In-Depth report on lessons to be learned from the Ebola crisis

THE WASHINGTON POST by By Lena H. Sun, Brady Dennis and Joel Achenbach                            Dec. 29, 2014

A year after it began, the Ebola epidemic in West Africa continues to be unpredictable, forcing governments and aid groups to improvise strategies as they chase a virus that is unencumbered by borders or bureaucracy.

The people fighting Ebola are coming up with lists of lessons learned — not only for the current battle, which has killed more than 7,500 people and is far from over, but also for future outbreaks of deadly contagions.

Alice Jallabah, head of a bushmeat seller group, holds dried bushmeat in Monrovia. (Zoom Dosso/AFP/Getty Images)

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

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.

BBC                                                                                                                       Dec. 22 2014

Spending cuts imposed by the International Monetary Fund (IMF) may have contributed to the rapid spread of Ebola in three West African states, UK-based researchers say.

                      Sierra Leone, along with Liberia and Guinea, have poor health facilities

It had led to "under-funded, insufficiently staffed, and poorly prepared health systems" in Sierra Leone, Liberia and Guinea, they said.

The IMF denied the allegation.

"A major reason why the Ebola outbreak spread so rapidly was the weakness of healthcare systems in the region, and it would be unfortunate if underlying causes were overlooked," said Cambridge University sociologist and lead study author Alexander Kentikelenis....

The IMF said in a statement that health spending in Guinea, Liberia and Sierra Leone had, in fact, increased in the 2010-2013 period.

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

THE LANCET                                                                                                              Dec.18, 2014
Communication and social mobilisation strategies to raise awareness about Ebola virus disease and the risk factors for its transmission are central elements in the response to the current Ebola outbreak in west Africa.1 A principle underpinning these efforts is to change risky "behaviour" related to "traditional" practices and "misinformation".

 Populations at risk of contracting Ebola virus disease have been exhorted to “put aside, tradition, culture and whatever family rites they have and do the right thing”....Such messages follow logically from clinical and epidemiological framings of contagion.

They pay little attention, however, to the historical, political, economic, and social contexts in which they are delivered....

Read the complete article.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2962382-5/fulltext

REUTERS                                                                                              Dec. 19, 2014

GENEVA –  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.

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

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

OXFORD UNIVERSITY PRESS                                                                                  Dec, 10, 2014

In an editorial published online today in the International Journal of Epidemiology, experts from the Departments of Psychiatry and Epidemiology at Columbia University, New York, are calling for survivors of the Ebola epidemic to be mobilised in a bid to hasten containment of the disease.

We already know that the current Ebola outbreak is unique in its magnitude and for its dispersion in dense, mobile populations. Physicians and nurses face high mortality, and foreign aid in the form of medical supplies and staff continues to be unequal to the scope of the problem. With a case recovery rate of around 30% at the present time in West Africa, survivors already number in the thousands.

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

 Read complete story

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

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.

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%.

A few months ago the U.S. Centers for Disease Control and Prevention predicted that up to 1.4 million people in Liberia and Sierra Leone could become infected with Ebola by mid-January. In a recent address to the Senate, CDC director Tom Frieden said that worst-case scenario would not pan out.

That is partly because health care workers in the Ebola hot zone are engaged in a battle to contain the epidemic. It is also because of assumptions about human and viral behavior that are built into the mathematical models used to predict the spread of infectious diseases. Assumptions are inherent in these models. “You take islands of data from different places and build bridges of assumptions that link up all these islands,” says Martin Meltzer, senior health economist at the CDC. Meltzer’s model, which predicted the 1.4 million infections in Liberia and Sierra Leone, worked on the assumption that things would not improve. “Our forecasts are based on the idea that nothing will change,” he says.

wwwnc.cdc.gov/eid

Schoepp RJ, Rossi CA, Khan SH, Goba A, Fair JN. Undiagnosed acute viral febrile illnesses, Sierra Leone. Emerg Infect Dis [Internet]. 2014 Jul [date cited]. http://dx.doi.org/10.3201/eid2007.131265

DOI: 10.3201/eid2007.131265

CLICK HERE - RESEARCH - Undiagnosed Acute Viral Febrile Illnesses, Sierra Leone

Table of Contents – Volume 20, Number 7—July 2014

Abstract

Archived Video - Watch the meeting held on Tuesday, December 9, 2014, from 1:00 to 2:00 p.m. (ET).

Speakers: Nancy A. Aossey, President and Chief Executive Officer, International Medical Corps

Laurie Garrett, Senior Fellow for Global Health, Council on Foreign Relations; Author, Ebola: Story of an Outbreak

David Nabarro, Special Envoy on Ebola, United Nations

Presider: Richard E. Besser, Chief Health and Medical Editor, ABC News

Experts recently returned from trips to West Africa with medical teams operating Ebola-treatment units there discuss the situation on the ground and developments in the international response to the crisis.

CLICK HERE - Council on Foreign Relations - Ebola Update: Assessment From Africa

CLICK HERE - YouTube - Council on Foreign Relations - Ebola Update: Assessment From Africa