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Obama to seek more funds to fight Ebola - Bloomberg

WASHINGTON (Reuters) - President Barack Obama is preparing to ask Congress for additional funding to fight the Ebola virus, Bloomberg reported on Saturday, citing White House and congressional officials.

Obama could make the request as early as next week, the congressional official told Bloomberg. Both officials declined to say how much additional funding Obama would seek, the report said.

White House spokesman Josh Earnest told reporters on Friday that Obama had not made any decisions about whether additional resources were necessary.

The U.S. government now has more than $1 billion available to fight the spread of Ebola from three West African countries, where it has killed more than 4,500 people.

Obama, who has been criticized by Republicans for the administration's handling of Ebola, urged Americans on Saturday not to give in to "hysteria" about the spread of the virus.

Three people have been diagnosed with Ebola in the United States and more than 100 are being monitored for possible signs of the disease. One of those diagnosed, a Liberian man who travelled to Dallas, Texas from his home country in late September, died last week.

(Reporting by Eric Beech; Editing by Grant McCool)

Oxfam urges more troops to stop Ebola 'disaster'

Ebola could become the "definitive humanitarian disaster of our generation", the aid agency Oxfam warned on Saturday, as it issued a call for more troops, funding and medical staff to be sent to west Africa.

The appeal was targeted at EU foreign ministers meeting in Luxembourg on Monday, and came as British Prime Minister David Cameron urged fellow European leaders to step up their collective action against the deadly virus.

"The Ebola crisis could become the definitive humanitarian disaster of our generation," said a spokesperson for the British-based charity, which is working to reduce the impact of Ebola in Sierra Leone and Liberia.

Oxfam admitted it was "extremely rare" for it to urge military intervention but said that troops had the logistical expertise and capacity to respond quickly in great numbers.

Chief executive Mark Goldring added: "We are in the eye of a storm. We cannot allow Ebola to immobilise us in fear, but instead we must move toward a common mission to stop it from getting worse.

"Countries that have failed to commit troops, doctors and enough funding are in danger of costing lives.

"The speed and scale of the intervention needed is unprecedented. Only a concerted and coordinated global effort will stop the spread."

Cameron also urged EU leaders meeting on Thursday and Friday in Brussels to commit more funds and staff to the fight against Ebola, and to increase coordination on screening at ports of entry to Europe.

British officials say the total contribution from the EU so far is 500 million euros ($640 million) -- of which almost 160 million euros is from Britain -- and Cameron said this should be doubled to one billion euros.

"The Ebola outbreak in west Africa is an issue that requires a substantial global response," the prime minister wrote, adding that "much more must be done".

He said EU leaders should "commit to an ambitious package of support to help reduce the rate of transmission in west Africa, to reduce the risk of transmission within Europe, and to pledge long-term support to assist with recovery, resilience and stability in the region".

Cameron also proposed the EU mobilise at least 2,000 workers to go to the region, including 1,000 clinical staff, by the middle of November.

Britain's contribution, which includes 750 troops, is focused on fighting Ebola in its former colony Sierra Leone.

Ebola lapses persisted for days at Dallas hospital

DALLAS (AP) — Just minutes after Thomas Eric Duncan arrived for a second time at the emergency room, the word is on his chart: "Ebola." But despite all the warnings that the deadly virus could arrive unannounced at an American hospital, for days after the admission, his caregivers are vulnerable.

The Centers for Disease Control and Prevention has pointed to lapses by the hospital in those initial days. And Duncan's medical records show heightened protective measures as his illness advanced. But either because of a lag in implementing those steps or because they were still insufficient, scores of hospital staffers were put at risk, according to the records.

The hospital's protective protocol was "insufficient," said Dr. Joseph McCormick of the University of Texas School of Public Health, who was part of the CDC team that investigated the first recorded Ebola outbreak in 1976. "The gear was inadequate. The procedures in the room were inadequate."

Duncan's medical records, provided by his family to The Associated Press, show Nina Pham, the first Texas nurse to be diagnosed with Ebola, first encountered the patient after he was moved to intensive care at 4:40 p.m. on Sept. 29, more than 30 hours after he came to the ER. Nearly 27 hours later, Amber Joy Vinson, a second nurse who contracted the disease, first appears in Duncan's charts.

Because doctors and nurses are focused on logging the patient's care, they may not always note their own safeguards in the medical records. In Pham's first entry, she makes no mention of protective gear. When she logs again the following morning, she specifically mentions wearing a double gown, face shield and protective footwear, equipment she mentions again in later entries.

In the first apparent mention of Vinson — identified by just her first name in another nurse's notes — she is said to have worn personal protection, including a hazardous-materials suit and face shield.

It's unclear whether those initial interactions with Duncan represent the time at which a breakdown in protection led to the infections, or whether such lapses persisted during the remainder of the patient's 11-day stay. At least 70 workers are named in the records as being involved with Duncan's care in that period.

Dr. Tom Frieden, the CDC director, told lawmakers during a congressional hearing Thursday that he did not know how the nurses got infected, only that "possible causes" had been identified.

In comments a day earlier, he gave a clue: "For the first several days of the patient's stay, before he was diagnosed, we see a lot of variability in the use of personal protective equipment."

Because Ebola has an incubation period of up to 21 days, those who cared for Duncan at the start of his second hospital stay will not be considered safe from infection until Monday. Those with him at the time of his death will not emerge from monitoring until Oct. 30.

Duncan first arrived at Presbyterian on Sept. 25 but was sent home. When he returned by ambulance at 10:07 a.m. on Sept. 28, he was sicker and probably more contagious. Staff noted immediately upon his intake that he had recently arrived from Liberia.

Five minutes later, a nurse notes that he is in a room and had "put on airborne precautions." Nine minutes after that, Duncan is seen by a doctor who writes that Ebola is a possibility and notes that he "followed strict CDC protocol" by being "masked, fully gowned and gloved" when treating Duncan.

The doctor makes no mention of eye protection such as goggles or a face shield, which are considered basic equipment in Ebola guidelines issued by the CDC. There is also no initial mention of foot coverings, which are suggested when such patients have diarrhea or vomiting, as Duncan did, according to the records.

It is also not clear when Duncan was safely isolated, though the records refer to him being in an "isolation room" in the ER on Sept. 29.

Numerous entries in the records of Duncan's stay at the hospital — both in the ER and later in intensive care — make note of precautionary measures. Many other entries are silent on the issue, and the mention of hazardous-material suits does not appear in Duncan's records until after his diagnosis is confirmed on Sept. 30.

Hospital officials say Duncan was immediately put in isolation in a private room and that staff adhered to CDC guidelines on protective gear, even though those guidelines changed during the course of Duncan's stay.

"The CDC guidelines changed frequently, and those changes were frustrating," hospital spokesman Wendell Watson said.

Dr. Victoria Sutton, a member of Texas Gov. Rick Perry's newly appointed infectious-disease task force, said the issue was not protocols, but preparation.

"I think the problem is there wasn't enough time to do training," she said.

The hospital has denied the allegations of several of its nurses who anonymously aired concerns through a statement issued by the National Nurses United union. Among their complaints: that Duncan was kept for hours in an area of the emergency department where seven other patients could have been exposed; that a nurse supervisor faced resistance from higher-ups when she said he should be moved to an isolation unit; and that even after the patient was isolated, hospital workers came and went from his bedside without proper protection, then walked through halls that were not properly cleaned.

"If any of those allegations — let alone more than one — are correct, if they are valid, then obviously his whole hospitalization put health care workers at risk," said Dr. William Schaffner, an infectious-disease specialist at Vanderbilt University Medical Center.

A half-dozen doctors and nurses make notes in Duncan's chart during the first 24 hours of his stay in the ER. As his first night at the hospital fades into the following morning, his condition worsens. A doctor notes he is suffering and deteriorating. At one point, he asks for a diaper because he's too exhausted to get up.

The records do not reveal what happened once hospital staffers left Duncan's bedside. Walking through the hallways, interacting with other staff and patients, removing protective gear and any other physical motions — even as seemingly minor as rubbing an eye or scratching an itch — before being properly sanitized could have led to further infections.

___

Associated Press writers Jamie Stengle and Martha Mendoza contributed to this report.

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Follow Matt Sedensky on Twitter at https://twitter.com/sedensky

Congo lends a hand to fight Ebola, urges African solidarity

By Aaron Ross

KINSHASA (Reuters) - Democratic Republic of Congo plans to train more than 1,000 volunteers to help fight an Ebola epidemic raging across West Africa, even as it battles the last traces of an outbreak at home.

Having endured six previous outbreaks of the deadly virus in 40 years, Congolese officials say they are eager to share their expertise with countries suffering from the worst epidemic in history, which has already killed more than 4,500 people.

Congo's Health Minister Felix Kabange said he hoped to inspire "African solidarity" in the Ebola fight and invited other countries to send volunteers to new training centers in the capital Kinshasa.

The World Health Organisation has criticized African countries for closing borders to Ebola countries, saying this has worsened their suffering by cutting off supplies.

"We have seen how the international community mobilized by deploying the means to intervene in West Africa. But Congo said, Africa has to mobilise," Kabange told Reuters. "We have made here what we call African solidarity in action," he said.

An initial workshop, run in collaboration with the U.N. children's fund UNICEF, the World Health Organisation and Johns Hopkins University, began this week to prepare 56 public health experts to train other volunteers who may ultimately be sent to Guinea, Liberia and Sierra Leone.

The programme aims to teach some 1,057 volunteers -- all of them health professionals -- although some could stay behind to contain Ebola locally.

A recruitment drive has already begun in Kinshasa to assemble an initial pool of 600 volunteers to start training at the end of the month, according to Susie Villeneuve, a senior health specialist for UNICEF.

Three teams of 30 could be ready for deployment to West Africa by as early as mid-November, she said.

"There is a capacity that exists in this country for fighting this illness," said Barbara Bentein, UNICEF representative in Congo.

Congo already sent a five-man medical team to Liberia in August to help support the country's health workers who have been badly hit by the virus.

BUILDING TRUST

Experts say that local suspicions of healthworkers has expedited the transmission of West Africa's first Ebola outbreak, which began in the forests of Guinea last December and then spread to Liberia and Sierra Leone.

Unlike past outbreaks in Congo, the West Africa epidemic quickly spread to densely populated urban centers, prompting governments to apply controversial emergency measures such as community quarantine in Liberia and a lockdown in Sierra Leone.

Kabange said Congo had succeeded in containing the country's past outbreaks through building trust with affected communities by working closely with local political and traditional leaders.

"We say everyday that as long as the community does not take charge of itself, does not participate itself in the fight against Ebola, Ebola won't be stopped," the minister said.

The deadly hemorrhagic fever was first detected in the dense tropical forests of Congo in 1976. Scientists named the illness after the nearby river Ebola.

The latest outbreak in Congo was thought to have started in August in the remote northern Equateur province after a hunter brought home an infected bush animal carcass. Since then, 49 people have died in the province among 69 cases.

But there has been a two-week lull in new confirmed cases, with the last one reported on Oct. 4. The outbreak could be declared over by the health ministry by mid-November if no additional cases are confirmed.

(Writing by Emma Farge and David Lewis; Editing by Crispian Balmer)

Canada to ship experimental Ebola vaccine to WHO in Geneva

TORONTO (Reuters) - The Canadian government will ship 800 vials of its experimental Ebola vaccine to the World Health Organization in Geneva beginning on Monday, the Public Health Agency of Canada said on Saturday.

The WHO, in consultation with health authorities in the countries most affected by the outbreak of the disease, will decide on how the vaccine will be distributed and used, the agency said in a statement.

The vaccine is undergoing clinical trials on humans at Walter Reed Army Institute of Research in the United States after showing promising results in animal testing, it said.

The Canadian government said in August it would donate between 800 and 1,000 doses of its VSV-EBOV vaccine to the WHO for use in Africa, but the vaccine remained in a government lab as Canadian and WHO officials grappled with logistical and ethical issues.

The vaccine was developed at Canada's National Microbiology Laboratory in Winnipeg, Manitoba.

The Canadian government has said that because the vaccine is experimental, it is not sure exactly how many people could be immunized or treated with the amount being shipped.

The vaccine vials are being sent to Geneva in three separate shipments, as a precautionary measure, as the vaccine must kept at a very low temperature at all times, the Canadian government said.

Iowa-based NewLink Genetics Corp holds the commercial license for the Canadian vaccine and said in August that it would be able to produce tens of thousands of vaccine doses within a month or two.

Canada, where there are no documented Ebola cases, will retain roughly a third of the vaccine for its own needs.

The Ebola outbreak, which was first confirmed in March, is the largest on record and has killed more than 4,500 people, most of them in the West African countries of Liberia, Sierra Leone and Guinea.

President Barack Obama urged Americans on Saturday not to give in to "hysteria" about the spread of the virus. Three Ebola cases have been diagnosed in the United States and dozens of people are being monitored in case they contract the illness.

(Reporting By Jeffrey Hodgson; Additional reporting by Frank McGurty in New York and Rod Nickel in Winnipeg; Editing by Raissa Kasolowsky)

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