Liberia

submitted by Stephen Morse

elifesciences.org - September 8, 2014 - eLife 2014;3:e04395
DOI: http://dx.doi.org/10.7554/eLife.04395

Ebola virus disease (EVD) is a complex zoonosis that is highly virulent in humans. The largest recorded outbreak of EVD is ongoing in West Africa, outside of its previously reported and predicted niche. We assembled location data on all recorded zoonotic transmission to humans and Ebola virus infection in bats and primates (1976–2014). Using species distribution models, these occurrence data were paired with environmental covariates to predict a zoonotic transmission niche covering 22 countries across Central and West Africa. Vegetation, elevation, temperature, evapotranspiration, and suspected reservoir bat distributions define this relationship. At-risk areas are inhabited by 22 million people; however, the rarity of human outbreaks emphasises the very low probability of transmission to humans. Increasing population sizes and international connectivity by air since the first detection of EVD in 1976 suggest that the dynamics of human-to-human secondary transmission in contemporary outbreaks will be very different to those of the past.

Conakry, Guinea --Statement issued by the heads of Guinea, Liberia and Sierra Leone upon approving an operational framework designed to reduce new Ebola infections to zero within 60 days.

The framework calls for infection prevention and control, social mobilization, community engagement, surveillance, cross border collaboration. 

The leaders also "advocated for a seamless and responsible exit by international partners dictated by the epidemiology and by the adequate transfer of capacity to national institutions."

The statement includes a list of developments and responses.

Read complete statement.

https://ebolaresponse.un.org/sites/default/files/150216-_unmeer_external_situation_report.pdf

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.

Read complete story

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

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....
Read complete story.

http://www.theatlantic.com/health/archive/2015/02/why-didnt-ebola-kill-me/385335/