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Ebola Doctors Are Divided on IV Therapy in Africa

NEW YORK TIMES  by Donald G. McNeil, Jr.                                                     Jan. 1, 2015

Medical experts seeking to stem the Ebola epidemic are sharply divided over whether most patients in West Africa should, or can, be given intravenous hydration, a therapy that is standard in developed countries. Some argue that more aggressive treatment with IV fluids is medically possible and a moral obligation. But others counsel caution, saying that pushing too hard would put overworked doctors and nurses in danger and that the treatment, if given carelessly, could even kill patients.

A nurse gave an Ebola patient intravenous fluids at the Red Cross treatment center in Kenema, Sierra Leone, in November. Credit Francisco Leong/Agence France-Presse — Getty Images

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Is Ebola Here to Stay?

SCIENTIFIC AMERICAN by Dina Fine Maron                                  Dec. 29, 2014
Kisses are at a premium in the capital of Liberia. Even a hug or a handshake between friends is often out of the question. That’s the new normal ever since Ebola began ravaging communities throughout Liberia, Sierra Leone and Guinea. For much of the past year, residents of these west African countries have wondered if daily life will ever be able to return to the way things once were.

Monrovia, Liberia - November 2014: Ebola survivor Korlia Bonarwolo leads a training of health workers at a mock Ebola Treatment Unit in Liberia. "I think with the knowledge we have now, the treatment is going to be much greater," he says.

Photo: Morgana Wingard/Sarah Grile, 2014

And at the heart of the matter is a scientific question: has Ebola now found a permanent foothold among humans?

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How Ebola Roared Back

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Ebola: How does it compare?

Ebola death rate compared to other diseases

BBC   by James Gallagher Health editor, BBC News website         Dec. 27, 2014

The world has witnessed the largest-ever epidemic of Ebola claim thousands of lives in West Africa in 2014....

Outbreaks such as Ebola have an ability to spread fear around the world, often through the prism of sensationalist media reporting.

So how does Ebola actually compare to previous outbreaks and other diseases? And while the world focuses on Ebola, are we guilty of ignoring much bigger killers?

Analysing the death rates from different viruses shows Ebola is certainly one of the most deadly infections ever encountered.
Read complete report
http://www.bbc.com/news/health-29953765

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Year in Review: Efforts to stop Ebola are gaining ground, but the fight isn't won

Ebola: Year in Review of 2014 developments
LOS ANGELES TIMES      by Alexandra Zavis                   Dec. 28, 2014

...As 2015 approaches, there is reason to hope that what at first was a plodding international response is finally catching up with the virus. In Liberia, where just a few months ago bodies were left in the streets for days and patients were turned away from treatment facilities because there weren't enough beds or personnel, the number of cases has been dropping rapidly. There are also signs that the disease may be slowing in Sierra Leone, which has overtaken Liberia as the country with the biggest caseload.

...Although the tactics being used have stemmed smaller Ebola outbreaks, some experts are beginning to question whether this one has spread too far to be fully contained without a vaccine or cure.

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State Ebola Protocols

CDC                                                                                                                Dec. 19, 2014

 The 2014 Ebola epidemic is the largest in history, affecting multiple countries in West Africa. Two imported cases, including one death, and two locally acquired cases in healthcare workers have been reported in the US. CDC and partners are taking precautions to prevent the further spread of Ebola within the US

CDC/OSTLTS Public Health Law Program and Office of the Associate Director for Policy compiled an Interim Table of State Ebola Screening and Monitoring Policies for Asymptomatic Individuals[PDF 826KB] to help law and policy makers prepare for and respond to Ebola-related situations.

See complete report.

http://www.cdc.gov/phlp/publications/topic/ebola.html

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GSK Ebola vaccine trial seen moving to wider phase in February

REUTERS                                                                                              Dec. 19, 2014

Trials of GlaxoSmithKline's experimental Ebola vaccine are likely to move to a second phase in February, later than previously suggested, after a meeting of national regulators said they needed more information.

The World Health Organization, which hosted a meeting of national regulatory authorities and ethics committees earlier this week, said they had thoroughly discussed all aspects of the proposed trials at the two-day meeting.

"Reviewing countries requested additional documentation from the manufacturer of the vaccine, GlaxoSmithKline, before authorization of the trials," the WHO said in a statement.

Countries where the trials are planned -- Cameroon, Ghana, Mali, Nigeria and Senegal -- should receive and review the additional information by the end of January.

"If these steps are completed to the satisfaction of the national authorities, Phase II trials are likely to begin in February," the statement said.

The GSK vaccine is already undergoing Phase I trials, to check its safety in humans, in Switzerland, Britain, Mali and the United States, and is one of the two leading candidate vaccines for Ebola already undergoing tests.

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The fight against Ebola: Exorcising the ghostly fever

In-depth description of the evolution of the Ebola crisis

THE ECONOMIST                                                                                                                               Dec. 13, 2014

AKPOIMA AND FREETOWN--Slowly and messily, the struggle against the virus is being won

 Read complete story.

http://www.economist.com/news/middle-east-and-africa/21636081-slowly-and-messily-struggle-against-virus-being-won-exorcising

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Ebola outbreak: Virus still 'running ahead of us', says WHO

BBC    by Tulip Mazumdar                                                                                                    Dec. 10, 2014

The Ebola virus that has killed thousands in West Africa is still "running ahead" of efforts to contain it, the head of the World Health Organization has said.
Director general Margaret Chan said the situation had improved in some parts of the worst-affected countries, but she warned against complacency.

The risk to the world "is always there" while the outbreak continues, she said.

She said the WHO and the international community failed to act quickly enough....

"It is fair to say the whole world, including WHO, failed to see what was unfolding, what was going to happen in front of our eyes," said Dr Chan.

"Of course, with the benefit of hindsight, if you ask me now... we could have mounted a much more robust response."

Read complete story.
http://www.bbc.com/news/health-30400304

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WHO: malaria gains 'at risk' in Ebola-affected countries

MEDICAL NEWS TODAY                                                                                                 Dec. 9, 2014

LONDON --Thanks to increased disease control, global deaths to malaria have fallen dramatically, and the number of new cases is steadily declining, say the World Health Organization in a new report. Also, an increasing number of countries are moving toward eliminating the mosquito-borne disease altogether. But the UN agency warns these gains are fragile, and no more so than in countries worse-affected by the Ebola crisis.

 
A new report from the World Health Organization says the number of lives claimed by malaria worldwide fell by 47% between 2000 and 2013, and by 54% in Africa, where the vast majority of deaths occur.

The 2014 World Health Organization (WHO) report says deaths to malaria worldwide fell by 47% between 2000 and 2013. In the WHO African Region, where 90% of deaths to malaria occur, the reduction is 54%.

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