Aviation and the Ebola epidemic in West-Africa

[Passenger]

Press release Institute of Tropical Medicine - Antwerp:

ITM to carry out Ebola diagnosis in Antwerp

The Institute of Tropical Medicine in Antwerp (ITM) will carry out Ebola diagnosis in its own laboratories in Antwerp. Until now, samples of suspected Ebola cases were sent abroad. This extended the waiting time for results with 12 to 24 hours. ITM had the technical capacity to do the diagnoses already in place and now got approval by the competent Flemish and federal authorities after a thorough biosafety inspection.

The diagnoses are carried out jointly by ITM’s virology research group and its clinical laboratory. Virologists first neutralise the blood sample and then extract and isolate its genetic material. The procedure is performed in a highly secure BSL3+ laboratory (“Biosafety Level 3+”). The perfectly innocuous sample is subsequently analysed by the clinical lab using advanced molecular diagnostics. The virus is identified via multiplication and detection of part of its genetic material.

The result is available within four hours after arrival of the samples. For further study, the virus-positive samples are still sent to a specialised BSL4 laboratory in Hamburg, where the virus can be cultivated. There are no laboratories with the highest biosafety level in Belgium.

ITM already has a few BSL3 laboratories for research on HIV multiresistant tuberculosis. Its researchers have years of experience with safe working practices in these laboratories. The institute reserves a specific area to the diagnosis of Ebola with stricter safety measures, such as the use of protective gear. The Ebola virus is not cultivated or studied here.

"By carrying out the diagnosis in Belgium we can quickly confirm or exclude Ebola virus infections and therefore reassure patients, their relatives and the community almost immediately in case of false alarms. The Ebola virus was discovered here in 1976. As a national reference centre for tropical diseases, the Institute has the expertise and infrastructure needed to safely fulfill this crucial task," said Prof. Kevin Ariën, head of ITM’s Unit of Virology.

In this function ITM also has extensive knowledge and experience in diagnosing infectious diseases in general. It acts as international reference laboratory for the World Health Organization for a range of pathogens. ITM houses in total 13 reference laboratories for diseases in humans and animals.

ITM advises and informs governments, institutions and the general public, among others via a new ebola website. The recently appointed national Ebola coordinator, Dr. Erica Vlieghe, comes from its ranks.

ITM supports the fight against Ebola in West Africa in different ways. Some of its doctors, laboratory technicians and other experts work with Médecins Sans Frontières (Doctors without Borders), the European mobile lab or the World Health Organization in the affected countries. The Institute also leads a prestigious international research consortium which will assess whether treatment with antibodies in the blood of Ebola survivors could help infected patients to fight off the disease.

Q&A – Ebola diagnostics at ITM

Where do the potential Ebola samples come from?
In principle each Belgian hospital can send a sample, but most of the times it will be a specialised hospital such as the Saint-Pierre University Hospital (Brussels) or the Antwerp University Hospital.

How are the samples delivered to ITM?
The samples are delivered with a special transport for dangerous goods, also known as an “ADR transport”. The samples themselves are placed in special containers for safe transport.

How is a diagnosis made?
The samples are neutralised in all safety in in the BSL3 laboratory. In the process viral genetic material is extracted from the samples. From this moment onwards the extract is completely harmless and is analysed in the medical laboratory (a Biosafety Level 2 laboratory) using molecular techniques. If a sample is found positive, it is sent to Hamburg (Germany) for further analysis in a BSL4 laboratory (the highest safety level). Belgium does not have a BSL4 laboratory.

Is it safe to perform the diagnosis in Antwerp?
ITM has extensive knowledge and experience in diagnosing infectious diseases. Our specialized laboratory technicians do so in a secured environment, sealed off from the outside world. Furthermore, the Ebola virus is not cultivated or studied in Antwerp. This is only allowed in a BSL4 laboratory (the highest biosafety level). There are no such laboratories in Belgium.

Why is it so important to perform the diagnosis in Belgium?
ITM can make a diagnosis within 4 hours of arrival of the sample. Until now 12 to 24 hours more were needed. If we can confirm or exclude Ebola virus infections quicker, it also means that we can reassure patients, their relatives and the community sooner in case of false alarms.

Ebola diagnostics at ITM was established after exhaustive consultations with the following public authorities:
•Belgian Federal Public Service Employment, Labour and Social Dialogue
•Division of Biosafety and Biotechnology (SBB) of the Scientific Institute of Public Health (IPH)
•Department of Environment, Nature and Energy of the Flemish government

Source and language change (NL/FR):
http://www.itg.be/itg/GeneralSite/Defau ... 37&IID=393

[sn-remember]

Passenger it seems you posted this info on the wrong thread, here is more adequate ?
viewtopic.php?f=12&t=54839

[Passenger]

Passenger I think your post is on the wrong thread, should be posted here IMO
viewtopic.php?f=12&t=54839

Oh, thanks for adjusting, I indeed forgot to mention that the above was a reply to this post in this topic:

Japan has a 30 minute lab test, experimental medicine available and 47 hospitals across the country on high alert training their staff on quarantine protocols. The border quarantine is staffed and they look at you very suspiciously, ready to stop you at any suspicious sign. In the meanwhile, Belgium sends its lab tests to Hamburg for a result within 48 hours. Belgium is not ready for Ebola, believe me.

[Passenger]

Meanwhile, the discussion is brought to a new height in HLN forum, for some representing Belgium's public opinion:

quote: "De meest effectieve oplossing tegen ebola : 1 maand de grenzen sluiten, 1 maand quarantaines én honden, apen en vleermuizen neerschieten in de gevarenzone".

Translated : the most effective measure against ebola: close all borders for one month, one month of quarantine, and shoot all dogs, bats and monkeys in the risk area.

[sean1982]

Do you want me to list all stupid remarks from this forum on certain subjects?? might take a day or two.


How can you seriously have so much time on your hand to find the most stupid remarks on HLN is beyond me

[Passenger]

Do you want me to list all stupid remarks from this forum on certain subjects?? might take a day or two. How can you seriously have so much time on your hand to find the most stupid remarks on HLN is beyond me

Some people insist and persist here that newspapers like Het Laatste Nieuws and Le Soir are far more important then what medical experts say. I insist and persist that they are wrong and that only medical experts should decide on ebola. Even if there are just a few of them, against hundred forum posters. Ecample: this post: "Why not acknowledge that it is the opinion of a good many citizens, probably the majority in this country ? Belgium is not ruled by a few self-appointed "specialists".

How can you seriously have so much time on your hand to find the most stupid remarks on HLN is beyond me

Yep - I can understand that. I have that same feeling when I read all those non-events, posted by you or other Ryanair staff. The only thing we don't get here yet, is a daily health report about His Royal Highness. But then, I accept that this is a forum and that everyone is free to post whatever he thinks that is on topic. Example: this post: "Ryanair has signed a long-term deal with flight operations software provider Navtech to provide aeronautical charts and flight management system (FMS) data for use onboard its fleet of 300 Boeing 737-800s.

[airazurxtror]

Gov. Martin O'Malley, Maryland, said the Centers for Disease Control and Prevention logs all travelers going to and from West Africa into Epi-X, a national computer network that Maryland has access to so it can identify and monitor those travelers from this state.

Passengers at high risk or of some risk of Ebola infection – those with known exposure to Ebola-containing fluids, with or without protection -- will have to sign an agreement, take their own temperature four times a day, report their symptoms daily to health officials and, if necessary, stay home. Those with some risk won't be allowed to use public transportation or go to large gatherings, and they'll have to consult public health officials on any planned travel.

Those who are at low risk coming in from those countries will have to take their own temperature twice a day and talk to health officials daily.

The monitoring lasts for 21 days, which is the maximum amount of time for Ebola symptoms to set in.

About 10 to 20 passengers a day come to Maryland from Guinea, Sierra Leone and Liberia.

Read more: http://www.wbaltv.com/health/maryland-a ... z3HMvdiEVt

[airazurxtror]

RAMSTEIN AIR BASE, Germany — Ramstein officials are implementing extra precautions for personnel returning from Ebola-afflicted regions in West Africa.

Steps include directing Ramstein personnel involved with Operation Unified Assistance to have their temperature checked twice daily at the base medical clinic for 21 days, even if they’ve had no known exposure to the Ebola virus, 86th Airlift Wing officials said at a town hall meeting Monday.

Temperatures of personnel returning to Germany are initially taken plane side, before anyone leaves the flight line, and then again at a separate screening location. Passengers traveling further must also be cleared for flight.

Some restrictions on movement also could be placed on military members with a “low risk” of exposure to Ebola, even if they are asymptomatic.

http://www.stripes.com/ramstein-taking- ... a-1.310739


U.S. Army troops are under an Ebola quarantine in Italy. Army Major General Darryl A. Williams, commander of U.S. Army Africa forces, along with 10 other personnel, are now under “controlled monitoring” after returning from West Africa over the weekend.
CNN is reporting that Army Major General Williams plane was met by Italian officials upon landing. The Italian authorities were reportedly decked out in “full CDC gear.”

Although none of the Army troops have reportedly shown any Ebola virus symptoms, they will be quarantined for 21 days in a “separate location” at the American military installation in Vicenza. Although Pentagon officials currently prefer the term “controlled monitoring,” the Army troops are reportedly being housed in an “access controlled” space on the base and will not be permitted to return home for the full 21-day period. The troops will have their temperatures monitored twice daily.

Read more at http://www.inquisitr.com/1566782/ebola- ... 673MXlq.99

They should fly to Brussels - here, we don't bother !

[Passenger]

Gov. Martin O'Malley, Maryland, said the Centers for Disease Control and Prevention logs all travelers going to and from West Africa into Epi-X, a national computer network that Maryland has access to so it can identify and monitor those travelers from this state.

"Ebola gets political”. That's the subtitle from today’s CNN update on the mandatory quarantine of that non-ill nurse, returning from Sierra Leone – quarantine that has been withdrawn on Monday.

CNN: Gov. Chris Christie's office said Monday that the nurse quarantined at a New Jersey hospital is being allowed to transfer to Maine, the latest development in a medical and political saga regarding possible cases of Ebola in the U.S., and how politicians in charge are responding.

CNN: The White House seemed to agree with Hickox's sentiment that Christie doesn't have the medical authority to impose regulations that trump federal guidelines on handling Ebola patients. A senior administration official told CNN on Sunday that the White House informed Christie and New York Gov. Andrew Cuomo -- who also ordered quarantine for people returning to his state from West Africa -- along with other state officials that it "has concerns with the unintended consequences of policies that are not grounded in science may have on efforts to combat Ebola at its source in West Africa."
http://edition.cnn.com/2014/10/26/polit ... index.html

Kaci Hickox, the nurse that was locked up Saturday in a tent in a hospital room without shower and without flushing toilet, was clear about this political stupidity: "I am completely healthy and with no symptoms. And if the governor knew anything about Ebola he would know that asymptomatic people are not infectious. Politicians shouldn’t take medical decisions."

- - -

Each year, the international market survey company GfK publishes a study “Trust in Professions”. I quote: “In 15 of the 25 countries fire fighters received most of the votes followed by nurses, doctors and teachers. In almost all countries politicians are trusted the least”.
http://www.gfk.com/news-and-events/pres ... ons--.aspx

[sn26567]

They should fly to Brussels - here, we don't bother !

I beg your pardon? Apparently you don't read posts from others in this thread...

[Passenger]

Christos Stylianides, European Ebola Coordinator:

...What is most needed at this stage is human expertise. The affected countries already had few skilled staff, especially health staff. Not only has the epidemic targeted them but those that are left and those that have come to help are being overwhelmed. They badly need reinforcements. Europe has skilled health staff and technicians who want to volunteer.

...We will follow up on the call by the European Council to mobilize European medical personnel through the ERCC. Doctors and nurses on the ground are urgently needed.

...We also need more beds. From one thousand at present to five thousand as soon as possible. Every bed requires eight health and support staff. This means we need to mobilise immediately at least forty thousand staff.

...Clearly, the European public is concerned about the spread of Ebola to Europe. As we have seen there have been cases in Europe and North America. We need to be vigilant and we need to be prepared. At a time when many doubt the usefulness of Europe, we recently passed legislation that put in place an early warning system for health threats such as Ebola for the whole of Europe. We must not allow fear to dictate our actions.

Full text:
http://europa.eu/rapid/press-release_SP ... 724_en.htm

[airazurxtror]

The (US) federal government announced new guidelines Monday for monitoring healthcare workers returning from West Africa.

The guidelines call for medical workers at high risk to isolate themselves and those at lower risk to regularly report their temperature to local health officials to see whether symptoms of the virus develop. They are merely suggested practices for state and local officials, who may quarantine as they see fit.

Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, emphasized that the new monitoring was based “on science,” an insistence the Obama administration has made repeatedly about its acts to stop the spread of the deadly virus.
In issuing Monday’s guidelines, CDC officials said that “high risk” travelers include those who have had a “needle stick” from an Ebola patient or are family members who have cared for an Ebola patient without protective gear.
Those people should stay off of airplanes, trains and buses, but can engage in public activities like going for a jog in a park, according to Frieden.

http://www.latimes.com/nation/la-na-new ... story.html

The Pentagon move went well beyond previously established military protocols and came just as the White House pushed to roll back steps by U.S. states to quarantine healthcare workers returning from the three countries at the center of the Ebola epidemic even if they were asymptomatic.

The U.S. Army has already isolated about a dozen soldiers at part of a U.S. base in Vicenza, Italy, including Major General Darryl Williams, who oversaw the initial response to the Ebola outbreak. Dozens more will be isolated in the coming days as they rotate out of West Africa, where the military has been building infrastructure to help health authorities treat Ebola victims, the Pentagon said.

"We are billeted in a separate area (on the base). There's no contact with the general population or with family. No one will be walking around Vicenza," Williams told Reuters in a telephone interview.
"Nobody is symptomatic. No Army soldier came in contact with Ebola-stricken patients," Williams said.

With thousands already dead from Ebola in Liberia, Sierra Leone and Guinea, concerns are high in the United States about stopping its spread.

[Flanker2]

A first suspected case in Japan: a journalist returning from Liberia on NH via BRU and LHR was quarantined today at 4 pm local time in HND with a fever of 37.8°C.
The man has already been tested and the infection is not verified yet, but he is kept in quarantine as it's possible that virus has not multiplied enough to test positive.

Japanese news media mentioning BRU as a gateway for Ebola. Great advertisement for Belgium.


NRT has a special ambulance on standby at the airport and Japan has 45 hospitals ready with 88 beds equipped to handle Ebola infections.

I was supposed to fly into HND at about the same time, but ended up choosing a NRT arrival and I'm very glad I did.

[Passenger]

The (US) federal government announced new guidelines Monday for monitoring healthcare workers returning from West Africa.

The guidelines call for medical workers at high risk to isolate themselves and those at lower risk to regularly report their temperature to local health officials to see whether symptoms of the virus develop. They are merely suggested practices for state and local officials, who may quarantine as they see fit.

Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, emphasized that the new monitoring was based “on science,” an insistence the Obama administration has made repeatedly about its acts to stop the spread of the deadly virus.
In issuing Monday’s guidelines, CDC officials said that “high risk” travelers include those who have had a “needle stick” from an Ebola patient or are family members who have cared for an Ebola patient without protective gear.
Those people should stay off of airplanes, trains and buses, but can engage in public activities like going for a jog in a park, according to Frieden.

http://www.latimes.com/nation/la-na-new ... story.html

Interesting article, thanks. Pity though that you have deleted the statements about the reckless quarantine and the remarks about the volunteers who go to West Africa. Doctor Frieden even calls them heros:

... Federal officials have criticized the quarantines put in place in recent days in New York, New Jersey and Illinois, saying they would discourage aid workers from going to West Africa to help stop Ebola from further ravaging Guinea, Liberia and Sierra Leone. “Managing Ebola is not easy, and what we’re doing with these new guidelines is using experience and data to refine the policies and programs we recommend,” Frieden said. White House Press Secretary Josh Earnest said the administration hopes those state leaders will be persuaded by the expertise and medical research provided by federal agencies. "What we hope," said Earnest, is that their decisions will be "driven by science."

The new guidelines increase the level of protection for Americans, while at the same time protecting those who are doing “the heroic work of protecting us from Ebola as they fight it on the shores of Africa,” dr. Frieden said. Earlier, New Jersey Gov. Chris Christie announced that a nurse who was quarantined in Newark after returning from treating Ebola-afflicted people in West Africa would be released and allowed to go home. Christie’s move followed a barrage of criticism from civil rights groups, aid agencies and White House officials over the quarantine he announced Friday.

[FLYAIR10]

japanese news media mentioning BRU as a gateway for Ebola

Maybe SN's west-africa flights should be handled through less crowded airports then such as OST or LGG or even military airports where there is less contact with passengers arriving/departing from/to other destinations..
Just a thought.
Grtz

[FlightMate]

I wonder what's on the 'questionnaire' that passengers are supposed to fill in on departure.

I suppose there is a question about being close to infected people.

If so, how are doctors or journalists allowed to board without extra measures?

[Passenger]

A first suspected case in Japan: a journalist returning from Liberia on NH via BRU and LHR was quarantined today at 4 pm local time in HND with a fever of 37.8°C. The man has already been tested and the infection is not verified yet, but he is kept in quarantine as it's possible that virus has not multiplied enough to test positive.

Strange. Last week you've blamed Belgium because Japan had a 30 minute lab test, and Belgium hasn't. But hey, what's going on now? Japan is confronted with a possibility, and your superb 30 minute lab test fails. Let me tell you why it fails: because a 30 minute lab test has a too high percentage of false negatives and false positives. To make a test 100% sure, the lab needs more time - and that is what Japan is doing right now.

Your statement "because the virus hasn't multiplied enough to test positive" is something that you will probably believe yourself, but it's nonsense! A lab test on ebola can be done at any moment, with a result that is as secure as a pregnacy test: it is a yes or a no. But then, just like 99% of all previous ebola alerts, we won't get an update here when the test is negative.

Japan has a 30 minute lab test, experimental medicine available and 47 hospitals across the country on high alert training their staff on quarantine protocols.

[Flanker2]

Canadian man tests negative for Ebola after arriving at Haneda: ministry
OCT 28, 2014
ARTICLE HISTORY

A Canadian journalist who traveled from West Africa and showed an elevated body temperature upon arrival at Tokyo’s Haneda airport was tested negative for the Ebola virus, the health ministry announced Tuesday.

Out of an abundance of caution, the man will remain hospitalized and under observation at the National Center for Global Health and Medicine in Shinjuku Ward, Tokyo, according to the Ministry of Health, Labor and Welfare.

This is the first case of someone suspected of being infected with the deadly virus, which is raging across West Africa, arriving in Japan.

The unnamed man, who according to NHK is 45 years old, stayed in Liberia for around two months from Aug. 18.

He was there to report on Ebola in the country hardest hit by the virus, and left West Africa about 10 days ago, the ministry said.

He arrived at Haneda airport Monday afternoon on an All Nippon Airways flight from London via Belgium.

According to ANA, 206 passengers were aboard the plane. The airline said it is waiting for instructions from the health ministry as to whether to notify other passengers or use the same plane again.

The man declared his travel history at the airport’s quarantine section and it was confirmed that he had a slight fever, at 37.8 C.

The man was then sent to the national center in Shinjuku Ward and a blood test was conducted at the National Institute of Infectious Diseases to see if it contained genes from the virus.

http://www.japantimes.co.jp/news/2014/1 ... E7VOiLkdc4

@Passenger, I'm only posting what the Japanese media are saying. What's your problem?

[Passenger]

@Passenger, I'm only posting what the Japanese media are saying. What's your problem?

Oh, I don't have a problem - I'm just wondering which Japanese media said this:

Great advertisement for Belgium.

[Flanker2]

What is it, we're not allowed to comment now?
Passenger in full panick mode!

Do you think that Belgium will be spared from criticism as this crisis goes forward?
Take a chill pill and get out of your bubble.