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Tracing the Ebola Outbreak, Scientists Hunt a Silent Epidemic

NEW YORK TIMES  by Sheri Fink, MD                         May 5, 2015

(Contains new information on the origin of the Ebola epidemic.)

Scientists are using blood samples collected throughout the Ebola outbreak to map the virus’s spread from country to country by tracking tiny mutations in its gene sequences.

The picture is not yet complete, but intriguing discoveries have been made. Virus mutations first detected in Sierra Leone last spring were found later in Liberia and Mali, and scientists are examining whether this resulted from the chance movements of people across borders....

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Ebola in graphics: The toll of a tragedy

Set of graphs on the Ebola Outbreak

THE ECONOMIST   by the Graphics Team                                                                   May 5, 2015 

The outbreak continues to claim lives, but Liberia could be confirmed Ebola free on May 9th. The situation in Guinea and Sierra Leone is also improving with fewer provinces reporting cases than in previous weeks. The World Health Organisation reports that each country now has enough treatment beds to be able to isolate and treat patients with Ebola, and to bury everyone known to have died of the disease.

The chart above shows numbers from both the WHO's regular situation reports and from patient databases, which tend to be more accurate but are less complete for recent weeks.
See complete story and set of graphics.
http://www.economist.com/blogs/graphicdetail/2015/05/ebola-graphics

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Review: ‘Frontline’ Looks at Missteps During the Ebola Outbreak

NEW YORK TIMES  By                      May 3, 2015

(UPDATE: Scroll down for link to the PBS FRONTLINE  program on Ebola originally aired last night on American television.)

Heartbreaking stories from the Ebola outbreak are familiar by now, although that doesn’t make them any easier to hear, and a “Frontline” installment being broadcast on PBS on Tuesday night has its share. But it also has something less familiar: Officials acknowledging that they could have done a better job of responding to the crisis.

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Host of Ailments Plague African Ebola Survivors

WALL STREET JOURNAL BY Betsy McKay                     May 1, 2015

MONROVIA, Liberia—Dorbor Sirleaf thought his ordeal with Ebola was over in October, when he walked out of a treatment unit, having overcome the ruinous disease.

 

Instead, the 29-year-old father of four is suffering from symptoms he says he never had before he had Ebola. His legs and other parts of his body ache. Worse, he has trouble seeing, particularly distances. His eyes itch, hurt and often water up. “Sometimes my tears can be rolling,” he said.

More than 15,000 people have survived Ebola in West Africa, and more than 10,800 died, in the largest epidemic of the disease by far in history—one that has yet to be extinguished. But many have emerged with an assortment of mysterious physical ailments, including joint pain, fatigue and a particularly worrisome and common complaint: vision loss. Some, like Mr. Sirleaf, say their eyes hurt. Others report blurred vision or say they can’t see at all.

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Nine Ways We Are Beating the Ebola Epidemic in West Africa

THE HUFFINGTON POST by                  April 26, 2015
.. Addressing an Ebola epidemic of this scale has taken the international community on a journey never before walked. Previously tried and tested methods have been used as well as novel strategies, but the scale that has been required is unprecedented.

Rapid response medical team outside a mobile treatment facility
Nathalie MacDermott/Samaritan's Purse International Relief

It is also apparent that no 'one size fits all' approach can work - the approach must be multifactorial, addressing the problem at it's roots within the communities where the outbreaks occur, but also on a national level to provide large scale isolation of cases and interrupt transmission of the virus.

Below are nine ways in which we are beating the Ebola epidemic in West Africa:

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UN chief names new head of Ebola mission as outbreak calms

ASSOCIATED PRESS by Jonathan Paye-Layleh             April 25, 2015

MONROVIA, Liberia — The U.N. chief on Saturday appointed a new head of the emergency mission responding to West Africa’s Ebola crisis amid hopes that the world’s deadliest outbreak of the virus will soon come to an end.

A statement from Ban Ki-moon’s office said Peter Jan Graaff of the Netherlands will work closely with David Nabarro, the U.N.’s special Ebola envoy, in addressing an epidemic that has claimed more than 10,000 lives in the three hardest-hit countries: Liberia, Guinea and Sierra Leone.

Outgoing head Ismail Ould Cheikh Ahmed was appointed as special envoy to Yemen on Saturday.

Graaff had been serving since October as the U.N.’s Ebola crisis manager in Liberia, which has recorded more Ebola deaths than any other country.

Read complete story.
http://www.washingtonpost.com/world/africa/un-chief-names-new-head-of-ebola-mission-as-outbreak-calms/2015/04/25/46ba3320-eb84-11e4-8581-633c536add4b_story.html

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Empowering local media can make the difference: 5 lessons from the Ebola crisis

DEVEX byAlison  Campbell                                                                          April 23, 2015

The Ebola crisis in West Africa was quickly recognized as being driven as much by misinformation and rumors as by weaknesses in the health care system. Mohamed Komah interviews an Ebola survivor at the Donka Ebola treatment center in Conakry, Guinea. Photo by: Internews

International response agencies invested significant resources in rolling out the Social Mobilization and Community Engagement drive, a wide-scale intensive social behavior change communication campaign. The result was a massive and rather poorly coordinated blast of messaging shared on billboards, in print, on radio and TV, through health outreach workers and community organizations, via SMS and call-in hotlines.

A preliminary assessment done by Internews in November found more than 300 types of social mobilization and messaging systems in the three worst-affected countries: Liberia, Guinea and Sierra Leone. This chaotic information landscape consisted mainly of information “out,” with little opportunity for community dialogue....

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Ebola Lying in Wait

NEW YORK TIMES by Pam Belluck and William J. Broad     April 20, 2015

A growing body of scientific clues — some ambiguous, others substantive — suggests that the Ebola virus may have lurked in the West African rain forest for years, perhaps decades, before igniting the deadly epidemic that swept the region in the past year, taking more than 10,000 lives.

Around 2004 at a government hospital in Kenema, Sierra Leone, a team of American scientists and West African medical personnel found what appeared to be Ebola antibodies in nearly 9 percent of blood samples. Credit Carl De Souza/Agence France-Presse — Getty Images

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Evaluating Clinical Trial Designs for Investigational Treatments of Ebola Virus Disease

PLOS MEDICINE   by Ben Cooper and others                                                             April 14, 2015
Experimental treatments for Ebola virus disease might reduce EVD mortality. There is uncertainty about the ability of different clinical trial designs to identify effective treatments, and about the feasibility of implementing individually randomised controlled trials during an Ebola epidemic

A treatment evaluation programme for use in EVD was devised using a multi-stage approach (MSA) with two or three stages, including both non-randomised and randomised elements. The probabilities of rightly or wrongly recommending the experimental treatment, the required sample size, and the consequences for epidemic outcomes over 100 d under two epidemic scenarios were compared for the MSA, a sequential randomised controlled trial (SRCT) with up to 20 interim analyses, and, as a reference case, a conventional randomised controlled trial (RCT) without interim analyses.

Read complete study.

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001815

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Crowdsourced Mapping Could Help Prevent the Next Big Ebola Outbreak

TAKEPART.COM by Jessica Dollin                                                                     April 14, 2015

Ebola dominated headlines this past year, but the epicenter of the outbreak wasn’t on a map until after the virus had infected and killed thousands. Without geographical resources, aid workers were tasked with the challenge of navigating remote areas to locate people in need of assistance.

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