Health Meaning

honey bees are apparently Typhoid Marys of the world pollinator. One study suggests that bees spread two kinds of pathogens to wild bumblebees. And one of them, the virus deformed wing (DWV), kills bees across the UK may have contributed to the decline of wild populations of the nation. The high occurrence of DWV is "truly alarming", said Peter Neumann molecular ecologist at the University of Berne, who was not involved in the study.

DWV can be nasty. Like many other viruses in bees, DWV spreads in two ways. Honey worker bees ( Apis mellifera ) orally transmitted to other workers, usually causing a mild infection. But the parasite varroa is a support, too. When the mite feeds on bee pupae, infecting them with DWV, the virus causes horrific malformations. The young bees develop with swollen abdomens and shriveled or wrinkled wings, causing one of the worst DWV viral diseases in commercial bee hives

DWV first shot in 04 in commercial bumblebees. the insect Bombus terrestris , is often used in greenhouses, especially to pollinate tomatoes. Commercial breeders initially noticed that about 10% of bumble bees died tiny misshapen wings. Then Elke Genersch the Bee Research Institute Hohen Neuendorf, Germany, and his colleagues discovered that the dead bees were infected with DWV. The researchers suspected that the bees were orally infected bumblebees, because farmers use bees to encourage bumble bees to start new nests.

Nobody knew the extent of DWV in wild bumblebees. Matthias Fürst and Mark Brown of Royal Holloway, University of London, Egham and colleagues collected bees and bumblebees than 26 sites across Britain. The virus was present in 11% of bumblebees and replicate in more than a third of them, suggesting active infection, they report in Nature . The virus is probably more common than these data indicate, Brown noted in a telephone news conference. Bees "on their death bed, will not be taken by our sampling plan," he said

The team found genetic evidence that the virus is shared between species :. When bees and bumble bees lived near each other, the two had a similar strain of the virus. Because DWV was more common among bees, 36% were infected, researchers believe it propagates them to bumblebees. The team also found the same pattern with the fungal pathogen Nosema ceranae , but it does not cause problems for bumblebees.

DWV, secondly, spelled trouble. When researchers fed bumblebees food contaminated with the virus, the symptoms of the disease appeared. (See pictures of bumblebees with deformed wings, not of this study.) The worker bees became ill and died on average 6 days earlier than normal, a significant reduction of the typical life span of 21 days. A bumblebee nest contains less than several hundred worker bees, so any DWV generalized infection could devastate the nest capacity to collect enough food.

Jeff Pettis of the US Department of Agriculture Bee Research Laboratory in Beltsville, Maryland, agrees, it is likely that bees infect bumblebees. "This highlights the need to better manage bees in a responsible manner and to find ways to keep all pollinators," he said. Wild bumble bee populations, which help pollinate certain crops seem to decrease in many places, so the need is urgent. There is no way to treat sick bees, so the best strategy is to keep the honey as healthy beehives as possible, including controlling the varroa mite which aggravate infections in bees.

dark chocolate really has a good body, and scientists now have a better idea why. Gut bacteria break down the large compound in its key ingredient, cocoa powder, into smaller molecules that may inhibit harmful inflammation, the researchers reported today at the meeting of the American Chemical Society in Dallas, Texas. In laboratory experiments, scientists have processed cocoa with stomach and pancreatic enzymes and the sample washed to remove soluble molecules in water. They then fed the insoluble material remaining bacteria cultured from samples lab members stool (yes, they pooped in a cup for this study) and fermented in anaerobic conditions similar to those of the ileum and colon. The fermentation products acted as anti-inflammatory when applied to monolayers of the digestive tract that researchers were exposed to inflammatory stimuli. The results suggest that we can thank our intestinal bacteria to give dark chocolate its touted health benefits.

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Get the vaccine against measles, and you will not be measles or give it to someone else. Right? Well, not always. A person fully vaccinated against measles contracted the disease and transmitted to others. The surprising case study contradicts received wisdom about the vaccine and suggests that a recent wave of measles outbreaks in developed countries could mean more illness, even among the vaccinated.

Regarding the vaccine against measles, two shots are better than one. Most people in the US are first vaccinated against the virus shortly after their first birthday and return to a booster as a toddler. Less than 1% of people who receive the two shots is contracting the potentially deadly skin and respiratory infections. And even if a fully vaccinated person becomes infected, a rare condition known as "vaccine failure" -They were not thought to be contagious.

This is why a theater employee of 22 years fully immunized in New York who developed measles in 2011 was released without hospitalization or quarantine. But as Typhoid Mary, this patient was found to be unintentionally contagious. Ultimately, it transmitted measles to four others, according to a recent report Clinical Infectious Diseases ensuing symptoms in the 88 persons with whom "Measles Mary" interacted while she was sick . Surprisingly, two secondary patients had been fully vaccinated. And while the other two had no record of receiving the vaccine, they both showed signs of prior exposure to measles which would have given immunity.

Further examination of blood samples taken during treatment revealed how the immune Mary measles broke down. As a first line of defense against measles and other microbes, humans rely on a natural spur of IgM antibodies. As a wooden shield, they offer some protection against microbial attacks, but are not impenetrable. The vaccine (or the measles) prompts the body to complete the primary buffer with a stronger armor IgG antibodies, some of which are able to neutralize the measles virus so can not enter cells or spread to other patients. This secondary immune response is presumed to last for decades.

By analyzing his blood, the researchers found that Mary measles IgM mounted a defense, as if she had never been vaccinated. His blood also contained a powerful arsenal of IgG antibodies, but a review revealed that none of these IgG antibodies were actually able to neutralize the measles virus. It seemed that his immunity given vaccine had decreased.

While officials of Public Health assumed that immunity against measles still hard, the case of Mary measles highlights the fact that "the actual length [of immunity] after infection or vaccination is not clear, "said Jennifer Rosen, who conducted the survey as director of epidemiology and surveillance at the New York City Office of immunization. The possibility of decreased immunity is particularly worrying that the virus surfaces in major US hubs such as Boston, Seattle, New York, and the Los Angeles area. Rosen does not believe this one case merit a change in the vaccination such strategy, give adults booster shots, but she said the more regular monitoring to assess the strength of measles immunity people is justified.

If it turns that vaccinated people lose their immunity as they age, which could expose them to measles outbreaks seeded by persons who are unvaccinated increasingly common in the United States and other developed countries. Even a vaccine failure rate of 3% to 5% could devastate a school with several thousand students, said Robert Jacobson, director of clinical research for a vaccine against the Mayo Clinic Research Group in Rochester, Minnesota, who was not involved in the study. Still, he said, "vaccine failure" The biggest thing with measles happens when people refuse the vaccine first. "

It's been 7 years that dozens of children with progeria, a devastating disease that causes symptoms resembling premature aging, began receiving an experimental drug called lonafarnib. That's an eternity for them and their parents as most afflicted with the extremely rare condition die in their teenage years. There is now a clue that this medical bet paid off, at least to a small extent. The Progeria Research Foundation (PRF), which funded the initial drug testing and ongoing monitoring and involving two other medicines, announced this week that interventions have probably added on average about 19 months for periods children's life.

This is "an important first step," said Leslie Gordon, a physician who, with her husband, founded PRF after their son was diagnosed with progeria. "Although these drugs are not curative, we show for the first time that life can be affected in children with progeria. "But this finding, detailed in a study published online may 2 in Traffic , has many scientists wondering if the results are significant, because the tests were missed an untreated control group as is sometimes the case for treatments for extremely rare diseases.

Only about one in 4 million to 8 million newborns have a mutation in a gene called LMNA causes what is officially known as progeria syndrome Hutchinson-Gilford. LMNA normally produces a protein that helps to provide a scaffold for the nucleus of a cell. The mutation leads to the accumulation of an abnormal version of the protein, causing deformed nuclei and other changes in the cells. The end result is a set of symptoms resembling premature aging of certain tissues: hair and weight loss, thin skin, joint stiffness, and atherosclerosis. This leads to heart attacks that cause the majority of deaths from the disease.

In 05, a study conducted by researchers at the University of California, Los Angeles, showed that a class of farnesyl transferase inhibitors drugs called (FTI), which block the binding of a molecule to defective protein allowing it to accumulate around the nucleus, restored normal form to kids with progeria cells. Several working groups with mice with the same mutation following established that the drug also reduces the signs of premature aging in rodents. Because FTI had already been tested in children with cancer without significant side effects, PRF quickly pushed to start a test of lonafarnib FTI in 07. Gordon, in collaboration with a team led by Mark Kieran oncologist Institute Dana-Farber Cancer Boston, initially followed 25 children as they received the drug for at least 2 years. The results of the test, published in 2012, showed that most patients had small gains and weight reductions in the stiffness of their blood vessels, although some scientists have found inconclusive and difficult to interpret.

In the new analysis, Gordon and his colleagues wanted to see if the children treated to date, including the first trial lonafarnib and those in an ongoing trial that adds two other drugs for the treatment survived more long as untreated children. But because there are so few children with progeria, and the disease is always fatal, PRF and designers in the study had agreed not to create a group receiving a placebo; all those who participated in the study received the drug, including the son of Gordon. For a comparison group, Gordon and colleagues instead of collecting data on untreated children from historical documents in the international register of the foundation, previously published case reports, and public databases.

This is what makes some question whether the extension of the apparent life is real. Studies with historical controls are "notoriously unreliable" said Donald Berry, a biostatistician at the University of Texas MD Anderson Cancer Center in Houston. Because various studies and databases can have an inclusion criteria patient, factors outside the drug's effectiveness could contribute to the life of differences. Gordon and his colleagues, however, have tried to solve this problem by matching children in the treatment group with untreated children the same age and sex, born after the subjects. the comparison showed that within 6 years after the start of treatment, those receiving the drug survived an average of 1.6 years longer than their untreated counterparts. in during this period, 21 of 43 children with progeria that has not included in the study died, against 5 of the 43 who had received treatment.

the discovery "is very rewarding and encouraging" said the doctor -geneticist Francis Collins, director of the National Institutes of Health in Bethesda, Maryland, whose research team studied the mechanisms and potential treatments for progeria. Collins acknowledges that the lack of direct control group enrolled in the trial is "not ideal", but noted "there was really not much of an alternative to what has been done, namely, to an open trial where all children had the chance to have access to the drug. "

But others, including Berry, are struggling to draw a positive conclusion from the study in the light of this limitation. It notes that a more dramatic improvement in life could overcome his doubts: "If patients have lived a normal life, then the results were convincing but even improved 'only' 10 years (and maybe even 5 years) would have been sufficient to establish the principle. which the treatment was effective. "

In addition to age and gender issues the Gordon team sent there differences between the countless trial participants and the untreated group, notes Howard Worman, a cell biologist and physician at Columbia University, who was the first to characterize LMNA gene. Children and their parents who enroll in a clinical trial may be more aware of their disease and more proactive with their health than non-participants, for example. "Until there is a matched group at the same time, ideally placebo-controlled, it is difficult to say whether there really is a survival advantage," he said.

Gordon and his colleagues are continuing to follow the children in the study who are still taking the IFT and the more time drug other two can make a clear survival advantage. His son, recently the subject of an award-winning documentary, died in January.

scientists have found a way to beat back the hands of time and fight against the ravages of old age, at least in mice . A new study reveals that high mouse pain without specific sensor, or a receiver, live longer and are less likely to develop diseases such as diabetes in the elderly. In addition, exposure to a molecule found in peppers and other spicy foods may confer the same benefits as the loss of the pain receptor which means that humans could potentially benefit, too.

When you touch something hot or get a paper cut villain, pain receptors in your skin are activated, causing the neurons to relay a message to your brain: "Ouch" Although pain protects your body against damage, it also causes damage. People who experience chronic pain, for example, are more likely to have a shorter lifespan, but the reason for this remains uncertain.

To investigate further mice, researchers at the University of California (UC), Berkeley, raised without pain receptor called TRPV1. Found in the skin, nerves and joints, it is known to be activated by the spicy compound found in chili peppers, known as capsaicin. (When you feel like your mouth burn after eating a jalapeño that TRPV1 is at work.) Surprisingly, mice without TRPV1 lived on average 14% longer than their normal counterparts, the reports of the team today ' hui in cell . (Meanwhile, calorie restriction Another popular way of extending the life span of mice, can live up to 40% longer.) When TRPV1-less mice aged, they still showed signs of young fast metabolisms. Their bodies continued rapidly clear the blood sugar to a feature called glucose tolerance generally decreases with age and they burned more calories during exercise than regular old mice.

The reason for the increase in mouse longevity may be in the role of the TRPV1 receptor in regulating insulin, a hormone that removes sugar from the blood, says principal investigator Andrew Dillin , a molecular biologist at UC Berkeley. In the pancreas, TRPV1 neurons stimulate the release of a substance called CGRP, which prevents insulin from entering the bloodstream. With less insulin, it is more difficult to control blood sugar. The mice without the TRPV1 gene had low levels of CGRP, which meant they had more insulin, which explains their increased ability to manage glucose levels. Interestingly, the naked mole-rat very long life, who lives more than 30 years, does not naturally CGRP, suggesting a key role for the chemical in the aging process, according Dillin.

TRPV1 is already a popular target for pharmaceutical companies that attempt to treat pain, and therapy that blocks CGRP is being developed for migraines. But Dillin suggests that companies should think beyond pain control. "These drugs may also be useful for treating diabetes and obesity," he said. Already, diets rich in capsaicin have been linked to lower cases of diabetes and metabolic problems in humans, he said. So, spicy foods may be a way to extend life? Perhaps, Dillin said, but you would have to eat a lot of them over a long period of time. "prolonged exposure to capsaicin can effectively kill the neuron "that transmits signals from TRPV1, he said. Knocking these signals could mimic the effects of being born without TRPV1 in the first place and therefore could lead to a longer life.

the idea that pain can cause aging is intriguing, says molecular biologist David Sinclair of Harvard Medical School in Boston, who was not involved in the study. "It is striking that the mice were without TRPV1 protected from some of the ravages of old age, including lower metabolism, cognition and physical activity, "said Sinclair. Although there is no guarantee that the pain receptors controlling aging in humans, he notes, perhaps the next step could be "to see if people with different variants of CGRP gene are protected against diseases related to age. "

Earlier this year, military engineering Authority of Egypt has announced a portable instrument that could detect a variety of viral infections without touching a person, and another device that erases the blood of a patient virus. the large-scale treatment of Egyptian patients with both devices was to begin today, but military officials said Saturday they delay deployment for 6 months.

The decision comes after months of controversy. According to government officials, the treatments not only eliminate AIDS and hepatitis at home and Egypt has the highest prevalence of hepatitis C in the world, but also make a fortune as foreign patients are flocking to the country . While Western scientific community ridiculed devices as pseudoscience, Egyptian academics were largely silent. the country's military regime was pronounced severe criminal penalties for its critics, including journalists. But an Egyptian expatriate scientist Islam Hussein has created videos, one of which garnered over 100,000 views on YouTube a lot since they are PowerPoint presentations 80 minutes in Arabic explaining the scientific problems of the devices. Like most top scientific talent from Egypt, Hussein, 36, left his country. After a PhD in virology at the University of Cambridge in the UK, he moved to the Massachusetts Institute of Technology in Cambridge, the United States, where he studied bird flu. This interview has been edited for clarity and brevity

Q:.? What do you know about these devices

A: The first is called C-FAST. [The Egyptian Armed Forces] claim that the antenna of this device can detect a patient infected at a distance of up to 500 meters. The device does not even need a battery; It is powered by static electricity from the body. The allegedly antenna detects the electromagnetic waves emitted by the vibrations of the hepatitis C virus genome in a specific manner to the sequence. C-FAST is one of a large series of devices which detects several viral infections: HIV, hepatitis C, influenza, coronavirus MERS, virus and malaria. Yes, malaria [which is a parasitic cell] is now promoted to the rank of a virus.

The second is called the complete device priest [CCD], much like a dialysis machine. She draws blood from the patient using a pump. The contaminated blood is passed through a spiral tube expensive, it consists of a highly specialized material as its 7 years manufacturer applications have to develop. The tube emits radiation mysterious secret that military kills the virus, then the blood is returned to the body

Q :. ? What makes implausible

has: for C-FAST, the research team has presented no scientific evidence that electromagnetic waves emitted by acid viral nucleic still detectable, and even less of diagnosis. A discovery of this caliber deserves Science or Nature paper. They claim that the electromagnetic signal of each virus is like a fingerprint that can be programmed on a small chip inside the C-FAST device. Replacing a C chip with a hepatitis to influenza, a device becomes capable of detecting the electromagnetic signal specific to influenza and so on.

As for the CCD, we have not even a single scientific publication describing how this device is safe and effective. We heard three contradictory mechanisms of action. Exposing the blood of a patient to a radiation hepatitis C him rid replicating in the liver or HIV integrated into the genome of infected CD4 + cells. They claim to have done experiments with chimpanzees; they even claim that thousands of people have been treated in a clinical trial. Again, where is the data

Q :? Are the Egyptian scientists speaking about

A: Essam Heggy, a researcher at the Jet Propulsion Laboratory of NASA and former adviser of ex-president Egypt, issued a statement that the whole thing is a big scandal. He was attacked by Egyptian media day and night. Outside Heggy, very few Egyptian doctors have spoken

Q:.? What motivated you to make these videos

A: I could not 't stand watching this happen in my home country and keep silent about it. This "cure" will affect millions of Egyptians, side effects of an unregulated therapeutic device, potentially toxic to false expectations that lead people infected do not take precautions

Q :. Are you worried about getting noticed by the government

A: no, I'm not worried. These videos were all about science and science only. There is no reason why the current regime or someone the Egyptian armed forces to get angry with what I said

Q:.? What impact do you hope to have

A: Many people have made fun of the devices. However, no one took the initiative to take them seriously and explain to the public why these claims are unfounded. I also hoped that my voice will reach the people behind these inventions and persuade them to change their course of action.

Peter Piot, currently Director of the London School of Hygiene & Tropical Medicine has become one of the world's most respected epidemiologists because of his work on the viruses that cause AIDS and Ebola. In the first extract of his memory 2012 No Time to Lose, Piot recalled the identification of a new virus behind a deadly epidemic in Zaire in 1976, the beginnings of Ebola. In this second extract, he and his colleagues are in the hot zone of Zaire and, with the help of the nuns who had survived, making a tragic discovery about how the virus had spread among pregnant women.

Mission Yambuku

I examined his blood, and it was a disaster . The platelet count was terribly low. As green and unimaginative as I was, the real murderer of the virus began to sink in, and my hands trembled a little as I manipulated his blood. Who knew how the virus was transmitted by insects or body fluids or dust.

I cut short weekend in Paris and quickly returned to Antwerp, where my boss Pattyn Stefaan and my colleague Guido Van Der Groen met me in the laboratory, in collaboration with Dr. Kivits, head of the health section of the Department of development aid in Brussels. We spent a few hours tracking down gloves and protective masks and basic laboratory equipment. I tried to familiarize myself with the maximum protection procedures against dangerous viruses, both in the laboratory and in the field. This essentially means protecting your eyes, mouth, nose and hands, and avoiding needle sticks. Guido gave me motorcycle goggles, which proved to be extremely useful.

I also quickly formed in the hematology laboratory procedures and blood tests. Because it was an epidemic of hemorrhagic fever included, which, by definition, symptoms of bleeding I need to watch all kinds of blood parameters: the degree of disseminated intravascular coagulation, which causes uncontrollable bleeding; platelet count and hematocrit; And so on.

But Pattyn was especially interested in learning me to capture bats. For some reason, he was convinced that they appear to be the reservoir of the virus. To be honest, it was the only thing that scared me about the trip. I am poor to catch flying objects in the best of times, even when they have claws and teeth. I nodded as he explained, but I decided on the spot that I would not take a single bat (and failed).

I ran home and packed enough for 10 days. Pattyn insisted that I take a suit and tie, as I would "represent the Belgian government" and to meet representatives of the Zairian government. Then I hunted in my passport, not an easy feat. He had long since expired . (I did not need to go to Paris, since I am a European Community national.) I'd even cut my photo ID to use for certain sports club membership card required for all emergency. and of course, this late excuse and disfigured passport did not have any type of visa for Zaire. I did not know if they would even let me on the plane. that night I could not sleep for nerves and excitement.

During recording, when the police officer to immigration wordlessly me sign on one side with a hostile look, Kivits intervened and had a sort of official supercard that magically gave me passage through immigration and outside my own country. Kivits had several of these tricks up his sleeve. He said, "Find a passenger called Paul Lelièvre-Damit first class. When you arrive in Kinshasa, just follow his instructions. Do exactly what he says and you'll be fine. "

Lelievre-Damit was the head of the Belgian Cooperation in Zaire, and one of the most powerful foreign Kinshasa. When he realized who I was, he interrupted my arrest story about an outbreak and began to swear. "Goddamn! It's always the same with these bloody bureaucrats in Brussels! We face a terrible epidemic, and everything they could find is that you? How old are you? Twenty seven? You are a totally green intern, just a doctor. You've never seen Africa in your life ... "

I winced at its robust graphical splendor of Flemish epithets Undeniably I had no expertise;.. Few skills; I could not save the heart of Africa from a mysterious virus that cartoon boy could have done. But after a few glasses of ouzo it appeared that Lelievre-Damit had played cards with my father when they were both students penniless in Leuven, and that helped a lot. "when we arrived in Kinshasa, just stick with me," he said. "Do not look left or right or turn around. The airport is pandemonium, the police are worse than criminals, and you're as clueless as a puppy you'll be eaten alive."

the next morning, the driver smoothly navigated our DC-10 in Ndjili airport in Kinshasa, where we parked near several wrecks were less fortunate. I was pushing to the front of the plane to find Lelievre-Damit, and I stuck to it down the DC-10 marches as tight as a baby monkey clings to its mother. To be honest, I am not only stunned and hungover I was a little scared. With practiced, fluid movements Lelievre-Damit Pattyn and slid me into the VIP room, where a very respectful servant smiled. There was no mention of anything so vulgar as an identity document.

The roads of Kinshasa were amazing, with people and animals wandering at random through them, not to mention cars, rushing in all directions. We drove directly to a meeting at the Fometro, the Tropical Medical Fund, a nongovernmental organization that operated a large part of broad program of Belgium for medical aid in Central Africa. American Karl Johnson header Special Pathogens at the Center for Disease Control (CDC) in the United States struck us attention, it was clearly his meeting and summarized the situation in a nutshell. We were dealing with a virus that was completely new to science. Its potential for transmission particularly medical teams and caregivers-seemed to be extremely dangerous. The reports claimed that more than 80 percent of those infected were dying. We had only one option possible treatment in the form of convalescent serum which had very high levels of antibodies, but we needed to track down these individuals test their blood to be sure it does not contain live virus and then process to be able to inject antibodies in people currently ill

He continued :. the worst we faced was the specter of an epidemic in Kinshasa, an unruly megalopolis with poor infrastructure, unreliable administration, and 3 million citizens used to challenge the arbitrary government controls. Just two weeks earlier, three people of Belgian mission Yambuku-two nuns and a priest had been brought to the capital for treatment. All were now dead, and had infected at least one nurse, Mayinga N'Seka, now hospitalized in critical condition. Efforts have been made to track down all his contacts in the city for quarantine. They included here Johnson paused for a second-staff of the Embassy of the United States, where the nurse had recently finalized arrangements for a student visa to the United States.

Is this the beginning of an epidemic in Kinshasa? Once that this deadly virus is introduced into an environment of this chaos, it is almost impossible to control. It is also an explosive political situation for the government, and it was clear from the bustle of the Minister of Health that the new epidemic was out and panic was already established. At that time, we had no real indication of how the disease was contagious, only that it seemed highly lethal.

priority was therefore Kinshasa, and it was decided that most of the team would there remain temporarily, while a small contingent would travel to Ecuador in the province for three or four recruiting trip to -day logistics bases and outline a plan for a full investigation. Karl asked for volunteers. I was the first to raise his hand. With an air wave of his hand, then Pattyn I also volunteered to visit Kinshasa infected nurse.

We were taken to a hospital Ngaliema clinic for the rich. It was near the Congo River, Gombe, one of the most beautiful parts of the city, which in colonial times was an area reserved for whites. There was a very scary atmosphere in the corridors of the clinic. Dr. Courteille, director of internal medicine, who received us, informed us first the safety instructions. After the death of two nuns, and their Belgian infection of the nurse-Mayinga their mattresses were burned, and their locked rooms and fumigated with formaldehyde vapors on four consecutive days. Elimination of the bodies was done by wrapping in cotton sheets impregnated with a phenolic disinfectant, and the wound body were sealed inside two large heavy plastic bags before being placed in their coffins.

Courteille, who was taking care of nuns and Mayinga, took care not to accompany us to the bedside of a sick nurse, and it seemed that all the staff kept a guarded distance from their former colleague . She was very sick, and completely hopeless, and convinced she was dying.

Mayinga was hospitalized Friday, October 15, with high fever and a severe headache. Now, on 18, she started to bleed; there were black spots, pantyhose around his nose, ears and mouth and spots under the skin where the blood was pooling. She had uncontrollable diarrhea and vomiting. She clung to Peter Elder of the Pasteur Institute, which soothed, talk about the serum that Margaretha Isaacson South Africa administer, which contained antibodies against Marburg virus, from a convalescent patient in Africa South, which could strengthen the immune system to fight the virus. Unfortunately, the serum did not work and Mayinga died a few days later.

We drew blood to perform a number of tests to guide the decision to prescribe a supportive therapy for intravascular coagulation, we found could be the cause of death in hemorrhagic fever. But none of the technicians or staff was ready to handle samples of Mayinga for some good reasons, the laboratory of the hospital did not have a containment facility.

I examined his blood, and it was a disaster. The platelet count was terribly low. As green and unimaginative as I was, the real murderer of the virus began to sink in, and my hands trembled a little as I manipulated his blood. Who knew how the virus was transmitted by insects or body fluids or dust.

**************

In the dark four hours, I watched our military pilots striding angrily before and back on the tarmac. They were clearly full of resentment at the idea of ​​flying to Yambuku in the epidemic area. They refused to help us to charge the device. Finally, they agreed to fly us Bumba as directed, but they said they would not stop there-just drop us off and fly.

A Land Rover was driven on and secure. We loaded into an essence, a few boxes of protective equipment and medicine, and some supplies for the Belgian mission. We sat in the seats of military style along the walls and preparing for a rocky ride.

As the sun rose, pilots loosens a bit. They let us go one by one, in the cockpit, where we could take in the incredible view of the rainforest that flowed beneath us like a vast green sea uprising punctuated now and then with a hamlet of fragile huts. The aircraft was essentially followed the Congo-largest river, nine miles wide in places, the other side often barely visible. Again, I heard the story of pilots watching the birds fall dead on the forest around Yambuku hit the air by the mystery virus, but there was a new twist :. human corpses lining the roads

We landed in Bumba, a riverside town then perhaps 10,000 people and the administrative and commercial capital of the district. For about two weeks, the entire area was quarantined and under martial law, cut off from the rest of the country. And this took place during the rice and coffee crucial harvest, main (if not only) source of liquidity in the region.

When the C-130 came to a stop, I moved to the door at the back, eager to get to work. What I saw through the open loading dock is printed permanently in my memory: hundreds of people-the whole town seemed he was standing on the red dirt airstrip in the hot sun, we first look and shouting "Oye! Hear Ye! "

The crowd cried because they were expecting deliveries of food and basic goods was the first aircraft to land in several weeks. When they realized we were not delivering food, the more desperate pushed forward, hoping to board the plane, but military police beat them back.

A Flemish determined man appeared, maybe 10 years older . that I, wearing black glasses and a shirt made of local African wax material It occurred to us: Father Carlos, in the order of Scheut, so a colleague Catholic missionary priests who had died of the virus in Yambuku . Father Carlos informed us about the epidemic. He started Yambuku in the first week of September, when the director of the school of the mission, who had traveled through the north on vacation, returned and ill.

After his death, crowds attended his funeral, and within days the hospital's mission began to fill with other patients, including the director's wife. They suffered high fever, headache, hallucinations, and usually bled to death. One after another, her caregivers at the hospital of Yambuku mission is sick, and members of his family, other patients, and dozens of other, seemingly unrelated people.

Nobody knew how many people had died, but those who became ill died within eight days. The few nuns still alive at the Yambuku mission were convinced they would die too soon. One person was known to have recovered from the virus. As regards ongoing cases, there were in Bumba, and several people who had traveled to Bumba Yambuku and were kept in quarantine.

By the time we left for Yambuku we heard of more than one hundred deaths. My natural skepticism began to fall, replaced by misfortune. The stories of Father Carlos and Dr. N'goy, district medical officer who first identified the outbreak, reports the hospital Bumba, the obvious fear of drivers and residents of Bumba and their desperate attempts to flee the city ... the apparent virulence of this disease, high mortality rates, put up with poverty and poor organization characterizes Zaire and the risk of contagion in Kinshasa added to an image that Joel Breman, a CDC senior epidemiologist, summarized as "potentially the most deadly epidemic of the century. "

we left two Rovers, one of them land lent to us by Fr. Carlos and silently led by the overwhelming exuberant strength, unstoppable Equatorial jungle uncut, well over 30 feet up. All kinds of green pressed on us, high walls of leaves and creepers muscle as something of a Tarzan movie. I had never seen how powerful and all-pervasive nature can be, and somehow it aggravated my feeling that we were making our way towards something horrible and uncontrolled.

We stopped at the Unilever plant in Ebonda. the staff were frantic. They had incredibly high expectations for our visit and our brief stay clearly disappointed and upset more women sang and shouted in grief around the small clinic. a number of death occurred recently

I had a photocopy of. image of the virus we had seen in our electron microscope Antwerp, and for some reason, it occurred to me to take it out and show it. This has had a fascinating placebo effect on the crowd. I guess that makes the virus less supernatural seems more real, and maybe less powerful.

Beyond Ebonda the road became almost impassable, just over a pit of mud and water, with entire sections washed away by the torrential equatorial rains. We drove through small villages of no more than 10 to 25 huts, huddling like nests at the foot of towering tropical trees. About half of the villages had erected barriers to control the popular movements in this quarantine period. The elders explained that they had done this without official instructions, as their elders did in the time of smallpox epidemics. We asked if anyone in these villages was being sick; all shook their heads no.

The thick green curtain around the closed road again, and we advanced with great difficulty until the coffee plantations first, then the Church and the red roofs of the mission is Yambuku appeared like mirages in the light of the blinding sun. Surrounded by a carefully swept courtyard lined with royal palms and manicured lawns, they seemed surreal. It was hard to believe that this same clean, orderly, idyllic Yambuku was really the heart of the mysterious killer virus.

The sisters were accommodated in the guest house between fathers convent on the right, and nuns convent and school, on the left. As our group walked, Sister Marcella, the Mother Superior, shouted: "Do not approach! Stay out of the gate or you'll die like us! "

Although she spoke French, I could hear her accent, she was not only Flemish, but also the region it came near Antwerp. I jumped on the gauze line who was hanged to warn visitors away and shook his hand in Flemish, I say.. "Hello, I'm Dr. Peter Piot, the Tropical Institute in Antwerp We are here to help and stop the epidemic. You'll be all right. "

There was a very emotional scene that the three nuns, sisters Marcella, Genoveva and Mariette broke down, clinging to my arm, holding each other and crying helplessly, they all started talking at once. Watching colleagues die one by one was a terrible experience.

Later, the sisters said they had read that in the case of an outbreak, a cordon has been put in place to contain the spread of the disease. They interpreted this letter, with an actual cord they strung around the guest house where they had found refuge. They also nailed to a palm tree near a sign in Lingala, warning "Whoever passes this fence will die." It instructed the visitors to ring a bell and leave messages at the foot of the tree. It was scary and sad and says a lot about the fear they had endured.

As Sister Mariette prepared dinner for us, Sister Marcella showed us the books she had recorded all deaths of patients with hemorrhagic fever, and all the information it considered relevant to their disease as recent travel. Nine of the 17 hospital staff members had died, like 39 others among the 60 families living in the mission, and four sisters and two fathers. She broke down several times as she described their symptoms and the agony of death, especially those of her sisters.

Sister Marcella continued to read his well-kept records I scribbled most valuable pieces information. She listed the names of the villages where the deaths occurred. She wondered if the disease could be related to the costs ape meat consumption: villagers often their food for food in the forest and the manager who was, temporarily, our "patient zero" was returned from his travels with several monkeys and antelope carcasses. She noted a high number of deaths among infants born at the clinic of the mission, and also observed a sudden rise in stillbirths among their herd of pigs. There are three months, she said, there was an epidemic among the goats in the Yandongi region.

These are all good lines of inquiry. (Later, I took the blood of pigs in their tail veins, a new experience for me.) None of them panned exactly, but another hypothesis Sister Marcella proved to be quite accurate. "Something strange is happening to the funeral," she says. "Again and again we have seen that the funeral was followed a week later by a lot of new cases among the mourners."

She was clearly pleaded with us for answers, but there was nothing we could say. Our first task was to ask questions. To break the ice, I showed photos of electron microscopy of the new virus, as I did later in all the villages we visited. The sisters also were fascinated by the wormlike structures that had caused so much pain and devastation in their community.

As we had no idea how the virus was transmitted, and whether the virus could somehow survive on materials such as mattresses and linens, we decided to sleep on the floor of a classroom in the girls' boarding school, which we first fumigated with formaldehyde and cleaned with bleach. I'm exhausted, but again could not sleep. There were too many impressions and race issues in my head. We did not know if the epidemic continues to spread or how fast, but we clearly approaching the heart of it soon would be staring us in the face. I also wondered what happens on earth in a funeral Zaire, and what might motivate a Flemish woman to spend his life in the midst of a distant jungle, totally disconnected from the world, without the most basic infrastructure and communication. How could you run a 100-bed hospital, not even a doctor? How do people survive in these villages? How could I be more useful here?

The night was filled with the croaking and animal sounds. I went outside into the blackest of nights where the stars shone uninhibited by the light of the city seemed so close over my head that I could almost reach, and I heard the distinct and sinister sound of drums. Perhaps, the old way, our arrival was announced.

**************

For the next two days we visited the village every morning, the blood test where we could, scribbling every detail and potentially say a piece of data that we can collect. We have seen patients with blood crusting around their mouths or oozing their swollen gums. They bled from their ears and noses and their rectum and vagina; they were intensely lethargic, drained of strength.

In each village, we held a meeting with the chief and elders. After the passage ritual of a plastic cup about distilled alcohol arak- banana, Peter had the courage (or perhaps a good way) to refuse-we asked them to describe their experience of the new disease the number of cases and deaths, dates, if they had been aware of people currently ill. We interviewed all the villagers we met about daily practices unusual-animal contact, new areas of cleared forests, food and beverage, travel, contact with traders.

We have heard of entire families had been wiped out by the virus moving fast. In one case, a woman in Yambuku died days after birth, quickly followed by her newborn. Her thirteen year old girl, who had traveled to Yambuku to support the child fell ill once she returned to her native village and died a few days later; followed by the wife of his uncle, who had taken care of it; then his uncle; and another relative who had come to care for him. This highly virulent human transmission was scary

We were all familiar with our terms of mission. We were here just for three or four days, to act as scouts preparing for the arrival of a great team that would try to set up systems to monitor the epidemic and break ground for further research. Our job was to document what was happening, sketch some basic epidemiology, take samples from severely ill patients, and if possible, find convalescent recovery that could provide plasma to help heal the sick to come.

And we do that job samples harvesting, collecting data and cataloging the basic logistical equipment that most team would need to bring. But we knew that from a human point of view it was just not enough. We needed to stop the virus to infect and kill people.

epidemic curve of the mystery fever began to take shape. The classic epidemiological curve is quite simple; he traces the number of new infections against time. In the simplest type of the soaring number of people infected rises gradually, then resumes rhythm, peaking in the middle of the graph. Once the virus has exhausted its stock of easy victims (weak or easily accessible), the rate of new infections begins to decline until the epidemic fades to a whisper.

We were all aware of the many exceptions that in real life the unexpected outliers, the blips and delays, complications epidemics spread with secondary and tertiary infections.

The epidemic of Ebola virus disease in West Africa is still getting up to speed, according to new cases and deaths from figures World health Organization (WHO) today. More than 3069 cases were reported, and at least 1,552 died 26 August, but the actual numbers may be two to four times higher, the agency said. WHO now says the epidemic is likely to continue for at least 6-9 more months, and up to 20 000 people could eventually be infected. A "road map" to bring the situation under control estimated to cost $ 40 million. This includes, for example, nearly 8,000 people in Liberia only to staff of isolation and treatment centers, trace contacts, safely bury the dead, and coordinate logistics. The budget estimate includes $ 6 million for security funerals to 13,500 victims.

Over 40% of the total cases were identified in the last 3 weeks, WHO said a clear sign that the epidemic is accelerating rather than decreasing. In Liberia, where the Ebola virus spreads in Monrovia densely populated, there are at least 694 cases, an increase of 296 since the last report on 20 August. There are also new cases in Nigeria, where a traveler from Liberia infected medical staff and other contacts. The new cases are linked to a diplomat who has escaped official surveillance and traveled to Port Harcourt, where he sought medical treatment. The diplomat recovered, but the doctor who treated died, and 70 contacts of the patient and the doctor are now under surveillance. So far at least 17 people were infected in Nigeria, six of whom died

A glimmer of good news :. The mortality rate seems not as high as it was in previous outbreaks of the Ebola virus. So far, the WHO said, the overall case fatality rate among identified cases is 52%, ranging from 42% in Sierra Leone to 66% in Guinea

* Ebola files: . Given the current Ebola outbreak unprecedented in terms of the number of people killed and the rapid geographic spread, science and Science Translational Medicine made a collection 'research articles and news on the viral disease available for researchers and the general public.

Clinical trials rarely have a second look, and when they do, their results are not always what the original authors reported. This is the conclusion of a new study, which compared how 37 studies that had been measured reanalyzed the original. In 13 cases, reanalysis came to a result-a different conclusion suggests that many clinical trials may not be accurately reported the effect of a new drug or intervention.

To conduct the study, published today in on Journal of the American Medical Association ( JAMA ), Shanil Ebrahim, a clinical epidemiologist at the school of medicine at Stanford University in Palo Alto, California, and colleagues combed through the MEDLINE database. The online archive contains nearly every life sciences and biomedical research studies conducted over the past 64 years. The team found 37 trials that were retested. Of these, 13 have come to contradictory conclusions with the findings of the original author. Moreover, only five were reanalyses by a set quite different authors, which means they do not get a neutral relook.

In one of the trials that examined the efficacy of methotrexate drug in the treatment of systemic sclerosis autoimmune disease that causes -a healing of the skin and internal organs, the original researchers found that the drug is no more effective than placebo, as they reported in a 01 paper However, in a reanalysis of the same trial in 09, another group of researchers, one of the original authors used Bayesian analysis a statistical technique to overcome the shortcomings of small data sets that plague clinical trials of rare diseases such as multiple. Reanalysis found that the drug was as it appeared more effective than placebo and had a good chance to benefit multiple sclerosis patients.

In another study, researchers re-analyze a 1984 clinical trial of sclerotherapy in which a drug is injected to treat enlarged veins in the esophagus. The original researchers found that the therapy reduces mortality, but did not reduce the risk of recurrent bleeding at a later date. Based on this finding, they recommended sclerotherapy patients. In 01, however, another group of researchers analyzed the same data with a different statistical method which examined the interaction between recurrent bleeding and mortality, and concluded that sclerotherapy does not reduce mortality. Their results imply that doctors should avoid prescribing sclerotherapy in patients with a high risk of mortality, in contrast to the initial conclusion. Sclerotherapy is still commonly used for the treatment of hemorrhoids and varicose veins.

Other reanalysis found fault with the original methodology. For example, in a study on the effectiveness of the mechanical cardiopulmonary resuscitation (CPR) compared to manual CPR in patients with cardiac arrest outside the hospital, one of the hospitals participating in the trial changed halfway protocols. This changed the outcome of the trial in favor of manual CPR, a flaw that the corrected reanalysis. The authors of this reanalysis belonged to the same research group that the original study.

"It is alarming that an important part of testing came to different conclusions," said Ebrahim. While reanalysis does not always mean the original research was flawed, the amended findings indicate a greater need for sharing clinical trial data, he said.

Tom Jefferson, a researcher based in Rome, which reviews the studies for the Cochrane Collaboration nonprofit, says the results of JAMA study does not surprise. "The process [of analyzing clinical trials] is so subjective, you can twist it as you wish." He noted that pharmaceutical companies often do not provide the all-important raw data from clinical trials, instead of choosing to publish summaries highly compressed their results.

last year, the Cochrane Collaboration has succeeded in a 4-year battle with the Swiss pharmaceutical giant Roche to access raw data from unpublished clinical trials of its drug against the flu Tamiflu. governments around the world were stored drugs to protect against a flu epidemic, after clinical trials found the drug to be effective in the disease. But during a re-analysis of these trials, Cochrane Collaboration found that the underlying raw data of several published studies had not been released. When he finally was able to access this data many years later, a re-analysis showed that Tamiflu was not as effective as thought earlier.

His victims include actor Christopher Reeve, Pope John Paul II, and the British poet Rupert Brooke, who died after a mosquito bite on her lip became infected. Sepsis remains one of the leading causes of death in the United States and worldwide. Now, researchers describe a new way to treat the deadly disease by filtering germs blood of patients.

Sepsis is over-the-top of the reaction of the organism to infection. Even with modern medical care, it can lead to organ failure and death within hours. Measures such as early treatment with antibiotics-which broad-spectrum kill many types of bacteria reduces mortality in recent years, but no drugs specifically target sepsis. Cell biologist and bioengineer Donald Ingber of Harvard University and his colleagues wanted to test a therapy a different technique to shoot the microbes and toxins they release into the blood. As the design guide, the researchers studied the spleen; the organ filter pathogens and poisons the blood wends through its narrow passages.

The first team needed a way to capture nasties. They have magnetic beads coated with tiny fragments of the lectin known as mannose-binding protein (MBL). In our body, MBL helps fight against the pathogens snap on them. Ingber and colleagues have shown that the sticky beads can enter a variety of microbes in the test tube.

With this key challenge of the road, researchers were ready to design the rest of the system. They designed a microchiplike device slightly larger than a deck package that works much like a dialysis machine. As blood enters the device, it receives a dose of magnetic beads, which snapped bacteria and fans in 16 channels. As blood flows through the device, a magnet pulls the beads-and all microbes or toxins stuck to them, the blood drop in neighboring channels containing saline.

The researchers first tested their device with donated human blood contaminated with bacteria. They found that the filtering of the blood through the device five times could remove 0% of the microbes.

Next, Ingber and his team hung anesthetized rats to a pump that circulates blood through the device, and then returned to their bodies. After dosing rats with bacteria, the researchers measured the effectiveness of their system. 1 hour, the device removed 0% of the microbes in the blood of rats, the team reports online today in Nature Medicine .

In determining whether filtering improved blood survival, the researchers injected a lethal bacterial toxin in anesthetized rats and then used the device to filter poison the blood of certain animals. Eighty-six percent of the control rats died during the experiment 5 hours. If their blood has been cleaned, however, only 11% of the animals perished. Although the pearls do not bind to all kinds of infectious microbes, "we get most of the bugs that are the most frequent causes of sepsis," says Ingber. In addition, because MBL focuses on an assortment of invaders, including viruses, the device could potentially eliminate pathogens that cause other blood diseases, including HIV and perhaps Ebola, he said. it may also help treat diseases caused by abnormal blood proteins, such as autoimmune diseases.

"This is a very promising study using a very creative system," says Richard Wenzel, an infectious disease specialist at Virginia Commonwealth University in Richmond.

But skeptics say it is unclear whether the technique can be used for the intended purposes, the treatment of sepsis. "What they have done is to invent an artificial spleen," says Clifford Deutschman, medical care and sepsis critical researcher in Jewish Hofstra North Shore-Long Island School of Medicine in New Hyde Park, New York. It think the device might help many types of patients, including those with injuries of the spleen. But people with sepsis usually are not microbes or toxins in the blood, he said, so there may be nothing to remove.

Ingber not agree. He notes that antibiotics often benefit sepsis patients, reducing the number of microorganisms should be beneficial. "that should help out the bugs," dit- he. He and his colleagues plan to test the device in pigs, which more closely mimic human sepsis.

After a 18-month saga, the European Medicines Agency (EMA) has approved the details of a new system allowing researchers to scrutinize unpublished data from clinical trials. Scientists and transparency campaigners welcomed the decision as a great step forward, but expressed continuing concerns, especially on information that could be redacted before the clinical study reports are divided.

EMA is the "first entity in the world" to introduce such rules, executive director Guido Rasi said at an event in the European Parliament earlier this week, adding that the agency is "establishes new standards for transparency. " the plan, which was approved yesterday at a meeting of the board of management in London, "represents a real shift to ensure that research data is shared and regularly re-used effectively in the public interest," agrees Carl Heneghan , director of the Centre for Evidence Based Medicine at Oxford University and co-founder of the AllTrials campaign, in a statement released yesterday.

the decision of the EMA is part of a great battle for who has the right to view and analyze data from clinical studies of drugs, vaccines and other medical products. published newspaper articles often contain the main results of these studies, but lack of data and information detailed information on the study design, effectiveness, and safety analysis, which could shed a different light on the results when analyzed by others also, some tests are not published at all. The AllTrials campaign argued that the details of each test shall be publicly available for anyone to examine. The industry balked at the idea, although some companies have recently committed to greater openness.

The new rules apply to data presented in the context of authorization applications on the market after 1 January 2015. "Access to clinical data allow third parties to verify the analysis and original conclusions, to conduct further analysis and to examine the positions of the regulatory authority and to challenge, if necessary , "states the policy. In return, the agency expects to receive a copy of the articles resulting secondary analysis before publication, and said they should also be in the public domain.

To avoid interfering with the decisions of regulatory bodies, however, the data will be shared only after the European Commission has taken a decision on a particular application, "which implies a delay of about 18 months, "EMA said in a memorandum.

For the relief of outraged activists, the agency scrapped recent plans that allowed users to view data only on the screen. As part of the future system, scientists will be able to download, save and print searchable clinical reports "for purposes of academic and other non-commercial research," while the data will be available on the screen for all other users after a simple registration process.

However, transparency campaigners are still concerned that the conditions of use are individual researchers "vulnerable to prolonged legal battles with large companies, "and that information may be blacked out before the clinical study reports are divided. Appendix 3 lists the elements of the policy that could be redacted from the clinical study reports, as it can be considered" confidential business information " . This includes, for example, details of proprietary information on analytical methods, or so-called exploratory parameters that could provide potential off-label uses indexes for competitors.

EMA expects that about 5% of the content of a report could be removed in this way, Rasi said, adding that the last word on what will be redacted responsibility of the organization, even if the company disagrees. But "the list of factors that would justify the writing is too expansive ..." says Ilaria Passarani, head of the department of food and health for the organization of European consumers BEUC in Brussels, in an e-mail to Science Insider. "the attitude of the EMA for redaction must be independently verified to ensure overzealous approaches do not hinder access to important information," said Heneghan.

the policy will be reviewed in June 2016 and serve as a bridge until the deployment of the revamped EU regulations clinical trial provides a legal basis for the publication of clinical trial results, but will enter into force at the earliest in May 2016 . (This means that the results of the first tests under the new law will be publicly available from 2019 or 2020.) at a later stage, the BMA also plans to make available data for each patient.

A second health care worker in Texas Presbyterian Hospital of Dallas has been tested positive for Ebola. Today, the US Centers for Disease Control and Prevention (CDC) said its investigation "suggest more" that she and a colleague diagnosed with Ebola on October 14 were at higher risk of infection between 28 and 30 September, when Thomas Eric Duncan had been admitted to hospital, but has not yet received confirmation that he was infected.

"These two health workers to After working on these days, and the two had numerous contacts with the patient when the patient had extensive production of body fluids due to vomiting and diarrhea, "said CDC Director Thomas Frieden in a conference release today.

second healthcare worker flew from Cleveland, Ohio, in Dallas October 13, the day before she developed symptoms, leading CDC to try to contact the 132 passengers and crew on this flight. (The woman had a temperature "high" of 99.5 ° F or 37.5 ° C ;. Who is below the threshold of the fever, which is 100.4 ° F or 38.0 ° C) said Frieden the woman, whose work he did not specify, "should not have traveled on a commercial flight" but stressed that she did not vomit and did not bleed during the trip. "The level of risk of people around her would be extremely low," he said.

Frieden promised that that amount does not happen again. "We will ensure from that point before any other individual who is monitored for exposure undergoes travel any other way that controlled movement, "he said, which could include aircraft or chartered cars, but imposes restrictions on the use of public transport. The new patient will be transferred to the hospital of Emory University in Atlanta, which has a specialized unit to provide care Ebola later today.

From now on, CDC will send a rapid response team "go" for all health care facility that has an Ebola patient. CDC has also sent staff in Dallas and two experienced nurses Emory Ebola provide training and supervision of health workers from Texas Presbyterian.

As often happens with major breaking news, CDC could not answer all the questions of the journalists who attended the press conference or joined by phone. Science Insider had two reporters on the call that are not selected. They were left with the following questions

• Q :. You said that both health workers may have been particularly vulnerable between September 28, when Duncan was admitted to hospital and isolated, and September 30, when he was diagnosed. the infection control was inadequate in these days and how? Why is it less likely that they were infected after diagnosis

• Q: nurses gaps in the Dallas hospital specified in the way their hospital treated the case of Duncan. Your investigation confirmed these errors

• Q: What training, in particular, health workers receive before treating Mr. Duncan? Who provided the training and how long did it last

• Q: Why the latter being moved to Emory? Are you concerned about the level of care at Presbyterian Texas, other infections, or both

• Q: If all future patients to be moved to the one of the four Ebola treatment centers -Specialized the US if their condition permits

• Q :? What specific Ebola training is now provided Texas Presbyterian and other hospitals around the country

• Q: In West Africa, some health workers were afraid to care for patients with Ebola, and some have not shown to work or even leave their homes. Someone in Texas Presbyterian refused to handle Ebola patients

• Q: During the formation of CDC Ebola in Anniston, Alabama, workers health are told to strictly limit travel in Ebola treatment units, starting with the rotation of 1 hour. Is Texas Presbyterian uses a similar strategy? Are Emory and other centers dedicated

• Q: You said that about 50 health workers entered the room Duncan and want to limit the number of people exposed Ebola patients. How do you do that? What is the minimum number required for a single patient

• Q :? Are the people who care for patients Ebola has helped other patients

• Q: You have repeatedly assured the States United we know how to stop the Ebola virus. Are you concerned about the impact both have on your credibility

• Q: Do you think the media pay too much attention to the American epidemic and too little to the epidemic in West Africa

* Ebola files: given the current Ebola outbreak unprecedented in terms the number of people killed and the rapid geographic spread, science and science Translational Medicine made a collection of research articles and news on the viral disease available researchers and the general public.