 On behalf of the U.S. Department of State, welcome and thank you for participating in this workshop on Ebola reporting. The large number of journalists participating in both the English and French sessions of the workshop underscore what an important issue this is. Prior to joining the State Department as Assistant Secretary of State for Public Affairs, I was a newspaper reporter and editor for more than 35 years. Over the course of my career, I reported from more than 40 countries and covered every major conflict from the first Gulf War to the Afghan War. People ask me often, are you a recovering journalist? And I say, no, you never recover from being a journalist, nor do I wish to. I'll always be a reporter at heart, and that's one of the reasons why I'm happy to address you this morning. I know firsthand how very difficult your job can be, but also how very important it is. I also know that journalists have an important role in shaping the public's view of an event or a crisis. It is therefore critical, critical, that you tell the story accurately. As Secretary of State, John Kerry has said, Ebola has the potential to become a scourge like HIV or polio unless we all do our part. Combating the Ebola epidemic is a major challenge, and it requires a unified, collaborative, global response. As for your part, there is an abundance of misinformation out there on Ebola that can make it even more difficult to fight this epidemic, and it can make it more dangerous for those who are treating it and for those who are exposed to it. Therefore, by providing accurate information about the disease, every one of you can prevent a potential panic over rumors and misunderstanding. Ultimately, you can save lives by getting the facts out to your communities. The information that you provide to your audiences and readers is a critical component of global health security, and we hope the knowledge and resources you gain from participating in this program will inform your reporting and help to ensure the well-being of your communities. As President Obama has said, no single country, no single NGO, no single UN agency can defeat this disease alone. We all need to work together, and your contributions as journalists are crucial to this effort. Hello. I'm Dr. Rudley Archer, an epidemiologist with the United States Center for Disease Control and Prevention, Center for Global Health. We understand that Ebola is scary to many people, and we want to give you information about Ebola so that you can help protect yourself, your family, and your community. Today, I'm going to tell you how Ebola is spread and how it is not spread, what is being done to stop the spread, and finally, how you can help end this epidemic by educating others through your work. Let me start by telling you the basic about Ebola. Ebola is a rare and deadly disease in humans that is caused by the Ebola virus. It is highly contagious, but can be prevented. Ebola viruses are found in several African countries. Ebola was first discovered in 1976 near the Ebola River in Central Africa, in what is now the Democratic Republic of the Congo. Since then, outbreaks have appeared sporadically in Africa. The current outbreak is the largest Ebola outbreak in history. So where does Ebola come from? From the evidence we have, researchers believe that the virus comes from animals and that fruit bats are the most likely reservoir hosts. A reservoir host means that the animal gets infected, but not sick, and pass the virus to other types of animal or people that can get sick after being infected. Ebola can cause disease in humans and primates like monkeys, gorilla, and chimpanzees. Once a person is infected with the Ebola virus, symptoms can appear within 2 to 21 days of exposure, although it is most common from 8 to 10 days after exposure. Historically, death rates for Ebola range from 50 to 90%, but early care can save lives. So what are the signs and symptoms of Ebola? Fever, headache, vomiting, diarrhea, fatigue, muscle pain, stomach pain, and unexplained bruising or bleeding. It is important to know the sign and symptoms of Ebola because a person can only spread Ebola when they have symptoms. It can only spread after symptoms begin. Now that you know the signs and symptoms, how is Ebola spread? Ebola is highly contagious. Ebola spreads to direct contact with a sick person, including the blood and body fluids, which include vomit, urine, stools, sweat, semen, and saliva. And when we say direct contact, we mean contact through either broken skin or through mucus membranes, which include your eyes, nose, or mouth. This means that people caring for family members or others who are sick with Ebola are at high risk of getting Ebola themselves. Ebola also spreads when family members participate in burial preparation of the body of a person who has died of Ebola, such as washing or touching the body. Ebola can also spread through direct contact with objects contaminated with infected body fluids, such as clothes, bedding, needles, or other medical equipment. Ebola can also spread through handling bush meat, that is, infected food bats or primates, wild animals, hunted for food, common in some African countries. The most common way that Ebola is spread is human-to-human transmission. So now you know how Ebola is spread, but how it is not spread. Ebola is not spread by people who don't have symptoms, even if they have been exposed to Ebola. Only a person with symptoms can spread Ebola. Ebola is not spread through the air or water. And it's not spread through mosquitoes or other insects. So how do you prevent getting Ebola? Here are a few prevention steps to follow. Always careful hygiene. Wash your hands often with soap and water, an alcohol-based hand sanitizer, or mild chlorine solution. Avoid contact with blood and body fluids, such as vomit, urine, stools, sweat, semen, and saliva. Do not handle items that may have come in contact with an infected person's blood or body fluids, such as clothes, bedding, needles, or other medical equipment. Avoid funeral or burial ritual that require handling the body of someone who has died from Ebola. Avoid contact with bats and primates, or blood, fluids, and raw meat prepared from these animals. Early care saves lives. See care immediately if you develop fever, severe headache, muscle pain, fatigue, diarrhea, vomiting, stomach pain, or unexplained bruising or bleeding. Who is really at risk of getting Ebola? Friends and family who have care for a person sick with Ebola? Healthcare provider taking care of patients with Ebola? People handling bushmeat that has not been thoroughly cooked? And burial teams who prepare, bury, or cremate the bodies? What is being done to stop the spread of Ebola? CDC and its partners are working with the ministries of health in the affected countries to respond to the outbreak. We do know how to stop the spread of Ebola. Finding and isolating sick people, contacting people exposed to the sick person, and further isolation of contacts if they develop symptoms. To stop Ebola, we need to use the find, respond, prevent model. We must find people with Ebola, confirm they have Ebola with a laboratory test, and isolate them so they can spread Ebola further. When we isolate them, we provide them supportive care while asking who they have had contact with. We then do contact tracing. This means we find everyone who had contact with the sick person and monitor them every day for 21 days to see if they show any sign or symptoms. And then we need to prevent spread by making sure healthcare workers use proper protective equipment and ensure that our deceased loved ones are safely buried with dignified medical burials or cremations. How do you treat Ebola? Early care saves lives. Basic action done early can significantly improve the chances of survival. These interventions include providing oral rehydration solutions and intravenous fluids to rehydrate the body, maintaining oxygen status and blood pressure, and treating other infections if they occur. Early case identification, isolation, treatment and effective infectious control are essential to prevent Ebola transmission. So how do patients recover from Ebola? Recovery from Ebola depends on good supportive care and the patient's immune response. People who recover from Ebola infection develop antibodies against that strain of Ebola that last for at least 10 years and possibly longer. It isn't known if people who recover are immune for life or if they can become infected with a different strain of Ebola. Some people who have recovered from Ebola have developed long-term complications such as joint and muscle pain and vision problems. Is there a vaccine for Ebola? Experimental vaccines for Ebola are under development, but they have not yet been fully tested for safety or effectiveness. So we should focus on our effort on finding cases and isolating them, following their contacts, preventing new cases and helping treat those who get infected. Most importantly, how can you help? Here are the basic messages we need your help in sharing. 1. Wash hands frequently with soap and water or an alcohol-based hand sanitizer or a mychlorine solution. 2. Avoid body contact with others. 3. Do not touch a sick person or the sick person's body fluids. 4. Do not touch anything a person sick with Ebola has touched. 5. Do not touch the body of someone who has died from Ebola. 6. Do not touch anything a person who has died from Ebola has touched. 7. Practice safe, dignify, medical burial or cremations. 8. Call district hotlines for help and more information. 9. Early care saves lives. With early care, a person immune system can fight off and clear the Ebola virus. Additionally, here are 6 key messages to tell your community to protect them from Ebola. 1. Early care saves lives. If you or a loved one has symptoms of Ebola, take action to protect your family in their home while waiting for help. Get help, call your district hotline and notify your local community authorities and traditional healers. Protect yourself and be safe while you wait. Do not touch the sick person, their body fluids or anything they touch. Support the sick person by giving them as much fluid as they can drink an oral rehydration solution if available. 2. Practice safe, dignify funerals, burials and cremations. Treat any death as if it could be Ebola because once someone has died, there could be massive amounts of the virus shed by their body. Call district alert hotlines to report all deaths. The body of someone who has died from Ebola or is suspected to have died from Ebola should only be handled by people who are trained in safe medical burial practices and are wearing full personal protective equipment. Protect yourself. Do not touch, wash or clean the body of anyone who might have died of Ebola. Do not touch body fluids of a dead person or anything a person who has died from Ebola has touched. 3. Address myths about Ebola. Ebola is real. The outbreak is not over. We all need to work together to stop Ebola. You can get Ebola from a person who is sick with Ebola or has died from Ebola. While prayer is very important and meaningful, you still need to take the necessary action to prevent getting Ebola and get to a health facility if you are sick. Provide accurate information that addresses rumors or misinformation. 4. Support and provide an accepting environment for survivors. It is safe to be around someone who has survived Ebola. Accept survivors and welcome them back to your family and the community. Once people recover from Ebola, they can no longer spread the virus to people in the community. However, because Ebola can stay in semen after recovery, men should wait to have sex, including oral sex, for three months. If waiting is not possible, condom may help prevent the spread of Ebola. Sexual transmission of Ebola has never been reported. 5. Eliminate stigma and provide an accepting environment for Ebola service providers. Healthcare workers, ambulance workers, contact tracers and burial teams are heroes in taking care of people sick with Ebola. Co-operate with them and treat them with respect and dignity. Speak out against negative comments or negative behaviors. 6. Promote unity, cooperation and hope in the fight against Ebola. The Ebola outbreak is not over. We need hope and action to stop Ebola together. Early care saves lives. We all have a role to work together to defeat this disease. For more information on Ebola, go to www.CDC.gov. The US government is mounting a major response to the Ebola outbreak in West Africa, one that draws on the capacities from all across our government. The US Agency for International Development has the lead on coordinating that response in West Africa and the Office that I lead, the Office of Foreign Disaster Assistance, has that lead on the ground and executes that mission. So we are working in very close cooperation with our partners from the Centers for Disease Control, the Department of Defense, the Embassy and other parts of the US government to mount one of the largest international disaster responses in the history of the US government. The Ebola outbreak poses an unprecedented challenge to international responders, to the global health community and to the international disaster community, and that is why we have pulled all of these different capacities together because we know that no one part of the international system can manage this response effectively on its own. So we're also focusing on providing support to the health system, to the economies and to food security support, for food security support in these countries because we know that those second order impacts could end up doing as much damage as the outbreak itself is doing. We are working very closely with international partners including the United Nations, other donor countries, non-governmental organization partners, and of course local organizations and partners within the countries themselves because this takes a whole of government, a whole of society and a whole of international system effort. This is unlike anything we've seen before and deploying all of those tools that the international and the national systems have is absolutely critical to ending this. We're pursuing a strategy that focuses on several elements. First of course we want to stop chains of transmission and ensure safe isolation and treatment in the countries and so for that we are working with CDC partners to support contact tracing. We are supporting the development of Ebola treatment units all over Liberia and across the region but we're also supporting effective coordination and leadership within each of the three countries. The US government is providing support but we're not leading the efforts. The efforts are being led by the governments in these countries and that is absolutely critical and central to success. These governments know their countries far better than we do or ever will and their leadership, their involvement and their overall management of this crisis is fundamental to success. We are coming in in support of that to fill in capacities that they may not have, to provide resources and to mobilize tools from across our government and across the international system. So we are supporting that coordination element through effective emergency operation centers in each of the three countries and pushing that coordination out to a district, county or regional level in the affected countries. We're also supporting safe burials. We have seen that unsafe burial practices in the affected countries can be one of the major drivers of transmission. There can be traditional funeral ceremonies where many people from the many members of the community will touch the body or potentially come into contact with the bodily fluids. We are supporting safe burial teams across all of the affected countries and we have seen particularly in Liberia that as those teams have come online, there has been a significant reduction in new cases which confirms to us that attacking that chain of transmission is having a major impact. We are also working to improve infection control in the health systems. Health workers on the front lines have been one of the most affected groups and face the greatest risks. Many cases do not necessarily present at an Ebola treatment unit. They often present at a normal health facility. So both to ensure safe triage and to ensure the safety of the staff working there, it is very important that staff in the normal health system, even outside the ETUs, have access to training and supplies to protect themselves from potential transmission. Finally, we are working to ensure that the public in these countries are well informed. Ebola is a disease that thrives on rumor and misinformation. When people have a little bit of knowledge about how to protect themselves from the disease and better understanding of how it is spread, it is much easier to avoid transmission. This is not a disease that is spread through airborne contact or through mosquitoes or something like that. It is only spread through direct contact with the bodily fluids of an infected person. With some basic measures to prevent that sort of contact, it is fairly easy to avoid potential transmission. So we are trying to help people to understand how it is spread and how they can protect themselves. And we're doing that through targeted information campaigns at a national level, but also through more grassroots peer-to-peer engagement so that people, even in far-phone communities who may not have access to major media, can get some basic information on how to protect themselves. Those are the core elements of the U.S. strategy and the core elements of the international strategy. In Liberia, where they have been most broadly applied, we see real impact. We are confident that our strategy in support of the Liberian government is working. We are seeing cases go down in Liberia, and while there is still a long way to go to fully extinguish the outbreak there, there are good signs of success and progress. Now that does not mean we are overconfident. It does not mean that we think that this will be over soon. It does not mean that we are taking our foot off the gas pedal or easing up on our focus. Instead, we are redoubling our efforts because we now know we have a strategy that works, and we are pursuing that with absolute vigor. As the nature of the outbreak changes, we are also making adjustments to our strategy. So we have seen, for example, that large numbers of Ebola treatment unit beds are not necessarily needed, but what is needed is to have access to an Ebola treatment unit in every major geographic area. So we are trying to ensure that rather than have hundreds and hundreds and hundreds of beds, we have smaller numbers of beds but placed in very strategic locations so that they are accessible to the population. We are also shifting towards a rapid response strategy, where small outbreaks may pop up in far-flung, outlying areas of these countries. Teams can be rapidly deployed to go there, educate the community, set up some very rapid isolation and conduct contact tracing to try and extinguish those micro outbreaks in the localized area before they can spread elsewhere. The United States government is absolutely committed to helping West African nations end this outbreak, but our commitment does not stop there. We are also investing in long-term health systems strengthening in these countries. And we have requested from the U.S. Congress significant resources to not just end this outbreak, but also to rebuild health systems to strengthen them against future Ebola outbreaks. We know from what we have seen of Ebola in Congo and Uganda and elsewhere that once Ebola is present in an area, even if an outbreak is extinguished, it can and will likely come back again. So it is imperative that the health systems and the health personnel in these countries be empowered, be strengthened to end outbreaks quickly, to extinguish them at the source rather than allowing them to spread. One of the biggest challenges in this response is not just the disease itself, but the fear of the disease and the stigma around the disease. We have seen overseas, but even in our own country, instances of health care workers who are doing heroic work being stigmatized, it is really imperative, it is really critical to the success of this response that the health care workers, the people working on the front lines, be supported, be admired and not be stigmatized, not be shunned, but be recognized and affirmed as the heroes that they are. These people, whether they come from West Africa or from the international community, are the lynchpin of defeating this disease. Recognizing that heroism, recognizing the risks that they are taking, the personal risks that they are taking to support this response and to end this disease is absolutely fundamental to our overall ability to end the outbreak. Again, thank you for taking the time to participate in the workshop and for the important health reporting work you will do going forward. The U.S. government is your partner in the fight against Ebola. Working together, we can all make a difference.