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Mystery Deaths in Sierra Leone Spread Fear of Ebola Relapses

submitted by George Hurlburt

      

Sierra Leonean doctors practice wearing protective clothing in the Ebola Training Academy in Freetown, Sierra Leone, December 16, 2014. Reuters

uk.reuters.com - by Kemo Cham and Emma Farge - October 21, 2015

. . . the case of Scottish nurse Pauline Cafferkey – the first known Ebola survivor to have an apparently life-threatening relapse – has revived concerns about the health of some 17,000 survivors in Sierra Leone, neighbouring Guinea and Liberia.

Doctors and health officials in Sierra Leone told Reuters that a handful of mystery deaths among discharged patients may also be types of Ebola relapses, stirring fear that the deadly virus may last far longer than previously thought in the body, causing other potentially lethal complications.

Diagnoses have not been made, partly because of a lack of relevant medical training and insufficient equipment for detecting a virus that can hide in inaccessible corners of the body - such as the spinal fluid or eyeball. In Cafferkey's case, the virus in her brain caused meningitis.

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The Chains of Mental Illness in West Africa

submitted by George Hurlburt

         

Yaovi Gaffa, 20, chained in a room at a prayer camp near Lomé, Togo, in April. Chaining is a last resort for families in West Africa where psychiatry is virtually unknown. Credit Joao Silva/The New York Times

nytimes.com - by Benedict Carey - October 11, 2015

KPOVÉ, Togo — The church grounds here sprawled through a strange, dreamlike forest. More than 150 men and women were chained by the ankle to a tree or concrete block, a short walk from the central place of worship. Most were experiencing the fearsome delusions of schizophrenia.

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Ebola Nurse Pauline Cafferkey 'In Serious Condition'

            

Pauline Cafferkey previously spent a month in the specialist isolation unit at the Royal Free Hospital in London

bbc.com - October 9, 2015

A Scottish nurse who contracted Ebola in Sierra Leone last year is in a "serious condition" after being readmitted to an isolation unit in London.

NHS Greater Glasgow and Clyde confirmed that the virus is still present in Pauline Cafferkey's body after being left over from the original infection.

She is not thought to be contagious.

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Peste des Petits Ruminants Kills Livestock in Lofa - Liberia

         

bushchicken.com - by Zeze Ballah - August 20, 2015

VOINJAMA, LofaAn investigation conducted by The Bush Chicken has established that scores of livestock in Lofa died from Peste des Petit Ruminants, or Ovine Rinderpest. . . .

. . . Over 1,000 farmers in Zorzor and Kolahun districts, including the towns Tenebu and Samodu, lost livestock to Peste des Petit Ruminants. . . .

. . . When contacted for comments, Lofa’s Agriculture Coordinator Theophilus Baah confirmed The Bush Chicken investigation and said the ministry has not been providing vaccines to animals prior to the recent outbreak.

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Offline: A pervasive failure to learn the lessons of Ebola

THE LANCET by Richard Horton                         Sept. 12, 2015

LONDON-- Post-Ebola reverie has given birth to a plethora of expert panels to consider what went wrong. The latest parade of global health specialists appointed to learn lessons gathered at the Wellcome Trust in London last week.
 Under the auspices of the US Institute of Medicine (IOM), a Commission to “deliberate and evaluate options to strengthen global, regional, and local systems to better prepare, detect, and respond to epidemic diseases” spent 2 days amassing evidence.

 There was no shortage of experience brought to bear on these important matters. Here were Margaret Chan, Jeremy Farrar, Ilona Kickbusch, David Heymann, Larry Gostin, Joy Phumaphi, Joanne Liu, and Peter Piot all wrestling with a seemingly intractable challenge. The statements offered to the Commission were arresting. But  the purpose of the meeting was not to talk. It was to identify the best system for an epidemic response....
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http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2900152-X/fulltext

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WHO - Polio Outbreak Confirmed in Mali

                                            

afro.who.int

Bamako, 7 September 2015 – A case of circulating vaccine-derived poliovirus type 2 (cVDPV2) has been confirmed in Bamako, the capital and largest city of Mali. The country is on high alert after national authorities detected a paralysis case with onset 20 July 2015. The patient is a 19-month old child of Guinean nationality whose paralysis occurred 7 days prior to the child’s arrival in Bamako to seek health care. The last case of wild polio virus (WPV) in Mali dates back to June 2011 in Goundam, Timbuktu Region.

The current detected virus is genetically linked to a confirmed VDPV detected in Siguiri district, in the Kankan Region of Guinea in August 2014, and has been circulating across international borders for more than 2 years without detection. 

The risk of spread of this virus is deemed high and it has the capacity to cause paralytic disease in humans or kill. The emergence and circulation of VDPV2 reveals low population immunity against the virus due to low rates of vaccination coverage in Guinea. Consequently, oral polio vaccine (OPV) must be administered multiple times to stop the outbreak and protect children. 

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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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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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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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