We’re ready if Ebola ar­rives, say health officials

China acts as killer virus takes heavy toll in West Africa, re­ports Shan Juan in Bei­jing.

China Daily (Canada) - - FOCUS -

China is on guard against the Ebola virus and well pre­pared to re­spond to any threat from it, health officials say as global con­cerns mount over the out­break in West Africa.

Dong Xiaop­ing, deputy direc­tor of the emer­gency re­sponse divi­sion at the Chi­nese Cen­ter for Dis­ease Con­trol and Pre­ven­tion, said the na­tion is far from the ar­eas af­fected and there are no di­rect flights to these coun­tries.

“The pos­si­bil­ity of Ebola en­ter­ing China re­mains re­mote, although it does ex­ist,” Dong said. “But a mass out­break in China can be ruled out, given the ca­pac­ity for re­spond­ing to it here.”

The lat­est Ebola out­break, the largest of its kind and the first in West Africa, has claimed more than 1,000 lives in four coun­tries.

Last week, the World Health Or­ga­ni­za­tion de­clared the epi­demic a “pub­lic health emer­gency of in­ter­na­tional con­cern”.

Dong said, “If there are iso­lated cases, we will be ca­pa­ble of ‘ con­tact trac­ing’ and fur­ther stop­ping the spread of the virus.”

Health­care pro­fes­sion­als and hos­pi­tals also stand ready to treat pa­tients and carry out in­fec­tion con­trol mea­sures if the need arises, he said.

Ebola virus dis­ease is one of the world’s most vir­u­lent dis­eases. The in­fec­tion is trans­mit­ted by di­rect con­tact with the blood, body flu­ids and tis­sues of in­fected an­i­mals or peo­ple.

The lat­est out­break, which started in Fe­bru­ary in Guinea in West Africa, has since spread to neigh­bor­ing Liberia, Sierra Leone, and Nige­ria, whose health sys­tems are too weak to han­dle the scourge.

The WHO warned that the pos­si­ble con­se­quences of any global spread of Ebola are se­ri­ous in view of its vir­u­lence and has called for a co­or­di­nated in­ter­na­tional re­sponse to stop and re­verse any such po­ten­tial­ity. Re­sponse plan in place

China’s top health au­thor­ity, the Na­tional Health and Fam­ily Plan­ning Com­mis­sion, is­sued an Ebola hem­or­rhagic fever re­sponse plan on July 31.

Un­der the plan, lo­cal med­i­cal in­sti­tu­tions must use an on­line sys­tem to re­port any con­firmed or sus­pected Ebola cases di­rectly to the com­mis­sion within two hours. The re­quire­ment makes it one of the most strin­gent of its kind in­volv­ing in­fec­tious dis­eases.

Other key in­for­ma­tion pro­vided cover clin­i­cal symp­toms, virus screen­ing and even the dis­posal of the bod­ies of in­fected vic­tims.

“The Ebola re­sponse plan has been dis­trib­uted among all stake­hold­ers, in­clud­ing the health, trans­porta­tion and cus­toms de­part­ments,” said Song Shuli, the com­mis­sion’s spokes­woman.

Song said the re­sponse in­cludes checks and prepa­ra­tions in bio-safety and se­cu­rity that in­volved mass events like the 2008 Bei­jing Olympics.

The coun­try al­ready has in place ac­tion plans to deal with Ebola, even though there have been no out­breaks of it nor sam­ple virus strains for re­search, she said.

He Xiong, deputy direc­tor of the Bei­jing CDC, agreed.

“A sound health emer­gency pre­pared­ness plan en­abled by mul­ti­de­part­ment col­lab­o­ra­tion is in place in China as a legacy of the coun­try’s re­sponse to ma­jor threats like SARS in 2003,” He said.

Over the years, China has grad­u­ally formed and con­stantly fine-tuned its emer­gency re­sponse and in­fec­tion con­trol sys­tem to deal with threats like the SARS epi­demic and H1N1 flu pan­demic scare.

The sys­tem forms the bedrock of any re­sponse to out­breaks and in­cludes early de­tec­tion, iso­la­tion of cases, con­tact trac­ing and mon­i­tor­ing, and rig­or­ous pro­ce­dures for fur­ther in­fec­tion con­trol, He said.

For ex­am­ple, hos­pi­tals can alert pub­lic health de­part­ments of sus­pi­cious cases or re­port con­firmed ones.

In re­turn, the health de­part­ments help up­date over­all out­break devel­op­ment and de­vise or ad­just re­sponse strate­gies.

“Such co­op­er­a­tion was not well- im­ple­mented be­fore SARS,” said Xu Qian, head of the in­fec­tious dis­ease de­part­ment of the China-Ja­pan Friend­ship Hos­pi­tal, which treated SARS pa­tients dur­ing the epi­demic that killed 349 peo­ple on the Chi­nese main­land alone.

“In­fec­tion con­trol aware­ness has largely been en­hanced since SARS and high alert at the front lines of our de­part­ment to­wards any in­fec­tions in­clud­ing Ebola has be­come rou­tine,” she said.

Even be­fore the com­mis­sion is­sued its emer­gency re­sponse plan, her hos­pi­tal had “taken ac­tions like staff train­ing and check­ing pa­tients with fever for back­ground in­for­ma­tion as if they had trav­eled to the af­fected ar­eas”.

Hos­pi­tals must also re­port cases of pa­tients suf­fer­ing un­ex­plained fevers to the CDC, un­der a new mech­a­nism that was set up fol­low­ing SARS to help de­tect po­ten­tial out­breaks, she said.

“Hos­pi­tals have been grad­u­ally tak­ing in­creas­ing pub­lic health re­spon­si­bil­i­ties ever since,” she said, adding that China is ready to re­spond to any out­breaks.

A con­sen­sus that every­one shares pub­lic health re­spon­si­bil­ity has grad­u­ally been reached na­tion­wide, He said.

Govern­ment agen­cies in­clud­ing health, tourism, cus­toms and trans­port will hold reg­u­lar talks and set up co­op­er­a­tion mech­a­nisms in case of any vi­ral out­break, he said. Guard­ing against virus

Chi­nese quar­an­tine au­thor­i­ties have strength­ened in­spec­tions at its bor­ders as part of mea­sures to pre­vent the Ebola virus from spread­ing into the coun­try.

On Aug 4, the Gen­eral Ad­min­is­tra­tion of Qual­ity Su­per­vi­sion, In­spec­tion and Quar­an­tine said in a work no­tice that it will im­ple­ment stricter in­spec­tions on in­bound air­lines from re­gions af­fected by Ebola, and step up san­i­tary mea­sures on in­com­ing ve­hi­cles and goods.

At Baiyun Air­port in the south­ern boom­town of Guangzhou, which re­ceives more than 1,000 pas­sen­gers from Africa One of the most danger­ous viruses known to man

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daily, rou­tine tak­ing of pas­sen­gers’ body tem­per­a­tures has been prac­ticed strictly.

“Those whose tem­per­a­ture is higher than 37.5 C might be put un­der med­i­cal ob­ser­va­tion to clear them of Ebola in­fec­tion,” said air­port em­ployee Chen Yan­ling.

In late July, a Hong Kong woman who showed symp­toms sim­i­lar to those of the Ebola virus af­ter vis­it­ing Kenya tested neg­a­tive for the dis­ease but still caused brief panic.

Sierra Leone’s Na­tional Olympic Com­mit­tee said its del­e­ga­tion for the up­com­ing youth games was asked not to travel to China be­cause of an out­break of Ebola, The As­so­ci­ated Press re­ported.

The pres­i­dent of the com­mit­tee, Pa­trick Coker, said the Chi­nese em­bassy in Sierra Leone said the del­e­ga­tion “might find them­selves in a trou­bled and awk­ward sit­u­a­tion once they get to China’s port of en­try”.

The Youth Olympics be­gin on Satur­day in Nan­jing, cap­i­tal of Jiangsu province. The 12-day event fea­tures more than 3,000 ath­letes from around the world, from the ages of 15 to 18.

Seven Chi­nese med­i­cal staff work­ing in the Sierra LeoneChina Friend­ship Hos­pi­tal, quar­an­tined af­ter treat­ing Ebola pa­tients, have also shown no Ebola symp­toms and their con­di­tions were sta­ble, an of­fi­cial with the Chi­nese em­bassy told Xin­hua News Agency on Tues­day.

The quar­an­tine of another mem­ber of the Chi­nese med­i­cal team in Sierra Leone was con­cluded af­ter he was checked and ruled out from be­ing in­fected with the virus, the leader of Chi­nese med­i­cal team, Wang Yaop­ing, told Xin­hua.

Tom Frieden, direc­tor of the US Cen­ters for Dis­ease Con­trol and Pre­ven­tion, said: “The bot­tom line with Ebola is we know how to stop it: tra­di­tional pub­lic health. Find pa­tients, iso­late and care for them; find their con­tacts; ed­u­cate peo­ple; and strictly fol­low in­fec­tion con­trol in hos­pi­tals. Do those things with metic­u­lous care and Ebola goes away.”

Xiang Ni­juan, a re­searcher of the China CDC, agreed and said that the coun­try’s tech­ni­cal guide­lines con­cern­ing con­tact trac­ing and man­age­ment, lab test­ing and pa­tient trans­fer will soon be dis­trib­uted to guide the over­all re­sponse.

For in­stance, metic­u­lous con­tact trac­ing means find­ing every­one who may have been ex­posed to a person with Ebola and check­ing for signs of ill­ness ev­ery day for 21 days, she said.

The Ebola virus can re­main in the body for weeks be­fore mak­ing a person sick. If the con­tact de­vel­ops a fever or other Ebola symp­toms, that person is iso­lated and treated and the cy­cle starts again — and all of that person’s con­tacts must be traced and fol­lowed for 21 days. Help­ing af­fected ar­eas

WHO Direc­tor-Gen­eral Mar­garet Chan also called for ef­fec­tive in­ter­ven­tion and co­op­er­a­tion at the in­ter­na­tional level, with de­mand for re­sponse to the out­break out­strip­ping lo­cal ca­pac­ity in West Africa.

With­out global part­ner­ship, the worst Ebola out­break in his­tory in terms of scale and sever­ity might be cat­a­strophic and spread to other places, she warned.

In re­spons e, China an­nounced last Thurs­day hu­man­i­tar­ian aid sup­plies worth 30 mil­lion yuan ($4.9 mil­lion) for three Ebola-hit coun­tries to help con­tain the out­break.

Three pub­lic health ex­pert teams have also been dis­patched to Guinea, Liberia and Sierra Leone to help dis­trib­ute sup­plies and guide lo­cal Chi­nese com­mu­ni­ties on self-pro­tec­tion.

About 20,000 Chi­nese na­tion­als live in the three coun­tries, fig­ures from China’s Min­istry of Com­merce showed.

More clin­i­cal in­fec­tious dis­ease doc­tors from Bei­jing and Hu­nan province are also pre­par­ing to med­i­cally as­sist the af­fected coun­tries, Bei­jing health au­thor­i­ties said.

Chi­nese med­i­cal teams un­der a long-stand­ing govern­ment med­i­cal as­sis­tance pro­gram con­tinue to work at the three coun­tries.

“China has joined the global com­mu­nity to boost the fight against Ebola in West Africa,” said Cus­to­dia Man­dl­hate, the WHO rep­re­sen­ta­tive for Kenya, adding that China’s past ex­pe­ri­ence with in­fec­tion re­sponse will help the af­fected coun­tries fight Ebola.

The in­volve­ment will also help China un­der­stand and pre­pare for any Ebola even­tu­al­ity, said Li Qun, the emer­gency re­sponse chief of the China CDC.

“Our ex­perts will gain first­hand ex­pe­ri­ence treat­ing the dis­ease dur­ing their com­mu­ni­ca­tion with lo­cal health work­ers,” he said.

On Sun­day, Pres­i­dent Xi Jin­ping sent mes­sages to the pres­i­dents of Guinea, Sierra Leone and Liberia to ex­press sym­pa­thy to the three African coun­tries over the deaths in the Ebola out­break.

China is will­ing to sup­port the three coun­tries in con­tain­ing the spread of Ebola, Xi said.

Chi­nese Am­bas­sador to Liberia Zhang Yue said med­i­cal sup­plies and equip­ment sent di­rectly to the cap­i­tal, Monrovia, from China were flown in by a spe­cial cargo plane on Mon­day af­ter­noon. The de­liv­ery in­cludes per­sonal pro­tec­tion equip­ment, med­i­cal in­stru­ments, san­i­tiz­ers, dis­in­fec­tants, symp­tom relief medicines and non-con­tact in­frared ther­mome­ters.

China has launched an emer­gency mech­a­nism with sim­pli­fied pro­ce­dures and sent a spe­cial cargo plane for quick de­liv­ery of the sup­plies, Zhang said.

Pres­i­dent Ellen John­sonSir­leaf of Liberia lauded the Chi­nese govern­ment for the help. Step­ping up re­search

On Tues­day, the WHO said that two ex­per­i­men­tal vac­cines for Ebola were set to start clin­i­cal tri­als in the com­ing weeks and there could be enough early-stage data to plan for their emer­gency use later this year.

WHO As­sis­tant Direc­torGen­eral Marie-Paule Kieny said: “There is a way to fast­track vac­cine clin­i­cal tri­als.”

Mean­while, An­thony Fauci, direc­tor of the US Na­tional In­sti­tute of Al­lergy and In­fec­tious Dis­eases, said in an ar­ti­cle in the New Eng­land Jour­nal of Medicine that “pro­duc­tion scale-up” of ZMapp was un­der way but would take time.

ZMapp is a mix of an­ti­bod­ies, pro­duced by Mapp Bio­phar­ma­ceu­ti­cal of San Diego, US, which was given to two US medics in­fected with Ebola.

In China, test­ing ca­pac­ity is ready for Ebola, said Dong of the China’s CDC. Con­tact the writer at shan­juan@chi­nadaily.com.cn

SHEN BO­HAN / XIN­HUA

Quar­an­tine of­fi­cers with the en­try-exit in­spec­tion and quar­an­tine bureau at the Bei­jing Cap­i­tal In­ter­na­tional Air­port give body tem­per­a­ture tests to four pas­sen­gers from Nige­ria on Thurs­day. They all passed the test and were al­lowed through the border.

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