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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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Ebola: media ‘overlooked Africa's role in combating crisis’

THE GUARDIAN by Sam Jones                                                              April 7, 2015

Africa’s efforts to tackle the Ebola crisis have been largely overlooked even though Africans have taken the lead in providing frontline staff and shown themselves “better placed to fight infectious diseases in their continent than outsiders”, according to the African Union (AU).

A Liberian health worker checks the temperature of students to curb the spread of Ebola in Caldwell, outside the capital Monrovia. Photograph: Ahmed Jallanzo/EPA

Dr Olawale Maiyegun, director of social affairs at the AU commission, said that despite the fact that Africans had proved both willing and able to deal with Ebola, the focus had been on the work of international agencies and those with the greatest media clout.

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Yes, We Were Warned About Ebola

NEW YORK TIMES OP-ED  By BERNICE DAHN, VERA MUSSAH and CAMERON NUTT   April 7, 2015               
MONROVIA, Liberia — The conventional wisdom among public health authorities is that the Ebola virus, which killed at least 10,000 people in Liberia, Sierra Leone and Guinea, was a new phenomenon, not seen in West Africa before 2013. (The one exception was an anomalous case in Ivory Coast in 1994, when a Swiss primatologist was infected after performing an autopsy on a chimpanzee.)

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Liberia, Sierra Leone gain in Ebola crisis; Guinea struggles

ASSOCIATED PRESS  by Sarah DiLorenzo                                                               April 2, 2015      

(Scroll below for related Wall Street Journal story.)   

DAKAR, Senegal (AP) — When will the world's largest and longest Ebola outbreak end? The West African countries of Sierra Leone and Liberia both appear to be on steady paths to ending the epidemic. The wild card is Guinea, where Ebola hasn't burned as hot but remains stubbornly entrenched.

 

In this file photo dated Friday, March. 27, 2015, a usually busy street is deserted as Sierra Leone enters a three day country wide lockdown on movement of people due to the Ebola virus in the city of Freetown, Sierra Leone. Sierra Leone's 6 million people were told to stay home for three days, except for religious services, beginning Friday as the West African nation attempted a final push to rid itself of Ebola. (AP Photo/ Michael Duff, FILE)

Liberia's last Ebola patient died March 27; it is now counting down the 42 days it must wait to be declared free of Ebola. Meanwhile, Sierra Leone recorded no new infections Wednesday for the second time; on average, it has logged a handful each day in recent days.

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Combatting Rumors About Ebola: SMS Done Right

When misinformation is a case of life or death, aid workers and communities need an ear to the ground

INTERNEWS   by  Anahi Ayala Iacucci                                                March 26, 2015

 What is now clear to healthcare organizations working on the ground in West Africa is that the Ebola epidemic has been driven as much by misinformation and rumors as by weaknesses in the health system. It is common sense that information is a critical element in combatting disease, particularly when contagion from common social practices, such as bathing the corpses of the deceased, were central to so much of the early spread of the disease. But in the context of a massive disease outbreak, when hundreds of international organizations and billions of dollars flood into a region whose fragile infrastructure has been damaged by years of civil war, information dissemination becomes a powerful challenge.

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The State of Vaccine Confidence

The Vaccine Confidence Project    2015
LONDON SCHOOL OF HYGIENE AND TROPICAL MEDICINE 

Lead Authors:  Heidi Larson, PhD and Will Schulz, MPH
Why this report:
 
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Laboratory support during and after the Ebola virus endgame: towards a sustained laboratory infrastructure

EUROSURVEILLANCE by I. Goodfellow, C. Reusken, and M. Koopmans  

  March 26, 2015                                                              

The Ebola virus epidemic in West Africa is on the brink of entering a second phase in which the (inter)national efforts to slow down virus transmission will be engaged to end the epidemic. The response community must consider the longevity of their current laboratory support, as it is essential that diagnostic capacity in the affected countries be supported beyond the end of the epidemic.

The emergency laboratory response should be used to support building structural diagnostic and outbreak surveillance capacity.

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Ebola pioneer, stem cell researcher honoured with Canada Gairdner Awards

CANADIAN PRESS                                                                                March 25, 2015
One of the co-discoverers of the Ebola virus and a leading Canadian stem cell researcher are among this year's winners of the prestigious Canada Gairdner Awards.

Dr. Peter Piot is the recipient of the Canada Gairdner Global Health Award, recognizing his work on the discovery of the Ebola virus in 1976 and his leadership in the global response to the HIV-AIDS epidemic.

Dr. Janet Rossant, chief of research at Toronto's Hospital for Sick Children, is the recipient of the 2015 Canada Gairdner Wightman Award, which honours a Canadian who has demonstrated outstanding leadership in medicine and medical science.

Five international scientists are also being honoured with Canada Gairdner Awards, two each from the United States and Japan and one from Switzerland....

Dr. Peter Piot won the 2015 Canada Gairdner Global Health Award in recognition of his work on the discovery of the Ebola virus in 1976 and his leadership in the global response to the HIV-AIDS epidemic. (David Azia/Associated Press)

Red complete story.

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Ebola virus not mutating as quickly as thought

SCIENCE NEWS  by Ashley Yaeger                                                      March 26, 2015

(Scroll down for full study.)

The virus causing the current Ebola epidemic in West Africa is not evolving as quickly as some scientists had suggested.

REGULAR RATE  A genetic analysis suggests that the Ebola virus, shown here in orange, is not evolving as fast as expected.

In a paper last August, researchers reported that the virus (Zaire ebolavirus) was altering its genes almost twice as fast as it had during previous Ebola outbreaks in Central Africa (SN: 9/20/14, p. 7). However, a new genetic analysis shows that the virus is mutating at roughly the same rate as in past outbreaks, researchers report online March 26 in Science. The finding suggests the virus has not become more virulent or transmissible during the West Africa outbreak.

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