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Ebola in west Africa: learning the lessons

THE LANCET  by  Anna  Petherick  Volume 385, No. 9968, p591–592, 14 February 2015
The (West Africa) region has presented unforeseen challenges, and the three worst affected countries have put in place different response strategies. Anna Petherick reviews some of the lessons learned so far.

The early history of the ongoing Ebola outbreak in west Africa is a salutary statement about the lack of infectious disease surveillance capacity in one of the world's poorest regions....

Opportunities to contain the virus were lost soon after, largely because of a lack of trust between local communities and the officials and medical professionals trying to nip the epidemic in the bud.

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http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2960075-7/fulltext

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

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Botswana Doctor Is Named to Lead W.H.O. in Africa

NEW YORK TIMES  by Donald G. McNeil, Jr.                                                               Jan. 27, 2015

A defining moment in the life of Dr. Matshidiso Moeti, the World Health Organization’s new regional director for Africa, came when she was 9 and her father realized that her little sister’s mathematics textbook was below even the level he had studied as a poor child on a South African farm.

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Ebola infection of humans linked to population density and vegetation cover

MEDICAL NEWS TODAY                                             Jan. 22, 2015

Ebola is a "zoonotic" disease: the virus starts out in animal populations - believed to be fruit bats - and then spills over into humans. Now, a new study that investigates landscape features of where spillover occurs suggests human population density and vegetation cover may be important factors.

The researchers examined landscape features of precise geo-locations of Ebola spillover into humans.

The study is the work of two researchers from SUNY Downstate Medical Center in Brooklyn, NY, who write about their findings in the open-access journal PeerJ.

First author Michael G. Walsh, assistant professor of epidemiology and biostatistics in SUNY Downstate's School of Public Health, says they found significant interaction between density of human populations and the extent of green vegetation cover in the parts of Africa that have seen outbreaks of Ebola virus disease (EVD).

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Time Magazine Person of the Year: the Ebola fighters

 

TIME MAGAZINE    by Nancy Gibbs                                                                                                      Dec. 10, 2014

They risked and persisted, sacrificed and saved. Editor Nancy Gibbs explains why the Ebola Fighters are TIME's choice for Person of the Year 2014

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http://time.com/time-person-of-the-year-ebola-fighters-choice/

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Evaluating Ebola Therapies — The Case for RCTs

THE NEW ENGLAND JOURNAL OF MEDICINE                                                                                 Dec. 3, 2014
By Edward Cox, M.D., M.P.H., Luciana Borio, M.D., and Robert Temple, M.D.

...Studying investigational therapies for EVD presents scientific, practical, and ethical challenges. Not surprisingly, there has been substantial debate about the best and most appropriate study approaches.2,3 It is generally agreed that a trial with a concurrent control group, in which patients are randomly assigned to receive the test drug plus the best available supportive care (BASC) or to BASC alone, would be the most efficient and reliable way to evaluate the safety and effectiveness of candidate products.

 Some people in the health care community, however, have argued against such trials, urging instead use of a historical control — that is, making investigational drugs as widely available as their supply allows and then comparing mortality rates among treated patients with rates that would have been expected absent the drugs, on the basis of past experience with EVD.

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UN security council criticises discrimination against those from Ebola-hit regions

THE GUARDIAN                                                    Nov. 21, 2014
THE UNITED NATIONS --The UN security council has criticized travel bans against nationals from Ebola-hit countries.

Last month the Australian immigration minster, Scott Morrison, announced Australia would stop granting temporary visas to visitors from west Africa. The security council statement criticised such blanket bans and urged countries to maintain links with affected countries.

“The security council expresses its continued concern about the detrimental effect of the isolation of the affected countries as a result of trade and travel restrictions imposed on and to the affected countries as well as acts of discrimination against the nationals of Guinea, Liberia, Mali and Sierra Leone,” said Julia Bishop, the Australian foreign mniister who was presiding over the session Thursday.

The council statement also described the Ebola outbreeak in Africa as "a threat to international peace and security..."

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Queen Fears Ebola Push at Expense of Other Killer Diseases

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The Shifting Ebola Epidemic

NEW YORK TIMES                                                                                         Nov. 16, 2014

EDITORIAL

Recent gains in controlling the Ebola epidemic in West Africa have been encouraging, but they offer no reason for complacency. In Liberia, the hardest-hit country, the rate of new infections has declined in some areas, and several treatment units have been reporting empty beds for more than a month. But in adjacent Sierra Leone the number of new cases has shot upward, while in Guinea, where the epidemic started, the incidence of new cases appears to have stabilized over all, with growth in some districts and declines in others. All told, Ebola has infected more than 14,000 people in West Africa and killed more than 5,000 of them...

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Are we asking the wrong questions about Ebola?

BBC NEWS MAGAZINE                                            NOV. 11, 2014

By Ben Carter

The Ebola virus has killed about 5,000 people since March - but one scientist who is studying the statistics says this is not the best figure to consider if we really want to understand the current state of the outbreak and how to beat it.

 

 

A total of 4,960 people have died from Ebola this year according to statistics released by the World Health Organisation on 4 November. More than half of those cases - 2,766 - were in Liberia.

But this cumulative figure, which is widely reported, can only go one way - up. It gives no meaningful insight into how the outbreak has developed says Hans Rosling, professor of global health at the Karolinska Institute in Sweden....

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http://www.bbc.com/news/magazine-30011521

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