22, October, 2014

WHO's  new report says the number of confirmed,suspected and probable Ebola cases has reached 9936 with 4877 deaths confirmed.

See full Report and graphs

http://apps.who.int/iris/bitstream/10665/137091/1/roadmapsitrep22Oct2014_eng.pdf?ua=1

A study projects up to three Ebola-infected people could be on overseas flights each month from the three most-affected African countries. WSJ's Gautam Naik reports. Photo: Getty

CLICK HERE - The Lancet - Assessment of the potential for international dissemination of Ebola virus via commercial air travel during the 2014 west African outbreak

wsj.com - by Gautam Naik - Oct. 20, 2014

Up to three Ebola-infected people could embark on overseas flights every month from the three most-affected African countries, according to a new study that projected travel patterns based on infection rates and recent flight schedules.

The findings, published Monday in the journal Lancet, suggest that Ebola cases could be spread overseas by unwitting travelers from the worst-hit countries—Guinea, Liberia and Sierra Leone.

The World Health Organization has estimated that, by early December, there could be as many as 10,000 new cases a week in west Africa.

DEUTSCHE  WELLE                                                                             Oct. 21, 1914

 By Philipp Sandner and Ibrahima Bah

West African countries that have escaped the Ebola outbreak intend to stay free of it by preparing for the worst. It is a strategy that can work as events in Senegal and Nigeria have shown. 

Mali, Senegal, Ivory Coast and Guinea-Bissau are countries that border on the epicenter of the Ebola epidemic that encompasses Guinea, Liberia and Sierra Leone. All these nations wish to protect themselves.

A health worker takes the temperature of man entering Mali from Guinea

One of the more obvious measures is to screen people entering the country. "We are using thermal imaging cameras to detect people at airports and borders who are running a temperature," said Malian physician Adamas Daou. He works at Mali's National Action Center for the fight against Ebola. Medical personnel are also on duty urging Malians to practice good personal hygiene. "This includes washing their hands in chlorinated water" Daou said.

journals.cambridge.org -  Eric Toner, Amesh Adalja and Thomas Inglesby. A Primer on Ebola for Clinicians.
Disaster Medicine and Public Health Preparedness, available on CJO2014. doi:10.1017/dmp.2014.115.

Abstract

The size of the world’s largest Ebola outbreak now ongoing in West Africa makes clear that further exportation of Ebola virus disease to other parts of the world will remain a real possibility for the indefinite future. Clinicians outside of West Africa, particularly those who work in emergency medicine, critical care, infectious diseases, and infection control, should be familiar with the fundamentals of Ebola virus disease, including its diagnosis, treatment, and control. In this article we provide basic information on the Ebola virus and its epidemiology and microbiology. We also describe previous outbreaks and draw comparisons to the current outbreak with a focus on the public health measures that have controlled past outbreaks. We review the pathophysiology and clinical features of the disease, highlighting diagnosis, treatment, and hospital infection control issues that are relevant to practicing clinicians. We reference official guidance and point out where important uncertainty or controversy exists. (Disaster Med Public Health Preparedness. 2014;0:1-5)

CDC                                                              Posted Oct. 20, 2014 from  CDC  Oct. 17 document

This document is a concise summary of published information on the current science about human-to-human transmission of Ebola virus. It is developed for use by healthcare personnel and public health professionals to use. It is a complement to the many guidance documents that CDC has issued already online at

www.cdc.gov/ebola.

It's been 42 days since the last new case

TIME MAGAZINE                                                      OCT. 20, 2014

Alexandra Sifferlin

 The World Health Organization declared Nigeria free of Ebola on Monday, a containment victory in an outbreak that has stymied other countries’ response efforts....

A school official takes a pupil's temperature using an infrared digital laser thermometer in front of the school premises, at the resumption of private schools, in Lagos, Sept. 22, 2014. Akintunde Akinleye—Reuters

“It’s possible to control Ebola. It’s possible to defeat Ebola. We’ve seen it here in Nigeria,” Nigerian Minister of Health Onyebuchi Chukwu told TIME. “If any cases emerge in the future, it will be considered—by international standards—a separate outbreak. If that happens, Nigeria will be ready and able to confront it exactly as we have done with this outbreak.”

ROUNDUP OF DEVELOPMENTS SUNDAY

REUTERS                                     Oct 19, 2014

By Erwin Seba

GALVESTON Texas --(Reuters) - The United States will issue strict new guidelines telling American health workers to cover their skin and hair when dealing with Ebola patients, a top health official said on Sunday, while some of the dozens of people being watched for possible exposure to the virus are expected to be cleared.

 A health care worker receives protocol on the proper removal of personal protection equipment from Centers for Disease Control and Prevention (CDC) instructors in preparation for the response to the current Ebola outbreak, during a CDC safety training course in Anniston, Alabama, October 6, 2014. Credit: Reuters/Tami Chappell

In Texas, a lab worker who spent much of a Caribbean holiday cruise in isolation tested negative for the deadly virus and left the Carnival Magic liner with other passengers after it docked at Galveston early on Sunday morning....

Image: An experimental Ebola vaccine has been developed by the U.S. National Institutes of Health and pharmaceutical company GlaxoSmithKline. Photograph by Steve Parsons, AP

news.nationalgeographic.com - October 14th, 2014 - Karen Weintraub

Ebola vaccines are so effective in monkeys that macaques can be protected or rescued even if they're injected with a hundred times the lethal dose of the Ebola virus after vaccination. But no one knows for certain whether the vaccines will work in humans; the vaccines haven't yet been rigorously tested in people.

Just developing the vaccines to test in monkeys was a grueling, decades-long process that has killed scores of macaques since the 1990s.

(VIEW COMPLETE ARTICLE)

nejm.org - WHO Ebola Response Team

N Engl J Med 2014; 371:1481-1495 - October 16, 2014 - DOI: 10.1056/NEJMoa1411100

Conclusions

These data indicate that without drastic improvements in control measures, the numbers of cases of and deaths from EVD are expected to continue increasing from hundreds to thousands per week in the coming months.

(SEE COMPLETE NEJM ARTICLE HERE)

NEJM - Ebola Virus Disease in West Africa — The First 9 Months of the Epidemic and Forward Projections (15 page .PDF file)

USA TODAY                                                     Oct. 19, 2014

BY Gregg Zoroya and John Bacon

The Pentagon will build a 30-person, rapid-response Ebola medical support team to aid civilian health care workers should additional cases of the virus be diagnosed in the U.S., officials said Sunday.

The effort was requested by the Department of Health and Human Services "as an added prudent measure to ensure our nation is ready to respond quickly, effectively and safely in the event of additional Ebola cases," a Pentagon statement said.

http://www.defense.gov/Releases/Release.aspx?ReleaseID=16986

The Pentagon said Defense Secretary Chuck Hagel ordered his Northern Command Commander, Gen. Chuck Jacoby, to prepare and train the team. It will include 20 critical-care nurses, five doctors trained in infectious disease and five trainers in infectious-disease protocols...

Team members will remain in a "prepare to deploy" status for 30 days after training. They will not be sent to West Africa or elsewhere overseas and "will be called upon domestically only if deemed prudent by our public health professionals," the statement said.

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Four suggestions on what we need to successfully counter Ebola

A healthcare worker mixes chlorine with water at an Ebola treatment center in Hastings, Freetown, Sierra Leone, Oct. 15. Associated Press

Suggestions include:

THE INDEPENDENT                                                  OCT. 18, 2014

LONDON ---Ebola is poised to become the “definitive humanitarian disaster of our generation", Oxfam has warned, with more troops, funding and medical aid urgently needed to tackle the outbreak.

In an "extremely rare" move, the charity is calling for military intervention to provide logistical support across West Africa.

It says the world has less than two months to counter the spread of the deadly virus, which means addressing a "crippling shortfall" in military personnel.

Oxfam’s call for more troops comes after UN chief Ban Ki-Moon criticised countries he said were able to provide financial support to the crisis for not doing so.
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NEW YORK TIMES                                                 Oct. 18, 2014

By MICHAEL D. SHEAR and MARK LANDLER

WASHINGTON — Beneath the calming reassurance that President Obama has repeatedly offered during the Ebola crisis, there is a deepening frustration, even anger, with how the government has handled key elements of the response.

Those frustrations spilled over when Mr. Obama convened his top aides in the Cabinet room after canceling his schedule on Wednesday. Medical officials were providing information that later turned out to be wrong. Guidance to local health teams was not adequate. It was unclear which Ebola patients belonged in which threat categories.

CANADIAN PRESS                                     Oct. 18, 2014

OTTAWA—The federal government says Canada will start shipping its experimental Ebola vaccine to the World Health Organization on Monday.

WASHINGTON POST

By Katie Zezima                               Oct. 18. 2014

WASHINGTON -Public health officials have been nearly unanimous in rejecting the idea of a travel ban between the United States and the West African countries at the epicenter of the Ebola outbreak.

But the drumbeat from politicians demanding Ebola-related restrictions on travel intensified Friday as a number of moderate Democrats joined the chorus, including Sen. Kay Hagan of North Carolina, who is enmeshed in a tough reelection fight, Rep. Tulsi Gabbard of Hawaii and Michelle Nunn, who is running for Senate in Georgia....

The calls have alarmed public health experts, who said a travel ban could result in the opposite of its intention and spread the virus throughout West Africa and beyond.

“It’s an 18th-century view that you can somehow place a cellophane wrapper around a whole region of the world and expect to keep germs out. It doesn’t work that way because it’s never worked,” said Lawrence O. Gostin, faculty director of the O’Neill Institute for National and Global Health Law at Georgetown University and director of the World Health Organization Collaborating Center on Public Health Law & Human Rights.

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