Monday, 14 April 2014

Will outbreak go global?





  • Dr. Sanjay Gupta is in Guinea reporting on the Ebola outbreak

  • Ebola has spread to Conakry, the capital city with 2 million residents

  • It has gone "viral," and now the hope is that it doesn't go global, Gupta says

  • Ebola, a simple virus with a small genome, is a swift and bloody killer




Conakry, Guinea (CNN) -- It took only moments to feel the impact of what was happening here.


We had just landed in Conakry, the capital of Guinea. In the fields right outside the airport, a young woman was in tears. She started to wail and shout in Susu, one of the 40 languages spoken in this tiny country of 12 million people. The gathered crowd became silent and listened intently.


The young man sitting next to me quietly translated, although I already had my suspicions. He told me the woman's husband had died of Ebola, and then quickly ushered us away.





Sanjay Gupta explains Ebola virus




How the Ebola outbreak began

It is probably not surprising the airplane bringing us into Conakry was nearly empty, as are all the hotels here. Not many people in the United States have ever visited Guinea, or could even identify where it sits in West Africa. It is already one of the world's poorest countries, and the panic around Ebola is only making that worse.


Some of it is justified. That's because this time, the outbreak is different. In the past, Ebola rarely made it out of the remote forested areas of Africa.


Key to that is a grim version of good news/bad news: because Ebola tends to incapacitate its victims and kill them quickly, they rarely have a chance to travel and spread the disease beyond their small villages. Now, however, Ebola is in Conakry, the capital city, with two million residents. Equally concerning: it's just a short distance from where we touched down, at an international airport.


It has gone "viral," and now the hope is that it doesn't go global.


Ebola: What you need to know


When I asked doctors on the ground about that scenario, they had split opinions. Several told me the concern is real but unlikely. Most patients with Ebola come from small villages in the forest and are unlikely to be flying on international trips, they told me. Furthermore, they don't think Ebola would spread widely in a western country; our medical expertise and our culture -- not touching the dead -- would prevent it.


Others aren't so sure.


No one wants to test that theory.


WHO: Ebola outbreak one of 'most challenging'


With Ebola, there is an incubation period of two to 21 days. Remember these numbers. This is the range of time it takes to develop symptoms after someone has been exposed.


With an international airport close by, that means you could be on the other side of the world before you develop the headache, fever, fatigue and joint pain which make up the early symptoms of an Ebola infection. The diarrhea, rash and bleeding come later. Hiccups is a particularly grave sign with Ebola. It means your diaphragm, which allows you to breathe, is starting to get irritated.


There is a lot we know about Ebola, and it scares us almost as much as what we don't know.


We do know Ebola, a simple virus with a small genome, is a swift, effective and bloody killer. The mortality rate is higher than 50% and in some outbreaks reaches 90%.


Ebola appears to kill in a clever way. Early on, it strategically disarms your immune system, allowing the virus to replicate unchecked until it invades organs all over your body. It convinces your blood to clot in overdrive, but only inside your blood vessels. While those blood vessels choke up, the rest of your body starts to ooze because the clotting mechanisms are all busy.


You start to hemorrhage on the outside of your body. Nose bleeds, bruising, even a simple needle stick will refuse to clot. But, it is the bleeding you don't see -- the bleeding on the inside -- that causes even more catastrophic problems.


Many patients die of shock, within an average of 10 days.


What is ebola?





Ebola outbreak: History of a killer








Members of the medical aid organization Doctors Without Borders carry a dead body in Guekedou, Guinea, near the borders of Sierra Leone and Liberia, on Friday, April 1. Dozens of people have died from an Ebola outbreak in coastal West Africa, aid workers reported.Members of the medical aid organization Doctors Without Borders carry a dead body in Guekedou, Guinea, near the borders of Sierra Leone and Liberia, on Friday, April 1. Dozens of people have died from an Ebola outbreak in coastal West Africa, aid workers reported.



Gloves and boots used by medical personnel dry in the sun April 1 outside a center for Ebola victims in Guekedou. Ebola is one of the world's deadliest viruses, causing a hemorrhagic fever that kills up to 90% of those infected. It spreads in the blood and shuts down the immune system, causing high fever, headache and muscle pain, often accompanied by bleeding.Gloves and boots used by medical personnel dry in the sun April 1 outside a center for Ebola victims in Guekedou. Ebola is one of the world's deadliest viruses, causing a hemorrhagic fever that kills up to 90% of those infected. It spreads in the blood and shuts down the immune system, causing high fever, headache and muscle pain, often accompanied by bleeding.



A health specialist works Monday, March 31, in a tent laboratory set up at a Doctors Without Borders facility in southern Guinea.A health specialist works Monday, March 31, in a tent laboratory set up at a Doctors Without Borders facility in southern Guinea.



Health specialists work March 31 at an isolation ward for patients at the Doctors Without Borders facility in southern Guinea.Health specialists work March 31 at an isolation ward for patients at the Doctors Without Borders facility in southern Guinea.



Workers associated with the Doctors Without Borders organization prepare isolation and treatment areas Friday, March 28, in Guinea. Workers associated with the Doctors Without Borders organization prepare isolation and treatment areas Friday, March 28, in Guinea.




Ebola outbreak in West Africa

Ebola outbreak in West Africa

Ebola outbreak in West Africa

Ebola outbreak in West Africa

Ebola outbreak in West Africa



Ebola outbreak in West AfricaEbola outbreak in West Africa



It sounds like the stuff of horror movies. But despite the real danger, Ebola is not at all easy to "catch." If it were, my wife would have refused to let me come in the midst of an outbreak.


To become infected, you generally need to spend extended time with someone who is gravely ill, and come into contact with his or her infected body fluids. That's why family members and health care workers are the most likely to get sick.


Over the last three weeks, at least 104 people have died, including 14 health care workers.


With some infections, you can shed and spread the virus long before you get ill. That's not the case with Ebola. It's only after you are sick and feverish do you become contagious. However, it only takes a miniscule amount to infect and kill. A microscopic droplet of blood or saliva on your bare hand could enter through a break in your skin. And, whether you realize it or not, we all have breaks in our skin.


Since I was a kid, I have been fascinated with outbreaks. I learned in medical school that new pathogens generally make a jump from animals to humans, a process called zoonosis.


This is happening in areas where human and animals come into continuous contact. David Quammen refers to it as "Spillover," in his book of the same name. A stew of ducks, geese, chickens, pigs and humans in southeast Asia led to the spillover of avian flu, H5N1. Contact between pigs and humans in Mexico led to swine flu, H1N1; pigs and fruit bats were the recipe for Nipah fever in Malaysia.


The best guess is that fruit bats may be a natural reservoir for the Ebola virus too, but this has not been confirmed. Quammen makes the point: Ebola didn't enter our world -- we entered its world.


Pathogens can be predators, like lions, tigers and bears. A virus may not plan the way a big cat does, but in a sense it stalks its prey -- waiting for the moment of opportunity, then attacking with fury. Because it can lie silent for years, it's also easy to see Ebola as a killing ghost, like Jack the Ripper.


Presumably outbreaks begin through some human-animal contact, but since that contact is ongoing we don't know what it is that leads Ebola to rear its ugly head. We don't know how to treat the illness or vaccinate against it. We certainly don't know how to cure it.


I thought about all of this as I left that woman in the airport, and I have thought about her a great deal since then. Her grief made an impression on all of us.


It also made this mysterious, exotic virus the world knows, but doesn't fully understand, so much more real and frightening. For the next 21 days (the outer range of the incubation period) the woman we saw will be monitored for a fever or any early signs she may have contracted Ebola from her husband. If she exhibits symptoms, she will be isolated and treated with fluids, oxygen and nutrition.


That is all that can really be offered. Again, there is no cure for Ebola.


For her neighbors, in Guinea and across its border, another critical number is 42 -- as in 42 days, or two incubation periods. If the health care teams here don't see any new cases during that time then they officially say the outbreak is over. We are not there yet, not even close.


The clock is ticking.



Top 5 moments at the MTV Movie Awards






Host Conan O'Brien arrives with Liza Powel at the 2014 MTV Movie Awards on Sunday, April 13, in Los Angeles. Check out the other celebrities as they grace the red carpet. Host Conan O'Brien arrives with Liza Powel at the 2014 MTV Movie Awards on Sunday, April 13, in Los Angeles. Check out the other celebrities as they grace the red carpet.

RihannaRihanna

Zac EfronZac Efron

Lupita Nyong'o Lupita Nyong'o

Seth RogenSeth Rogen

Anthony Mackie Anthony Mackie

Jessica Alba Jessica Alba

Will PoulterWill Poulter

Trevor Jackson Trevor Jackson

Amber Stevens Amber Stevens

Dave Franco Dave Franco

Victoria Justice Victoria Justice

Sam ClaflinSam Claflin

Miles Teller Miles Teller

Chris PrattChris Pratt

Bailey Buntain Bailey Buntain

Zedd Zedd

Jennifer "JWoww" Farley and Nicole "Snooki" Polizzi Jennifer "JWoww" Farley and Nicole "Snooki" Polizzi

Nick Lachey Nick Lachey

Leslie Mann Leslie Mann

Grumpy Cat Grumpy Cat

Dylan O'BrienDylan O'Brien

Nicki Minaj Nicki Minaj

Michael J. Willett Michael J. Willett

David HasselhoffDavid Hasselhoff

Bella Thorne Bella Thorne

Linda Perry and Sara Gilbert Linda Perry and Sara Gilbert

Gregg SulkinGregg Sulkin

Pia MiaPia Mia

Ellie Goulding Ellie Goulding

Tyler Hoechlin Tyler Hoechlin

Christine Teigen Christine Teigen

Iggy Azalea Iggy Azalea

Shailene WoodleyShailene Woodley

Drake Bell Drake Bell

Katie Stevens Katie Stevens

ZendayaZendaya

Arden Cho Arden Cho








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  • The awards were held Sunday in Los Angeles

  • Zac Efron had his shirt ripped off

  • Seth Rogen got in a smooch

  • Hutcherson paid homage to Philip Seymour Hoffman




(CNN) -- The 2014 MTV Movie Awards in Los Angeles Sunday were filled with laughs, standout fashion and rocking musical performances.


Host Conan O'Brien kicked off the show with a record 50 celebrity cameos and an unexpected musical number, Lupita Nyong'o donned an eye catching pleated dress in dozens of colors from Karl Lagerfeld's Fall 2014 collection, and viewers got a sneak peak at the hottest upcoming action-adventure films with exclusive clips from "X-Men: Days of Future Past" and "The Amazing Spider-Man 2."


Viewers voted for their favorite onscreen performances this year in out-of-the-box categories like "best fight," "best scared s**tless performance," and "best WTF moment." The winner and musical performers took the stage at the Nokia Theater, leading to the top five memorable moments of the night:


No. 5: Rita Ora rips off Zac Efron's shirt


Several sculpted actors were nominated for "best shirtless performance," including Chris Hemsworth, Leonardo DiCaprio, Sam Claflin, and the lone female Jennifer Aniston for her strip tease in "We're the Millers."


But the prize went to a fit Zac Efron for a bedroom scene in "That Awkward Moment." Presenters Jessica Alba and Rita Ora warned that the winner better show off the assets and come up onstage sans top. But Efron ignored the mandate and began accepting his award very much covered by his shirt -- that is until Rita snuck up behind him and ripped open the front of his blue button-up. The "Awkward Moment" actor played along, pulling his shirt off while blowing kisses to the audience who weren't disappointed with the reveal of the tan and toned 6-pack that won him the prize.


No. 4: Seth Rogen shares a smooch with his mom


Dave Franco, Seth Rogen, and Zac Efron took the stage to present the steamy category of "best kiss." To kick off the smooching shenanigans they held their own kissing contest, where they announced that three lucky audience members had a golden ticket that won them some lip time with the stars.


Two beautiful young women bounded to the stage to claim their kisses with Franco and Efron ... but the third woman looked a little too familiar to Rogen. "Wait a minute, that's my mom!" he yelled. "Mom, no, go back to your seat Mom!" Yet with all three women onstage, the men delivered and Rogen, not one to back down on his word, completely sucked face with his mother on live national television. Or, at least the woman pretending to be his mother.


Jennifer Aniston, Emma Roberts, and Will Poulter were awarded the golden popcorn for "best kiss" for their three-way make out session in "We're The Millers."


No. 3: Channing Tatum and Mark Wahlberg take home two big prizes


Two of the evening's biggest honors went to leading men Channing Tatum and Mark Wahlberg.


Tatum won the Trailblazer Award for his diverse roles in funny, romantic, and action-packed films. As his buddy Jonah Hill said while presenting Tatum the award, "What's more trailblazing than an attractive man becoming a movie star, eh?" Tatum danced his way up to the stage to accept the honor, and gave a heartwarming speech of sincere thanks -- until he was silenced -- by Conan O'Brien's picture of his privates. Yes, the comedian found a way to keep chatty celebrities quiet; loading a dirty picture of himself smiling and pantless into the teleprompter.


Mark Wahlberg was honored with the "Generation Award" for his varied work over the course of his career. During his acceptance speech, the 42-year-old former rapper brought back his bad-boy side by dropping an F-bomb whenever he could. Joking that the "Generation Award" meant he was past his prime and too old for a comeback, Wahlberg quipped, "This is not the Channing Tatum 'You're dancing around, chicks want you' award. This is the 'You're f***g-done award. But look, it was a great run!'"


But his career is not really over yet. The cast of "Entourage" presented Wahlberg with his award, and the new "Entourage" movie hits theaters in 2015.


No. 2: Eminem and Rihanna give a 'Monster' performance


Even though the MTV Movie Awards are all about the silver screen, Rihanna and Eminem's musical performance of their hit "The Monster" had viewers and stars alike buzzing. Rihanna kicked off the smash hit backed by a live band, wearing an all-white dress and a FEAR headband. She was soon joined by Eminem, who made his entrance onstage amongst flashing red lights. It was the first time Slim Shady and the Barbados Babe have performed their smash hit on television, offering a sneak peak of their upcoming mini-tour set to hit New York, Los Angeles, and Detroit this summer. Other performances of the night included Ellie Goulding, Zedd, and twenty one pilots.




No. 1: 'Catching Fire' takes top prize


The biggest honor at the MTV Movie Awards is the "Best Movie of the Year," and this year the golden popcorn statuette for the prize went to "The Hunger Games: Catching Fire."


Johnny Depp presented the award to "Catching Fire" stars Sam Claflin and Josh Hutcherson. Hutcherson and Jennifer Lawrence, who did not attend, also took home Best Male and Female Performances. After winning the top prize of the night, Claflin thanked all the fans of the franchise, while Hutcherson went on to acknowledge the hundreds of people whose hard work went into making the blockbuster. He also acknowledged his fellow cast member, Philip Seymour Hoffman, who died of acute mixed drug intoxication in February.


"I know if Philip were here, he'd think this was really cool," Hutcherson said. "He's one of the actors I look up to most in my life, so wherever he is, this goes out to him as well."