Ebola outbreak: weaknesses in health-care systems in Liberia, Sierra Leone revealed

CANADIAN BROADCASTING CORP                                                                                               Dec. 11, 2014

GENEVA --Ebola in West Africa has made it almost impossible for people to get treatment for other ailments, health ministers from the three worst affected countries say.

The health systems in Sierra Leone, Liberia and Guinea were barely functional before the Ebola outbreak struck.

Liberia's Chief Medical Officer, Bernice Dahn, said the country's Ebola outbreak needs to be contained and routine health-care services need to be revived.

Liberia's Chief Medical Officer, Bernice Dahn, said the country's Ebola outbreak needs to be contained and routine health-care services need to be revived. (Martial Trezzini/Keystone/Associated Press)

"We want to expand the health workforce because it's crucial for providing quality health care," Dr. Bernice Dahn, Liberia’s chief medical officer, told World Health Organization in Geneva today....

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Mali says has no remaining Ebola cases as last patient recovers

REUTERS                                                                                  Dec. 11, 2014
BAMAKO-Mali has no remaining cases of the Ebola virus as the last patient in the country has recovered and left hospital, the Ministry of Health said on Thursday.

Six people have died of Ebola in Mali, while two others have recovered. The country is the sixth West African state to be hit by the worst outbreak on record of the hemorrhagic fever.

Ebola first entered Mali through an infant girl who died of the disease in October after arriving from neighboring Guinea. Later that month, an imam who also arrived from Guinea with the disease died in Mali. He infected other people.

"The only remaining case in treatment has recovered and has been released today so there are no more people sick with Ebola in Mali," said Ministry of Health spokesman Markatié Daou.

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http://www.reuters.com/article/2014/12/11/us-health-ebola-mali-idUSKBN0JP2HG20141211

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The Path to Zero Ebola Cases

Op-ed

NEW YORK TIMES by Jim Yong Kim, President of the World Bank Group      Dec. 11, 2014                                              

MONROVIA, Liberia — In my career as a medical doctor and global health policy maker, I have been in the middle of monumental struggles, including fights to make treatment accessible in the developing world for those living with H.I.V./AIDS as well as multi-drug resistant tuberculosis. But the Ebola epidemic is the worst I’ve ever seen...

Members of District 13 ambulance service disinfect a room in a village north of Monrovia, Liberia. Credit Jerome Delay/Associated Press

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UN Says Several Months Needed to Control Ebola

ASSOCIATED PRESS by EDITH M. LEDERER                       Dec. 11, 2014

UNITED NATIONS-- The U.N. Ebola chief said Thursday it will take several more months before the outbreak in West Africa is under control, an assessment that makes clear the World Health Organization's goal of isolating 100 percent of Ebola cases by Jan. 1 won't be met.

Dr. David Nabarro said there has been "a massive shift" over the last four months in the way affected governments have taken the lead in responding to the epidemic, communities are taking action and the international community has pitched in.

But he said greater efforts are needed to combat Ebola in western Sierra Leone and northern Mali, to reduce the number of new cases in Liberia and to limit transmission to Mali.

WHO conceded that it didn't meet an interim Dec. 1 target of isolating 70 percent of Ebola patients and safely burying 70 percent of victims in hardest-hit Sierra Leone. But it hasn't made clear what that means for its Jan. 1 goal, which it set in September. It has acknowledged that its patchy data could compromise the goal, since the agency does not know how many Ebola patients there actually are and is unable to track all of their contacts.

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Ebola response roadmap - Situation report

WHO                                                                                                                       Dec. 10, 2014

A total of 17 942 confirmed, probable, and suspected cases of Ebola virus disease (EVD) have been reported in five affected countries (Guinea, Liberia, Mali, Sierra Leone, and the United States of America) and three previously affected countries (Nigeria, Senegal and Spain) up to the end of 7 December. There have been 6388 reported deaths.

Reported case incidence is slightly increasing in Guinea (103 confirmed and probable cases reported in the week to 7 December), declining in Liberia (29 new confirmed cases in the 3 days to 3 December), and may still be increasing in Sierra Leone (397 new confirmed cases in the week to 7 December). The case fatality rate across the three most-affected countries in all reported cases with a recorded definitive outcome is 76%; in hospitalized patients the case fatality rate is 61%.

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http://www.who.int/csr/disease/ebola/situation-reports/en/

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Ebola vaccine trial suspended for checks after joint pains

THE GUARDIAN   by Lisa O'Carroll                                Dec. 11, 2014
GENEVA --A clinical trial of an Ebola vaccine has been suspended in all 59 volunteers in Geneva a week early “as a measure of precaution” after four patients complained of joint pains in hands and feet, the University of Geneva hospital said.

“They are all fine and being monitored regularly by the medical team leading the study,” it said on Thursday.

The human safety trials of the vaccine being developed by the pharmaceutical firms Merck and NewLink are scheduled to resume on 5 January in up to 15 volunteers after checks to ensure that the joint pain symptoms were “benign and temporary”, the hospital added.

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http://www.theguardian.com/world/2014/dec/11/ebola-vaccine-trial-suspended-joint-pains

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Ebola outbreak: Virus still 'running ahead of us', says WHO

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."

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http://www.bbc.com/news/health-30400304

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Experts call for faster mobilisation of “overlooked” survivors to contain Ebola epidemic

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.

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Time Magazine Person of the Year: the Ebola fighters

 

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

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

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Senate Foreign Relations Subcommittee hearing on Ebola

President Ellen Johnson Sirleaf of Liberia speaks via video on the international response to the Ebola crisis during a Senate subcommittee hearing on Capitol Hill in Washington on Wednesday. (SAUL LOEB, AFP/Getty Images)

Update Liberian president warns that Ebola still threatens her nation

LOS ANGELES TIMES                                                                                                    Dec. 10, 2014

liberian President Ellen Johnson Sirleaf thanked the Obama administration Wednesday for its efforts in stemming the tide of the country’s Ebola outbreak, but warned that the disease was still a threat in her developing nation.

The American response, a combination of funding and military aid, helped galvanize other countries to join the fight against the epidemic in West Africa, she told the Senate Foreign Relations Committee over video link.

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WHO: malaria gains 'at risk' in Ebola-affected countries

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.

 
A new report from the World Health Organization says the number of lives claimed by malaria worldwide fell by 47% between 2000 and 2013, and by 54% in Africa, where the vast majority of deaths occur.

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%.

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Ebola Airport Screening Finding Few Suspected Cases in US

MEDSCAPE MEDICAL NEWS by Larry Hand                                                                        Dec. 9, 2014

Airport exit screening in West Africa and entry screening in the United States have identified few persons potentially infected with Ebola virus, according to an article published online December 9 in the Centers for Disease Control and Prevention (CDC) publication Morbidity and Mortality Weekly Report.

 

 Number of travelers arriving from Guinea, Liberia, and Sierra Leone who were screened for Ebola at US airports, by state and county of destination (October 11 - November 10, 2014). Source: CDC

Of 80,000 travelers who have departed from West Africa since Ebola-specific screening began, 1993 people have been screened on arrival at one of five US airports. Of those, 86 passengers were referred to the CDC public health officers; only seven have shown symptoms and been referred for evaluation. None eventually wound up with an Ebola diagnosis.

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High Risk: 100-Fold Ebola Rate for Health Workers in Sierra Leone

NBC NEWS --  by Maggie Fox                                                                                            Dec. 9, 2014

Health care workers have more than 100 times the risk of catching Ebola in Sierra Leone as the general public there does, according to a new report.

And it's not necessarily down to failed protective measures in hospitals. Health care workers form their own community, and when one gets sick or dies, he or she can infect fellow medics, the report finds.

The World Health Organization has been saying that health care workers such as doctors and nurses are at special risk of Ebola. It says 622 health-care workers have been infected and 346 of them have died in all the affected countries.

Dr. Peter Kilmarx of the U.S. Centers for Disease Control and Prevention, who led an investigation into the high infection rate in Sierra Leone...said  "We think of health care worker infections as a failure of personal protective equipment.,"But there are so many different ways that they are exposed there."

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Ebola Infections Fewer Than Predicted by Disease Models

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.

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Ebola still spreading in western Sierra Leone, Guinea's forest: U.N

REUTERS    By Stephanie Nebehay                                                                                 Dec. 9, 2014
GENEVA --More foreign health workers are needed to help tackle the Ebola epidemic, which is spreading quickly in western Sierra Leone and deep in the forested interior of Guinea, a senior U.N. official said on Tuesday.

A woman walks pass an Ebola virus awareness campaign poster in Monrovia, December 8, 2014. Credit: Reuters/James Giahyue

The death toll from the Ebola outbreak in West Africa has risen to 6,331 in the three worst hit countries, with Sierra Leone overtaking Liberia as the country with the highest number of cases, the World Health Organization says.

"We know the outbreak is still flaming strongly in western Sierra Leone and some parts of the interior of Guinea. We can't rest, we have to still push on," said David Nabarro, the U.N. Special Envoy on Ebola.

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