The U.S. Centers for Disease Control and Prevention has issued its highest-level alert for a response to the Ebola crisis in West Africa.

Ops Center moved to Level 1 response to given the extension to Nigeria & potential to affect many lives, CDC chief Tom Frieden said Wednesday on Twitter.

Level 1 means that increased staff and resources will be devoted to the outbreak, officials said. It is the first time the agency has invoked its highest level alert since 2009, over a flu outbreak.

Meantime, a Nigerian nurse who had treated the country's first fatality from Ebola two weeks ago has died from the virus that has now claimed more than 900 lives in the latest outbreak, Nigerian health officials said.

The World Health Organization, which convened a two-day emergency meeting of global health workers to discuss the crisis in Guinea, Liberia, Nigeria and Sierra Leone, said Wednesday that the death toll had jumped to 932, an increase of 45 fatalities in just four days.

Next week, the WHO will convene a panel of medical ethicists to explore the use of experimental treatment in the latest outbreak in West Africa.

In a statement on Wednesday, the WHO noted that the recent use of experimental drugs to treat two American medical missionaries has raised questions on whether drugs that have never been tested on humans should be used and, if so, who should receive it when there is only an extremely limited amount.

The two Americans, Kent Brantly and Nancy Writebol, have been repatriated from Liberia and are being treated for Ebola at the Emory University Hospital in Atlanta.

In New York, Mount Sinai Hospital said a patient placed in isolation since Monday does not have an Ebola infection, as feared. The patient is in stable condition and improving, a statement from the hospital said.

In Nigeria, health officials said five other Nigerian health workers who also had treated American Patrick Sawyer have been diagnosed with the disease. Sawyer, a financial expert of Liberian descent who lives in Minnesota, died July 25 after arriving in Lagos on a flight from Liberia.

Meanwhile, a Saudi man being tested for the disease has died in Jeddah after returning from Sierra Leone on Sunday, according to Saudi health authorities.

If the Saudi death is found to be linked to the Ebola virus, it would be the first fatality outside the four West African countries during the latest outbreak, the Saudi Health Ministry says.

In Liberia late Wednesday, President Ellen Johnson Sirleaf declared a state of emergency because of the Ebola outbreak, saying some civil rights may have to be suspended as a result of the crisis. At least 282 people in Liberia have died from the disease.

In her televised speech, Sirleaf said that ignorance and poverty, as well as entrenched religious and cultural practices, continue to exacerbate the spread of the disease.

Earlier, Nigerian health minister, Onyebuchi Chukwu, speaking to reporters in the capital, Abuja, confirmed the death of the Nigerian nurse on Tuesday and said the five newly diagnosed cases are being treated at an isolation ward in Lagos, The Guardian reports.

Lagos health officials also acknowledged that Sawyer was not initially isolated after becoming ill because authorities did not know immediately that he had contracted the Ebola virus.

There is no known cure for Ebola. Experts say people infected with the virus can spread the disease only through their bodily fluids and after they show symptoms. Since the incubation period can last up to three weeks, some of the Nigerians who treated Sawyer are only now showing signs of illness that can mimic many common tropical illnesses fever, muscle aches and vomiting.

In April, Saudi Arabia said it would not issue visas this year to Muslim pilgrims from Sierra Leone, Liberia and Guinea during the hajj pilgrimage to Mecca.

Saudi Ambassador in Guinea Amjad Bedaiwi was quoted in the Saudi Arab News Wednesday as saying the decision affects a total of 7,400 pilgrims from those three countries.

Meanwhile, Spain was sending a specially equipped plane to Liberia to pick up a 75-year-old Spanish missionary priest, Miguel Pajares, and two nuns who have tested positive for the virus.

The three had worked at St. Joseph's Catholic hospital, which was shut down following the death last week from Ebola of Patrick Nshamdze, the hospital's director. Three other hospital staff members have been diagnosed with the disease.

In Washington, President Obama pledged international support for the countries affected by the Ebola outbreak in remarks at the U.S.-Africa summit.

The United States and our international partners will continue to do whatever we can to help our African partners respond to this crisis and stand with the people of Guinea, Liberia and Sierra Leone, he said.

The CDC released the following press release on Wednesday:

The Centers for Disease Control and Prevention (CDC) is rapidly increasing its ongoing efforts to curb the expanding West African Ebola outbreak and deploying staff to four African nations currently affected: Guinea, Sierra Leone, Liberia, and Nigeria.

The outbreak began in March 2014 in Guinea and spread to the neighboring countries of Liberia and Sierra Leone. It recently spread to Nigeria through a traveler from Liberia. On Aug. 5, the CDC issued an Alert Level 2 Travel Notice for travelers to Nigeria, notifying travelers to the area to practice careful hygiene and avoid contact with blood and body fluids of people ill with Ebola. A Warning Level 3 Travel Notice remains in effect for Guinea, Liberia, and Sierra Leone advising people to avoid nonessential travel to these countries.

CDC s 24/7 mission is to prevent, detect, and stop disease outbreaks wherever they occur and to protect America s health by improving public health both at home and abroad. CDC has contributed to the World Health Organization s (WHO) efforts to control the Ebola outbreak in West Africa since the start of the outbreak. CDC now is taking a more active role, and has been invited by WHO to provide leadership on the technical front. The CDC has activated its Emergency Operations Center to its highest response level.

The bottom line with Ebola is we know how to stop it: traditional public health. Find patients, isolate and care for them; find their contacts; educate people; and strictly follow infection control in hospitals. Do those things with meticulous care and Ebola goes away, said CDC Director Tom Frieden, M.D., M.P.H. To keep America safe, health care workers should isolate and evaluate people who have returned from Guinea, Liberia, and Sierra Leone in the past 21 days and have fever or other symptoms suggestive of Ebola. We will save lives in West Africa and protect ourselves at home by stopping Ebola at the source.

CDC is rapidly sending more disease-control experts to the four nations currently reporting cases. As CDC announced last week, 50 additional disease control experts will be in the region within 30 days. Some staff have completed their deployments and are rotating out of country but overall staff numbers are increasing. As of Monday Aug. 4, CDC staff deployments are:
Guinea: 6 currently deployed,
Liberia: 12 currently deployed
Nigeria: 4 currently deployed
Sierra Leone: 9 currently deployed
This sustained, agency-wide response will continue until the outbreak is under control, an effort expected to take three to six months.

In West Africa, CDC disease detectives are directing efforts to pinpoint cases and their contacts using a new tool developed at CDC. This Epi Info viral hemorrhagic fever (VHF) application speeds up one of the most difficult parts of disease detection: finding everyone exposed to the virus. Other CDC experts will educate the general public about how to avoid Ebola infection; ensure that healthcare personnel strictly follow protocols that protect them against infection; strengthen laboratory aspects of the response; and improve communications among all stakeholders (the public, patients and their families, healthcare workers, governments and non-government organizations, and the media).

CDC efforts are not confined to West Africa. At home, CDC has updated infection-prevention protocols for hospitals where travelers with suspected Ebola exposures may present for treatment; for aircraft crew and airport personnel; and for laboratories handling specimens from suspected Ebola cases.

U.S. hospitals can safely manage patients with Ebola disease. The key factors are isolation of patients, diligent environmental cleaning and disinfection, and protection of healthcare providers. Providers in U.S. hospitals should wear gloves, fluid resistant/impermeable gown, and eye protection. In certain situations involving copious body fluids, additional equipment may be needed (for example, double gloving, disposable shoe coverings, and leg coverings). CDC has posted detailed infection prevention and control recommendations.

Going forward, President Obama s FY 2015 budget requests $45 million for CDC to build global health security capacity by helping other nations prevent, detect, and stop disease outbreaks such as Ebola.

Related links:

Centers for Disease Control: 2014 Ebola Outbreak information and updates

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