Ebola: infected nurse may have been sick on earlier flight, CDC official says – latest

More from the White House where Dan Roberts has been covering the president’s briefing to reporters on the Ebola response:

Despite insisting earlier in the week that the various federal agencies responding to the crisis were co-ordinating well, the White House now acknowledges it may need an “Ebola tsar” to oversee the US response.

“Not because these three haven’t been doing an outstanding job but [because] they are also responsible for a whole bunch of other stuff,” he explained. “After this initial surge of activity, we may have a more regular person.. to make sure we’re crossing all the t’s and dotting all the i’s”

But the biggest political U-turn may come over the vexed question of travel restrictions on passengers arriving from countries in west Africa where Ebola is most common, something Republicans have been demanding the White House reconsider.

“I don’t have a philosophical objection necessarily to a travel ban if that is what is going to keep the American people safe,” Obama told reporters. “The trouble is all the discussion I have had so far with experts in the field is that it is less effective than the measures were are already implementing.”

“I continue to push and ask our experts whether we are doing what’s adequate to protect the American people, if they come back to me and say we need to do more then we will do it,” he added. “If it turns out I am getting different answers I will share that with the American people and we will not hesitate.”

Texas healthcare workers deemed at risk of having contracted Ebola have been asked to sign voluntary agreements to stay away from the public, my colleagues Jon Swaine and Lauren Gambino report.

After Dallas authorities decided not to declare a state of emergency, 75 staff members of Texas Health Presbyterian hospital were to be given a “binding legal document and order” that states they will avoid public transport, not go to areas where large numbers of people congregate, and continue to be monitored twice a day for symptoms, county judge Clay Jenkins said on Thursday.

Any of those involved in the care of Thomas Eric Duncan who refuse to sign the agreement would be subject to a legal control order, Jenkins told reporters after a meeting of the county commissioners court in downtown Dallas. “All the remedies of the law are available,” he said. However he said he believed this would not be necessary. “These are hometown healthcare heroes,” he said. “They’re not going to jail.”

The healthcare workers will also have their home addresses flagged on the internal systems of emergency services, said Jenkins, adding that this would prompt first responders responding to calls from their houses to raise an alarm. The flags would disappear when they are no longer at risk of Ebola.

In all more than 135 people – including the 75 healthcare workers, 48 other people who had contact with Duncan before he entered hospital, and a number of people Vinson encountered in Ohio – are being monitored for signs of Ebola.

You can read the full report here.

Jamaica has put an immediate travel ban on people who have transited through Liberira, Guinea and Sierra Leone, Reuters reports.

The ministry of national security said in a statement that the ban covered “certain persons traveling directly or indirectly, from or through” those West African countries, where nearly 4,500 people have died of the disease.

Guyana, meanwhile, has announced that it will deny entry to citizens from those three countries and Nigeria – although the outbreak has seemingly been extinguished in the fourth nation.

Guyana stopped issuing visas to citizens from Guinea, Liberia, Sierra Leone and Nigeria on Sept. 9, said Foreign Affairs Minister Carolyn Rodrigues-Birkette.

In addition to the visa denials in Guyana, health officials will screen anyone who traveled to those four African countries in the six weeks prior to their arrival in Guyana.

Nina Pham is en route to Love Field, the Dallas-area airport from which she’ll travel to the NIH’s facility in Bethesda, Maryland.

Texas Presbyterian Hospital asks that “Dallas commuters who might pass her ambulance to honk their horns in support.”

Passenger luggage and the Air France aircraft in Madrid will be disinfected, Ashifa Kassam reports for the Guardian from Madrid.

The passenger, who showed signs of shaking on board the flight, had travelled from Lagos, Nigeria, to Madrid via Paris. After the plane staff informed ground crews of the situation, the plane was parked in a special area of the airport and the other 155 passengers were allowed to leave the flight as normal, said Air France. Health authorities took note of their details and advised them to contact the Carlos III Hospital if they show any signs of a fever.

What was the last uninfected district in Sierra Leone is now contaminated after two confirmed deaths from Ebola, AP reports, quoting a government health officer.

As Ebola spread across the rest of Sierra Leone, locals in the far northern Koinadugu district had tried to block movement in and out of the area to stop anyone bringing in the haemorrhagic fever.

However, disease surveillance officer Abdul K Sesay said two of six samples taken from the village of Fankoya, where suspicious deaths had been recorded, tested positive on Wednesday.

“On Friday we will burn the house in which the two confirmed cases lived, and the two houses nearby to it,” said district task force representative Momoh Konteh.

Sierra Leone, with Liberia and Guinea, is one of the three countries suffering most from the epidemic. In a precious bit of good news, Liberia’s chief medical officer, Bernice Dahn, ended her 21-day quarantine Thursday, with no signs of infection.

On Wednesday the Guardian received accounts from the district saying that “panic” had riven the community as rumors of the infections spread.

Frontier Airlines is notifying passengers on seven flights that either flew with Amber Vinson or were on the same plane afterward, AP reports.

The flights include Vinson’s first, from Dallas to Cleveland last Friday, one from Cleveland to Dallas on Monday night, and five other flights with the same aircraft on Tuesday.

The airline said Thursday that it was telling those passengers to contact the Centers for Disease Control and Prevention if they were concerned. The CDC has downplayed risk of exposure to other passengers.

Frontier grounded the plane on Wednesday after the CDC notified the airline that a passenger had tested positive for Ebola. The plane is currently out of service in a hangar at the Denver airport.

President Obama has just begun another meeting with top members of his administration, including Lisa Monaco, the Homeland Security chief who is in charge of coordinating various agencies’ Ebola protocols.

According to a White House pool report, the meeting will also include Sylvia Burwell, secretary of Health and Human Services; Denis McDonough, White House chief of staff; Susan Rice, national security advisor; and Dr Thomas Frieden, director of the Centers for Disease Control and Prevention.

The Guardian’s Washington bureau chief Dan Roberts says it looks like Obama may speak briefly afterward.

In the UK, prime minister David Cameron convened a meeting of Cobra, the government’s emergency response committee. The group was told by Britain’s chief medical officer that the risk of Ebola to the UK remains low, a spokesman said.

Per the spokesman:

“There was a discussion over the need for the international community to do much more to support the fight against the disease in the region,” the spokesman said.

“This included greater co-ordination of the international effort, an increase in the amount of spending and more support for international workers who were, or who were considering, working in the region. The prime minister set out that he wanted to make progress on these issues at the European Council next week.

Downing Street also said there are “detailed plans for protecting the UK against Ebola” in place, including screening “up and running across all Heathrow terminals, and [soon in] Gatwick and St Pancras”.

In Sierra Leone, where more than 100 British army personnel have landed, work is being done to build six new treatment facilities, train staff, improve existing centers, and support the government.

The Ebola epidemic may not end until the world has a vaccine, according to one of the scientists who discovered the virus. Sarah Boseley, the Guardian’s health editor, has more from Professor Peter Piot’s talk in Oxford earlier Thursday:

Piot said it would not have been difficult to contain the outbreak if those on the ground and the UN had acted promptly earlier this year. “Something that is easy to control got completely out of hand,” said Piot, who was part of a team that identified the causes of the first outbreak of Ebola in Zaire, now the Democratic Republic of Congo, in 1976 and helped bring it to an end.

Three vaccines are being fast-tracked through early safety trials in in the UK, US and in unaffected Mali. Healthcare workers – who are at highest risk of being infected and over 200 of whom have died – could be offered a vaccination before Christmas, but the only proof that a vaccine is acceptable would be a significant drop in the number of deaths among vaccinated people on the frontline.

Piot compared the epidemic to war, saying the world too often says “‘never again’ and then we forget about it.”

“It could lead to major destabilisation of societies and also political destabilisation,” said Piot. “It is going to come at a very high cost. Just as Sars a decade ago only killed 700, but the economic impact was tens of billions of dollars.”

Piot, like US healthcare researcher Dr Anthony Fauci, said he thought the prospects for an effective vaccine were good, and that the candidates had shown good results in animal trials.

Nina Pham has released a statement through Texas Presbyterian Hospital, in part about her imminent transfer to the special NIH center in Maryland.

The hospital says the decision was made “in consultation with Mr Pham and her family”, and that the nurse’s condition remains good. The statement reads, in part:

With many of the medical professionals who would normally staff the intensive care unit sidelined for continuous monitoring, it is in the best interest of Nina, hospital employees, nurses, physicians and the community to give the hospital an opportunity to prepare for whatever comes next.

Pham says she’s “so thankful for the outpouring of love and support from friends and family, my coworkers and complete strangers. … I appreciate everything that my coworkers have done to care for me at Texas Health Presbyterian Hospital Dallas. I believe in my talented coworkers.”

Republican congressmen insisting on a travel ban for flights to and from west Africa have a visible, if lonely, supporter.

In Dallas, the Guardian’s Jon Swaine says a vote has “gone a bit weird” after convening to decide whether or not to declare a state of emergency.

Jon says there’s “a strange dance going on. The Dallas County judge and commissioners are saying they don’t need a state of emergency regarding Ebola. The mayor seems to stands to agree.”

“Seems instead, Dallas hospital staffers who encountered Ebola patients will be asked to sign an agreement that they’ll stay away from the public.”

A fourth person in Spain is being tested for Ebola, agencies report, adding the detail that a feverish passenger started shaking before their Air France flight was grounded.

The new case is in the Canary Islands, where two people were admitted to a hospital for “precautionary monitoring”. According to the AP, a Red Cross health worker, who recently worked with Ebola patients in Sierra Leone, was hospitalized with a fever in Tenerife, officials said. Two roommates, who showed no symptoms, were placed in hospital isolation as a precaution.

The Air France passenger, Reuters reports, had originally travelled from Nigeria before taking a connecting flight, and developed tremors on a flight from Paris. The plane was evacuated and isolated, and the passenger taken to Madrid’s Carlos III hospital.

The other two people being monitored are a priest who recently traveled in west Africa and one of 68 “low risk” people who came into contact with sick nurse Teresa Romero.

A UN trust fund aiming for $1bn to fight Ebola has only $100,000 in the bank, secretary general Ban Ki-moon said Thursday. The fund was set up about a month ago.

Ban asked the world to provide the money “to get ahead of the curve and meet our target of reducing the rate of transmission by 1 December,” agencies reports.

As of Thursday, just $100,000 was paid into the fund, by Colombia, although $365m had been committed. Much of the pledged amount was donated directly to UN agencies and nonprofits working on the ground in the three worst affected countries of Liberia, Sierra Leone and Guinea, according to UN records.

According to AP, the UN leader said dozens of countries “are showing their solidarity,” singling out the US, Britain, France, Canada and Germany. But he said it’s time that countries that have “the capacity” which he didn’t identify provide support.

Despite the clamor from Washington leaders to impose travel bans, the Obama administration is still debating whether to change its policy, my colleague Dan Roberts reports from the capital.

FAA administrator Michael Huerta said to reporters “We are now working together and assessing this on a daily basis. CDC’s determination is that a travel ban in and of itself doesn’t address the challenges that we have here.” “But”, he added, “this is something that we continue to monitor.”

Asked if he had discussed a ban with the White House, Frieden refused to rule it out. “We have had discussions on the issue of travel to and from West Africa,” he told the hearing. “From the CDC’s perspective we will consider anything that will increase the safety of Americans.

Existing screening measures at JFK airport in New York have led to 8 passengers undergoing further tests since they were introduced on October 11 and similar systems were put in place at Dulles, Newark and O’Hare airports on Thursday.

A congressperson excoriates Texas Presbyterian again and asks Frieden to comment – he says he agrees completely about the need for better training but “the CDC can’t be everywhere”.

Finally, chairman Tim Murphy says that he appreciates Dr Varga’s “honesty, and saying that we made mistakes.” He says that the other witnesses didn’t say as much, which he finds “disturbing”.

He says people will always make mistakes or perhaps not be entirely honest, and that guards like “the buddy system” for removing gear would help ensure that protocols are followed.

He calls for a travel ban from infected countries, better guards domestically; and he calls for immediate training of healthcare workers, including a review of gear; identify and designate specific medical centers equipped for Ebola; accelerate development and trials of all “promising” vaccines and treatments; and he calls for coordination with Congress in confronting Ebola in west Africa.

After a few procedural comments the hearing adjourns, clocking in at almost three hours of testimony and questions.

More about Dallas – where the Guardian’s Jon Swaine is reporting on an imminent vote on whether to declare a state of emergency. From Jon:

John Wiley Price, the commissioner for district three, told the Guardian that the situation was putting a strain on the county’s funds.

“This is still evolving and the only way we can get reimbursed as a county is to make this declaration,” he said. “We escrowed a million dollars last week and we are already north of that. As we continue with clean-ups, surveillance and containment, we need to be able to pay for it.”

Speaking shortly before the commissioners meeting, Price said the Dallas hospital at the centre of the crisis had bungled its response. “It wasn’t handled appropriately and as a result we are all suffering,” he said.

“I can’t speak for the White House … we’ve discussed the issue of travel,” is all Frieden will say to the peroration of Representative Scalise, of Louisiana, on travel bans.

The congressman says the US should at least suspend visas then.

Frieden: “The CDC does not issue visas …”

Scalise: “Do you have a high level of confidence that our US troops … up to 3,000 troops are going to be sent over by president Obama … do you have confidence that they’re protected?”

Frieden says it’s not “zero risk” but “they’re not participating in high risk [activities].”

“There will not be an outbreak here barring a mutation,” Frieden tells the representative from North Carolina, Renee Ellmers.

He reassures her: “We are confident it is not airborne. These nurses were working with someone who was very ill. There was lots of vomiting, lots of hazardous material.”

Asked about the CDC’s authority to help hospitals prepare, Frieden says the US has “a federalist system.” Of the CDC, he says “we are not a regulatory agency.”

He says there are one of the important lessons the CDC has learned so far: “To prevent it at the source. If we had had the basic public health system in these three countries a year ago, this would be over.”

Representative Long, of Missouri, asks basic questions after saying that he does not like how people refer to Nina Pham and Amber Vinson as “nurse one and nurse two”. Then he asks about contagion.

Frieden: “Direct contact from someone who is ill and showing symptoms, or from contact with a corpse.”

Long: “Do you need a fever to be contagious?”

Frieden says a sick person needs to be showing symptoms. Asked again, Frieden says: “Late in the disease when people are deathly ill, they may not have fever, but they probably wouldn’t be able to woalk at that point.”

Frieden tells the representatives that speed is the key to success in west Africa, particularly Liberia. He also confirms what Representative Matheson of Utah says about the importance of stopping the outbreak in west Africa, adding that it improves Americans’ safety.

Asked about funding, Frieden diplomatically thanks Congress for having approved Defense Department funding and resources for the CDC.

“The US navy has a pilot test in development, we’re currently testing that in parts of west Africa. … We’re working with a number of commercial manufacturers as well.”

In Dallas, county authorities will vote Thursday afternoon on whether to declare a state of emergency, my colleague Jon Swaine reports.

Four commissioners and the county judge are scheduled to meet at 2pm to consider “extraordinary measures” necessary because Dallas “has the potential to suffer widespread or severe damage, injury, loss or threat of life resulting from the Ebola virus,” according to a proposal obtained in advance by the Guardian.

Passing the proposal would activate the county’s emergency management plan and a request that Texas governor Rick Perry also declare a state of emergency. This would pave the way for state or federal funds to be transferred to Dallas to help pay for dealing with the crisis.

The state of emergency would give the county judge, Clay Jenkins, wide-ranging authority under state law to control the movement of people into, out of and within the county if he chose. It would also allow him to “order the evacuation of all or part of the population from a stricken or threatened area” if this was deemed necessary.

Dr Elba Garcia, the commissioner for district four of Dallas county, plans to vote in favour of the measure, her chief of staff, Brooks Love, told Jon, who is reporting from Dallas.

Representative Yarmuth, of Kentucky, asks about diagnostics and offers a skeptical take on the media representation of the infections.

Freiden answers about testing first: “At this point we don’t have a test before someone shows symptoms … the test is for the virus itself. We can’t even find tiny amounts of it in people’s bodies until they get sick. There’s a lot of research being done to try to diagnose and treat and prevent better.”

But Freiden says it’s important the media reports it extensively so that the plain facts can get across.

He concedes that “some of the coverage, I think many would agree, exaggerate the potential risks, or may confuse people. But there really is a lot we know about Ebola. CDC has a whole branch … working on ebola and similar infections. We have stopped every outbreak of Ebola except the current outbreak in west Africa. … We welcome the attention; it would be important at times to put it in perspective.”

Representative Griffith, of Virginia, asks how much we really know about Ebola and past outbreaks, including about how it’s spread. He expounds on the matter of dogs, and whether they have antibodies that fight the virus.

Freiden says that “although we’re still learning about every organism we study, we have a lot of information about Ebola. We’ve looked at the issue of exposure to animals … we don’t know of any transmission to dogs [but because] we don’t know we’ve quarantined a dog.”

Griffith: “Don’t you think we ought to at least restrict travel to dogs?”

Freiden looks surprised. “We’ll follow up.”

Welch asks a number of questions that get the standard answers from Frieden:

“People travel, and people will be getting in. … We’ll look at any proposal that would improve the safety of Americans.”

The congressman takes it back to the question of funding and suggests that “Congress revisit its priorities” and make sure that NIH, CDC and HHS have sufficient funding for infrastructure and medical support around the country. Murphy, the chairman, says that he’s arranged to have a hearing on that topic in the near future.

Representative Welch asks about the nature of Ebola and how, practically, hospitals should deal with the CDC and consider and diagnose the virus.

“It’s a severe disease, it’s not as contagious as some other diseases … but any infection of a healthcare worker is unacceptable.” He says that every hospital should be able to communicate with the CDC about cases, and that the agency has received hundreds of calls. In the event of a diagnosis, he says that a team will go to the hospital and consider it as a case by case basis.

Representative Gardner, of Colorado, says that 100-150 people are coming to the US from west Africa each month, and asks Wagner about the logistics of screening travelers.

Gardner: “Would we be checking their temperatures?”

Wagner: “We will not be checking their temperatures, or asking them to fill out a contact sheet.”

Gardner: Wagner: “So we will not be checking the temperatures of 2,000-2,500 people?”

“They’re going to arrive at hundreds of different airports throughout the United States.”

Wagner: “There are no commercial flights coming directly into the United States from those three areas.”

Gardner asks about flights through Europe, and by way of repeating “hundreds of flights, 94% screening,” implies an uncertain level of readiness.

Freiden: “The single most important thing for them to do is for them to ask where they’ve been for the past 21 days, and whether they’ve been in west Africa. … By all means get a flue shot, and for healthcare workers, whenever anyone comes in with a fever or other symptoms, get a travel history.

Gardner goes back to harping on the number of flights, personnel and equipment moving to and fro from the US, directly and indirectly. Freiden defends the greater benefit of travel information over the marginal benefit of rerouting travelers en route to the US.

Fauci says the world’s response has not been commensurate to the rate of the epidemic.

Fauci says: “if you have a raging epidemic, to be quite honest with you Ms Castor, I cannot predict when that will be” that a vaccine or effective treatments begin to make a difference.

Representative Castor, of Florida, gets into the question about research for treatments and vaccines – and begins with a shot at Republicans over last year’s government shutdown.

“Dr Fauci can you explain to us why government support is so important to developing a vaccine?”

Fauci says it’s not in the interests of the pharmaceutical companies to develop treatments for a disease of Ebola’s nature, since not many people have it. “We were sturggling for years to get pharmaceutical partners. We were doing the research … and now we do have pharmaceutical partners [so we’ve made progress] … The research is on this end, and you have to push it so that [there’s less risk to companies]. Companies don’t like to take risks.”

A representative (his name obscured) asks whether Varga and Texas officials have determined where safety breaches occurred in the exposure cases of Pham and Vinson.

“We’ve confirmed that Nina, through her care with Mr Duncan, was wearing protective patient equipment through the whole period of time of the diagnosis confirmed. The level of equipment was elevated to the full hazmat style. We don’t know at this particular juncture what the source or cause to the exposure of Nina was.”

The representative turns to Frieden and asks whether CDC guidelines “mirror international standards”, which he says are being followed.

“There’s no single right answer. Our current guidelines are consistentn with recommendations from the World Health Organization.”

The represntative says “some consistency is what we need.”

Moving on – “on the issue of elevated temperature: is it 101, 99.5, 103.6? I think there’s some issue here. … Mr Duncan came for the first time to the hospita, his temperature was 100.1, within 24 hours of course it was 103! When mom and dad are out there when their child has flu season … “ He asks what parents and Americans should be worried about with regard to fevers and symptoms.

“Parents should not be concenred unless you’re living in west Africa or your child has had exposure to Ebola. Right now in the US it’s just [these three healthcare workers and those being monitored]. We’re always going to have an extra margin of safety for our screening.”

Representative Schiakowsky, of Illinois, asks “how come the nurses in Dallas weren’t protected, and how do we make sure that everyone can be?”

“Those first days were before his diagnosis was known. He suspected, but the tests had not yet been drawn.”

Schiakowsky yields briefly to DeGette, who interjects with a bit of outrage: “He presented with Ebola symptoms, he came to the emergency room … saying he had come from Africa. I believe that CDC protocol says workers should be wearing protective gear even before diagnosis. … I hope that if a person shows up vomiting [and with diarrhea] then you wouldn’t say ‘The lab results aren’t back’ but [that you would] treat him as if he had Ebola.”

Back to Schiakowsky’s question, Frieden says that the CDC tells doctors to “think Ebola” first, and that “the day the diagnosis was confirmed we sent a team to Texas.”

Frieden is now asked about whether the two Ebola patients are being moved because staff fears about the virus.

Frieden says that the hospital faces the challenge of having to monitor some 50 healthcare workers, and that “we felt it would be more prudent” for the CDC and NIH to take over treatment of the two ill nurses.

The representative now asks him about proper protective gear – about shoe protection and exposed skin, particularly. He pulls out a picture of a fully-covered man in west Africa: “This is your picture, in west Africa, with goggles [etc] and you’re about to be doused with a near toxic dose of chlorine?”

Frieden: “Yes”

“And that’s why you can’t have skin expose – it’s impossible to do the disinfection. … What kind of stockpile of this kind of personal protective equipment do you have?”

He asks whether supplies are ready to get quickly to whomever needs them, and the Human and Health Services assistant secretary says there are no shortages and things seem ready.

The congressman turns back to Frieden: “What did you think … patient zero was going to look like?”

“Our goal has been to get hospitals ready. The specific type of personal protective equipment to be used [is more complicated question]… There is no one right answer. The use of different types of personal protective equipment is obviously something we’re looking at very closely right now in Dallas.”

Braley asks John Wagner about the pros and cons of travel bans with regard to border security.

Wagner says through airline data, authorities can track the travel history of passengers and that he “agrees with the experts, it’s easier to manage” that information and contact and track people of interest.

Representative Braley, of Iowa, is asking about how health officials are adapting to the crisis: “Are you familiar with the concept of sentinel event reporting? Has CDC done an analysis of what happened at Texas Presbyterian? Have there been any recommendations on changing, updating [guidelines and plans]?”

“Twenty of the top disease detectives” are on the job, Frieden says, before getting into what the CDC is trying to improve.

“First is the prompt diagnosis of anyone who has fever or shows symptoms and has traveled to west Africa.”

“The second is contact tracing and monitoring – [the contacts of Thomas Duncan have] their temperature taken, every day, for the 21 days. We’re now looking at the contacts of the two healthcare workers.”

“The third area is effective isolation and we’re looking very closely at what might have happened with these two exposures.”

Representative Blackburn, of Tennessee, starts talking at length about the border with Mexico, apparently misunderstanding Dr Frieden’s “porous border” phrase as meaning the southern US border – rather than the borders of Liberia, Guinea and Sierra Leone.

Frieden clarifies his point. John Wagner, of US border patrol, is cut off as he tries to answer how the southern border is at all relevant to the Ebola crisis.

Blackburn moves on to the dangers of medical waste, asking whether the CDC is providing

Frieden: “We’ve worked very closely with the Department of Transportation as well as the commercial waste companies.”

Blackburn: “So we have an added danger of removing and moving waste.”

Frieden: “We have detailed guidelines for the disposal of medical waste from the care of Ebola patients.”

Blackburn: “Are American troops going to come into contact with Ebola patients [in Africa]”

Frieden: “As I understand it from the Department of Defense, their plans [do not include] any care of Ebola patients. … The Department of Defense is trying very hard to avoid the possibility of soldiers coming into contact [with anyone showing symptoms, as well”

Waxman asks Dr Fauci whether he agrees, which the latter does.

“It’s certianly understandable that someone might come to the conclusion that the best approach would be to seal off the border of those controls. … But we know what we’re dealing with. [If we were to close airports] there would be this big web of things that we don’t know what we’re dealing with.”

Representative Waxman defends the CDC, pointing out that they don’t have the authority to impose anything on hospitals across the US but can only provide guidance and assistance. He says Frieden and other officials are tasked with dealing with “a fluid situation” and also trying to forestall panic.

“So we have to make sure we monitor healthcare workers … so the question has been raised, what about all these people coming in from Africa?”

He gestures with a map of airline traffic flows from Africa, making the point that it’s easy to catch layovers to the US from airports around the world. In effect Waxman is reinforcing Frieden’s earlier argument: airports as control points are far more useful than trying to block the “porous borders” around the world.

Representative Upton is asking about how people could contract the disease, be asymptomatic, and then manifest Ebola here in the US.

Upton: “Does the president have the legal authority to impose a travel ban, is that correct?”

Frieden: “I don’t have the legal expertise to answer that question.”

From what he’s seen, Upton says, the president does have that power. Upton now asks about travel restrictions imposed by other countries, which Frieden says are in some cases “in flux”.

Finally, he asks “why can’t we move toward a similar ban … especially knowing that … this is not a fail-safe system that’s been put into place?”

Frieden: “Right now we know who’s coming in. If we try to eliminate [air travel] … we won’t be able to check them for fever when they leave, when they arrive, we won’t be able to check for a detailed history. We wouldn’t be able to impose quarantine … we wouldn’t be able to identify and trace contacts – email history, phone history [etc]. … We wouldn’t be able to impose controlled motion …”

Upton: “If we have a system in place that requires any airline passenger coming in from overseas that we can’t look at one’s travel history and say ‘No, you’re not coming here.’ … Until the situation is resolved in Africa.”

They go back and forth about how Vinson boarded a plane with a fever.

DeGette: “She was told by your agency that she can board your plane?”

Frieden: “I do not know exactly what was said, but she did contact our agency and she did board the plane … People who are in what’s called controlled movement, should not board commercial airlines.”

DeGette: “And that’s people who’ve had contact with these patients.”

Frieden: “The guidelines say people who were not protected [by appropriate equipment] should not, but that people [who were can].”

Representative DeGette is asking Dr Varga about what happened with Thomas Eric Duncan in Texas, running through much of what he just said.

“Because Ebola is highly contagious, the protective gear that [health workers] have to wear has to cover them completely, correct?”

She gestures with a New York Times graphic and asks what workers should have been wearing before Ebola was diagnosed. Frieden says it depends on whether a patient has diarrhea and vomiting, then additional covering is recommended.

Back in Washington, Dr Luciana Borio, assistant commissioner for counterterrorism policy and actinv chief scientist of the FDA, and John Wagner, of US Customs and Border Protection, have both testified about US readiness.

Borio goes through FDA plans to test and supply treatments, and Wagner talks about the preparedness at airports and among border security, stressing good communication about what to look for.

Dr Daniel Varga, a Texas health official, describes, in depth and without shying from the errors, the timeline of treatment for Duncan, Pham and Vinson – until the chairman asks him to conclude to preserve time.

Seven people in north-east Ohio have entered voluntary quarantine – despite having no symptoms – after confirmed contact with Amber Vinson, the second Texas nurse who tested positive for Ebola.

CNN broke the story with word from Ohio Department of Health spokesman Jay Carey, who said that the people are monitoring themselves for fever or symptoms.

In what may be an excess of caution, two schools have closed in Ohio, because someone who works there “traveled home from Dallas on Frontier Airlines Tuesday on a different flight, but perhaps the same aircraft” as Vinson, the school district said in a statement. In Texas schools closed as well, because two students were on Frontier flight 1143 with Vinson.

Spain is testing a third person for Ebola today – Reuters reports, saying he was a religious missionary recently in Liberia.

A Spanish missionary who worked in Africa has been taken to hospital in Madrid with symptoms of Ebola, a hospital source said on Thursday.

The priest had been in Liberia and had been in contact there with people infected with Ebola, El Mundo newspaper reported, adding he was hospitalized on Thursday after developing a fever of over 37.6 (99.68) degrees Celsius.

He was in the same religious order as two other Spanish priests who were repatriated from west Africa in recent weeks with the disease, and who later died in Madrid, the newspaper said.

The Spanish government confirmed the third person’s testing in a statement.

He says that all the therapeutics tried so far are experimental – and emphasizes “We do not know” whether they’re having an effect, or what that effect might be.

He runs down the list of treatments attempted so far, and says “We are in phase one trials” for a vaccine, and that the US military in collaboration with the NIH is working on a vaccine as well.

Fauci says the trials in animals have been “favorable” so far, but that it is one of the highest priorities is making sure any such treatment is safe and would not create more harm than good.

Finally, he confirms the report about the first Texas Ebola patient: “This evening tonight we will be admitting to the clinical studies unit at the NIH Nina Pham, otherwise known as ‘nurse number one’, where we will be giving her state of the art care.”

Dr Anthony Fauci, of the National Institute of Allergy and Infectious Diseases, is now describing some of the science behind Ebola, saying that it’s difficult to confront the virus because it’s highly lethal and infective on contact with bodily fluids, and because there is no cure.

Fauci describes NIAID’s roles as one of diagnostics and research, with an endgame in “vaccines and therapeutics” .

He says that the CDC fields calls from healthcare professionals and anyone who fears they have symptoms, and that only one of those calls – “one call too many” – turned out to be positive: Thomas Eric Duncan.

Frieden also says that the CDC has teams ready to be deployed anywhere in the country “within hours”.

He now demonstrates with some documents, saying that he is ready to explain in full how the CDC traces contacts of infected patients. “There are no shortcuts. … We’re always open to new ideas.”

Dr Tom Frieden, director of the CDC, takes the floor:

He goes through is credentials and almost 25 years of experience researching communicable diseases.

“Ebola is not new, even if it is new to the United States … We know how to control Ebola, even in this period, even in Lagos, Nigeria. We do this by [isolating, treating] and tracing contacts.”

“To protect the United States we have to stop it at its source. There is a lot of fear about Ebola, and I’ll tell you as director of the CDC, that I fear it will spread more in Africa. Our top priority, our focus, is to work 24/7 to protect Americans. We protect Americans from threats, and in the case of Ebola we do that through a system of multiple levels.”

“We have helped each of the infected countries to use exit screening. We identified 72 people with fever, none of them … boarded a plane. … Recently we added another level of [screening] at the US. … We’ve also increase awareness among physicians in the US to think Ebola, to look for anyone who has fevers or symptoms of infection and has been to Africa in the past 21 days.”

Back in DC at the hearing, Fred Upton, a Republican from Michigan, tells the medical officials that he’s going to “hold your feet to the fire” to make sure that proper safeguards are implemented immediately.

He too suggests travel bans to and from west Africa, although he does say that the US must work to confront the outbreak there.

Simon Waxman, a Democrat from California, ridicules the idea of a ban, pointing out that people can easily fly “to Brussels” and then into the US. He goes after Republicans who backed the government shutdown in 2013 and says: “We have our share of responsibility of funding the infrastructure … we shouldn’t leave ourselves vulnerable to these irrational budget cuts.”

Ending the outbreak in west Africa is “a national security imperative”, RepresentativeDiana DeGette of Colorado says.

She says we need to find out why Texas Presbyterian Hospital was not prepared, and says that Americans should be concerned about the appearance of Ebola in the US, but “should not panic”.

“It would be an understatement to say that the response to the first US patient of Ebola has been mismanaged.”

DeGette says that steps at airports are appropriate, and “there’s no such thing as ‘fortress America’ when it comes to infectious diseases”.

A Democrat, she’s now saying that budget cuts and lack of funding to medical research and international efforts against infectious diseases have in part helped to make “this situation dire”.

Murphy calls the current protocols of thermal scanning and questions at airports as “troubling” and says that passengers can mask symptoms of a fever.

He calls for the administration just to ask Congress to get things done – a noble, if suspect offer, considering the legislature’s recent history of partisan stalemate.

Dan also flags some interesting points from prepared testimony, including updates on the mission to develop an Ebola vaccine, and a disturbing detail of mismanagement at Texas Presbyterian Hospital in Dallas.

In pre-submitted evidence, Dr Daniel Varga, the chief clinical officer at the Dallas hospital that first treated cases in the US, revealed how the temperature of the first patient Eric Duncan had spiked to 103 degree fahrenheit during his first visit to the emergency department, yet he was still sent home.

About experimental drugs and production capabilities, Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID) warned that they were still some distance from widespread trials.

“While NIAID is an active participant in the global effort to address the public health emergency occurring in west Africa, it is important to recognize that we are still in the early stages of understanding how infection with the Ebola virus can be treated and prevented,” he said.

“As we continue to expedite research while enforcing high safety and efficacy standards, the implementation of the public health measures already known to contain prior Ebola virus outbreaks and the implementation of treatment strategies such as fluid and electrolyte replacement are essential to preventing additional infections, treating those already infected, protecting health care providers, and ultimately bringing this epidemic to an end.”

A congressional hearing of the US House of Representatives is due to begin at 12pm ET, and my colleague in Washington, Dan Roberts, briefs us on what to expect:

In prepared testimony ahead of a hearing of a House of Representatives oversight committee, Thomas Frieden, director of the CDC, pointed to the temporary re-emergence of the disease in Nigeria as a sign of what happens if contact tracing protocols are not fully followed.

“It’s like fighting a forest fire: leave behind one burning ember, one case undetected, and the epidemic could re-ignite.”

Frieden points to “meticulous work” in Nigeria as a model to emulate – noting “that the outbreak appears to have been extinguished there.” He does warn, however, that even with 10 CDC staff and highly trained Nigerian epidemiologists, one missed case caused a cluster of others in Port Harcourt.

Airline cleaner crews “don’t really have enough time” to properly clean planes, one US worker tells the Washington Post – just as another told my colleague Lauren Gambino last week.

From the Post:

“We go in there, wipe down the lavatories, empty the garbage. We do the same thing, wipe down the seat pockets, empty out the pockets,” says Luke-Anthony, who lives in the Bronx and has two small children. “If there are blankets, we put ‘em in bags. Vacuum, mop.”

“Food, wet napkins, sanitary wipes, dirty Pampers. It’s disgusting,” Luke-Anthony says. “Sometimes we find dirty needles.”

Last week workers at New York’s LaGuardia airport walked off the job for a day to protest poor preparation. As one told the Guardian:

They expect us, that if a little bit of feces stays on the toilet, that we remove it with our hands because [if not] they will say that bathroom is dirty. And I refuse to do it because I think it’s disgusting and I don’t have the appropriate attire, and because I don’t know what that person has.

“We come in contact with a lot of stuff that is dangerous for our health and obviously they don’t give us the appropriate tools to work with.”

You can read the full piece here.

A nurse with a high fever in has been rushed to a hospital in France, Reuters and local French media report, where she will be evaluated. France has had two false alarms in recent weeks, and one infected humanitarian worker has recovered there.

Reuters says the woman being tested today was taken under high security to the Begin de Saint-Mande military hospital outside Paris.

The woman had been in regular contact with a French volunteer nurse working with humanitarian group Doctors Without Borders who contracted Ebola in Liberia and was repatriated to France last month.

That nurse, the first French national to be infected with the disease, received an experimental treatment for the virus and subsequently recovered.

Reuters could not confirm the report, however, with the French Health Ministry, which has a policy of not commenting until tests are completed.

Screening for Ebola will begin today at four US airports, following New York’s JFK airport, which began checks on Saturday.

Each of the airports – O’Hare in Chicago, Newark airport, Washington DC’s Dulles and Atlanta’s international – is a major international hub for airliners.

Teams equipped with thermal guns will take the temperatures of travellers from Liberia, Sierra Leone and Guinea and ask questions about their possible exposure to the virus as they enter the US.

Dr Martin Cetron, a director at the CDC, said in a Saturday briefing that despite any number of checks at airports: “No matter how many procedures are put into place, we can’t get the risk to zero.”

Test results for a person with a fever in Spain will come in this afternoon, after a Spanish health official confirmed.

The official, Fernando Simon, also says that one of the people being monitored for having had contact with an infected nurse, is being evaluated:

“One of [the 68 people being monitored] has developed fever this morning. She was immediately told to remain at home and will be immediately transferred to the Carlos III Hospital. The appropriate protocol has been put in place very quickly because the case has been detected in a very timely manner and we understand that we will have results by this afternoon or this evening of the first Ebola test.”

About the Teresa Romero, the nurse who contracted the disease:

“The patient is in stable condition, the viral load seems to be down, which means that a priori, the immunity system of the patient is being able to control the infection – which is a positive sign.”

We have information that the infection of the organs that had been affected during the infection also are improving. But as always with a disease like this, we have to be cautious until the last moment and although there are clear signs of hope, we should continue to be cautious and maintain moderation when giving information about her condition.”

So far 15 people, including Romero’s husband and hospital staff who came into contact withe her, are under observation in an isolated ward, and none have shown symptoms. Today’s developments mean two people with fevers are being tested, one of whom is known to have contacted Romero, who remains in serious condition.

One last major point from the WHO: it plans to send teams to test Ebola preparedness in at Mali and Ivory Coast’s borders.

Mali borders Guinea, and Ivory Coast borders both Guinea and Liberia – the latter of which has been particularly hard hit by the outbreak. In August Ivory Coast closed its land borders with both countries, despite the WHO’s counsel that the measure is counter-productive. Per Reuters:

A team of around 10 will leave for Mali on Sunday and another team will leave for Ivory Coast within days, Nuttall said, adding that Ivory Coast had checkpoints to monitor people coming across the border and had already done a simulation exercise to test its response.

Here are the main points from the WHO briefing:

• The number of Ebola cases is set to exceed 9,000 by the end of this week, and the number of deaths will soon exceed 4,500.
• The number of new cases is doubling every four weeks. Guinea, Liberia and Sierra Leone remain the worst hit.
• There has been an “encouraging” drop in the number of cases in the Lofa district of Liberia. The WHO said it was hopeful that the decrease was the result of community engaging paying off, but cautioned that it was too early to tell.
• The WHO is to focus attention of 15 African countries to stop the disease spreading. They are: Ivory Coast, Guinea Bissau, Mali, Senegal, Benin, Burkina Faso, Cameroon, Central African Republic, the Democratic Republic of Congo, Gambia, Ghana, Mauritania, Nigeria, South Sudan, Togo. They have to be “better prepared” the WHO warned.
  

This is what Nutall said about pickups and ambulances:

We have enough evidence now to know that the best ambulance is not a closed ambulance it’s pickup. Why is better to have pickup? The driver is protected. The [infected] person can be put in the back and therefore you limit the manipulation of the person.

Nuttall named the 15 countries (corrected from the figure of 14 she mentioned earlier) where the WHO is trying to stop the disease spreading. They are: Ivory Coast, Guinea Bissau, Mali, Senegal, Benin, Burkina Faso, Cameroon, Central African Republic, the Democratic Republic of Congo, Gambia, Ghana, Mauritania, Nigeria, South Sudan, Togo.

These priority countries either have land borders with affected countries or they have high travel and trade with the worst hit countries.

She said: “The objective is to stop the transmission from occurring in these countries. They may have a case but after one case we don’t want more cases.” These countries need to be “better prepared” Nuttall said.

Here’s a transcript of the first part of Nuttall’s statement, including the “encouraging” drop in cases in one district of Liberia.

This week we will cross 9,000 cases of Ebola and 4,500 deaths. The outbreak continues to hit health workers hard. So far 427 health care workers have been infected with Ebola and 236 have died.

Our data shows cases are doubling every four weeks. The disease is still widespread in Guinea, Liberia and Sierra Leone, and there is persistent transmission of the virus.

An increase in new Ebola cases in Guinea is being driven by a spike in confirmed and suspected cases in the capital Conakry, and the nearby district of Coyah.

In Liberia problems with data gathering makes it hard to draw any firm conclusions. There is significant under-reporting of cases from the capital Monrovia. But it is also worth mentioning that in Lofa district appears to have a decrease in the number of cases. This is encouraging since this area was hit hard early on, but we need a concerted effort to sustain this drop. Remember we have seen drops before and have then seen another increases in the number of cases.

WHO has had a strong community engagement in the area of Lofa in Liberia, and we are hopeful that this work is paying off. Time will tell.

In Sierra Leone, intense transmission is still occurring in the capital Freetown and surrounding districts.

It will take months before this outbreak is stopped. In the meantime we need to make sure it doesn’t spread to other countries.

Here’s a recording of Nuttall’s update on the WHO’s latest Ebola assessment.

Nuttall points out that pick up trucks are better than ambulances for transporting patients because they provide better protection for drivers.

Nuttal says the WHO is focusing on 14 countries to stop the disease spreading.

The WHO reports a rare bit of good news from in Liberia.

But elsewhere the news is still grim.

There is another suspected Ebola case in Spain, while the the condition of nursing assistant who contracted the virus is improving, a health ministry spokesman told AP.

Someone who came into contact with Teresa Romero before she was treated in hospital has a fever and is awaited test results, he added.

Spokesman Fernando Simon said Romero is stable condition at Madrid’s Carlos III hospital and the level of Ebola virus in her body is declining.

Simon said the person to be tested reported having a fever above 37.7 C (99.9F) the level Spanish authorities have set for at-risk people to be tested.

He did not identify the person but said it is not a healthcare worker. The results of the tests are expected on Thursday evening.

Ebola survivor Will Pooley explains his decision to return to Sierra Leone, in this video.

The 29-year-old is so far the only Briton to have contracted the disease. He was airlifted out of Sierra Leone in September but later made a full recovery. Doctors are confident he is now free of all five strains of the virus

The Ministry of Health in Sierra Leone has announced that Ebola has now reached every district of the country.

It noted two Ebola cases in the Koinadugu district, in Sierra Leone’s far north. Until today this was the only area of the country where there were no confirmed cases.

The World Health Organization reported 4,249 infections in Sierra Leone with 2,458 fatalities.

A British school has called off a visit by African teachers after parents raised concerns about pupils contracting the Ebola virus, PA reports.

Teachers from Gambia were due to take part in a long-planned exchange trip at Raysfield Infants’ School in Chipping Sodbury, Gloucestershire.

Health authorities were consulted about possible risks from Ebola but insisted there was “no reason” to cancel the trip on safety grounds.

The school was forced to postpone the exchange regardless following concerns and a meeting with parents last week.

Head teacher Alison Wood said: “The level of concern from some parents about the planned trip has prompted Kristina Lundahl, director of education from The Future in our Hands in the Gambia, to postpone the trip.

The trip was planned last February when Wood and other members of staff were at The Future in our Hands in the Gambia.

In a letter to parents, Wood said the school had agreed to cancel the trip as it would be “overshadowed by concerns” and was trying to get a refund on the flights.

Last week a school in Stockport cancelled a planned placement of a boy from Sierra Leone because of the fears of parents.

Nine-year-old Kofi Mason-Sesay from Sierra Leone was due to study at St Simon’s Catholic primary school in Hazel Grove, Stockport, while his mother, Miriam, was fundraising for the charity EducAid, which runs a network of free schools for vulnerable youngsters in the west African country.

Despite being cleared by immigration officials the placement was cancelled. The headteacher complained off “misguided hysteria” among some parents.

The UN’s new high commissioner for human rights Zeid Raad al-Hussein has drawn comparison between the Ebola outbreak and the Islamic State group Thursday, labeling them “twin plagues” upon the world, AP reports.

At his first news conference in the role, Zeid focused on the “two monumental crises” that he said would inevitably cost nations many billions to
overcome.

“The twin plagues of Ebola and Isil,” he told reporters, “both fomented quietly, neglected by a world that knew they existed but misread their terrible potential before exploding into the global consciousness during the latter months of
2014.”

The photograph currently running at the top of this blog Ebola patients Amber Vinson being helped onto a flight by health workers in protective clothing and one man who is plain clothes.

Sky News highlights a similar photograph of the man, who is carrying a clipboard, coming within a few feet of Vinson.

It says the incident is the latest to raise questions about the US response to the outbreak.

CBS has footage of the incident.

Liberia, one of three countries most affected by Ebola, is running low on body bags, according to CNN.

It only has 4,900 body bags nationwide and needs another 85,000 more in the next six months CNN reported citing the Liberia’s Health Ministry.

A grim inventory of supplies shows body bags were not the only items lacking. Liberia is also experiencing a shortage of other supplies needed to fight the virus, including protective suits, face masks, gloves and goggles.

Liberia said it needs 2.4 million boxes of gloves in the next six months, but it has only 18,000 boxes. Each box has 100 pairs.

It also needs about 1.2 million hooded overalls within the same time frame, but it has only 165,000.

Infection control experts have criticised the “lax” federal guidance on treating Ebola that was still being issued to US hospital and their staff last week, the New York Times reports.

The CDC has since updated its guidance to include full-body suits covering the head and neck plus advice on how to remove the protective clothing.

Sean Kaufman, who oversaw infection control at Emory University Hospital which treated the first two American Ebola patients, described earlier CDC guidelines “absolutely irresponsible and dead wrong.”

Medical organisations in Germany argue that the government could do more to support the international effort against Ebola, writes Philip Oltermann in Berlin.

A working group at Leopoldina, the German national academy of sciences, on Wednesday released a call for Germany to accelerate its effort to develop experimental vaccines and medicines for clinical application.

“Germany already has very good expertise in this field, particularly with the research going on in Marburg’s Institute for Virology and Hamburg’s Bernhard Nocht Institute for Tropical Medicine”, said Jörg Hacker, Leopoldina’s president.

The discovery and development of vaccines against Ebola should not be solely subject to market economy principles, he said. He added that recent progress in the field of Aids research had shown that governments could drive progress via public-private partnerships or medical foundations.

The cost of the three Ebola victims who have been treated so far has not been footed by the German government, but the patients’ own health insurers. A spokesperson for Leipzig’s St Georg clinic said that in the case of the Sudanese UN employee who had died of the disease in Germany on Monday night, the cost of the treatment had been covered by the UN’s own insurance.

He said that the cost of treating patients with Ebola was “extremely high”, amounting to around 10,000 euros plus additional medicine costs.

1,600 Germans have so far answered a Red Cross call for volunteers to help fight the epidemic in West Africa; 350 of them have been deemed suitable applicants. The organisation said that 117 volunteers were already available to be deployed in West Africa, 43 of them doctors.

A Chinese drugmaker has sent an experimental Ebola drug to Africa for use by Chinese aid workers and is planning clinical trials there to combat the disease, Reuters reports.

Sihuan Pharmaceutical Holdings Group Ltd has supplied several thousand doses of its drug JK-05 to the region, chief operating Officer Jia Zhongxin said. More doses could be sent if needed, Jia said.

“Aid workers have already taken the drug with them, and if a case breaks out (amongst the aid workers), then the drug may be used,” added Huo Caixia, Sihuan’s assistant general manager.

Sihuan, part-owned by US investment bank Morgan Stanley , is hoping to get the drug fast-tracked for civilian use in China.

It has signed an agreement with the Academy of Military Medical Sciences (AMMS), a research unit, to seek approval for the drug’s use in China and push it to market.

The drug, approved in China for emergency military use only, was initially developed by AMMS.

The company is preparing for clinical trials in Africa and could test the drug on African Ebola patients, said Huo.

No Chinese nationals have been infected.

There are about a million Chinese nationals living in Africa, with some 10,000 in the countries most affected by Ebola, which are Sierra Leone, Guinea and Liberia.
JK-05 has not been used on humans, although Sihuan says it has proven effective in tests on mice.

Its development lags some way behind US-developed ZMapp and TKM-Ebola, which have been tested on monkeys and used on Ebola patients.

However, analysts said the drug’s similarities to Japanese influenza drug Favipiravir is an encouraging sign.

Japanese firm Fujifilm Holdings Corp last week said the French and Guinean governments were considering clinical trials of Favipiravir, developed by group firm Toyama Chemical Co, to treat patients with Ebola.

France will start carrying out health checks on Saturday on travellers arriving by plane from Guinea, AFP reports.

Medics at Paris’s main international Charles de Gaulle airport will take the temperature of passengers arriving from the daily flights still operating from the Guinean capital Conakry, Health Minister Marisol Touraine.

The checks will be carried out before passengers enter the airport building, by medical staff with the help of the Red Cross and French emergency response services.

France and the Red Cross will also be helping Guinea to step up existing checks on passengers boarding flights in Conakry.

“The first precaution is to ensure that someone who has a fever does not board the plane,” Touraine told French radio earlier.

Passengers will also be asked to fill out a questionnaire enabling them to be tracked down if necessary after they land.

Two students from Guinea-Bissau have been taken to hospital in the Russian town of Oryol, to check for Ebola, RT reports.

They arrived in the country at Moscow’s Domodedovo Airport and travelled to Oryol by bus, it said.

The students, Monteyro Bolde Iyury (20) and Santoush Monteyro Ayuk Lidish (23) are being kept in an isolation unit. Both are reported to have had a fever, but their temperature levels have since returned to normal.

Ebola survivors are meeting in Kenema, one of the centres of the Ebola outbreak in Sierra Leone, to share their experience of the disease and learn how to deal with its psychological aftermath.

The event is organised by the Sierra Leone government with the help of Unicef.

Alhaji Moijue Kaikai, minister of social welfare, said the survivors “give hope” to others still fighting the the disease. He said: “We need to accept survivors and welcome them back to our families and our communities.”

The survivors will hear from experts on how to deal with trauma and stigmatisation.

People who have been exposed to, and survived Ebola, are often shunned by their communities, Unicef warned. It found that 96% of households in Sierra Leone reported some discriminatory attitudes toward people with suspected or confirmed Ebola.