“It’s basically admitting defeat,” said Dr. Peter H. Kilmarx, the leader of the federal Centers for Disease Control and Prevention’s team in Sierra Leone, adding that it was “now national policy that we should take care of these people at home.”

“For the clinicians it’s admitting failure, but we are responding to the need,” Dr. Kilmarx said. “There are hundreds of people with Ebola that we are not able to bring into a facility.”

連邦CDCのシエラレオネハケンチームリーダのDr. Peter H. Kilmarxは「これは基本的には敗北を認めたということだ。今や、自宅でこれらの人々を看護するというのが国家政策である。医療関係者にとっては敗北を認めることだが、我々に必要なことには対処していく。施設に収容できていないエボラ感染者が数百人いる」と述べた。

The effort to prop up a family’s attempts to care for ailing relatives at home does not mean that officials have abandoned plans to increase the number of beds in hospitals and clinics. But before the beds can be added and doctors can be trained, experts warn, the epidemic will continue to grow.

C.D.C. officials acknowledged that the risks of dying from the disease and passing it to loved ones at home were serious under the new policy − “You push some Tylenol to them, and back away,” Dr. Kilmarx said, describing its obvious limits.


CDCのDr. Kilmarxは、「新たな方針のもとは、自宅でエボラで死亡し、周囲の人々に感染を広めるリスクが重大であること」を認めて、「タイレノールを患者にかけて、患者に触れないこと」とできることの明らかな限界を述べてい

But many patients with Ebola are already dying slowly at home, untreated and with no place to go. There are 304 beds for Ebola patients in Sierra Leone now, but 1,148 are needed, the World Health Organization reported this week. So officials here said there was little choice but to try the new approach as well.

“For the first time, the nation is accepting the possibility of home care, out of necessity,” said Jonathan Mermin, another C.D.C. official and physician here. “It is a policy out of necessity.”


CDC職員で医師であるJonathan Meriminは「初めて、やむをえず、シエラレオネ政府は自宅看護の可能性を認めている。これは、やむをえない政策だ。」と述べた。

[ADAM NOSSITEROCT: "Officials Admit a ‘Defeat’ by Ebola in Sierra Leone" (2014/10/11) on NYTimes]


When it opened, there were 120 beds available. Within hours, the clinic was already stretched − every space available filled with the city’s most frightened and seriously ill. Somehow, room was made for more patients and currently, by adding beds and sofas where possible, staff estimate the total number is likely closer to 200.


[Stephanie Jenzer: "Ebola outbreak: Liberia's newest, largest treatment clinic already at capacity" (2014/09/29) on CBC]
So many Ebola victims are dying at home because of the severe shortage of treatment centers here in Monrovia, Liberia’s capital, that they are infecting family members, neighbors and others in a ballooning circle of contagion.

Only 18 percent of Ebola patients in Liberia are being cared for in hospitals or other settings that reduce the risk of transmission by isolating them from the rest of the population, according to the Centers for Disease Control and Prevention. Unless that rate reaches 70 percent, the center predicted this week, Ebola cases will keep soaring.



[NORIMITSU ONISHI: "In Liberia, Home Deaths Spread Circle of Ebola Contagion" (2014/09/24) on NYTimes]
Looking for a new approach to blunt the Ebola epidemic sweeping West Africa, the Liberian government, the World Health Organization and their nonprofit partners here are launching an ambitious but controversial program to move infected people out of their homes and into ad hoc centers that will provide rudimentary care, officials said Monday.


[Lenny Bernstein and Lena H. Sun: "New effort to fight Ebola in Liberia would move infected patients out of their homes" (2014/09/22) on WashingtonPost]
Faced with similar circumstances in neighboring Liberia, where even more people are dying from the disease, the American government said last month that it would ship 400,000 kits with gloves and disinfectant.

“The home kits are no substitute for getting people” to a treatment facility, said Sheldon Yett, the Unicef director for Liberia. “But the idea is to ensure that if somebody has to take care of somebody at home, they’re able to do so.”


ユニセフのリベリア担当のSheldon Yettは「ホームキットは、治療施設への収容に代わるものではない。しかし、これは自宅で看護せざるをえなくなったときに、それができるようにするものである。」

[ADAM NOSSITEROCT: "Officials Admit a ‘Defeat’ by Ebola in Sierra Leone" (2014/10/11) on NYTimes]

posted by Kumicit at 2014/10/12 09:28 | Comment(0) | TrackBack(0) | Disease | このブログの読者になる | 更新情報をチェックする



豪州のSue Ellen Kovack(57歳, 登録看護師)がシエラレオネのエボラ対策に1か月間ボランティアで参加して、2014/10/07に豪州に帰国後。体調不良で2014/10/09に入院。当日遅くにエボラ検査の結果が出て、陰性だった。

A Cairns nurse who was hospitalised on Thursday has tested negative to the deadly Ebola virus, authorities say.

Sue Ellen Kovack, 57, presented herself to the Cairns Hospital on Thursday afternoon after complaining of a fever. Three days earlier she returned from a month-long volunteering stint in Sierra Leone treating Ebola hospital victims.

In a statement, Queensland Health chief health officer Dr Jeanette Young said Ms Kovack would remain under observation for at least another 24 hours.

"This is a necessary precaution given the patient has been to West Africa and has had a fever within the incubation period of 21 days. For the sake of her health and to follow due diligence, we want to be sure she is clear of Ebola virus disease as well as any other disease."


Sue Ellen Kovack(57)は、2014/10/09午後に発熱してCairns Hospitalに来た。3日前に、一か月間のシエラレオネでのエボラ治療ボランティアから帰国したところだった。

豪州Queesland州保健省の最高保健責任者Dr Jeanette Youngは、声明で、Ms Kovackは最低24時間は観察下に置かれると述べた。


[Kristian Silva: "Ebola scare: Cairns nurse tests negative" (2014/10/10) on SMH]

ここまでは何の問題もなかったのだが、そこにCairnsを含むKennedy選挙区選出のBob Katter国会議員が登場した。
Mr Katter said on Thursday it was "unbelievable and incomprehensive" how a person could get into Australia from an Ebola infected country.

"There cannot be any compromise with this," Mr Katter said.

"If you want to go to one of these countries, however laudable your motivation, I am sorry but when you return to Australia, you must be quarantined for three weeks - not home quarantined."

Mr Katter said Australian aid workers travelling to west Africa, including Ms Kovack, were putting Australia at risk.

"We love these people, and we honour these Australians for being self-sacrificing, but compared to the risk they create for our country, it is not remotely comparable. One person's moral and humanitarian ambitions are being carried out at a very grave cost to Australia."


[Aid workers creating Ebola risk in Australia, Bob Katter claim (2014/10/09) on SMH]
Australian Medical Association head Brian Owler has lashed out at Mr Katter's 'hysterical' response. He has called for calm until the results are known, and for Australia to dedicate more resources to stopping the crisis overseas.

"Now is not the time to be creating hysteria and concern," he said. "We also need to show a level of empathy for this individual, instead of creating hysteria. This woman has done everything right.

[Aid workers creating Ebola risk in Australia, Bob Katter claim (2014/10/09) on SMH]

QUEENSLAND MP Bob Katter's comment that a nurse put the country at risk of Ebola through her "humanitarian ambitions" in west Africa were unfortunate, and the "real hero" deserves a pat on the back, Opposition Leader Bill Shorten says.

[Katter comments 'unfortunate': Shorten (2014/10/11) on NewsComAu]
posted by Kumicit at 2014/10/11 10:54 | Comment(0) | TrackBack(0) | Disease | このブログの読者になる | 更新情報をチェックする

リベリアとシエラレオネのエボラアウトブレイク Update(2014/10/10)


The UK is sending 750 military personnel to Sierra Leone to help deal with the deadly Ebola outbreak, Foreign Secretary Philip Hammond has confirmed.

The UK will also send medical ship the RFA Argus and three helicopters. The personnel will be deployed next week.

Philip Hammond外相によれば、英国はシエラレオネに750名の部隊を派遣し、エボラアウトブレイク対応を支援する。さらに英国は病院船RFA Argusと3機のヘリコプターも派遣する。兵員移動は来週実施される。

[Ebola outbreak: UK sending 750 troops to Sierra Leone(2014/10/08) on BBC]

Sierra Leone on Tuesday launched an ambitious schooling effort for more than a million children denied their education due to the Ebola epidemic, saying lessons would be delivered via radio.

Classes in a variety of subjects will be broadcast for four hours, six days a week, on 41 radio stations and the country's sole TV channel, the government announced.

"The plan is to provide a suitable option for our school-going population as the entire school system has been disrupted since the outbreak of the Ebola disease," said Education Minister Minkailu Bah.

Schools have been closed since the government announced a state of emergency in July in response to an epidemic which has killed 3,500 people in west Africa, more than 600 of them in Sierra Leone.

More than two million of its population of 5.7 million are aged between three and 17, although in reality the secondary school attendance rate is less than 40 percent for both boys and girls.


「エボラアウトブレイク以来、学校制度が崩壊しているので、この計画により、学校に通う世代に適切な選択肢を提供する。」とMinkailu Bah教育相が述べた。


[Rod Mac Johnson: "Ebola-hit Sierra Leone launches school by radio" (2014/10/07) by The Associated Press]

世界銀行Jim Kim総裁曰く「エボラ対策が無様に失敗しており、200億ドルの資金がさらに必要」

世界銀行Jim Kim総裁はエボラ対策が無様に失敗しており、200億ドルの資金がさらに必要だと述べた。
The president of the World Bank, Jim Kim, admitted on Wednesday that the international community had “failed miserably” in its response to the Ebola virus that has killed more than 3,800 people in west Africa and warned that the crisis now affecting Spain and the US was going to get much worse.

Amid signs yesterday that western governments were being forced to take the risks of a global pandemic more seriously, Kim said he wanted them to back a new $20bn (£12bn) global health fund that would be able to react instantly to emergencies.

“It’s late. It’s really late,” he said in an interview with the Guardian before the annual meeting of the Washington-based organisation this weekend.

“We should have done so many things. Healthcare systems should have been built. There should have been monitoring when the first cases were reported. There should have been an organised response.”

世界銀行Jim Kim総裁は2014/10/08に、西アフリカで3800人以上を死亡させたエボラ対応に、国際社会は無様に失敗しており、危機はスペインと米国身も影響し、事態は悪化していると述べた。昨日の兆候から、西側世界の政府たちは、世界的なパンデミックのリスクをもっと真剣に受け止めることを余儀なくされており、
Jim Kim総裁は、ただちに非常事態に対処できるように、200億ドルの世界医療資金のバックアップが新たに必要だと述べた。

今週末の世界銀行本部ワシントンでの年次総会の前のGuardianとのインタビューで、Jim Kim総裁は「遅すぎる。本当に遅すぎる。たくさんのことをやっているべきだった。医療体制が構築されているべきだった。最初の症例が報告されたときに、モニタリングが実施されているべきだった。組織的対応が必要だった」と述べた。

[Larry Elliott: "Ebola crisis: global response has ‘failed miserably’, says World Bank chief" (2014/10/09) on TheGuardian]
米英が人の移動制限を進めているが、これに対して、Jim Kim世界銀行総裁は...
“We don’t need to stop all travel from these countries. It’s going to be impossible to stop people. The way to stop the flow of patients from these countries getting to the rest of the world is to have programmes that will treat people and increase survival dramatically. It’s possible.

“We need to have quality services in place so that the motivation to leave these countries goes away. It is a rational thing to do to get away because we don’t have the treatment in place.”

Rudimentary healthcare systems in the three west African countries have encouraged people to travel abroad for treatment, thereby spreading the virus. Before the crisis, Liberia had 61 doctors and 1,000 nurses, while Sierra Leone had 327 hospital beds.



[Larry Elliott: "Ebola crisis: global response has ‘failed miserably’, says World Bank chief" (2014/10/09) on TheGuardian]

posted by Kumicit at 2014/10/11 09:05 | Comment(0) | TrackBack(0) | Disease | このブログの読者になる | 更新情報をチェックする



  • 2014/08/03: リベリアの首都MonroviaのSan José de Monrovia Hospitaの医長Brother Patrick Nshamdzeがエボラで死亡[TheSpainReport]。
  • 2014/08/05: Brother Patrick Nshamdzeの治療にあたっていたBrother Miguel Pajares (75)をスペインへ搬送[TheSpainReport]。
  • 2014/08/12: Brother Miguel PajaresがマドリードのCarlos III Hospitalで死亡[TheSpainReport]。
  • 2014/09/22: シエラレオネの首都Freetownでエボラ対策に当たっていて、エボラ感染したBrother/Dr Manuel García Viejo(69)がスペインに到着し、マドリードのCarlos III Hospitalに入院した。彼は、Lunsar市にあるSan Juan De Dios Hospitalの医長であり、熱帯疾病の専門家である[TheSpainReport]。
  • 2014/09/25: Brother/Dr Manuel García Viejo(69)がCarlos III Hospitalで死亡[TheSpainReport]。
  • 2014/09/30: Manuel García Viejoを治療するチームの一員だった看護助手Maria Teresa Romero Ramosが発熱し、当局に連絡するも、特にアクションなく、数日後も同様[Guardian]。
  • 2014/10/06: Maria Teresa Romero Ramosが当局へ連絡するも、近隣の病院へ行くよう指示。Alcorcon Hospitalでエボラ感染の可能性を申告したが、病院側は特に防護装備もせず、救急救命室で対処。その後、勤務先でもあるCarlos III Hospitalに移送。エボラ感染確認[NBCnews] 。既に接触者を追跡・特定[AP]。30名の医療従事者を21日間のモニタリング対象に[NBCnews]。
  • 2014/10/09: Maria Teresa Romero Ramosと接触した医師2名を入院させてモニタリング[WashingtonPost]。

Maria Teresa Romero Ramos(44)看護助手への感染経路については明確ではないが、防護装備を脱ぐときに、手袋で顔に触れた可能性があるという。ただし、未確定。
“I think the error was the removal of the suit,” she told Spanish newspaper El País by phone. “I can see the moment it may have happened, but I’m not sure about it."

Initially, Ramos told another Spanish newspaper El Mundo from her isolated hospital bed that she had "no idea," how she might have become infected.

But on Wednesday, German Ramirez, a doctor in the Carlos III Hospital's Tropical Diseases unit, said Ramos recalled that she might have had contact with her face after leaving an Ebola patient's isolation room.

"During the course of the morning, we looked at actions taken when [the nurse’s aide] put on her protective suit," Ramirez said outside the hospital. "She has told us of the possibility that her suit had contact with her face.... It could have been an accident. It looks like it was the gloves."

[Abby Phillip and Abby Ohlheiser: "Spanish nurse with Ebola may have touched her face with a glove when removing protective gear" (2014/10/08) on WashingtonPost]
Maria Teresa Romero RamosとともにManuel García Viejoの治療にあたった医師の一人によれば、自身が着用した防護服の丈が短かったという。
One of the doctors who treated her, Juan Manuel Parra, said in a statement posted to the El Pais Web site that the sleeves on the protective suit he wore while working with Ramos were too short.

[Abby Ohlheiser and Abby Phillip: "As Spanish Ebola patient’s health deteriorates, two doctors who treated her are under observation" (2014/10/09) on WashingtonPost]
posted by Kumicit at 2014/10/10 07:25 | Comment(0) | TrackBack(0) | Disease | このブログの読者になる | 更新情報をチェックする



心臓などに障害をもたらす症例があり、米国FDAが使用を禁じたDMAAとよく似た1,3-dimethylbutylamine(DMBA, AMP Citrate, 4-amino-2-methylpentane citrate, Pouchong tea)が12種のサプリから見つかったという研究をLiveScienceが紹介している(癌研究で使われるDMBA=dimethylbenzanthraceneとは別物)。
The synthetic compound, called 1,3-dimethylbutylamine (or DMBA), is extremely similar to another stimulant called DMAA, the researchers say. In 2012 the Food and Drug Administration banned DMAA because of reports of its side effects, including heart problems, nervous system disorders and death.

In the new study, the researchers found that 12 out of the 14 weight loss and sport supplement products that they tested contained large amounts of DMBA, in the range of 13 to 120 milligrams per serving. Molecules of DMBA are very structurally similar to those of DMAA but with some tweaks, such as one fewer carbon atom, the researchers said. The compound has only been tested in a few animal studies, the researchers said.

It is concerning that many consumers may be using these supplements, unaware that they contain untested stimulants, said Dr. Pieter Cohen, an assistant professor of medicine at Harvard Medical School and a general internist at Cambridge Health Alliance in Boston, who co-authored the new study.

"There's not a single experiment that we are aware of, in which this substance was given to humans," Cohen told Live Science.

Because of the structural similarity of DMBA to DMAA, it is highly possible that the drugs have similar effects, Cohen said. Both drugs can be stimulating in a way similar to amphetamines, but have a different chemical structure from that class of compounds.

研究者たちによれば、合成化学物質1,3-dimethylbutylamine (DMBA)は興奮剤DMAAと非常によく似ている。2012年に米国FDAは、心臓や神経系の障害や死亡を含む副作用報告があったため、DMAAの使用を禁じている。


研究の共著者であり、Harvard Medical Schoolの医学助教授で、BostonのCambridge Health Allianceの内科医であるDr. Pieter Cohenは、「消費者が、安全性を実験されていない興奮剤が含まれていることを知らないで利用していることは問題だ」と述べた。

Dr. CohenはLiveScienceに「この物質を人間に投与したという実験を我々はまったく関知していない」と語った。

DBMAとDMAAの構造が似ているので、同様の効果が持つ可能性が非常に高いと考えられるとDr. Cohenは言う。いずれも、同じ化学物質群で構造の異なるアンフェタミンと同様に興奮剤として機能しうる。
DMBA came to researchers' attention when a consumer in the Netherlands reported to health authorities about feeling side effects such as jitteryness after using a supplement called Unstoppable, the researchers said.

An entirely different drug that is used in cancer studies is also called DMBA, but has a different full name and chemical structure.


[Bahar Gholipour: "Untested Stimulant Found in 12 Supplements" (2014/10/08) on LiveScience]
サプリの成分記述にありがちな、「天然由来の成分は安全である」という幻想を前提とした表現として、この1,3-dimethylbutylamine(DMBA)も、Pouchong tea (文山包種茶)抽出物と記載される。たとえ、実際にPouchong teaに含まれていたとしても、ごく微量であり、それを大量に摂取したときに、何が起こるかは誰も知らない。

Frenzy (Driven Sports)
Contraband (Iron Forged Nutrition)
Redline White Heat (Vital Pharmaceuticals Inc)
MD2 Meltdown (Vital Pharmaceuticals Inc)
Evol (Genomyx LLC)
Oxyfit Xtreme ( planetary nutrition.com)
Synetherm ( planetary nutrition.com)
Decimate Amplified (Genomyx LLC)
AMPitropin (Lecheek Nutrition)
AMPilean (Lecheek Nutrition)
OxyphenXR AMP’D (Beta Labs, LTD)

posted by Kumicit at 2014/10/09 07:44 | Comment(0) | TrackBack(0) | Quackery | このブログの読者になる | 更新情報をチェックする