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Survey Finds Many Physicians Overestimate Their Ability to Assess Patients’ Risk of Ebola

massgeneral.org - August 27, 2015

While most primary care physicians responding to a survey taken in late 2014 and early 2015 expressed confidence in their ability to identify potential cases of Ebola and communicate Ebola risks to their patients, only 50 to 70 percent of them gave answers that fit with CDC guidelines when asked how they would care for hypothetical patients who might have been exposed to Ebola. In addition, those who were least likely to encounter an Ebola patient – based on their location and characteristics of their patients – were most likely to choose overly intense management of patients actually at low risk.  The results of the survey, conducted by a team of Massachusetts General Hospital (MGH) investigators, have been published online in the Journal of General Internal Medicine.

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CLICK HERE - RESEARCH - Ebola Risk and Preparedness: A National Survey of Internists 

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Assessing the Potential Role of Pigs in the Epidemiology of Ebola Virus in Uganda

Ebolavirus, animal - Uganda: porcine, epidemiological assessment

CLICK HERE - Assessing the Potential Role of Pigs in the Epidemiology of Ebola Virus in Uganda

promedmail.org - September 2, 2015

Summary

Uganda has experienced 4 Ebola outbreaks since the discovery of the virus. Recent epidemiological work has shown pigs are hosts for ebolaviruses. Due to their high reproduction rates, rapid weight gain, potential to provide quick financial returns, and rising demand for pork, pig production in Uganda has undergone massive expansion. The combination of pork sector growth supported by development programmes and Ebola virus risk prompted a foresight exercise using desk, interview, and spatial methods. The study found that the lack of serological evidence for specific reservoir species, the number of human index cases unable to account for their source of infection, domestic pig habitat overlap with potential Ebola virus zoonotic host environments, reported interactions at the human-pig-wildlife interface that could support transmission, fever in pigs as a commonly reported problem by pig farmers, and temporal correlation of outbreaks with peak pork consumption periods, warrants further research into potential zoonotic transmission in Uganda from pigs.

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WHO Director-General addresses the Review Committee of the International Health Regulations focused on the Ebola response

Opening remarks at the Review Committee on the role of the International Health Regulations in the Ebola outbreak and response Geneva, Switzerland by Dr. Margaret Chen Director-General of the World Health Organization
24 August 2015

....Since Ebola first emerged in 1976, WHO and its partners have responded to 22 previous outbreaks of this disease. Even the largest were contained within four to six months....

In West Africa, WHO, and many others, were late in recognizing the potential of the outbreak to grow so explosively. Some warning signals were missed. Why?

Our challenge now is to look for improvements that leave the world better prepared for the next inevitable outbreak.

Managing the global regime for controlling the international spread of disease is a central and historical responsibility of the World Health Organization. We need to pinpoint the reasons why the response fell short,. We need to learn the lessons. We need to put in place corrective strategies just as quickly as possible....

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http://www.who.int/dg/speeches/2015/review-committee-ihr-ebola/en/

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With Many Ebola Survivors Ailing, Doctors Evaluate Situation

ASSOCIATED PRESS  by Carley Petesch              Aug. 23, 2015

DAKAR, Senegal --Lingering health problems afflicting many of the roughly 13,000 Ebola survivors have galvanized global and local health officials to find out how widespread the ailments are, and how to remedy them.

The World Health Organization calls it an emergency within an emergency. Many of the survivors have vision and hearing issues. Some others experience physical and emotional pains, fatigue and other problems. The medical community is negotiating uncharted waters as it tries to measure the scale of this problem that comes on the tail end of the biggest Ebola outbreak in history.

"If we can find out this kind of information, hopefully we can help other Ebola survivors in the future," Dr. Zan Yeong, an eye specialist involved in a study of health problems in survivors in Liberia, told The Associated Press.

About 7,500 people will enroll — 1,500 Ebola survivors and 6,000 of their close contacts — and will be monitored over a five-year period in the study launched by Partnership for Research on Ebola Vaccines in Liberia, or PREVAIL.

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Ebola: What Happened

COUNCIL ON FOREIGN RELATIONS  BY John Campbell
(Scroll down for Laurie Garett's essay "Ebola's Lessons.")

With a rapidly growing and urbanizing population, persistent poverty, and weak governance, Sub-Saharan Africa is likely to be the source of new epidemics that potentially could spread around the world. Understanding the disastrous response of African governments, international institutions, and donor governments to the Ebola epidemic is essential if history is not to be repeated yet again. That makes Laurie Garrett’s essay, “Ebola’s Lessons,” in the September/October 2015 issue of Foreign Affairs, essential reading.

The Ebola virus treatment center where four people are currently being treated is seen in Paynesville, Liberia, July 16, 2015. (Courtesy Reuters/James Giahyue)

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Some Ebola Survivors Still Suffer—And Doctors Don’t Know Why

SCIENCE    by  Katie  M. Palmer                      Aug. 15, 2015

For the communities in Guinea, Sierra Leone, and Liberia where Ebola took the greatest toll last year, the worst is over. After claiming 11,000 lives, the fatal virus has finally begun to retreat. Numbers of new Ebola cases are dwindling. But for some of the survivors—the 50 percent or so of the infected who pull through—Ebola’s effects still linger.

                            Ebola survivor Fayiah, 11, sits with her relatives in Monrovia, Liberia. Jerome Delay/AP

For the communities in Guinea, Sierra Leone, and Liberia where Ebola took the greatest toll last year, the worst is over. After claiming 11,000 lives, the fatal virus has finally begun to retreat. Numbers of new Ebola cases are dwindling. But for some of the survivors—the 50 percent or so of the infected who pull through—Ebola’s effects still linger.

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Proposed Ebola biobank would strengthen African science

NATURE by Erika Check Hayden                                                                             Aug. 10, 2015
As West Africa’s Ebola outbreak winds down, an effort is under way to make the best use of the tens of thousands of patient samples collected by public-health agencies fighting the epidemic.  Samples from the Ebola epidemic in West Africa are held by public-health agencies in the region and abroad. Daniel Berehulak/NYT/Redux/Eyevine

On 6–7 August, the World Health Organization (WHO) convened a meeting in Freetown, Sierra Leone, to discuss how to establish a biobank for up to 100,000 samples of blood, semen, urine and breast milk from confirmed and suspected Ebola patients, as well as swabs taken from the bodies of people who died from the virus. Held by health agencies in both West Africa and the West, the samples could be valuable in understanding how the current Ebola crisis evolved, preparing for future outbreaks and developing public-health research capacity in a region that depends on outside experts.

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Ebola terrified us a year ago. What did it teach us about West Africa?

WASHINGTON POST  by

“If it bleeds, it leads.” That’s the cliché in journalism that describes why a certain kind of tragedy tends to dominate the news cycle. One year ago today, the World Health Organization declared Ebola an “international health emergency.” But today, coverage of West Africa is beginning its drift into media disinterest as Ebola cases wane. International attention has now largely disappeared along with the sight of biohazard suits and ambulances.....

But it would be a mistake to celebrate victory over Ebola and return to the pre-outbreak status quo. The lessons of Ebola reach beyond the preparedness of West African health systems to confront crises, touching on issues that have been critical for the region in recent years: peace, security and how responsive governments are to society’s most vulnerable members. These lessons must be understood before a post-outbreak aid and development agenda is designed....

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Ebola Survivors Face Lingering Pain, Fatigue and Depression

NEW YORK TIMES  by Denis Grady                               Aug. 8, 2015

The Ebola outbreak that started more than a year ago seems to be waning at last. But now, West Africa faces another difficulty: More than 13,000 people survived the virus, and many have lingering health problems, psychological troubles like depression and post-traumatic stress disorder, and worries about returning to work to feed themselves and what is left of their families.

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How to Beat the Next Ebola

submitted by George Hurlburt

             

Graves dug in Freetown, Sierra Leone, to cope with those dying from Ebola in late 2014.  Mads Nissen/Panos

The world is ill-prepared for the next epidemic or pandemic. But the horror of the Ebola outbreak in West Africa may drive change.

nature.com - by Declan Butler - August 5, 2015

If there was one point last year when public-health experts held their breath, it was when a Liberian man infected with Ebola virus flew to Lagos, Nigeria, in July. Ebola was already raging uncontrolled through impoverished countries in West Africa, killing half of those it infected. Now a vomiting man had carried it straight to the heart of Africa's largest megacity — with 21 million inhabitants, many of whom live in slums. Experts were horrified at the prospect that the virus might rip through the city — and then, because Lagos is an international travel hub, spread farther afield.

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