'No apology' over Ashya King search





















Naveed King









A video clip posted on YouTube before the couple were arrested showed Mr King explaining why they had travelled to Spain








Police say they will not apologise for the way they conducted a search for a five-year-old boy with a brain tumour, who was removed from a UK hospital by his parents against medical advice.

Ashya King was found in Malaga, Spain on Saturday following an international search. His parents have been arrested.

In a video posted on YouTube, Ashya’s father, Brett King, said there had been a “ridiculous chase”.

Hampshire Police said medical advice was that Ashya was in “grave danger”.

Southampton General Hospital said the family had been offered a second opinion over Ashya’s condition.
















Assistant Chief Constable Chris Shead of Hampshire Constabulary









Assistant Chief Constable Chris Shead: “We had to act on warnings”








Assistant Chief Constable of Hampshire Police Chris Shead said: “I make no apology for being as proactive as possible in trying to find him.

“I’d much rather be standing here facing criticism over being proactive than do nothing and explain why a child has lost his life.”

Following the discovery of the family, Ashya was taken to hospital in Malaga. He has since been moved from a high dependency to a lower dependency unit.


Ashya King's parents arriving at a court in Velez MalagaAshya’s parents arrived by police car at a court near Malaga

Mr King and his wife Naghemeh have not been charged with any offence in Spain.

The couple are expected to appear in court in Madrid on Monday where a judge will consider grounds for their extradition to the UK.

On Sunday evening, they were driven by police to a court in Velez Malaga, 30 miles east of Malaga city.

They were believed to be speaking to a judge who would decide whether they would travel to Madrid that evening.

As they left, Mr King told the BBC: “We just want the best for Ashya.”


‘Very angry’

Speaking after Mr Shead’s comments, Ashya’s paternal grandmother, Patricia King, told the BBC she thought the five-year-old would be better off staying in Spain.
















Ashya King






Ashya’s grandmother describes her anger over the events surrounding her grandson








She said she was “very, very angry” at the way the investigation had been handled, saying: “It has been taken too far – much too far,” with Ashya now separated from his parents following their arrest.

Ms King, who lives in Southsea, said the experience had been “terrible” for Ashya’s parents.

In the YouTube video, Mr King said he and his wife were seeking a treatment for Ashya that he had not been offered.

He said they wanted Ashya to have proton beam radiotherapy – a treatment that targets tumours directly – because they did not want him to be “pelted with radiation”.


Ashya King Ashya is being treated in a Spanish hospital

Mr King said the couple had “pleaded” with Southampton General Hospital for Ashya to receive the treatment, but were told it would have “no benefit whatsoever”.

Responding to the claims made in the video, a spokesman for the hospital said: “Our priority has always been Ashya’s welfare and we are delighted that he has been found.

“Throughout Ashya’s admission we have had conversations about the treatment options available to him and we had offered the family access to a second opinion, as well as assistance with organising treatment abroad.”

The charity Cancer Research UK says proton beam treatment is available on the NHS in the UK only for eye conditions.

However, in some circumstances the NHS will pay for patients to go abroad for proton treatment.


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What is proton beam therapy?

  • It uses charged particles instead of X-rays to deliver radiotherapy for cancer patients
  • The treatment allows high energy protons to be targeted directly at a tumour, reducing the dose to surrounding tissues and organs
  • In general, it gives fewer side-effects compared to high energy X-ray treatments
  • It can be used to treat spinal cord tumours, sarcomas near the spine or brain, prostate cancer, lung cancer, liver cancer and some children’s cancers
  • In December 2011, the UK Department of Health said that proton therapy will be made available for patients in London and Manchester from 2018

Sources: NHS England, Cancer Research UK


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Police officers from Hampshire have travelled to Spain to “assist the Spanish officers in the extradition proceedings”, Mr Shead said.

The Foreign Office is assisting the family, he added.

The couple had travelled to Spain, where they own a property, in order to raise money for Ashya’s treatment elsewhere.

Are you affected by the issues in this story? You can share your experiences by emailing haveyoursay@bbc.co.uk






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Heart drug launch could be 'most exciting ever', says Novartis

The logo of Swiss drugmaker Novartis is seen at its headquarters in Basel October 22, 2013.   REUTERS/Arnd Wiegmann

The logo of Swiss drugmaker Novartis is seen at its headquarters in Basel October 22, 2013.

Credit: Reuters/Arnd Wiegmann


(Reuters) – The expected launch of Novartis’s new heart failure drug next year promises to be the company’s most exciting ever and profit margins on the medicine will be good, its head of pharmaceuticals said on Sunday.

The Swiss drugmaker impressed doctors at the European Society of Cardiology meeting in Barcelona at the weekend by unveiling strikingly good clinical trial results for the drug, known as LCZ696, in a keenly awaited clinical trial.

Investigators working on the study and the company itself believe it has potential to replace drugs that have been central to treating heart failure for a quarter of century, opening up a multibillion-dollar sales opportunity.

“It will be possibly the most exciting launch the company has ever had,” David Epstein told an investor meeting.

The profitability of the drug would also be higher than Novartis achieved when its blockbuster hypertension medicine Diovan was still patent-protected, since the cost of marketing LCZ696 will be lower. That reflects the more specialized nature of heart failure, which requires a smaller sales force.

As a result, LCZ696 should become profitable relatively quickly, though Novartis will be investing to ensure a strong launch. Epstein said he did not expect any increase in the overall sales force because staff would be switched from promoting some older drugs.

In a research note issued by investment bank Leerink on the back of the strong trial results, analyst Seamus Fernandez said that LCZ696 could rack up annual sales of $6-8 billion, with further upside in emerging markets and from new indications.

The study unveiled in Barcelona targeted heart patients with reduced ejection fraction, where the heart muscle does not contract effectively. However, Novartis is also starting a trial in a similar-sized group with preserved ejection fraction, where the ventricles do not relax as they should.

(Reporting by Ben Hirschler; Editing by David Goodman)

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Study raises concerns over Servier, Amgen heart drug


(Reuters) – A major clinical study has raised concerns about a drug from private French company Servier that helps lower the heart rate and which was licensed to U.S. group Amgen last year.

Ivabradine is not currently approved in the United States but it is sold in Europe for treating stable angina, or chest pain due to obstruction of heart arteries, and for heart failure, when the heart fails to pump blood effectively.

Although lowering the heart rate is seen as good for both conditions, a 19,000-patient study presented on Sunday at the European Society of Cardiology congress found a large group of patients with severe activity-limiting angina did worse on the drug.

The SIGNIFY trial had been designed to show that adding ivabradine to standard therapy would be beneficial. The negative result in the sub-group of 12,000 patients with severe angina meant it failed.

The increase in the combined risk of cardiovascular death and heart attack in this patient group was small but statistically significant, with 7.6 percent of them suffering an adverse event against 6.5 percent of those on placebo.

A commentary in the New England Journal of Medicine, where the results were also published, said more research was needed to understand the finding and in the meantime doctors should “exercise caution” in using the drug in severe angina patients.

The European Medicines Agency said in May it had launched a review into the safety of the medicine, which is sold under the brand name Procoralan, because of the signal from the SIGNIFY trial. But the detailed results have only now been released.

The agency could decide to maintain, amend, suspend or withdraw its approval for the drug.

Servier said at the time it had informed all relevant regulators about the findings and would update doctors as soon as the European agency made a decision.

Amgen, which signed a deal in July 2013 for U.S. commercial rights to ivabradine, last week won a priority review for the drug as a treatment for chronic heart failure from the U.S. Food and Drug Administration.

It is unclear what impact, if any, the SIGNIFY results might have on this heart failure application. Amgen officials were not immediately available to comment.

(Reporting by Ben Hirschler; Editing by Hugh Lawson)

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Celebration in Liberia slum as Ebola quarantine lifted


(Reuters) – Crowds sang and danced in the streets of a seaside neighborhood in Liberia on Saturday as the government lifted quarantine measures designed to contain the spread of the deadly Ebola virus.

Faced with the worst Ebola outbreak in history, West African governments have struggled to find an effective response. More than 1,550 people have died from the hemorrhagic fever since it was first detected in the forests of Guinea in March.

Residents of the impoverished seaside district of West Point in Monrovia were forcibly cut off from the rest of the capital in mid-August after a crowd attacked an Ebola center there, allowing the sick to flee.

The quarantine sparked protests and security forces responded with tear gas and bullets, killing a teenaged boy.

But at dawn on Saturday, the community woke up to find the soldiers and barricades gone.

“I tell God thank you. I tell everyone thank you,” said Koffa, a female resident of West Point. Others danced in the streets chanting slogans like “we are free” while others rolled about on the asphalt pavement in celebration.

President Ellen Johnson-Sirleaf, a U.S.-educated Nobel Peace Prize winner, has sought to quell criticism of the government’s response by issuing orders threatening officials with dismissal for failing to report for work or for fleeing the country, and has ordered an investigation into the West Point shooting.

Liberia, where infection rates are highest, plans to build five new Ebola treatment centers each with capacity for 100 beds, government and health officials said on Saturday.

In neighboring Sierra Leone, President Ernest Bai Koromo dismissed his health minister Miatta Kargbo on Friday over her handling of the epidemic which has killed more than 400 people there.

Her replacement Abubakarr Fofana on Saturday confirmed that a third doctor in the county had died from Ebola, further hampering its ability to respond to the outbreak.

“It is with a deep sense of sadness that we have lost one of our finest physicians in the line of duty at a time like when we need a lot of them to help in out fight against Ebola,” he said.

Physician Dr. Sahr Rogers caught the disease while treating outpatients in the same hospital where a doctor died last month and where British nurse William Pooley was also infected.

SPREAD TO SENEGAL

Transmitted through the vomit, blood and sweat of the sick, Ebola has also spread to Nigeria and Senegal, which reported its first confirmed case on Friday – a Guinean student who was lost to authorities in his own country while under surveillance.

“His brother came from Sierra Leone where he was infected and has died. Shortly afterwards, this student left for Senegal,” said Dr. Rafi Diallo, spokesman for the Guinean health ministry.

Two other members of his family – his sister and mother – have died from Ebola, Guinean health ministry sources said.

A resident in the suburb of the Senegalese capital Dakar where the student resided said on Saturday that a team of health ministry officials wearing white protective suits and masks came to spray disinfectant at his home and a local grocer’s shop.

Many Dakar residents worry that the student could have spread the highly contagious virus in the three weeks since he was last reported in Guinea.

In Nigeria, where an infected traveler collapsed after arriving the Lagos airport, there have so far been 19 suspected, probable and confirmed cases and seven deaths.

“To avoid a situation like Nigeria, they need to be able to follow hundreds of contacts,” said epidemiologist Jorge Castilla of the European Commission’s Humanitarian Aid and Civil Protection Department in Dakar. “Whatever they do, there will probably be a second set of sick people as this guy has been here for some time.”

Senegal has since closed its land border with Guinea and halted flights to Guinea, Sierra Leone and Liberia, defying advice from the World Health Organization (WHO) that there is no need for travel restrictions.

A note from the WHO and the International Civil Aviation Organization sent to health ministries on Aug. 29 said: “Lives are being unnecessarily lost because health care workers cannot travel to the affected countries, and delivery of life saving equipment and supplies is being delayed.”

The World Food Programme said it needs to raise $70 million to feed 1.3 million people at risk from shortages in the Ebola-quarantined areas in West Africa, with the agency’s resources already stretched by several major humanitarian crises.

(Additional reporting by Umaru Fofana, Diadie Ba and Emma Farge; Writing by Emma Farge; Editing by Rosalind Russell)

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Test Ebola drug '100% effective'








By James Gallagher
Health editor, BBC News website


Ebola virus

The only clinical trial data on the experimental Ebola drug ZMapp shows it is 100% effective in monkey studies, even in later stages of the infection.

The researchers, publishing their data in Nature, said it was a “very important step forward”.

Yet the limited supplies will not help the 20,000 people predicted to be infected during the outbreak in West Africa.

And two out of seven people given the drug, have later died from the disease.

ZMapp has been dubbed the “secret serum” as it is still in the experimental stages of drug development with, until now, no public data on effectiveness.

Doctors have turned to it as there is no cure for Ebola, which has killed more than 1,500 people since it started in Guinea.


Cocktail

Researchers have been investigating different combinations of antibodies, a part of the immune system which binds to viruses, as a therapy.

Previous combinations have shown some effectiveness in animal studies. ZMapp is the latest cocktail and contains three antibodies.

Trials on 18 rhesus macaques infected with Ebola showed 100% survival.

This included animals given the drug up to five days after infection. For the monkeys this would be a relatively late stage in the infection, around three days before it becomes fatal.


William PooleyWilliam Pooley, from the UK, has been given the ZMapp drug

Scientists say this is significant as previous therapies needed to be given before symptoms even appeared.

One of the researchers, Dr Gary Kobinger from the Public Health Agency of Canada, said this was a huge step up from previous antibody combinations.

“The level of improvement was beyond my own expectation, I was quite surprised that the best combination would rescue animals as far as day five, it was fantastic news.

“What was very exceptional is that we could rescue some of the animals that had advanced disease.”


Human implications?

However, there is always caution when interpreting the implications for humans from animal data.

A Liberian doctor, one of three taking the drug in the country, and a Spanish priest both died from the infection despite ZMapp treatment.

William Pooley, the first Briton to contract Ebola during this outbreak, has been given the experimental drug ZMapp as were two US doctors who recovered.

The course of the infection is slower in humans than macaques so it has been cautiously estimated that ZMapp may be effective as late as day nine or 11 after infection.

But Dr Kobinger said: “We know there is a point of no return where there is too much damage to major organs, so there’s a limit.”

The group wants to start clinical trials in people to truly assess the effectiveness of the drug.


Ebola health workers in LiberiaThe drug is unlikely to help the 20,000 people expected to be infected

Commenting on the findings, Prof Jonathan Ball, a virologist at the University of Nottingham, told the BBC: “Before, ZMapp was a total mystery.

“This is an incredible improvement on those earlier cocktails, to have 100% clearance and most importantly that clearance when they’ve started to show outward signs of infection.”

Referring to the seven treated patients, he added: “Clearly there is the caveat that all evidence in humans is anecdotal and no hard evidence has been released on what happens to the virus in those patients.”

Prof Peter Piot, the director of the London School of Hygiene and Tropical Medicine, said: “I never thought that 40 years after I encountered the first Ebola outbreak, this disease would still be taking lives on such a devastating scale.

“This well designed trial in non-human primates provides the most convincing evidence to date that ZMapp may be an effective treatment of Ebola infection in humans.

“It is now critical that human trials start as soon as possible. “


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Ebola Virus Disease (EVD)

  • Symptoms include high fever, bleeding and central nervous system damage
  • Spread by body fluids, such as blood and saliva
  • Fatality rate can reach 90% – but current outbreak has mortality rate of about 55%
  • Incubation period is two to 21 days
  • There is no vaccine or cure
  • Supportive care such as rehydrating patients who have diarrhoea and vomiting can help recovery
  • Fruit bats, a delicacy for some West Africans, are considered to be virus’s natural host

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Post-natal care lacking, say midwives








Woman and her baby in hospitalIn a survey of midwives, most said women do not receive the post-natal care they need


A survey by the Royal College of Midwives suggests that up to 40% of women may be being discharged from hospital before they are ready after having a baby.

The report, entitled Postnatal care planning, says the needs of women and babies after birth are not being met.

More midwives are required to ensure women get the post-natal visits they need, the RCM says.

Surveys of mothers and midwives were used to compile the report.

The RCM surveyed more than 2,000 midwives, 950 student midwives and 98 maternity support workers to find out their views on post-natal care.

Sixty-five per cent of midwives surveyed said the number of post-natal visits was determined by organisational pressures rather than women’s needs.

This is contrary to official guidelines from the National Institute for Health and Care Excellence (NICE), the RCM says.


‘Massive impact’

Cathy Warwick, chief executive of the Royal College of Midwives, said this had an impact on the care women received.

“The continuing shortage of midwives particularly in post-natal care and the need to ensure cover for women in labour means that organisational needs are preventing midwives giving care based on clinical need and women are not getting the best possible post-natal care.

“This can have a massive impact on the health and well-being of the mother and her baby after the birth and well into the future.”

Midwives also say that there is often not enough time to give women all the information they would like to about post-natal care.

In the survey, only a third of midwives and maternity support workers said they had enough time to talk to women about their post-natal care.

The report also highlights the views of nearly 500 women in the UK who were surveyed via the Netmums website in 2013. Around 40% felt they had been discharged too quickly, a figure the RCM described as “a real concern”.

NICE recommends that the “length of stay in a maternity unit should be discussed between the individual woman and her healthcare professional, taking into account the health and well-being of the woman and her baby and the level of support available following discharge”.

Cathy Warwick said: “We are seeing women being discharged earlier without adequate support. This leads to readmissions later on and more cost to the NHS.

“This is a false economy. It is not good for women and babies and it is not good for the NHS.”

The report is the fourth in a five-part series from the Royal College of Midwives looking at post-natal care.

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Ebola outbreak reaches Senegal, riots break out in Guinea

Health workers wearing protective clothing prepare to carry an abandoned dead body presenting with Ebola symptoms at Duwala market in Monrovia August 17, 2014. REUTERS/2Tango


(Reuters) – The West African state of Senegal became the fifth country to be touched by the world’s worst Ebola outbreak on Friday, while riots broke out in neighboring Guinea’s remote southeast where infection rates are rising fast.

In the latest sign that the outbreak of the virus, which has already killed at least 1,550 people, is spinning out of control, the World Health Organisation (WHO) said that Ebola cases rose last week at the fastest pace since the epidemic began in West Africa in March.

The epidemic has defied efforts by governments to control it, prompting the leading charity fighting the outbreak, Medicins Sans Frontieres, to call for the U.N. Security Council to take charge of efforts to stop it.

Including the fatalities, more than 3,000 have been infected since the virus was detected in the remote jungles of southeastern Guinea in March, and quickly spread across the border to Liberia and Sierra Leone. It has also touched Nigeria where six people have died.

Senegal’s first case is a student from Guinea.

Senegalese Health Minister Awa Marie Coll Seck said the man turned up for treatment at a hospital in the capital Dakar on Tuesday, concealing the fact that he had had close contact with victims in his home country. Tests at the Pasteur Institute in Dakar showed he had the disease.

“We are tracing his whole itinerary and also identifying anyone who had contact with the patient, who now that he has been diagnosed is much more cooperative and supplied all the necessary information,” the minister said.

A Health Ministry official, who asked not to be named, said that the 21-year-old crossed into Senegal via its southern border with Guinea and had been living in the densely populated Dakar suburb of Parcelles Assainies for three weeks. He added that the man appeared to have a good chance of recovering.

The man had been under surveillance by health authorities in Guinea because of his contact with Ebola victims but escaped to Senegal, Seck said.

Residents in Dakar reacted with anger and concern. “When you are sick, why do you leave your own country to export the disease to another?” asked radio host Taib Soce on RFM, a popular station owned by Senegalese music star Youssou N’dour.

In an attempt to prevent the spread of the virus, Senegal last week banned flights to and from three of the affected countries and shut its land border with Guinea.

The country, a regional hub for U.N. agencies and aid groups, has also refused to give clearance for U.N. aid flights to Ebola-hit countries in a move that humanitarian workers say is hampering their ability to respond to the epidemic.

CATASTROPHE WARNING

The director of the United States Centers for Disease Control (CDC) warned on Friday of a “catastrophe” if emergency action were not taken immediately to reverse the trend of rising cases.

“There is time to avoid a catastrophe but only if immediate and urgent action is taken at every level,” Tom Frieden said in the Sierra Leone capital Freetown.

The World Health Organization (WHO) said on Thursday that the actual number of Ebola cases could be up to four times higher than reported and said 20,000 people in total could be infected before the outbreak ends.

In the remote southeastern Guinean city of Nzerekore, riots broke out on Thursday night over rumors that health workers had infected people with Ebola, a Red Cross official and residents said.

The government of Guinea says it has the epidemic under control, but the number of cases has flared up in southern Guinea, a trend the government blames on people spilling over the borders from Liberia and Sierra Leone.

A crowd of young men, some armed with clubs and knives, set up barricades across Nzerekore on Thursday and threatened to attack the hospital before security forces moved in to restore order. Gunshots were fired and several people were injured, said Youssouf Traore, president of the Guinean Red Cross.

“A rumor, which was totally false, spread that we had sprayed the market in order to transmit the virus to locals,” Traore said. “People revolted and resorted to violence, prompting soldiers to intervene.”

Local Red Cross workers had to flee to the military camp with their medical equipment. Another resident said the security forces were preventing people leaving their neighborhoods overnight. More than 400 people have died in Guinea, though the infection rate is slower than in Liberia and Sierra Leone.

FINANCIAL SUPPORT

The WHO, on Thursday, unveiled a $490 million road map to bring the outbreak under control over the next nine months.

The International Monetary Fund (IMF) has said it may give more support to affected countries. “We’re working on a financing package subject to the approval of the IMF Executive Board to help Liberia along with Guinea and Sierra Leone mitigate any socio-economic impacts of the epidemic,” IMF Liberia representative Charles Amo-Yartey said on Friday.

Scientists reported on Friday that in tests the experimental Ebola drug ZMapp had cured all 18 lab monkeys infected with the virus.

In Freetown, a new WHO-backed mobile laboratory opened this week, speeding up the time needed to test suspected cases.

But often financial pledges have not translated into more clinics and staff on the ground, said Jorge Castilla, epidemiologist with the European Commission’s Humanitarian Aid and Civil Protection Department.

“I’ve seen many declarations, I see treatment centers on the maps but I know they are not working,” he said in an interview after a trip to the affected countries.

Suspicion of healthcare workers has dogged government responses to the Ebola outbreak across West Africa.

Frightened by the sight of healthcare workers clad from head to toe in plastic protective gear and wearing protective masks, many locals have shunned their assistance, often preferring to die in their own homes.

So far, more than 120 healthcare workers have died in the epidemic. Liberia reported five new cases of infection among them in a single day this week.

(Additional reporting by Emma Farge in Dakar, James Giahyue Harding in Monrovia and Umaru Fofana in Freetown; Writing by Emma Farge; Editing by Daniel Flynn and Susan Fenton)

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West Africa Ebola outbreak could infect 20,000 people, WHO says

Volunteers prepare to remove the bodies of people who were suspected of contracting Ebola and died in the community in the village of Pendebu, north of Kenema July 18, 2014.  REUTERS/WHO/Tarik Jasarevic


(Reuters) – The Ebola epidemic in West Africa could infect over 20,000 people and spread to more countries, the U.N. health agency said on Thursday, warning that an international effort costing almost half a billion dollars is needed to overcome the outbreak.

The World Health Organisation (WHO) announced a $490 million strategic plan to contain the epidemic over the next nine months, saying it was based on a projection that the virus could spread to 10 further countries beyond the four now affected – Guinea, Liberia, Sierra Leone and Nigeria.

With the IMF warning about the economic effects of the outbreak, Nigeria reported that a doctor indirectly linked to the Liberian-American who brought the disease to the country had died of Ebola in Port Harcourt, Africa’s largest energy hub.

In Britain, drugmaker GlaxoSmithKline said an experimental Ebola vaccine is being fast-tracked into human studies and it plans to produce up to 10,000 doses for emergency deployment if the results are good.

So far 3,069 cases have been reported in the outbreak but the WHO said the actual number could already be two to four times higher. “This is not a West African issue or an African issue. This is a global health security issue,” WHO’s Assistant Director-General Dr Bruce Aylward told reporters in Geneva.

With a fatality rate of 52 percent, the death toll stood at 1,552 as of Aug. 26. That is nearly as high as the total from all recorded outbreaks since Ebola was discovered in what is now Democratic Republic of Congo in 1976.

The figures do not include deaths from a separate Ebola outbreak announced at the weekend in Congo, which has been identified as a different strain of the virus.

Aylward said tackling the epidemic would need thousands of local staff and 750 international experts. “It is a big operation. We are talking (about) well over 12,000 people operating over multiple geographies and high-risk circumstances. It is an expensive operation,” he said.

The operation marks a major raising of the response by the WHO, which had been accused by some aid agencies of reacting too slowly to the outbreak.

Medical charity Medecins sans Frontieres (MSF) welcomed the WHO plan but said the important thing was now to act upon it.

“Huge questions remain about who will implement the elements in the plan,” said MSF operations director Brice de le Vingne. “None of the organizations in the most-affected countries … currently have the right set-up to respond on the scale necessary to make a serious impact.”

EXPERIMENTAL DRUGS

Early this month, the WHO classified the Ebola outbreak as an international health emergency. Concerns that the disease could spread beyond West Africa have led to the use of drugs still under development for the treatment of a handful of cases.

Two American health workers, who contracted Ebola while treating patients in Liberia, received an experimental therapy called ZMapp, a cocktail of antibodies made by tiny California biotech Mapp Biopharmaceutical. They recovered and were released from hospital last week.

The virus has already killed an unprecedented number of health workers and is still being spread in a many places, the WHO said. About 40 percent of the cases have occurred within the past 21 days, its statistics showed.

Previous Ebola outbreaks have mainly occurred in isolated areas of Central Africa. However the current epidemic has spread to three West African capitals and Lagos, Africa’s biggest city. The WHO said special attention would need to be given to stopping transmission in capital cities and major ports.

Authorities in Nigeria announced the doctor’s death in Port Harcourt, the main oil industry terminal of Africa’s largest crude exporter. The doctor had treated a patient who evaded quarantine after coming into contact with Patrick Sawyer – a U.S. citizen who died in Lagos after flying in from Liberia last month.

Health Ministry spokesman Dan Nwomeh wrote in his Twitter feed that 70 people were now under surveillance in Port Harcourt, which is home to foreigners working for international oil companies.

A spokesman for leading operator Royal Dutch Shell said in London that the firm was “liaising with health authorities on the steps being taken to contain the disease”.

Oil traders in Europe said insurance premiums for Nigerian cargoes had gone up slightly, but otherwise business was continuing as normal.

Analysts urged caution. “While major disruption to oil production appears unlikely, any further spread of Ebola … is likely to cause serious operational challenges,” said Roddy Barclay of the Control Risks consultancy.

According to new figures released on Thursday, Nigeria has recorded 17 cases, including six deaths, from Ebola, since Sawyer collapsed upon arrival at Lagos airport in late July.

While Nigeria has yet to suffer any major economic disruption, the International Monetary Fund said the smaller, poorer nations at the heart of the epidemic were being badly hurt. “The Ebola outbreak is having an acute macroeconomic and social impact on three already fragile countries in West Africa,” IMF spokesman Gerry Rice told reporters in Washington.

Rice said the IMF was assessing the impact and any extra financing needs with Guinea, Liberia and Sierra Leone.

AID EFFORT CHOKED OFF

The Lagos case contributed to the decision by a number of airlines to halt services to Ebola-affected countries. Air France said on Wednesday it had suspended flights to Sierra Leone on the advice of the French government.

Aylward said it was vital to restore commercial airline routes to the region to help transport aid workers and supplies, but in the meantime the WHO plan includes an “air bridge” to be operated by the U.N.’s World Food Program.

“We assume current airline limitations will stop within the next couple of weeks. This is absolutely vital,” he said. “Right now the aid effort risks being choked off.”

West African health ministers meeting in Ghana on Thursday echoed the WHO’s concerns and called for the reopening of borders and an end to flight bans.

(Additional reporting by Kwasi Kpodo in Accra, Ben Hirschler and Julia Payne in London, Anna Yukhananov in Washington and Sharon Begley in New York; Writing by Joe Bavier; Editing by Daniel Flynn and David Stamp)

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Genetic clues to spread of Ebola








By Helen Briggs
Health editor, BBC News website


Augustine Goba, laboratory director at Kenema Government Hospital Lassa fever laboratoryExperts at Kenema Government Hospital in Sierra Leone have been monitoring the outbreak

Scientists have tracked the spread of Ebola in West Africa, revealing genetic clues to the course of the outbreak.

Genetic analysis of patient samples suggests the virus spread from Guinea to Sierra Leone at a single funeral.

The virus is mutating and must be contained rapidly, warn African and US experts. But they say there is no evidence the virus is changing its behaviour.

The current outbreak is the largest ever, with more than 3,000 cases.

The number of cases could exceed 20,000 before the outbreak is stemmed, according to the World Health Organization.

“We’ve uncovered more than 300 genetic clues about what sets this outbreak apart from previous outbreaks,” said Stephen Gire from the Broad Institute and Harvard University in the US.


A picture of the isolation ward at Kenema Government Hospital in Kenema, Sierra LeoneThe isolation ward at Kenema Government Hospital in Kenema, Sierra Leone

“Although we don’t know whether these differences are related to the severity of the current outbreak, by sharing these data with the research community, we hope to speed up our understanding of this epidemic and support global efforts to contain it.”

The data, published in Science, suggests the virus made the leap from animals to humans only once in the current outbreak.

The strain emerged in Central Africa in the past 10 years, probably carried by animals such as fruit bats or primates.

The first human cases appeared in Guinea, then the disease spread to Sierra Leone, reportedly at the funeral of a traditional healer.

There is evidence the virus is mutating, “underscoring the need for rapid containment”, the team writes in Science.

“The longer the outbreak happens, the more opportunity the virus has to accumulate mutations,” Dr Gire told the BBC.

But he said there was no evidence at present that the virus was changing its behaviour and becoming better adapted to humans.

Commenting on the research, Prof Jonathan Ball, a virus expert at Nottingham University, said: “Clearly this virus is evolving, but what’s not clear is whether or not the mutations it’s accumulating affect the way it behaves.”

The genetic samples came from 78 patients at a hospital in Sierra Leone who were infected in May and June.

These were compared with existing virus samples from Guinea.

Five of the 58 experts named on the paper died from Ebola in Sierra Leone during the study.

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