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Ebola in west Africa: learning the lessons

THE LANCET  by  Anna  Petherick  Volume 385, No. 9968, p591–592, 14 February 2015
The (West Africa) region has presented unforeseen challenges, and the three worst affected countries have put in place different response strategies. Anna Petherick reviews some of the lessons learned so far.

The early history of the ongoing Ebola outbreak in west Africa is a salutary statement about the lack of infectious disease surveillance capacity in one of the world's poorest regions....

Opportunities to contain the virus were lost soon after, largely because of a lack of trust between local communities and the officials and medical professionals trying to nip the epidemic in the bud.

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http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2960075-7/fulltext

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Ebola spending: will lack of a positive legacy turn dollars to dolour?

Millions were invested in west Africa to tackle the Ebola crisis, but some experts doubt there will be any lasting benefits for public health systems

THE GUARDIAN by 

LONDON -- While it is still too early to call time on the Ebola outbreak, a sense that the worst may have passed is tentatively taking root in west Africa, alongside an acute realisation of the need to ensure a positive long-term legacy for battered healthcare systems.

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Why Didn't Ebola Kill Me?

An ambulance transports the author to the Nebraska Medical Center in October. (Sait Serkan Gurbuz/Reuters)

THE ATLANTIC by Ashoka Mukpo                                                                          Feb. 12, 2015

Like the majority of patients taken to Western hospitals, I recovered from the disease—but health authorities are still struggling to figure out how to bring up the much-lower survival rate in West Africa.

...the 80-percent survival rate among patients who were evacuated to Western hospitals shattered the idea that an Ebola diagnosis spelled near-certain death. I know this all too well, as I’m one of those patients myself. In October, I contracted Ebola while covering the outbreak as a freelance journalist in Liberia. I was airlifted to a hospital in Nebraska, where aggressive treatment likely saved my life....
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http://www.theatlantic.com/health/archive/2015/02/why-didnt-ebola-kill-me/385335/

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Lack of Effect of Lamivudine on Ebola Virus Replication

CDC EID JOURNAL by  Lisa E. Hensley, Julie Dyall, Gene G. Olinger, and Peter B. Jahrlin (NIH)                     Feb. 12, 2015

The unprecedented number of Ebola virus disease (EVD) cases in western Africa has compelled the world to consider experimental and off-label therapeutics to mitigate the current outbreak. For clinicians, approved drugs are an attractive solution because of known safety profiles and availability.

Oral lamivudine (GlaxoSmithKline, Brentford, UK), a US Food and Drug Administration–approved anti-HIV drug, has been suggested as a possible antiviral agent against Ebola virus (EBOV). In September 2014, a Liberian physician, Dr. Gorbee Logan, reported positive results while treating EVD with lamivudine (1). Thirteen of 15 patients treated with lamivudine survived presumed EVD and were declared virus free. Clinical confirmation of EVD in these cases remains to be verified....

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For Immediate Release February 11, 2015 FACT SHEET: Progress in Our Ebola Response at Home and Abroad

THE WHITE  HOUSE  PRESS OFFICE                                          FEB. 11, 2015

Fact sheet on the Ebola situation

"...Together with our international partners – and the people of the three nations themselves – we have bent the curve of the epidemic and placed it on a much improved trajectory. We have gone from over 1,000 new suspected, probable, and confirmed Ebola cases a week in October, to roughly 150 new confirmed weekly cases in the most recent reports.  Liberia has reported only a handful of new cases per week, a drop of well over 90 percent.  Significant declines also have been reported in Sierra Leone from the epidemic’s peak. Among the accomplishments in this response:..."

Read complete Statement
http://www.whitehouse.gov/the-press-office/2015/02/11/fact-sheet-progress-our-ebola-response-home-and-abroad

Also see:

Most U.S. Troops will be withdrawn, posted yesterday, Feb. 11, 2015

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UK should resume flights to Ebola-hit nations: parliamentary watchdog

REUTERS   by  Katie Nguyen                                                                                       Feb. 11, 2015

LONDON - Britain's decision to stop direct flights to Ebola-hit countries had "no scientific justification", probably increased the cost of dealing with the outbreak and should be reversed, a parliamentary watchdog said on Wednesday.

Several airlines including British Airways and Emirates stopped flights last year to countries in West Africa affected by the worst outbreak of Ebola since the deadly virus was identified in 1976.

In September, independent health advisers to the World Health Organization (WHO) concluded that there should be no general ban on travel or trade with Ebola-affected areas....

The committee also criticized the Department for International Development (DFID) for failing to respond to the crisis with enough urgency. It said DFID should focus on strengthening healthcare systems in the region so they could cope better with future public health emergencies.
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http://news.yahoo.com/uk-resume-flights-ebola-hit-nations-parliamentary-watchdog-132034795--finance.html;_ylt=AwrBEiHpi9tUnhAA7srQtDMD

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Reform After the Ebola Debacle

      

Margaret Chan, the director general of the World Health Organization.
Credit Salvatore Di Nolfi/Keystone, via Associated Press

nytimes.com - by The Editorial Board - February 10, 2015

The World Health Organization’s anemic performance in handling the Ebola outbreaks in West Africa may yield one positive outcome: sweeping, and long overdue, institutional reforms to improve its ability to respond more quickly to the next outbreak of a lethal infectious disease. Scrambling to answer growing criticism, the W.H.O.’s executive board recently endorsed changes to enhance the agency’s rapid response capabilities.

The reforms call for well-trained public health workers to rush to the aid of beleaguered countries and an emergency fund to support their initial operations, among other advances.

(READ COMPLETE ARTICLE)

(CLICK HERE - WHO - RESOLUTION AND SUPPORTING DOCUMENTATION)

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The Origins and Evolution of the Ebola Epidemic in West Africa

Investigations yield insights into Ebola outbreak's early months

cidrap.umn.edu - by Lisa Schnirring - December 30, 2014

With West Africa's Ebola epidemic passing the 1-year mark, two new reports yielded details about factors that fueled the event, including bats in a hollow tree that may have infected the index patient, a young Guinean child, and a silent chain of transmission that caused the disease to flare again in May after cases had sharply dropped off.

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See also:

Dec 30 EMBO Molecular Medicine study

Dec 29 New York Times story

Dec 30 WHO timeline

Dec 30 WHO situation summary

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Ebola Survivor Corps Establishment Guidance Toolkit

submitted by Novil Wijesekara

communityresiliencecenter.org

Ebola virus disease (EVD), formerly known as Ebola hemorrhagic fever, is a severe, illness in human with average case fatality rate of around 50% (range 25%-90%). At present, survivors of EVD face psychological effects, social isolation and serious repercussions on health care seeking behavior for EVD.  Ebola Survivor Corps is a comprehensive and sustainable program aimed at getting survivors of EVD back to their communities and society as helpers, advocates, champions and heroes of health and development.

Vision of Ebola Survivor Corps:

A world with zero discrimination for Ebola Survivors

Mission of Ebola Survivor Corps:

To establish a comprehensive and sustainable social organization with Ebola Survivors at the heart for reintegrating, empowering and engaging Ebola Survivors as leaders, advocates, champions and heroes of health and development.

Objectives:

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Ebola infection 'linked to visor'

THE PRESS ASSOCIATION                               Feb. 4, 2015
LONDON --A British nurse who contracted Ebola while working in Sierra Leone possibly caught the virus by wearing a visor and not goggles, an investigation has suggested.
Press Association - Save the Children said Pauline Cafferkey, pictured on her return to health, may have contracted Ebola by wearing a visor rather than goggles when treating patients in Sierra Leone

The report by Save the Children said it cannot be completely certain how Pauline Cafferkey contracted Ebola but said both pieces of equipment are "equally safe".

The nurse, from Cambuslang in South Lanarkshire, had volunteered with the charity at the Ebola Treatment Centre (ETC) in Kerry Town before returning to the UK in December....

Save the Children published the findings of an independent review into the possible causes of how the 39-year-old caught the virus. The report said both visors and goggles are safe but there are slight differences in the type of clothing worn with each and in the protocols for putting them on and removing them....

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