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How to stop the next epidemic

THE ECONOMIST                                                                                    May 19, 2015

..when the next epidemic breaks out, how do we prevent it from spreading around the world? It is easier said than done.
 
First: Early detection is critical, and it relies on good surveillance. But only 64 of the 194 member states of the World Health Organisation (WHO) have the surveillance procedures, laboratories and data-management capabilities required by the International Health Regulations. Improvements in things like basic public health infrastructure are needed...

Second: A swift response to an outbreak – which might involve getting skilled people, equipment and money to the right places – can potentially save more lives than drugs and vaccines. ... The World Health Organisation and the global community were slow to recognise that there was an international public health emergency.

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How to Fight the Next Epidemic

The Ebola Crisis Was Terrible. But Next Time Could Be Much Worse.

 

NEW YORK TIMES OPINION PAGE by Bill Gates                                                           March 18, 2015

(Scroll down for fuller Bill Gates article in the New England Journal of Medicine)

SEATTLE — The Ebola epidemic in West Africa has killed more than 10,000 people. If anything good can come from this continuing tragedy, it is that Ebola can awaken the world to a sobering fact: We are simply not prepared to deal with a global epidemic.

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Care Differs for American and African With Ebola

NEW YORK TIMES  by Sheri Fink, MD                                                           March 17, 2015
    
The latest American aid worker to contract Ebola overseas, last week in Sierra Leone, was swiftly evacuated to a specialized treatment center for infected health workers run by the British Defense Ministry in the country’s capital, Freetown, then on to the National Institutes of Health clinical center in Bethesda, Md. Doctors at the center said Monday that his condition had worsened from serious to critical since his arrival on Friday.

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FDA approves Corgenix's Ebola test for emergency use

REUTERS                                                           Feb. 26, 2015

Diagnostics company Corgenix Medical Corp said on Thursday U.S. health regulators had approved its rapid Ebola test for emergency use, in response to the world's worst outbreak of the virus that killed more than 10,000 so far.

The company's ReEBOV Antigen Rapid Test, which involves putting a drop of blood on a paper strip and waiting for at least 15 minutes for a reaction, was cleared by the World Health Organization last week.

The test is less accurate than the standard test, which has a turnaround time of 12-24 hours, but is easy to perform and does not require electricity. It is able to correctly identify about 92 percent of Ebola-infected patients and 85 percent of those not infected with the virus, the WHO said.

The WHO is still assessing four or five other rapid test candidates.

Read complete story.
http://www.reuters.com/article/2015/02/26/us-health-ebola-testing-idUSKBN0LU1OO20150226

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Decision on Ebola mass vaccination in August at earliest: WHO

REUTERS by Stephanie Nebehay                                                             Feb. 27, 2015

GENEVA -- An independent advisory body will decide in August at the earliest on whether to recommend widespread introduction of an Ebola vaccine, depending on results of clinical trials and the epidemic's course, the World Health Organization said on Friday.

All three worst-hit countries in West Africa - Guinea, Liberia and Sierra Leone - aim to conduct phase III final-stage clinical trials of experimental vaccines.

Liberia is already testing both the GlaxoSmithKline and Merck-NewLink vaccines, while Sierra Leone and Guinea are due to announce plans soon....

WHO spokesman Christian Lindmeier, reporting on a three-day meeting of experts, told a news briefing: "Vaccine introduction is by no means a given and will depend on the results of clinical trials and recommendations from WHO's Strategy Advisory Group of Experts (SAGE) on vaccines and immunization....

Read complete story.

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Leaders of Ebola Fight at U.N. Express Worry About Eradication

NEW YORK TIMES  by Rick Gladstone                                    Feb. 20, 2015

The top two health officials managing the Ebola epidemic cast doubt Friday on a pledge by West African leaders to reduce new cases to zero by mid-April, and expressed concern about a possible rebound of the disease.

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Finishing Off Ebola

NEW YORK TIMES  OP-ED BY Ron Klain, the former White House Ebola response coordinaor                                    FEB. 20, 2015

...The world needs to do a better job of quickly detecting and responding to future outbreaks in unlikely places. The President’s Global Health Security Agenda, the government’s strategy to combat infection disease around the world, will help. But vulnerable countries, including those in Africa, need their own version of our Centers for Disease Control and Prevention, so that they are not so dependent on ours.

For the hardest task of front-line epidemic fighting, our planet is too reliant on courageous and talented — but underfunded, under-equipped and volunteer-dependent — nongovernmental organizations. The world needs a permanent standing force — or a ready reserve that can be quickly organized — of public health emergency responders who have the training, gear and resources to race into a region in the early phases of epidemic control. The United States military cannot do that job every time; future outbreaks might occur in countries where our troops will not be welcomed as they were in West Africa.

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WHO May Lose Credibility After Ebola

Agency seeks a new model after flaws revealed by Ebola crisis.

COMMENTARY MEDPAGE TODAY by Michael Smith            Feb. 15, 2015 

As the Ebola epidemic drags on, the World Health Organization is in danger of losing its credibility as a bulwark against infectious disease.

The West African epidemic is a "mega-crisis (that) overwhelmed the capacity of WHO," according to Director-General Margaret Chan, MD, speaking to reporters in late January.

To prevent a similar crisis in the future, Chan has proposed a package of reforms, including a large contingency fund for emergencies, an increase in the number of trained people able to deploy quickly to a crisis site, and structural changes to streamline the famously unwieldy organization.

Whether those get anywhere is the vital question, according to Lawrence Gostin, JD, of the O'Neill Institute for National and Global Health Law at Washington's Georgetown University.

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Doctors Who Treat Ebola Feel More Socially Isolated

LIVESCIENCE.COM   by Rachael Rettner                                                                         Feb. 13, 2015

Doctors who take care of very sick Ebola patients may feel socially isolated, but surprisingly, they may not feel more stressed than usual, a new study from Germany suggests.

Researchers surveyed 46 health care workers who treated Germany's first Ebola patient in August 2014, as well as 40 health care workers who worked in the same hospital but did not treat the Ebola patient.

The researchers who did the study hypothesized that the people who treated the Ebola patient would have more symptoms of psychological distress because they were working in a challenging environment that presented a risk that they could become infected with the deadly virus.

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Why Didn't Ebola Kill Me?

An ambulance transports the author to the Nebraska Medical Center in October. (Sait Serkan Gurbuz/Reuters)

THE ATLANTIC by Ashoka Mukpo                                                                          Feb. 12, 2015

Like the majority of patients taken to Western hospitals, I recovered from the disease—but health authorities are still struggling to figure out how to bring up the much-lower survival rate in West Africa.

...the 80-percent survival rate among patients who were evacuated to Western hospitals shattered the idea that an Ebola diagnosis spelled near-certain death. I know this all too well, as I’m one of those patients myself. In October, I contracted Ebola while covering the outbreak as a freelance journalist in Liberia. I was airlifted to a hospital in Nebraska, where aggressive treatment likely saved my life....
Read complete story.

http://www.theatlantic.com/health/archive/2015/02/why-didnt-ebola-kill-me/385335/

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