11-7-2014 Updates

It’s been too quiet here. Complete Media Blackout. Try to share this with as many people so we aggregate our knowledge!

No Ebola in Akron, Ohio : http://www.vindy.com/news/2014/nov/06/ohio-ends-its-ebola-monitoring/

Last person in Dallas Cleared of Ebola: http://www.washingtonpost.com/news/post-nation/wp/2014/11/06/the-last-person-connected-to-the-texas-ebola-patients-will-be-cleared-friday/

1 Unconfirmed Case in Iowa: http://whotv.com/2014/11/06/one-person-in-iowa-quarantined-monitored-for-ebola-symptoms/

 

 

Ebola Virus Disease Electron Micrograph

Ebola countries to get $450 million in financing

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UNITED NATIONS (AP) — A new private sector initiative announced Wednesday will provide at least $450 million in commercial financing to the three West African countries hardest hit by Ebola to promote trade, investment and employment.

The International Finance Corporation, which is part of the World Bank Group, announced that the package will include $250 million in rapid response projects and at least $200 million in investment projects to support the economic recovery of Liberia, Sierra Leone and Guinea after the Ebola outbreak is controlled.

The announcement coincides with the U.N. Development Program’s release of a study on the socio-economic impact of the outbreak, which found that the governments of the three countries need $328 million to be able to function at pre-crisis levels. The study said the shortfalls are caused by increased spending to tackle Ebola and the slowdown of economic activity in fields such as tourism, mining and trade.

“Ebola is a humanitarian crisis first and foremost, but it’s also an economic disaster for Guinea, Liberia and Sierra Leone,” World Bank President Jim Yong Kim said in a statement. “That’s why in addition to our emergency aid, we will do all we can to help support the private sector in these countries to build back their business.”

IFC, the largest global development institution that focuses exclusively on the private sector, said its initiative includes a $75 million Ebola Emergency Liquidity Facility to fund critical imports for the Ebola-affected countries, including energy, food and agricultural commodities and manufactured goods.

IFC said its board approved the rapid response program last week. It will initially be available to six IFC client banks and could be expanded to additional banks.

Jin Yong Cai, IFC executive vice president and CEO, said the corporation “will find and create opportunities to encourage private investors to play a large role in the recovery of markets directly and indirectly affected by the ongoing Ebola outbreak in West Africa.”

The UNDP study found that because of Ebola, government expenses have risen about 30 percent in Liberia, Sierra Leone and Guinea, and fiscal deficits in the three countries are rising. In addition, Liberia has sacrificed $20 million worth of infrastructure improvements and Sierra Leone has sacrificed $16 million worth since the beginning of the crisis, it said.

In Liberia, half the mining and agricultural concessions have reduced their activities, UNDP said. In northeast Guinea, exports of fruit and vegetables to neighboring countries have dropped 90 percent, and in Sierra Leone’s capital, Freetown, nearly all bars, restaurants and nightclubs have closed. That has forced the country’s largest brewery to scale down operations, culminating in a loss of 24,000 jobs in the supply chain.

The financial constraints have forced the three countries to resort to domestic and international borrowing, and they have already taken financial packages from the International Monetary Fund and the World Bank, UNDP said.

UNDP’s Africa regional director, Abdoulaye Mar Dieye, said the crisis has taken a toll on budgets and reduced the ability of the three governments to invest in critical areas such as health and education.

“We need to make sure that the Ebola outbreak does not lead to socio-economic collapse,” Dieye said in a statement. “These countries were heavily reliant on aid but beginning to see healthy rates of economic growth and opportunities for business, economic diversification and domestic resource mobilization. We need to avoid a situation where these countries increase their dependence on external sources of financing.”

Ebola Virus Disease Electron Micrograph

Ebola: Sierra Leone hit by lack of treatment units

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FREETOWN, Sierra Leone (AP) — The 7-year-old boy’s family and friends are praying over his body when the men in yellow protective suits, face shields and masks arrive. The boy had died at his home in Freetown. This same day, the collection team goes into a house for the body of another Ebola victim. Family members scream in grief as the workers put the corpse into a black body bag and carry it on a stretcher down a dirt path.

These victims, seen in video released by an international charity, died in their homes because Sierra Leone is desperately short of Ebola treatment centers more than five months after the virus came to the impoverished West African country. Of the three countries hardest hit, the epidemic is currently infecting more people in Sierra Leone.

In the past 21 days there have been 1,174 new Ebola cases in Sierra Leone, almost triple the 398 new cases in Liberia and more than quadruple the 256 new cases in Guinea, according to figures released Wednesday by the World Health Organization.

While Sierra Leone accounts for almost two-thirds of new cases, there are only an estimated 400 beds in Ebola treatment units in the whole country. The international community is slowly responding but many more lives will be lost before the level of assistance approaches the need.

“Patients are being turned away from hospitals, reducing their chance of survival and allowing the disease to spread,” said Justine Greening, Britain’s international development secretary. She spoke as the first of six treatment centers to be built by Britain was opened Wednesday outside Freetown, the capital.

The total capacity of the 80-bed facility, built of framing covered by white material, will be phased in over coming weeks. On the first day, two males and one girl, who all tested positive for Ebola, were admitted, said Helen Mayelle, a spokeswoman for Save the Children which is managing the unit in Kerry Town.

The rise of new cases in Sierra Leone is particularly startling because its population of 6 million is about half the size of Guinea’s 12 million. Liberia, with the smallest population of the three countries with 4.2 million people, has been hardest hit overall, suffering more than half the estimated 4,800 deaths in the outbreak.

Ebola, for which there is no licensed treatment, is spread through contact with bodily fluids. About 70 percent of people who get Ebola have died in this outbreak.

In September, Doctors Without Borders turned a cassava field near Bo, Sierra Leone’s second-largest city, into a tented treatment center.

Treatment centers have also been erected in hospitals and a police training school run by Sierra Leonean officials, said Dr. Sarian Kamara of the health ministry. One was just completed in Port Loko, Kamara said. That district, in the northwest, has had among the highest number of Ebola cases at 563, the National Ebola Response Center reported Thursday.

Reported cases in two districts in and around Freetown are surging with a total of 1,261.

Video provided by Concern Worldwide, an international humanitarian organization managing 10 burial teams in Freetown and its suburbs, shows the human toll. After a yellow-suited collection team left with a body, some inconsolable family members collapsed in the mud, their screams sounding throughout the tree-studded neighborhood.

Dr. Bruce Aylward, in charge of WHO’s Ebola operational response, said that until more Ebola care facilities are built, “there’s a basic standard of care which we can try to provide at the community level that will markedly improve the ability of most people to survive, or a substantial portion of people to survive.”

That involves providing a minimum amount of protective gear and teaching how to avoid getting infected, he said.

In neighboring Liberia, Doctors Without Borders has distributed more than 50,000 family protection and home disinfection kits and plans to hand out 20,000 more.

More people should have access to treatment centers, but the disinfection kits are needed for now “because of the weak international response to Ebola,” the group said. Doctors Without Borders started the campaign in Liberia when the situation was dire in its capital, said group member Sophie-Jane Madden.

USAID and UNICEF have also distributed thousands of kits in Liberia. CARE International has distributed hygiene packs to 1,100 households in Sierra Leone, including soap and buckets fitted with taps.

Justin Forsyth, CEO of Save the Children, was recently in Sierra Leone. He said he is proud that his organization has worked with British organizations and its army to build and run the new center in Kerry Town.

“But we know we need to redouble our efforts if we are to get ahead of this crisis,” he said. “We are in a life and death race against time.”

___

Selsky reported from Johannesburg. AP journalists Maria Cheng in London and Sarah DiLorenzo in Dakar, Senegal contributed to this report.

Ebola Virus Disease Electron Micrograph

A look at the worst-ever Ebola epidemic by numbers

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LONDON (AP) — As the biggest-ever outbreak of Ebola continues to ravage West Africa, here are a few key numbers to get a handle on the epidemic:

13,268 and 4,960:

According to an update Friday from the World Health Organization, there have been 13,268 Ebola cases and 4,960 deaths since the first child died of the virus in December — but those figures include all probable, suspected and confirmed cases and are subject to change as more information becomes available. The numbers fluctuate as more data becomes available, and as probable and suspected cases are either discarded or confirmed.

Experts warn the actual number of cases and deaths are likely far higher than what’s been reported, because people may be reluctant to seek care and officials are too overwhelmed with control efforts to record every single case. The vast majority of patients are in Guinea, Sierra Leone and Liberia.

Cases and deaths are typically only recorded days after people become symptomatic or die, which complicates a real-time understanding of Ebola.

“We are definitely getting a delayed picture of the outbreak,” said Sebastian Funk, a lecturer in infectious diseases at the London School of Hygiene and Tropical Medicine. “It’s difficult to tell if we are reaching a turning point or if there will be a doomsday scenario. I could see it going either way at the moment.”

4,707:

According to WHO, 4,707 beds are needed across West Africa in Ebola treatment clinics; at the moment, just 22 percent of the necessary number are operational. The agency estimates a further 2,685 beds are needed for basic Ebola clinics where minimal treatment is provided and people are mostly isolated while waiting for test results. At the moment, just 4 percent of beds in these community clinics are available.

Given the uncertainty around case numbers, Funk says things like bed occupancy are a good sign of how the outbreak is evolving. “We really need to see numbers go down for several weeks to be confident it’s a real trend,” he said.

549:

WHO reports that 549 health workers have been infected with Ebola, of whom 311 have died. Since Ebola is spread via contact with the bodily fluids of a patient, health workers are at high risk of catching the disease. The U.S. Centers for Disease Control and Prevention recommends that no skin be showing in a health worker treating Ebola patients.

Eight:

There are now eight countries that have reported Ebola detected on their soil: Guinea, Liberia, Sierra Leone, Mali, Nigeria, Senegal, Spain and the U.S. Other countries like Britain, France and Germany have taken in people sickened by the deadly virus in West Africa but they have not reported any spread of the virus there.

Four:

There have been four cases of Ebola diagnosed in the U.S. and a single death — Thomas Eric Duncan, the Liberian man who was the first person diagnosed with Ebola in the country, who later died at a Dallas hospital. Two cases were nurses who cared for Duncan. The fourth is a New York doctor who became sick a week after returning from West Africa.

Two:

It took two months for Britain to build and open its first Ebola treatment center in Sierra Leone this week, an 80-bed facility with a dozen other beds reserved for infected health workers. The Kerry Town clinic, near the capital, Freetown, is the first of six centers to be built by the U.K. in Sierra Leone. It includes a triage center, ambulance pads, laboratory, pharmacies and decontamination units. In about the same time that it took to build the Ebola clinic, Sierra Leone has reported more than 3,500 cases of Ebola.

One:

There is one remaining American hospitalized with Ebola, Dr. Craig Spencer in New York, a physician who worked for Doctors Without Borders in Guinea. He continues to show improvement, remains in isolation and is in stable condition.

Ebola Virus Disease Electron Micrograph

President George W. Bush Visits Nurse Who Beat Ebola

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Former President George W. Bush swung by the Dallas hospital where an Ebola patient died and two nurses were infected to congratulate a nurse who survived and voice his support for the criticized facility. Texas Health Presbyterian Hospital encountered a “tough period,” Bush said Friday, but called it “a really important institution for our city.”

Bush gave a kiss to Amber Vinson, one of two hospital nurses who contracted the deadly disease while treating a patient but later recovered. Bush told Vinson, who was declared Ebola-free on Oct. 28.

Friday at 12 a.m. marked 21 days since anyone in Texas contracted Ebola or had contact with any of the three Ebola patients, meaning the state is currently not at risk of an Ebola outbreak, stemming from the original patient.

“It’s been a tough period for Dallas,” Bush said. “It’s been a tough period for this hospital and the people who work here,” he said, expressing gratitude to the workers. Bush said he had received care at Texas Health Presbyterian Hospital, adding that it is “a really important institution for our city.”

“I guess it’s hard to say I loved my time here. But let me put it this way, if I had to be somewhere, I’m thrilled it was here,” Bush said. Vinson embraced Bush and told him she was feeling “good.”

First published November 7 2014, 6:03 PM

Ebola Virus Disease Electron Micrograph

Dallas marks Ebola end with relief, ‘selfies’ with President Bush

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(Reuters) – A relieved Dallas got the U.S. government’s all-clear on Friday from Ebola, and former President George W. Bush marked the event by visiting the hospital that was at the center of fighting the virus and the origin of an American scare over the disease.

 

“It’s official,” the Texas Department of State Health Services said in a tweet announcing the final monitoring check Friday evening of the last of the 177 people who had been considered at risk of catching the virus.

 

“No symptoms. We are happy to close this Ebola chapter with Dallas tonight,” the department said.

 

The announcement came four hours after the U.S. Centers for Disease Control and Prevention said that, as of Friday, 176 of the 177 people in Texas it had been checking for possible Ebola exposure had been cleared. They had been monitored for symptoms of Ebola for 21 days, the disease’s maximum incubation period. Ebola causes fever, vomiting, diarrhea and bleeding.

 

The Texas city’s Ebola worries began on Sept. 30 when a visiting Liberian man, Thomas Eric Duncan, was taken by ambulance to Texas Health Presbyterian Hospital, where he was diagnosed with the disease.

 

The first case on U.S. soil of the virus, in the middle of an Ebola epidemic that has killed more than 4,950 people in three poor West African countries, prompted questions about whether the U.S. government was doing enough to prevent the disease from entering the country.

 

“The last five weeks have been a trying time for the city and residents of Dallas and especially the people of Texas Health Presbyterian Hospital Dallas,” Bush told hospital staff.

 

The former president, who lives a few miles from the hospital, hugged now-Ebola-free nurse Amber Vinson, who contracted the virus after treating Duncan. He also posed for “selfies” with staff at the medical facility where he himself has underwent care.

 

No one else in Texas has contracted Ebola since nurses Nina Pham and Vinson became infected while caring for Duncan, who became ill while visiting relatives in Dallas. He died on Oct. 8. Both nurses eventually made a full recovery.

 

“Dallas is officially #Ebola free today!” Pham tweeted on Friday. “So grateful to all the doctors, nurses, and other healthcare workers that were involved in my care.”

 

Clay Jenkins, the top political official in Dallas County who was at the forefront of the region’s public health response, said the end of Ebola was like Thanksgiving coming early.

 

President Barack Obama called state and local officials, including Jenkins, on Friday to express his gratitude.

 

Obama also extended his appreciation “to the people of Dallas, whose strength and resilience helped reassure the nation,” the White House said.

 

The U.S. Ebola response became a hot-button issue in the midterm elections that ended Tuesday, even though it killed only Duncan, one of just four infected nationwide.

 

Ebola, which has ravaged Liberia, Sierra Leone and Guinea, can only be caught via bodily fluids from an infected person. It is not airborne.

 

(Additional reporting by Roberta Rampton in Washington; Writing by Jon Herskovitz; Editing by Jonathan Oatis)

 

Ebola Virus Disease Electron Micrograph

Dallas marks Ebola end with relief, ‘selfies’ with President Bush

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Former U.S. President George W. Bush (C) poses with caregivers in the Medical Intensive Care Unit at Texas Health Presbyterian Hospital in Dallas, Texas November 7, 2014.  REUTERS/Texas Health Presbyterian Hospital Dallas/Handout via Reuters

 

 

(Reuters) – A relieved Dallas got the U.S. government’s all-clear on Friday from Ebola, and former President George W. Bush marked the event by visiting the hospital that was at the center of fighting the virus and the origin of an American scare over the disease.

 

“It’s official,” the Texas Department of State Health Services said in a tweet announcing the final monitoring check Friday evening of the last of the 177 people who had been considered at risk of catching the virus.

 

“No symptoms. We are happy to close this Ebola chapter with Dallas tonight,” the department said.

 

The announcement came four hours after the U.S. Centers for Disease Control and Prevention said that, as of Friday, 176 of the 177 people in Texas it had been checking for possible Ebola exposure had been cleared. They had been monitored for symptoms of Ebola for 21 days, the disease’s maximum incubation period. Ebola causes fever, vomiting, diarrhea and bleeding.

 

The Texas city’s Ebola worries began on Sept. 30 when a visiting Liberian man, Thomas Eric Duncan, was taken by ambulance to Texas Health Presbyterian Hospital, where he was diagnosed with the disease.

 

The first case on U.S. soil of the virus, in the middle of an Ebola epidemic that has killed more than 4,950 people in three poor West African countries, prompted questions about whether the U.S. government was doing enough to prevent the disease from entering the country.

 

“The last five weeks have been a trying time for the city and residents of Dallas and especially the people of Texas Health Presbyterian Hospital Dallas,” Bush told hospital staff.

 

The former president, who lives a few miles from the hospital, hugged now-Ebola-free nurse Amber Vinson, who contracted the virus after treating Duncan. He also posed for “selfies” with staff at the medical facility where he himself has underwent care.

 

No one else in Texas has contracted Ebola since nurses Nina Pham and Vinson became infected while caring for Duncan, who became ill while visiting relatives in Dallas. He died on Oct. 8. Both nurses eventually made a full recovery.

 

“Dallas is officially #Ebola free today!” Pham tweeted on Friday. “So grateful to all the doctors, nurses, and other healthcare workers that were involved in my care.”

 

Clay Jenkins, the top political official in Dallas County who was at the forefront of the region’s public health response, said the end of Ebola was like Thanksgiving coming early.

 

President Barack Obama called state and local officials, including Jenkins, on Friday to express his gratitude.

 

Obama also extended his appreciation “to the people of Dallas, whose strength and resilience helped reassure the nation,” the White House said.

 

The U.S. Ebola response became a hot-button issue in the midterm elections that ended Tuesday, even though it killed only Duncan, one of just four infected nationwide.

 

Ebola, which has ravaged Liberia, Sierra Leone and Guinea, can only be caught via bodily fluids from an infected person. It is not airborne.

 

(Additional reporting by Roberta Rampton in Washington; Writing by Jon Herskovitz; Editing by Jonathan Oatis)

 

Ebola Virus Disease Electron Micrograph

Ebola death toll rises to 4,950 – WHO

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

Credit: Reuters/2Tango

(Reuters) – The death toll from the Ebola epidemic has risen to 4,950 out of 13,241 cases in the three worst-hit countries of West Africa, the World Health Organization (WHO) said on Friday, calling for widespread rigorous control measures to halt the virus.

 

“Case incidence is declining in some districts in Guinea, Liberia and Sierra Leone, while steep rises persist in other districts,” the United Nations agency said in a statement.

 

The latest figures to Nov. 4 reflect 132 new deaths since the last update issued on Wednesday, which was as of Nov. 2.

 

A slowdown in Liberia’s Ebola outbreak and the continued rampant rate of infection in Sierra Leone may reflect contrasting ways the two countries are dealing with burials, WHO experts said earlier on Friday.

 

Shoring up defenses in states neighboring the three countries remains critical, the WHO said. Nigeria and Senegal have stamped out outbreaks, while Mali has recorded one case.

 

“The best protective measures for non-affected countries are adequate levels of preparedness including heightened surveillance to detect and diagnose cases early and well-prepared staff and operational planning to ensure that suspect cases of Ebola are managed safely and in ways to minimize further spread,” the Travel and Transport Task Force on Ebola Virus Disease said in a separate statement issued on Friday.

 

Members include the WHO, International Civil Aviation Organization, the World Tourism Organization, International Air Transport Association, and International Maritime Organization.

 

The group said measures such as quarantine of travelers arriving from Ebola-affected countries could create a false impression of control. It could also reduce the number of health care workers volunteering to help fight the outbreak.

 

“Such measures may also adversely reduce essential trade including supplies of food, fuel and medical equipment to the affected countries,” it added.

 

The task force voiced concern at reports that medical care had been denied to sick seafarers on board ships that had previously called at ports in the Ebola-affected region.

 

(Reporting by Stephanie Nebehay; Editing by Ralph Boulton)

 

ebola_chlorinespray_monrovia_reuters

Change of Ebola pace may be reflected in burial practices

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A member of a burial team sprays a colleague with chlorine disinfectant in Monrovia October 20, 2014. The worst epidemic on record of the deadly virus Ebola has now killed more than 4,500 people in Liberia, Sierra Leone and Guinea. REUTERS/James Giahyue

A slowdown in Liberia’s Ebola outbreak and the continued rampant rate of infection in Sierra Leone may reflect contrasting ways the two countries are dealing with burials, the World Health Organization said on Friday.

Ebola victims are most infections right after death, which means that traditional West African funerals, where families often touch the bodies, can cause the disease to spread rapidly.

Pierre Formenty, the leader of the WHO’s Emerging and Epidemic Zoonotic Diseases team, said major efforts had been undertaken to make funerals safe, with more attention paid initially to Liberia than Sierra Leone.

At least 4,818 people have died in the outbreak in West Africa, but while the spread is slowing in Liberia and stable in Guinea, two-thirds of new cases in the past three weeks have been in Sierra Leone.

The Red Cross, which is leading the campaign for risk-free funerals, has conducted more than 2,200 burials in Liberia, but only 909 in Sierra Leone.

In Liberia’s capital city, Monrovia, the delay between death and burial averaged three days in August. That period has now been reduced to less than 24 hours, meaning there is much less time for exposed bodies to infect anyone.

However, it has proved more difficult to spread the notion of safe funerals in areas of Sierra Leone, where the disease is still rampant.

“Monrovia was a capital, it was easier for us to be organized compared to the west part of Sierra Leone, where there have been some delays in organizing the teams,” Formenty told a news conference.

The importance of burials to stopping Ebola was shown by the case of a traditional healer who died in Sierra Leone early in the outbreak. The WHO has said 365 cases of Ebola were later traced back to participation in her funeral.

It is the first Ebola outbreak in West Africa, meaning that people were not easily persuaded to adapt their cultural practices to fight the disease because they did not recognize the importance of doing so, experts say.

The WHO published a protocol on Friday to guide burial teams on how to conduct safe and dignified burials, with a 12-point plan that includes guidance on how to put a corpse into a body bag and sanitize the family environment afterwards.

Ebola Virus Disease Electron Micrograph

Ebola hits health care access for other diseases

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MONROVIA, Liberia (AP) — The Ebola outbreak has spawned a “silent killer,” experts say: hidden cases of malaria, pneumonia, typhoid and the like that are going untreated because people in the countries hardest hit by the dreaded virus either cannot find an open clinic or are too afraid to go to one.

Evidence of what the World Health Organization calls an “emergency within the emergency” is everywhere in Guinea, Liberia and Sierra Leone, the West African countries worst hit by the Ebola epidemic.

It can be seen in a decline in the number of kids being vaccinated for preventable diseases. It can be seen in the mother who crosses Monrovia, Liberia’s capital, searching for an open clinic that will treat her 3-year-old daughter who has a fever and is vomiting, both signs of Ebola but also of many other diseases. It can be seen at the hospital in Kissidougou, Guinea, which sees not even a tenth of the patients it used to.

It can also be seen at the hospital outside Sierra Leone’s capital run by the medical charity Emergency. It is inundated with patients because nearby hospitals are closed or only partially operating.

“There’s this incredible silent killer health crisis behind the Ebola crisis,” said Eric Talbert, the executive director of Emergency’s U.S. branch.

None of roughly a dozen experts interviewed by The Associated Press could say how many people might be sick or dying for lack of health care. Tracking the diseases that usually plague Guinea, Liberia and Sierra Leone — malaria, pneumonia, cholera and diarrhea diseases — is difficult even in the best of times. Now the countries’ already weak health systems are broken down amid the Ebola epidemic.

In July, only about half the health facilities in Liberia were reporting data to the Health Ministry. That doesn’t mean half the facilities were closed, but it shows many were at least not operating fully. Hospitals and clinics in Sierra Leone have also been forced to shut or curtail their activities.

There are signs of improvement. In Guinea, many facilities were open in September but they were waiting for patients. The hospital in Kissidougou, near where Ebola outbreak began, was seeing only 12 to 15 patients a day at the end of September, compared to the typical intake of 200 to 250 patients, said Dr. Franco Pagnoni, who at the time was WHO’s Ebola field coordinator there.

“If we don’t pay attention, we will have thousands of deaths because of Ebola, but we will have tens of thousands of deaths for other diseases,” said Pagnoni.

WHO noted simply that there are “high numbers of deaths” from other diseases.

Mariama Bary’s 3-year-old daughter risked becoming one of the fatalities. Bary took the girl around Monrovia, looking for treatment as she had a fever and was vomiting, according to SOS Children’s Villages, a charity that runs a medical center there. Bary struggled to find a clinic that was open or that would accept a child with symptoms of Ebola. She was finally able to get treatment at the SOS center, where the girl was diagnosed with malaria, the charity said.

In an effort to encourage more clinics to open and accept patients, WHO has developed a set of “no-touch” guidelines for community health workers who work in small, basic clinics. With little protective gear, they are supposed to keep their distance from patients and ask, for instance, a mother to feel her child’s forehead to see if he has a fever.

But there is no way to vaccinate someone without touching, and so vaccinators require protection. Vaccination rates have suffered at least in part because immunization campaigns — large events organized to vaccinate children who have missed their routine check-ups — have been on hold in all three countries since May. There won’t be any before the end of the year because large gatherings could serve as hotbeds for Ebola transmission.

This could have devastating effects, WHO warned recently, noting that cases of measles have been reported in Ebola-affected countries and that there is a “growing risk of significant measles outbreaks.” A full-blown outbreak could create another public health emergency.

To boost confidence in the safety of vaccination, UNICEF, the U.N. Children’s Fund, plans to provide gloves and other protective gear like gowns and face shields to all vaccinators in Liberia in the coming weeks

Docas Kollie, a 24-year-old mother, walked for three hours this week to get to the Pipeline Community Health Center for a vaccination for her 3-week-old infant. When she gave birth, it was away from the care of medical professionals.

“Because of the Ebola situation, there was no hospital for me to go to deliver. I delivered in the community,” she said.

Because the community clinic is closed in the U.N. Drive section of Monrovia, some mothers do the diagnosing themselves and get whatever they think their children need at a pharmacy.

Last week, Doctors Without Borders announced it will hand out anti-malarial medication — which can be taken either as a treatment or preventively — to families in the poorest parts of Monrovia. The group will eventually hand out enough medication for 300,000 people to treat themselves for three months. It plans a similar program in the Sierra Leone capital of Freetown. Typically, sick people would seek treatment for malaria at a clinic, but with so many facilities closed and people wary of them, the medical group wants to blanket communities with malaria protection.

Anti-malaria programs have been trying for years to get countries to test before treating malaria because giving drugs unnecessarily raises the strains will become drug-resistant. But Thomas Teuscher of Roll Back Malaria says malaria treatment has been so severely neglected amid the Ebola epidemic that even giving medication to those who might not have malaria is justified.

“We’re so concentrated on this very scary Ebola thing — because we don’t understand it, we don’t see it very often, it is just very worrisome — and so we forget about the very common things,” said Teuscher.

___

DiLorenzo reported from Dakar, Senegal. Associated Press journalist Wade Williams in Monrovia contributed to this report.