HEALTH : eath Toll From Ebola in W. Africa Hits 887: WHO

The doctor who treated a man who flew to Nigeria and died of Ebola now
has contracted the disease, authorities said Monday, presenting a dire
challenge to Africa's most populous nation as the regional toll for
the outbreak grew to 887 dead.

As Nigerian health authorities rushed to quarantine others who had
been exposed, a special plane left Liberia to evacuate the second
American missionary who fell ill with Ebola. Nancy Writebol, 59, is
expected to arrive in Atlanta on Tuesday, where she will be treated at
a special isolation ward.
The second confirmed case in Nigeria is a doctor who treated Patrick
Sawyer, the Liberian-American man who died July 25 days after arriving
in Nigeria from Liberia, said Nigerian Health Minister Onyebuchi
Chukwu.

Three others who also treated Sawyer now show symptoms of Ebola and
their test results are pending, he said.
Authorities are trying to trace and quarantine others in Lagos,
sub-Saharan Africa's largest city of 21 million people.
"This cluster of cases in Lagos, Nigeria is very concerning," said Dr.
Tom Frieden, director of the U.S. Centers for Disease Controls and
Prevention, which is dispatching 50 experienced disease control
specialists to West Africa.
"It shows what happens if meticulous infection control, contact
tracing, and proper isolation of patients with suspected Ebola is not
done. Stopping the spread in Lagos will be difficult but it can be
done," he said.
The World Health Organization announced Monday that the death toll has
increased from 729 to 887 deaths in Guinea, Sierra Leone, Liberia and
Nigeria.

Cases in Liberia jumped from 156 to 255, WHO said, as the government
ordered that all Ebola victims must now be cremated because of rising
opposition to burials in neighborhoods around the capital. Over the
weekend, police were called in amid a standoff over whether health
authorities could bury nearly two dozen victims in a neighborhood on
the outskirts of the capital, Monrovia.
Sierra Leone marked a national stay-at-home day Monday in an effort to
halt the disease's spread.

A documentary film of the first outbreak of the Ebola disease in Congo
was being shown intermittently throughout the day by the national
broadcaster.
The emergence of a second case in Nigeria raises serious concerns
about the infection control practices there, and also raises the
specter that more cases could emerge.
It can take up to 21 days after exposure to the virus for symptoms to appear.
They include fever, sore throat, muscle pains and headaches. Often
nausea, vomiting and diarrhea follow, along with severe internal and
external bleeding in advanced stages of the disease.

"This fits exactly with the pattern that we've seen in the past.
Either someone gets sick and infects their relatives, or goes to a
hospital and health workers get sick," said Gregory Hartl, World
Health Organization spokesman in Geneva.
"It's extremely unfortunate but it's not unexpected.
This was a sick man getting off a plane and unfortunately no one knew
he had Ebola."
Doctors and other health workers on the front lines of the Ebola
crisis have been among the most vulnerable to infection as they are in
direct physical contact with patients.
The disease is not airborne, and only transmitted through contact with
bodily fluids such as saliva, blood, vomit, sweat or feaces.
Sawyer, who was traveling to Nigeria on business, became ill while
aboard a flight and Nigerian authorities immediately took him into
isolation upon arrival in Lagos.
They did not quarantine his fellow passengers, and have insisted that
the risk of additional cases was minimal.

Nigerian authorities said a total of 70 people are under surveillance
and that they hoped to have eight people in quarantine by the end of
Monday in an isolation ward in Lagos.
Tracking down all the people who came into contact with Sawyer and his
caregivers could prove difficult at this late stage, said Ben Neuman,
a virologist and Ebola expert at Britain's University of Reading.

"Contact tracing is essential but it's very hard to get enough people
to do that," he said.
"For the average case, you want to look back and catch the 20 to 30
people they had closest contact with and that takes a lot of effort
and legwork ...
The most important thing now is to do the contact tracing and
quarantine any contacts who may be symptomatic."

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Paye-Layleh reported from Monrovia, Liberia.
Associated Press Medical Writer Maria Cheng reported from London.
Krista Larson in Dakar, Senegal; Clarence Roy-Macaulay in Freetown,
Sierra Leone; and Maram Mazen in Lagos, Nigeria contributed to this
report.