Group to consider clinical trials to fight Ebola outbreak

State of emergency declared in Liberia, army blockade set up in Sierra Leone

A Liberian soldier is deployed to restrict the movement of Liberians traveling from Bomi County to the capital Monrovia as a measure to try to curb the spread of the deadly Ebola virus. Photograph: Ahmed Jallanzo/EPA
A Liberian soldier is deployed to restrict the movement of Liberians traveling from Bomi County to the capital Monrovia as a measure to try to curb the spread of the deadly Ebola virus. Photograph: Ahmed Jallanzo/EPA

The Obama administration is forming a special Ebola working group to consider setting policy for the potential use of experimental drugs to help the hundreds infected by the deadly disease in Africa, an official said today.

The group will include scientists and other officials from such government health agencies as the National Institutes of Health and the Centers for Disease Control and Prevention, said Dr Anthony Fauci, director of NIH‘s National Institute of Allergy and Infectious Diseases (NIAID).

The army blockaded rural areas hit by the deadly Ebola virus in Sierra Leone today, a senior officer said, after neighbouring Liberia declared a state of emergency to tackle the worst-ever outbreak of the disease, which has killed 932 people.

A Liberian nurse wearing protective clothing during the removal and burial of an Ebola victim in the Virginia community on the outskirts of Monrovia, Liberia. Photograph: Ahmed Jallanzo/EPA
A Liberian nurse wearing protective clothing during the removal and burial of an Ebola victim in the Virginia community on the outskirts of Monrovia, Liberia. Photograph: Ahmed Jallanzo/EPA

Worried Liberians queued at banks and stocked up on food in markets in the ramshackle capital Monrovia while others took buses to unaffected parts of the West African country after president Ellen Johnson-Sirleaf announced the powers lasting for 90 days late yesterday.

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The state of emergency allows Liberia’s government to curtail civil rights and to deploy troops and police to impose quarantines on badly affected communities to contain an epidemic that has struck four west African nations.

“Everyone is afraid,” civil servant Cephus Togba told Reuters by telephone. “Big and small they are all panicking. Everyone is stocking up the little they have.“

With troops setting up checkpoints outside Monrovia on the way to some of the worst-hit towns, Johnson-Sirleaf said the state of emergency was necessary for “the very survival of our state and for the protection of the lives of our people”.

In Geneva, World Health Organization (WHO) experts were due to hold a second day of meetings to agree on emergency measures to tackle the highly contagious virus and whether to declare an international public health emergency.

After a trial drug based on the tobacco plant was administered to two U.S. charity workers infected in Liberia, Ebola specialists have urged the WHO to offer Africans the chance to take such experimental drugs. The UN agency has asked medical ethics experts to explore this option next week.

Many in Liberia - a nation founded by the descendants of freed American slaves, whose capital is named after former US president James Monroe - look to the United States in time of crisis, as they did during a 1989-2003 civil war that killed nearly a quarter of a million people.

“We need help from America. We need help,” said Nancy Poure, a small trader in the suburb of Johnsonville. “This is the beginning of hardship. Ninety days of fear and suffering.”

Among the most deadly diseases known to man, Ebola kills up to 90 per cent of those infected, causing internal and external bleeding, diarrhoea and vomiting in its final stages. Discovered in Democratic Republic of Congo in 1976, near the Ebola river, it is believed to be carried to the west of the continent by fruit bats, which are eaten as a delicacy in the region.

Fears for Lagos

Though most cases are in the remote border area of Guinea, Sierra Leone and Liberia, alarm over Ebola’s spread grew last month when a US citizen died in Nigeria of the virus after arriving from the region.

A nurse who treated Patrick Sawyer has now also died in Lagos and at least five other people have been isolated with symptoms, raising fears of an outbreak in the city of 21 million people, Africa’s largest metropolis.

A hospital in the capital of Benin is treating a Nigerian man suspected of having contracted Ebola and a sample of his blood has been sent to Senegal for testing, health minister Dorothe Gazard said on state television today.

The case is unconfirmed but Ms Gazard’s announcement triggered widespread fears in Cotonou. Many people said they would stock up on food and stop eating at popular roadside food stalls to avoid possible infection.

In Saudi Arabia, a man suspected of contracting Ebola during a recent business trip to Sierra Leone died yesterdayin Jeddah. Major airlines, such as British Airways and Emirates, have halted flights to affected countries, while many expatriates are leaving.

In eastern Sierra Leone - the worst-hit area of the country - the police chief said security forces deployed last night “to establish a complete blockade” of Kenema and Kailahun districts, setting up 16 checkpoints on major roads.

“No vehicles or persons are allowed into or out of the districts,” Alfred Karrow-Kamara told Reuters, saying the measures would last for an initial 50-day period.

Traders who had registered with security agencies would be able to bring in food and medicines. Security forces would mount foot patrols to ensure civilians did not slip past their road-blocks through the bush.

Hospital closed

In Liberia, where the death toll is rising fastest, authorities yesterday shut a Monrovia hospital after its Cameroonian director died of Ebola and six other staff tested positive, including two nuns and a 75-year-old Spanish priest.

Miguel Pajares, the first European infected, was in a stable condition in a Madrid hospital after being repatriated with his co-worker, nun Juliana Bohi, today. The two were escorted by police out-riders on their arrival in Madrid to the Carlos III hospital, which cleared its entire sixth floor for their treatment.

The Liberian military deployment - Operation White Shield - is expected to be fully in place by tomorrow, officials said. In the chaotic, ocean-front capital, residents greeted the announcement with fear and concern, though the precise details of the emergency powers have not yet been made public.

Liberian authorities have said they are willing to authorise in-country clinical trials of experimental drugs. However, US president Barack Obama said he lacked enough information to approve their use, adding that Ebola could be controlled with a strong public health response.

Lacking the medical equipment and training to handle the new disease, some 32 health workers had already died of Ebola in Liberia and many sick people were going untreated after doctors deserted their posts, Johnson-Sirleaf said.

The outbreak is costing its war-scarred economy millions of dollars as airlines cancel flights. Schools across the country were shut last week and non-essential government workers sent home.

Ebola has now been reported in eight of Liberia’s 15 counties and the only two treatment centres - in northern Lofa County and Montserrado County near Monrovia - are unable to cope. In other areas, patients are simply being kept in improvised holding centres, aid workers say.

Reuters