain isolated in their homes for 21 days upon their return. But such measures could discourage volunteers, he said.

Nurses, doctors and others who hold down regular jobs back home would say, “I want to go over and help for a month, but now you’re telling me that when I get back I can’t go to work for 21 days?” Johnson said. “Yes, I think that will dampen the generous spirit of people in the U.S. who want to go help.”

Samaritan’s Purse, a Christian relief organization based in North Carolina, said that its returning aid workers spend three weeks quarantined in a “safe house,” where their temperatures are monitored.

They can go out for things like a walk in the park or a visit to the drive-thru of a fast-food restaurant, but are asked to stay away from crowds and are isolated from their families, said Franklin Graham, president of the organization.

Graham said the federal government should rent out a hotel — perhaps one in the Caribbean, to ease public fears — and then staff it with doctors and quarantine all returning health care workers there for three weeks.

“They can sit by the pool and eat hamburgers,” Graham said. “I would call it a country club quarantine and let them just relax and cool their heels. … It’s an inconvenience, but it is not a hardship.”

—

DALLAS NURSE NOW EBOLA FREE

DALLAS — A second Dallas nurse who contracted Ebola is now free of the virus, Emory University Hospital in Atlanta said on Friday.

Amber Vinson, one of two nurses from a Dallas hospital infected with Ebola after treating the first patient diagnosed with the disease in the United States, is still receiving supportive care at Emory and no release date has been set.

But tests no longer detect the virus in her blood, the hospital said in a statement.

The other nurse, Nina Pham, also was declared virus-free on Friday and left the Maryland hospital where she had been treated.

—

MALI CASE PUT MANY AT HIGH RISK FOR EBOLA

DAKAR, Senegal — Many people in Mali are at high risk of catching Ebola because the toddler who brought the disease to the country was bleeding from her nose as she traveled on a bus from Guinea, the World Health Organization warned Friday.

The U.N. agency is treating the situation as an emergency since many people may have had “high-risk exposures” to the 2-year-old girl during her journey through several towns in Mali, including two hours in the capital, Bamako. The girl was traveling with her grandmother.

This is the first Ebola case in Mali and may expand to many more. The case highlights how quickly the virus can hop borders and even oceans, just as questions are being asked about what precautions health care workers who treat Ebola patients should take when they return home from the hot zone. Doctors Without Borders insisted Friday, after one of its doctors who worked in Guinea came down with Ebola in New York, that quarantines of returning health workers are not necessary when they do not show symptoms of the disease.

In the Mali case, however, the girl was visibly sick, WHO said, and an initial investigation has identified 43 people, including 10 health workers, she came into close contact with who are being monitored for symptoms and held in isolation. The child was confirmed to have Ebola on Thursday.

“The child’s symptomatic state during the bus journey is especially concerning, as it presented multiple opportunities for exposures — including high-risk exposures — involving many people,” the agency said in a statement.

The girl first went to a clinic in Mali on Monday and she was initially treated for typhoid, which she tested positive for. When she did not improve, she was tested for Ebola, and she is now being treated in isolation in the western city of Kayes.

Mali has long been considered highly vulnerable to Ebola’s spread since it shares a border with the Ebola-hit countries of Guinea and Senegal, and staff from WHO and the U.S. Centers for Disease Control and Prevention were already there helping to prepare for a case. More WHO staff are being deployed.

The Ebola outbreak began in Guinea and has since spread to five other West African countries. The virus has also been imported to Spain and the United States. On Thursday, Craig Spencer, who had been working with Doctors Without Borders in Guinea and returned home to the U.S. about a week before, reported a fever and is now being treated at a New York hospital.

Some countries have banned travelers from the three main Ebola countries — Guinea, Liberia and Sierra Leone — and the U.S. started health screening of travelers arriving from there. But Doctors Without Borders said having its staffers quarantine themselves after leaving a country with Ebola is going too far if no symptoms are evident. A person infected with Ebola is not contagious until he or she starts showing symptoms.

“As long as a returned staff member does not experience any symptoms, normal life can proceed,” Doctors Without Borders said in a statement sent to The Associated Press on Friday. “Self-quarantine is neither warranted nor recommended when a person is not displaying Ebola-like symptoms.”

“Extremely strict procedures are in place for staff dispatched to Ebola affected countries before, during, and after their assignments,” said Sophie Delaunay, the group’s executive director, said in a statement. “Despite the strict protocols, risk cannot be completely eliminated. However, close post-assignment monitoring allows for early detection of cases and for swift isolation and medical management.”

The group is investigating how Spencer became infected, it said.

Several spokespeople for the group refused to say where Spencer had been working in Guinea. Doctors Without Borders runs two treatment centers in Guinea: one in Gueckedou, in the southeast where the outbreak began, and the other in Conakry. It also runs a center near Gueckedou where patients are screened for Ebola and then sent for treatment if they have the disease.

Doctors Without Borders tells health workers who are returning home after a tour of duty that they must stay within four hours of a hospital with isolation facilities. It asks them to take their temperature twice a day and to be vigilant for symptoms, which include a fever.

The group said Spencer followed these procedures and immediately notified the New York office when he came down with a fever.

The group discourages staff returning from West Africa from going back to work before the incubation period is up, so they can recover from the grueling work in the field and also so they don’t pick up an infection while at work whose symptoms may look like Ebola, causing unnecessary anxiety.

—

2-YEAR-OLD MALI EBOLA PATIENT DIES

A two-year-old girl who was Mali’s first confirmed case of Ebola has died, a local health official said on Friday.

The health official, who asked not to be named, said she died in the western Malian town of Kayes at around 1600 GMT.

There was no immediate official comment from health authorities but Oumar Sylla, a Kayes resident, said local radio stations were reporting the information.