REPORTS Of RESEARCH ON TWO METHODS OF RAPID TESTING FOR EBOLA

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MEDICAL PRESS                                                                                     Dec. 8, 2014

Rutgers researcher David Alland, working with the California biotechnology company Cepheid, has received a grant of nearly $640,000 from the National Institutes of Health to develop a rapid test to diagnose Ebola as well as other viruses that can cause symptoms similar to Ebola.

Researchers will adapt this cartridge, now used worldwide for tuberculosis screenings, to collect and test samples from potential Ebola patients. Credit: John Emerson

Alland, a professor of medicine and associate dean for clinical research at Rutgers New Jersey Medical School and the principal investigator of the project, says health workers would be able to take the test to small villages and other remote locations where the spread of Ebola has been especially rampant and diagnose patients where they live...

ASSOCIATED PRESS -By MARIA CHENG and SARAH DiLORENZO Dec. 14, 2014

LONDON--As health officials struggle to contain the world's biggest-ever Ebola outbreak, their efforts are being complicated by another problem: bad data.

Having accurate numbers about an outbreak is essential not only to provide a realistic picture of the epidemic, but to determine effective control strategies. Dr. Bruce Aylward, who is leading the World Health Organization's Ebola response, said it's crucial to track every single Ebola patient in West Africa to stop the outbreak and that serious gaps remain in their data.

"As we move into the stage of hunting down the virus instead of just slowing the exponential growth, having good data is going to be at the heart of this," Aylward said. "We are not there yet and this is something we definitely need to fix."

THE TORONTO GLOBE AND MAIL by Kelly Grant                Dec.7, 2014

When the World Health Organization declared Nigeria officially Ebola-free in October, most of the fanfare centred on how Africa’s most populous country had managed to keep the virus from spreading.

But there was another, less heralded aspect of Nigeria’s success story that a Canadian doctor and her colleagues wanted to explore in more depth: How had 12 of Nigeria’s 20 Ebola patients beaten the virus?

The hospitals in Nigeria weren’t maybe to the standards of a Western hospital in terms of equipment, but the staff were phenomenal. They managed to get a very high survival rate,” said Eilish Cleary, a New Brunswick chief medical officer of health who travelled to Nigeria to provide epidemiological support to the World Health Organization during the outbreak. “Case fatality rate for Ebola can be up to 70 to 90 per cent. In Nigeria, it was 40 per cent.”

Dr. Cleary conducted detailed, videotaped interviews with six of the Nigerian patients to learn more about their treatment and recovery. The key to their survival seemed to be guzzling a stunning amount of water with oral rehydration solution [ORS] to fend off the cascade of internal failures typically caused by the virus.

THE WEEK -- by S.E. Smith                                                                                                     Dec. 5, 2014
While West Africa battles Ebola, another outbreak is striking just across the continent. In Madagascar, cases of plague are erupting in the small village of Mandritsara and the disease is spreading to neighboring communities. The two outbreaks are related by more than simple surface similarities, though. In fact, fighting the first has provided an invaluable blueprint for containing the second.

THE ECONOMIST                                                                                                      Dec. 4, 2014

THE first reported case in the Ebola outbreak ravaging west Africa dates back to December 2013, in Guéckédou, a forested area of Guinea near the border with Liberia and Sierra Leone. Travellers took it across the border: by late March, Liberia had reported eight suspected cases and Sierra Leone six. By the end of June 759 people had been infected and 467 people had died from the disease, making this the worst ever Ebola outbreak. The numbers keep climbing. As of November 30th, 17,145 cases and 6,070 deaths had been reported worldwide, the vast majority of them in these same three countries. Many suspect these estimates are badly undercooked.

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http://www.economist.com/blogs/graphicdetail/2014/12/ebola-graphics

Link to an interactive map of the virus's current global reach:

http://www.economist.com/blogs/graphicdetail/2014/12/interactive-ebola-map

Clinical Trials Are Being Launched in Africa but Face Challenges in Designing Ethical Studies, Compensating Donors

WALL STREET JOURNAL                                                                                                    Dec. 5, 2014
by Betsy McKay in Atlanta, David Gauthier-Villars in Conakry, Guinea, and Patrick McGroarty in Monrovia, Liberia

...Nearly a year after Ebola began spreading in West Africa, and with a proven drug or vaccine still far off, researchers are launching clinical trials on a product at hand: the blood of survivors.

 They want to determine whether so-called convalescent plasma or serum, chock full of antibodies, can help fight off the disease. But they face a number of complexities in carrying out the trials, including persuading survivors to participate....

Additonal  Nigerian and British health workers arrive in Liberia and Sierra Leone to help counter Ebola

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REUTERS  by James Harding Giahyue and Umaru Fofana   Dec. 5, 2014
MONROVIA/FREETOWN --More than 175 Nigerian medics arrived in Liberia and Sierra Leone on Friday to join the fight against Ebola, the first of 600 volunteers promised by the regional giant which contained its own outbreak earlier this year.

An army medic teaches NHS staff how to dispose of potentially contaminated waste last month, before their deployment to Sierra Leone. Photograph: Simon Davis/AFP/Getty Images

The medics will boost weak local health systems that are also struggling to contain other preventable diseases as Ebola discourages people from going to clinics for fear of contracting the fever.

"This is the African spirit you are showing, this is the Nigerian spirit,” Nigeria's ambassador to Liberia, Chigozie Obi-Nnadozie, told 76 Nigerian medics who landed there.

Another 100 volunteers landed in Freetown, Sierra Leone. Months into the Ebola response, experts say they are still short of medical personnel to staff treatment centers.

ASSOCIATED PRESS by EDITH M. LEDERER                                                                             Dec. 5, 2014

UNITED NATIONS -- Sierra Leone said Friday that between 80 and 100 new cases of Ebola are being reported every day and the country now hardest-hit by the deadly virus desperately needs over 1,000 beds to treat victims.

Sierra Leone's Finance Minister Kaifalah Marah painted a grim picture to the U.N. Economic and Social Council Friday of the challenges facing his West African nation which failed to meet a World Health Organization interim goal of isolating 70 percent of Ebola patients and safely burying 70 percent of victims by Dec. 1.

The two other hard-hit countries, Liberia and Guinea, did meet the deadline, and the U.N.'s Ebola chief Dr. David Nabarro said the number of new cases in Liberia has dropped from 60 per day in September to 10 per day. ...

VOICE OF AMERICA                                      Dec. 3, 2014

New data shows the Ebola outbreak intensifying in Sierra Leone, even as it stabilizes or drops off in other West African countries.   (Scroll down for link to WHO roadmap.)

The World Health Organization says Sierra Leone reported 537 new confirmed cases in the week ending November 30, a jump of more than 150 over the week before.  

In its latest update Wednesday, the WHO says "transmission remains persistent and intense across the country with the exception of the south."  The worst affected area was the capital, Freetown, where more than 200 new cases were reported.  

According to the WHO, the number of Ebola cases worldwide is more than 17,000, with all but a few dozen in Sierra Leone, Guinea and Liberia.  The overall death toll is up to 6,070.

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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.

INSTITUTE FOR SECURITY STUDIES                                                                                Dec. 2, 2014

Morocco’s refusal to host the Africa Cup of Nations (Afcon) from 17 January to 8 February next year, due to fears of Ebola,has sparked a furore among soccer lovers across the continent.

The North African kingdom has since become the target of some of the most aggressive xenophobia from fellow Africans, notably on social media. ‘Morocco is scared of outsiders,’ ‘Morocco is not an African country,’ are some of the insults that have been directed at the country in the wake of its decision.

... The competition has now been moved to Equatorial Guinea, co-host of the 2012 Afcon with Gabon. This decision has huge financial and political implications. Morocco has also been barred from participating in the 2015 Afcon, and risks more sanctions for its national team and Moroccan clubs.

World Bank Meanwhile lowers growth forecasts.

(See link below to World Bank Report)

ASSOCIATED PRESS                                                                                               Dec. 2, 2014
By JONATHAN PAYE-LAYLEH and SARAH DiLORENZO

MONROVIA, Liberia (AP) — The international response to Ebola is still too slow and piecemeal, Doctors Without Borders warned Tuesday, as officials said the disease is crippling the economies of the three West African countries hardest hit....

"Foreign governments have focused primarily on financing or building Ebola case management structures, leaving staffing them up to national authorities, local health care staff and NGOs (non-government organizations) which do not have the expertise required to do so," said the group, which is a primary provider of treatment in the outbreak, said in a statement Tuesday.

It reiterated its call for countries with biological-disaster response teams to deploy them.

NEW YORK TIMES  By Sheri Fink and  Somini Sengupta                                                       Dec. 2, 1014

GENEVA — The World Health Organization expressed doubt on Monday about achieving important United Nations benchmarks in battling Ebola, saying the year-end goals of isolating and treating all patients and safely burying all the dead would be major challenges.

REUTERS  -- By Roberta Rampton                                                                      Dec. 2, 2014

WASHINGTON --President Barack Obama on Tuesday will press Congress to approve $6.18 billion in emergency funding to help fight the Ebola outbreak in West Africa and prepare U.S. hospitals to handle future cases.

Most of the request is aimed at the immediate response to the disease at home and abroad. But the package also includes $1.5 billion in contingency funds - money that could become a target if lawmakers decide to trim the bill.

"That is the part of the package that is most at risk," said Sam Worthington, president of InterAction, an alliance of U.S. non-governmental aid groups.

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BBC    By   Mark Doyle                                                                                                        Dec. 1, 2014

Tony Banbury declined to say if targets he had set in the fight against Ebola, to be achieved by Monday, had been met.

The targets were for the proportion of people being treated and for the safe burial of highly infectious bodies.

In October, Mr Banbury told the UN Security Council that by 1 December, "70% of all those infected by the disease must be under treatment and 70% of the victims safely buried if the outbreak is to be successfully arrested".

Mr Banbury said the 70% targets were being met in "the vast majority" of areas in the three worst-affected countries - Guinea, Sierra Leone and Liberia.

"But in some areas", he said, "including here in Sierra Leone - especially in the capital Freetown and in the town of Port Loko - we are falling short. And it is in those areas where we really need to focus our assets and our capabilities".

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