As concerns spread over U.S. hospital readiness, there are some lessons to be learned from Nigeria, where officials managed to get ahead of the fast-moving virus after it was brought into Africa's most populous country by an Ebola-infected man who'd flown into Lagos. This week, the U.S. Centers for Disease Control and Prevention reported that the outbreak could be coming to an end in Nigeria, with no new Ebola cases since Aug. 31.
As in the U.S. case, Ebola arrived in Nigeria by passenger plane. But unlike Thomas Eric Duncan — who arrived in Dallas before he became symptomatic and was therefore not contagious during his flights from Liberia to Texas through Brussels and Dulles International Airport — Patrick Sawyer was already symptomatic when he landed in Lagos on July 20. At that point, Sawyer, Nigeria's Patient Zero, was contagious and dying.
It was a nightmare scenario with the potential to spiral out of control, given the bustling city of Lagos, Africa's largest, is a major transportation hub. As Sawyer was placed in isolation, public health officials had to track down every single person who'd come into contact with him, from the flights he'd boarded to the Lagos airport and the private hospital where he went after landing. And they had to do so quickly, making the process known as contact tracing a priority.
"In the whole system approach in beating the war on Ebola, contact tracing is the key public health activity that needs to be done," said Gavin MacGregor-Skinner, who helped with the Ebola response in Nigeria with the Elizabeth R. Griffin Research Foundation. "The key is to find all the people that patient had direct close contact with."From that single patient came a list of 281 people, MacGregor-Skinner said. Every one of those individuals had to provide health authorities twice-a-day updates about their well-being, often through methods like text-messaging. Anyone who didn't feel well or failed to respond was checked on, either through a neighborhood network or health workers.
Nigeria took a "whole community approach," with everyone from military officials to church elders in the same room, discussing how to handle the response to the virus, MacGregor-Skinner said.
Such an approach, and contact tracing in general, requires people be open and forthright about their movements and their health, he said. Stigmatization of patients, their families and contacts could only discourage that, so Nigerian officials sent a message to "really make them look like heroes," MacGregor-Skinner said.
"This is the best thing people can do for Nigeria: They are going to protect and save Nigeria by being honest, by doing what they need to do, by reporting to the health commission," he said. This made people feel like they were a part of something extremely important, he said, and also took into account real community needs. "You got real engagement and compliance from the contacts. They're not running and hiding."
Sawyer had come into contact with someone who ended up in Port Harcourt. That person, a regional official, went to a doctor who ended up dying from Ebola in August. Within a week, 70 people were being monitored. It ballooned to an additional 400 people in that one city.Success stories of people coming through strict Ebola surveillance alive and healthyhelped encourage more people to come forward, as they recognized that ending up in a contact tracer's sights didn't mean a death sentence.
In the end, contact tracers — trained professionals and volunteers — conducted 18,500 face-to-face visits to assess potential symptoms, according to the CDC, and the list of contacts throughout the country grew to 894. Two months later, Nigeria ended up with a total of 20 confirmed or probable cases and eight deaths.
The CDC also pointed to the robust public health response by Nigerian officials, who have had experience with massive public health crises in the past — namely polio in 2012 and large-scale lead poisoning in 2010.
When someone is on a contact list, that doesn't mean that person has to stay at home for the entire incubation period of 21 days from the last contact with someone who had Ebola. People on contact lists are not under quarantine or in isolation. They can still go to work and go on with their their lives. But they should take their temperature twice a day for 21 days and check in with health workers.
The CDC recommends that people without symptoms but who have had direct contact with the bodily fluids of a person sick with Ebola be put under either conditional release, meaning that they self-monitor their health and temperature and check in daily, or controlled movement. People under controlled movement have to notify officials about any intended travel and shouldn't use commercial planes or trains. Local public transportation use is approved on a case-by-case basis.When symptoms do develop, that's when the response kicks into high gear. People with Ebola are contagious only once they begin exhibiting symptoms, which include fever, severe headaches and vomiting.
While four people in Dallas are under government-ordered quarantine, that is not the norm. Those individuals "were non-compliant with the request to stay home. I don’t want to go too far beyond that," Dallas County Judge Clay Lewis Jenkins said Thursday.
Obama is expected to meet with top health and security officials on Monday to
consider whether to launch additional screening at U.S. airports for some
travelers arriving from Ebola-stricken African nations.
top U.S. health officials confirmed to Fox News on Monday that they were
looking at those options as they try to contain the Ebola virus.
will be discussed at the White House is the issue of entry screening," Dr.
Anthony Fauci, director of the National Institute of Allergy and Infectious
explained that the first line of defense right now is for travelers to be
screened when they attempt to leave the affected African nations. Officials
have said dozens of travelers have been stopped from boarding this way after they
exhibited symptoms at these departure points.
said the president and his team are now looking at imposing an extra layer of
screening -- by instituting new measures at U.S. airports.
certainly open for discussion," he said.
Tom Frieden, of the Centers for Disease Control and Prevention, also confirmed
that officials are "looking at those possibilities and others as
confirmed the extra screening might include asking travelers who they had
contact with and checking to see if they have a fever.
is scheduled to get the update on the Ebola outbreak Monday afternoon from his
national security team and other senior officials.
Obama administration has said that it won't shut down flights from affected
countries, particularly those in West Africa, arguing this would be
counterproductive by restricting aid flights.
reiterated that point Monday, and Frieden also alluded to it on Fox News.
off the table in terms of keeping Americans safe, except doing things that
might actually backfire," Freiden said.
some lawmakers have called for the Obama administration to at least consider
the possibility of a travel ban, considering the first diagnosed case of Ebola
in the United States was confirmed last week in spite of existing
ISIS fighters pounded the Syrian city of Kobani with tanks and
heavy artillery Monday as the extremist group came closer to capturing the key
city on the border with Turkey.
The fall of the city would carry huge symbolic and strategic
weight, giving ISIS sway over an uninterrupted swatch of land between the
Turkish border and its self-declared capital in Raqqa, Syria, 100 kilometers
(62 miles) away.
Although the fight was not over, CNN crews on Monday spotted what
appeared to be the black flag ofISISflying from a hilltop on the eastern side of the
city. The flag was farther east into the city from one shown flying atop a
building in video from Reuters and also seen by the CNN crews.
The Turkish military, which has bulked up its defenses along the
border in recent days as the fighting has flared, blocked people fleeing the
fighting from crossing the border.
"We want to go across!" would-be refugees chanted as
they pressed against a border fence.
A civilian in Kobani, who can't be named because of security
concerns, estimated that few civilians remain in the city -- maybe 100. They
are prepared to die should ISIS take over, he said.
The city's defenders vowed to keep fighting.
"We are afraid of this. We are obliged to defend our home,
our town," Kurdish Kobani official Idriss Nassan said. "We didn't
choose this war, but we are obliged to fight."
Yet, members of the Kurdish People's Protection Unit, called YPG,
and other groups defending the city couldn't move overnight because of ISIS
snipers equipped with night vision equipment, a fighter inside the city told
President Olusegun Obasanjo has said that some of the missing
Chibok girls may never return and we'll continue to read about them in years to
come. He said this yesterday Oct 5th while speaking at the Hausa service of the
British Broadcasting Corporation
"I believe that some of them will never return. We will
still be hearing about them many years from now, some will give birth to
children of the Boko Haram members, but if they cannot take care of
them in the forest, they may release them.”
President Goodluck Ebele
Jonathan will undertake a one-day official visit to Niamey, capital of Niger
Republic tomorrow, Tuesday, October 7, 2014 to participate in an Extraordinary
Summit of Heads of State and Government of the Lake Chad Basin Commission.
President Jonathan and
other participating Heads of State and Government are expected to review
ongoing collaboration against terrorism and agree on further joint action to
curb terrorism and insurgency within and across their national boundaries.
It will be recalled that President
Jonathan and the Heads of State and Government of the neighbouring countries of
Niger, Chad, Cameroon and Benin Republic resolved at a meeting in Paris in May
this year to intensify joint efforts to curtail terrorism and violent
At the Paris Summit hosted by
President Francois Hollande of France in the aftermath of the dastardly
abduction of the Chibok College girls, President Jonathan and
neighbouring heads of state and government also agreed to establish joint
anti-terrorism patrols and a system of sharing intelligence to
support operations against terrorists and other cross-border criminals.
They likewise agreed to create a
dedicated team to draw up and advise on the implementation ofa regional counter-terrorism
strategy under the framework of the Lake Chad Basin Commission.
Benin Republic, which participated in
the Paris Summit but is not a member of the Lake Chad Basin Commission, has
been invited to the Niamey talks.
The Lake Chad Basin Commission was
established in 1964 by Nigeria, Chad, Niger and Cameroon with the mandate of
sustainably and equitably managing shared water resources of
the Lake Chad Basin and promoting regional integration, peace and security
across the Basin.
President Jonathan who will be
accompanied to Niamey by the Minister of Foreign Affairs, Ambassador Aminu
Wali, the Minister of State for Defence, Senator Musiliu Obanikoro, the Chief
Of Defence Staff, Air Chief Marshall Alex Barde and other senior government
officials will return to Abuja at the conclusion of the one-day summit.
How would you like to be
the assistant to a MAJOR Hollywood producer? You can get the job now by
going online. You will receive a job offer and an assignment ... that
will ultimately screw you out of thousands of dollars, thanks to Nigerian fraudsters.
Here's the fraud by
the numbers ...
-- People who want
to break into Hollywood post resumes on various websites. Some of them
get an email from people claiming to be major Hollywood players, looking for an
"players" -- who actually register Gmail accounts using the names of
the actual big shots -- offer jobs to the super-eager applicants from all over
"players" give the applicants a start date and a first assignment, to
get their feet wet.
"players" actually send the applicants a check to deposit -- usually
for $3,000 -- and then purchase pre-loaded debit cards. The applicants
are told to send the cards to several charities near and dear to the
-- But since the
applicants haven't even had their first day of work, the "players"
tell them to snap a photo of the debit cards with the numbers to prove they
followed instructions correctly ... kind of a test.
-- The applicants
then dutifully send the pics and the "players" then execute the fraud
by draining the cards with online shopping.
So, by the time the
charity gets the cards the account is dry.
As for the checks
... well, they look like the real deal, but they're fake. So by the time
your bank figures out the scam, the money is spent and you're on the hook.
We've confirmed the
names of 2 big wigs are being used ... famed directorLouis Leterrierand
big-time producerAlex Orlovsky-- he madeRyan Gosling.
Islamic militants in Iraq have created slave
markets, trading and
selling women and children of Christian and Yazidi groups, according to UN investigators.
At least 2,500 women
and children have been imprisoned, sexually abused and sold for around $10
each by Isis slavers.
to the International Business Times,The
slave markets in the al-Quds area of Mosul in Iraq and Raqqa in Syria have been
used as a way of attracting new recruits to Islamic State, the UN
said according to a Times report.
Women who were
captured at the end of August managed to contact the UN, having kept hold of
their mobile phones. They reported being subject to sexual assaults
One 13-year-old Yazidi
girl gave a harrowing account of what happened to her after she was abducted by
Isis from her village on 3 August.
"She stated that
ISIL [Islamic State] took hundreds of women who had not been able to flee to
Jabal Sinjar,""The girl stated that she was raped several times by several ISIL
fighters, before she was sold to a market."
One Yazidi woman was
given to 10 Islamic State men.
"We were sold for
$10 or $12. Who could accept that behaviour? Can God accept that?" the
woman told Euronews. "It's a shame to rape a woman, but when she is raped
by 10 men... what is this? They are animals, they are not humans. Because of them I am afraid all the
She managed to flee
her captors with the help of sympathetic local residents and sought safety in
A 17-year-old woman
said she was being held captive with 40 other Yazidi women by Islamic State
fighters.The newspaper was able to interview her by calling her on her mobile
phone, after being given the number by her parents, who are in a refugee camp in Iraqi
"I beg you not to
publish my name because I'm so ashamed of what they are doing to me. There's a
part of me that just wants to die. But there is another part of me that still
hopes that I will be saved and that I will be able to embrace
my parents once again,"
We've asked our
jailers to shoot us dead, to kill us, but we are too valuable for them. They
keep telling us that we are unbelievers because we are non-Muslims and that we
are their property, like war booty. They say we are like goats bought at a