CDC Official Who Handled Zika and Ebola Outbreaks Mysteriously Missing

© Tami Chappell / Reuters

A respected Centers for Disease Control and Prevention (CDC) official who worked on the Ebola and Zika outbreaks has disappeared without a trace. He was last seen leaving work midway through the day, saying he was feeling ill.

The Harvard-educated epidemiologist and US Navy officer Timothy J. Cunningham, 35, has been missing since February 12, when he left work after saying he was feeling unwell.

His parents became concerned when he wouldn’t answer any texts or calls. They drove all the way from Maryland to Atlanta, Georgia, after some relatives went by and saw his house was empty and two windows were open. Inside the house, they found Cunningham’s phone, wallet and driver's license. His car was still parked in the garage and his dog, Mr. Bojangles, aka Beau, was left on his own.

“Tim never leaves Beau unattended,” the missing man’s father, Terrell Cunningham told NBC News. "He just doesn't do it.”

“None of this makes sense,” Timothy’s brother Anterio told WAGA-TV, a Fox affiliate in Atlanta. “He wouldn't just evaporate like this and leave his dog alone and have our mother wondering and worrying like this. He wouldn't.”

“I feel like I’m in a horrible Black Mirror episode,” his sister Tiara told the New York Times.

With two degrees from Harvard, Cunningham worked on the government’s response to the Zika and Ebola crises. He had recently been promoted to the rank of commander, and was one of The Atlanta Business Chronicle’s ‘40 Under 40 Award’ winners. But family members said in recent calls and texts that Cunningham seemed to not be himself.

Family, friends, and Timothy’s college alumni are all taking part in the search, and have raised more than $20,000 as a reward for any information, a sign of the high regard in which Cunningham was held. His family hopes that someone may recognize him somewhere, perhaps as a patient at a hospital.

Ebola Making a Comeback in Guinea

Guinea has suffered a setback in its fight against Ebola with a rash of new cases, including three doctors infected by the virus, with officials blaming weak surveillance and a failure to follow safety procedures.

Ebola vaccine trial

The outbreak, which began in eastern Guinea more than a year ago and has killed over 10,000 people in the three West African countries worst hit, had appeared to be on the wane, but Guinea has seen cases rise for three consecutive weeks, according to World Health Organization data.

A government health report from the weekend showed there were 21 new cases in a single day, a spike from the recent daily average of eight.

President Alpha Conde said on Tuesday that everything must be done to end the outbreak by mid-April, ahead of a meeting with donors scheduled around that date.

Ending Ebola could reboot Guinea's mining-dependent economy that has been hammered by the outbreak which has scared investors, he said.

"With Ebola, it is easier to go from 100 cases to 10 cases than from 10 cases of to zero. To end it, we need 10 times more effort than when the outbreak was at its height," he said.

New infections

A big source of concern is a chain of new infections that can be linked back to a woman who died of Ebola and was not buried safely, according to Fatoumata Lejeune-Kaba, spokeswoman for the UN's Ebola emergency response mission UNMEER.

"It's a major setback .... It's due to individual behaviours. That is having a devastating effect on the community. People are simply not practising the safety rules that we have been talking about for a year," she told Reuters.

Guinean President Alpha Conde says the final push to get cases down to zero
is a major challenge that requires even more effort than when the Ebola outbreak
 was at its peak. (Cellou Binani/AFP/Getty Images)

Of the other two countries worst hit, Sierra Leone has also seen a spate of new cases while Liberia has no known cases at present and is waiting to be declared free of the disease.

The new cases in Guinea are in the capital and the southwestern town of Forecariah but if the situation is not brought under control they could spread across borders, said Lejeune-Kaba.

Guinea officials said the new cases came from high risk Ebola contacts who had left Forecariah and developed symptoms elsewhere, pointing to poor surveillance.

Sakoba Keïta, Guinea's anti-Ebola task force coordinator, said on Tuesday that the government was putting in place new measures including strict rules regulating the movement of corpses and contact tracing.

"There are numerous gaps in the Ebola response in Guinea, notably in surveillance of contacts, and that explains the difficulty in making any lasting progress towards ending the epidemic," said a spokesman for medical charity MSF.

The three doctors were infected at the Ignace Deen hospital in Conakry, which is not an Ebola centre. More than 50 doctors in Guinea have caught the virus during the outbreak.

WHO Failure has Made Ebola Crisis Much Worse than It Should Have Been

Poor communication and incompetent staff meant the World Health Organization failed to react swiftly Ebola outbreak in Africa, reports say.

An internal document said those involved "failed to see some fairly plain writing on the wall", according to the Associated Press.

Separately, sources close to the WHO told Bloomberg of multiple failures in the outbreak's early stages.

In the worst affected countries - Liberia, Guinea and Sierra Leone - the Ebola virus has now killed 4,546 people with cases of infection numbering 9,191, according to the latest WHO figures.

The reports have brought into focus the way the WHO dealt with the outbreak in the months after it received the first reports of Ebola cases in Guinea in March.

Medical charity Medecins Sans Frontieres (MSF) warned in April that the outbreak was out of control - something disputed by the WHO at the time.

"Nearly everyone involved in the outbreak response failed to see some fairly plain writing on the wall," the document obtained by AP says.

The draft report - a timeline of the outbreak - also reportedly says that experts should have realised that traditional methods of containing infectious disease would not work in a region with porous borders and poor heath systems.

Among the problems cited in the information obtained by AP and Bloomberg are:

A failure of WHO experts in the field to send reports to WHO headquarters in Geneva

Bureaucratic hurdles preventing $500,000 reaching the response effort in Guinea

Doctors unable to gain access because visas had not been obtained

Responding to the allegations, the WHO's head of global response and alert, Isabelle Nuttall, told the BBC: "Time will come for investigation. Right now we have to focus on the response."

Head of global response and alert at the WHO, Isabelle Nuttall

On the alleged failure of the WHO to react quickly enough, she said the disease had, up till then, not been common in West Africa, only in Central Africa.

"When we scaled up, the beginning of the outbreak was very comparable to what we had seen elsewhere in Africa," she said. "And then, by June, it became something different.

"We indicated that this outbreak was different. I'm afraid we probably didn't say it loud enough for the world to understand what we were saying and for all the international community to be mobilised."

Earlier, WHO Director General Margaret Chan told Bloomberg that she was "not fully informed of the evolution of the outbreak" and the response might not have matched the "scale" and "complexity" of the spread.

A medical worker dons protective gear before entering
an Ebola treatment centre in Freetown, Sierra Leone 

Analysis: Imogen Foulkes, BBC News, Geneva

The combination of a leaked internal document and frank comments from the WHO's director general signal growing concerns about the effectiveness of the agency's efforts against Ebola.

Back in April, MSF described the outbreak in West Africa as unprecedented, warning that it risked spiralling out of control.

The WHO responded that it had seen only sporadic cases in a limited geographic area. It was not until August that the organisation suggested international reaction to Ebola may have been too slow.

Perhaps WHO officials feared accusations of overreacting: in 2009 the organisation swiftly declared a global pandemic of swine flu, advising countries to spend billions on treatments and vaccines against a virus which caused far fewer deaths than regular seasonal flu.

There are allegations too that the WHO's regional office in Africa may be part of the problem, that its staff failed to properly monitor West Africa's Ebola outbreak. We now know it began in December, but the first cases were not notified until March.

Earlier, MSF said international pledges of deployments and aid for Africa's Ebola-hit regions had not yet had any impact on the epidemic.

MSF's Christopher Stokes said the disease was still out of control.

He said it was "ridiculous" that volunteers working for his charity were bearing the brunt of care in the worst-affected countries.

Mr Stokes, who leads MSF's Ebola response, said international efforts would not have any effect for another month and a half.

MSF runs about 700 out of the 1,000 beds available in treatment facilities Liberia, Sierra Leone and Guinea.

The BBC's Mark Doyle, at the UN Ebola logistics base in Ghana, says it is generally agreed that at least three times that number are needed.

Responding to MSF's criticisms, David Nabarro, the UN system co-ordinator for Ebola, told the BBC that he had seen a big increase in the international response over the past two months.

"I am absolutely certain that when we look at the history, that this effort that has been put in place will have been shown to have had an impact, though I will accept that we probably won't see a reduction in the outbreak curve until the end of the year."

Family suffering from Ebola waiting for treatment

In other developments:

The WHO has announced that Senegal is now officially free of Ebola, as it has gone 42 days without any sign of the virus.

President Obama named Ron Klain - former chief of staff to Vice President Joe Biden - as Ebola "tsar" in charge of combating the virus in the US

Five East African countries - Kenya, Uganda, Tanzania, Rwanda and Burundi - are to send 600 personnel to help in the worst affected nations

How not to catch Ebola:

Avoid direct contact with sick patients as the virus is spread through contaminated body fluids
Wear goggles to protect eyes

Clothing and clinical waste should be incinerated and any medical equipment that needs to be kept should be decontaminated

People who recover from Ebola should abstain from sex or use condoms for three months

Ebola Deaths Could Reach 1.4 Million in 4 Months - CDC

The Ebola epidemic in West Africa could reach up to 1.4 million cases by late January 2015 under a worst-case scenario, says a report by the U.S. Centers for Disease Control that comes as experts from the World Health Organization call for drastic improvements in measures to prevent the virus from becoming endemic.

In a worst-case scenario, Liberia and Sierra Leone could have 21,000 cases of Ebola by Sept. 30 and 1.4 million cases by Jan. 20, the CDC model suggests, assuming that effective control measures aren't put into place.

Tundunwada Secondary School principal Enenwan Essien checks a student's temperature for Ebola during an assembly in Abuja, Nigeria, on Monday. Health officials were able to stop transmission in Lagos, Nigeria, Doctors Without Borders says, a hopeful sign. (AFP/Getty)

"A surge now can break the back of the epidemic," Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, told reporters on Tuesday.

The model also shows the severe cost of delay, which not only increases the risk of deaths and further infections but makes the job of stamping out Ebola more difficult, Frieden said.

The CDC analysis focuses on data available in August from Liberia and Sierra Leone, two of the three worst affected countries. Guinea, where the epidemic started, was not included.

The analysis is based a mathematical model that allows researchers to test how different actions affect the course of the epidemic.

The World Health Organization published another analysis of data from the first nine months of the epidemic in all three countries late Monday in the New England Journal of Medicine.

"If we don't do anything immediately then the exponential growth that has been forecast will continue, so far as we can see, and we'll have not a few thousand cases but probably tens of thousands of cases," said Christopher Dye of the World Health Organization in Geneva.

Dye said they’re beginning to see signs in the response that offer hope that the increase in cases won’t happen. For example, when Ebola entered Lagos in Nigeria, a city of 20 million people, health officials were able to stop transmission, he said.

Speed is of the essence, both CDC and WHO stressed. Had there been more interventions in Guinea between March and July, for example, control could have been achieved, the WHO researchers said.

Dye’s team also calculated the death rate to be about 70 per cent among hospitalized patients. Part of the difficulty in estimating the fatality rate is that many Ebola cases were only identified after death.

The researchers used data from informal case reports, diagnostic labs and burial records for the study.
The case fatality rate among hospitalized patients could differ from patients who are never seen by a doctor, the researchers said.

The WHO researchers said they infer that the epidemic is "exceptionally large" not because of the biological characteristics of the virus itself but rather features of the affected population  such as the highly interconnected populations in the three worst-affected  countries and insufficient control efforts so far.

Dr. Armand Sprecher, an infectious diseases specialist at Doctors Without Borders, questioned WHO’s projections.

"It's a big assumption that nothing will change in the current outbreak response," Sprecher said. He noted that Ebola outbreaks usually end when people stop touching the sick and practise safe burial, which local health officials in West Africa now emphasize in education campaigns.

Gayle Smith, special assistant to U.S. President Barack Obama and senior director of the National Security Council, also stressed that there’s been a tremendous surge in resources and response to the Ebola outbreak in the last few weeks.

Ebola outbreak: Canada to donate $2.5M for protective equipment

The surge includes a pledge from the U.S. to build more than a dozen medical treatment centres in Liberia and to deploy 3,000 troops to help. Britain and France have also pledged to build treatment centres in Sierra Leone and Guinea. The World Bank and UNICEF have sent more than $1 million worth of supplies to the region. Canada has pledged $2.5m for protective equipment.

The African Union is deploying health-care workers, and Asian countries, South Africa and Cuba have also responded, Smith said.

To stop transmission in the community, the WHO team said, the period from when symptoms appear to hospitalization needs to be reduced from the average of five days reported in the study. Surprisingly, the researchers said, the average time was not shorter among health-care workers, who are both at higher risk of infection themselves as well as transmitting it to others.

So far, about 2,800 deaths have been attributed to the Ebola virus in the current outbreak.

In Sierra Leone, officials said they found 130 confirmed cases of Ebola infection during a weekend lockdown designed to slow the spread of the outbreak.

About 70 more suspected cases are still being tested, said Deputy Minister for Political and Public Affairs Karamoh Kabba.

The Ebola shutdown campaign in Sierra Leone reached 80% of households.

8 Ebola workers murdered

Friday, the Guinean government said it was stopping Ebola education activities in the country’s southeast after eight missing health workers and journalists were murdered there this week. Their bodies were found in a septic tank in a primary school in a nearby village on Thursday, reportedly killed by villagers fearful of the disease and suspicious of official efforts to combat it. Two other workers remain missing.

Ebola workers don't have enough stress in their lives with the fear of catching Ebola, but they also have to fear people with primitive superstitions.

Authorities have arrested at least six people in connection with the attack.

Team allegedly accused of lying

A government spokesman told VOA's French to Africa service that some people do not believe Ebola exists, or that the delegation came to kill people.

The regional anti-Ebola effort has been hampered by widespread fears and misinformation about the disease.

A local reporter told VOA by telephone that villagers accused the delegation of spreading lies about Ebola.

The delegation was trying to educate locals about Ebola, said Guinea’s prime minister, Mohamed Said Fofanah. Villagers in Wome, as in other places, are still “intoxicated by information making them believed this sickness does not exist or was created to eliminate them.”

Nigeria Considering Charges Against Diplomat Who Brought Ebola to Port Harcourt

The Nigerian diplomat attached to the Economic Community of West African States (ECOWAS), Olubukun Koye who escaped from quarantine in Lagos after testing positive to Ebola virus and travelled to Port Harcourt for treatment, an action that resulted in the death of the doctor who treated him (Iyke Enemuo) may face manslaughter charges.

Olubukun Koye ECOWAS

This is coming on the heels of report that the number of persons under surveillance in the state (Rivers State) for Ebola Virus Disease has increased from 100 to 160.

 Late Dr. Iyke Enemuo

According to Thisday, Sources said that the issue of Koye (a primary contact of the index case, late Liberian Partick Sawyer) who defied instruction not to leave Lagos after being placed in the isolation unit, was discussed at the Federal Executive Committee meeting on Wednesday and that the Minister of Justice and Attorney General of the Federation Mohammed Adoki was directed to look into the Nigerian laws and see how he could be sanctioned for his action that resulted in the death of Enemuo.

Ebola Hits Nigerian Seaport of Port Harcourt - Dr Dies, Hospital Closed, 200 Quarantined

Just like a Nurse who was suspected to have contracted the Ebola virus escaped from Lagos to Enugu some weeks back, another woman, this time the sister of the Doctor who died of Ebola in Port Harcourt has escaped. It was gathered that the woman escaped to Abia State to avoid being quarantined along with others who came into contact with the late doctor.

The good news is that one of her siblings, who is also a Medical Doctor, has forced her to return to the quarantine center in Port Harcourt.

Port Harcourt, Nigeria

Port Harcourt is a city of more than a million people and is Nigeria's main seaport.

The woman, whose action would have further endangered the lives of more Nigerians, helped care for her brother, the late Doctor, before it was discovered that he died of the deadly Ebola.

At least 200 people who came in contact with Dr. Enemuo, who died last Friday in Port Harcourt, and most of those who visited his hospital and the hotel where Dr. Iyke Enemuo treated the ECOWAS (The Economic Community Of West African States) staff that took the disease to Port Harcourt have been quarantined.

The ECOWAS diplomat who had had contact with late Patrick Sawyer flew to Port Harcourt the same day he died, and met up with Dr. Enemuo. Possibly aware of the deadly nature of the disease the diplomat was suffering from, Dr. Enemuo opted to treat him secretly at a local hotel.

After recovering, the ECOWAS staff flew back to Lagos to seek clearance to travel out of Nigeria.

Quarantined and checked for Ebola in Lagos, he was found to be free of the virus. However, a few days after he left Port Harcourt, Dr. Enemuo took ill and was hospitalized at Good Health Hospital in Port Harcourt where he died of Ebola.

The hospital has now been closed down, until further notice.

The good news is that antidotes are being discovered in several countries; the bad news is that they haven't been properly tested, and there seems to be little cooperation between different countries involved resulting in a lot of duplicated work and probable delays.