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Special Report - A Primer on Ebola for Clinicians

journals.cambridge.org -  Eric Toner, Amesh Adalja and Thomas Inglesby. A Primer on Ebola for Clinicians.
Disaster Medicine and Public Health Preparedness, available on CJO2014. doi:10.1017/dmp.2014.115.

Abstract

The size of the world’s largest Ebola outbreak now ongoing in West Africa makes clear that further exportation of Ebola virus disease to other parts of the world will remain a real possibility for the indefinite future. Clinicians outside of West Africa, particularly those who work in emergency medicine, critical care, infectious diseases, and infection control, should be familiar with the fundamentals of Ebola virus disease, including its diagnosis, treatment, and control. In this article we provide basic information on the Ebola virus and its epidemiology and microbiology. We also describe previous outbreaks and draw comparisons to the current outbreak with a focus on the public health measures that have controlled past outbreaks. We review the pathophysiology and clinical features of the disease, highlighting diagnosis, treatment, and hospital infection control issues that are relevant to practicing clinicians. We reference official guidance and point out where important uncertainty or controversy exists. (Disaster Med Public Health Preparedness. 2014;0:1-5)

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Review of Human-to-Human Transmission of Ebola Virus

CDC                                                              Posted Oct. 20, 2014 from  CDC  Oct. 17 document

This document is a concise summary of published information on the current science about human-to-human transmission of Ebola virus. It is developed for use by healthcare personnel and public health professionals to use. It is a complement to the many guidance documents that CDC has issued already online at

www.cdc.gov/ebola.

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Nigeria Is Ebola-Free: Here’s What They Did Right

It's been 42 days since the last new case

TIME MAGAZINE                                                      OCT. 20, 2014

Alexandra Sifferlin

 The World Health Organization declared Nigeria free of Ebola on Monday, a containment victory in an outbreak that has stymied other countries’ response efforts....

 

A school official takes a pupil's temperature using an infrared digital laser thermometer in front of the school premises, at the resumption of private schools, in Lagos, Sept. 22, 2014. Akintunde Akinleye—Reuters

“It’s possible to control Ebola. It’s possible to defeat Ebola. We’ve seen it here in Nigeria,” Nigerian Minister of Health Onyebuchi Chukwu told TIME. “If any cases emerge in the future, it will be considered—by international standards—a separate outbreak. If that happens, Nigeria will be ready and able to confront it exactly as we have done with this outbreak.”

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U.S. to issue new Ebola care guidelines, watch lists to shrink

ROUNDUP OF DEVELOPMENTS SUNDAY

REUTERS                                     Oct 19, 2014

GALVESTON Texas --(Reuters) - The United States will issue strict new guidelines telling American health workers to cover their skin and hair when dealing with Ebola patients, a top health official said on Sunday, while some of the dozens of people being watched for possible exposure to the virus are expected to be cleared.

 

 A health care worker receives protocol on the proper removal of personal protection equipment from Centers for Disease Control and Prevention (CDC) instructors in preparation for the response to the current Ebola outbreak, during a CDC safety training course in Anniston, Alabama, October 6, 2014. Credit: Reuters/Tami Chappell

In Texas, a lab worker who spent much of a Caribbean holiday cruise in isolation tested negative for the deadly virus and left the Carnival Magic liner with other passengers after it docked at Galveston early on Sunday morning....

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NEJM - Ebola Virus Disease in West Africa — The First 9 Months of the Epidemic and Forward Projections

nejm.org - WHO Ebola Response Team

N Engl J Med 2014; 371:1481-1495 - October 16, 2014 - DOI: 10.1056/NEJMoa1411100

Conclusions

These data indicate that without drastic improvements in control measures, the numbers of cases of and deaths from EVD are expected to continue increasing from hundreds to thousands per week in the coming months.

(SEE COMPLETE NEJM ARTICLE HERE)

NEJM - Ebola Virus Disease in West Africa — The First 9 Months of the Epidemic and Forward Projections (15 page .PDF file)

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Pentagon building rapid-response Ebola team

USA TODAY                                                     Oct. 19, 2014

BY Gregg Zoroya and John Bacon

The Pentagon will build a 30-person, rapid-response Ebola medical support team to aid civilian health care workers should additional cases of the virus be diagnosed in the U.S., officials said Sunday.

The effort was requested by the Department of Health and Human Services "as an added prudent measure to ensure our nation is ready to respond quickly, effectively and safely in the event of additional Ebola cases," a Pentagon statement said.

http://www.defense.gov/Releases/Release.aspx?ReleaseID=16986

The Pentagon said Defense Secretary Chuck Hagel ordered his Northern Command Commander, Gen. Chuck Jacoby, to prepare and train the team. It will include 20 critical-care nurses, five doctors trained in infectious disease and five trainers in infectious-disease protocols...

Team members will remain in a "prepare to deploy" status for 30 days after training. They will not be sent to West Africa or elsewhere overseas and "will be called upon domestically only if deemed prudent by our public health professionals," the statement said.

Read full story

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Ebola: What Should We Do Now?

Four suggestions on what we need to successfully counter Ebola

A healthcare worker mixes chlorine with water at an Ebola treatment center in Hastings, Freetown, Sierra Leone, Oct. 15. Associated Press

Suggestions include:

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Ebola outbreak could be 'definitive humanitarian disaster of our generation', warns Oxfam

THE INDEPENDENT                                                  OCT. 18, 2014

LONDON ---Ebola is poised to become the “definitive humanitarian disaster of our generation", Oxfam has warned, with more troops, funding and medical aid urgently needed to tackle the outbreak.

In an "extremely rare" move, the charity is calling for military intervention to provide logistical support across West Africa.

It says the world has less than two months to counter the spread of the deadly virus, which means addressing a "crippling shortfall" in military personnel.

Oxfam’s call for more troops comes after UN chief Ban Ki-Moon criticised countries he said were able to provide financial support to the crisis for not doing so.
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Amid Assurances on Ebola, Obama Is Said to Seethe

NEW YORK TIMES                                                 Oct. 18, 2014

By and

WASHINGTON — Beneath the calming reassurance that President Obama has repeatedly offered during the Ebola crisis, there is a deepening frustration, even anger, with how the government has handled key elements of the response.

Those frustrations spilled over when Mr. Obama convened his top aides in the Cabinet room after canceling his schedule on Wednesday. Medical officials were providing information that later turned out to be wrong. Guidance to local health teams was not adequate. It was unclear which Ebola patients belonged in which threat categories.

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Canada to start shipping experimental Ebola vaccine on Monday

CANADIAN PRESS                                     Oct. 18, 2014

OTTAWA—The federal government says Canada will start shipping its experimental Ebola vaccine to the World Health Organization on Monday.

 

 A lab worker at the JC Wilt Infectious Diseases Research centre at Canada's National Microbiology Laboratory in Winnipeg, Manitoba. An experimental Ebola vaccine developed in Canada will be shipped to the World Health Organization in Geneva starting Monday.

The government says in a release the Public Health Agency of Canada is supplying the vaccine to the UN body in Geneva in its role as the international co-ordinating body for the Ebola outbreak in West Africa. It says Canada will ship 800 vials of its experimental vaccine in three separate shipments, as a precautionary measure.

The WHO will consult with its partners, including the health authorities from the affected countries, to determine how best to distribute and use the vaccine. For instance, it must take into account concerns about using an experimental vaccine in people.

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