U.S. Ebola experience changes thinking about disease

USA TODAY                                   Nov. 11, 2014
By Liz Sazbo
The successful treatment of Westerners with Ebola in the USA and Europe is changing the way doctors think about the disease.

The conventional wisdom about Ebola has been that it's usually fatal, with a mortality rate of up to 90%. That was based largely on experience with Ebola in developing countries in Africa, where many hospitals have no running water and soap, let alone personal protective equipment for the medical staff.

All eight American patients with Ebola treated in the USA have survived. So have most Europeans evacuated to their home countries for care....

With early and aggressive care, "Ebola can be an eminently treatable disease," says Amesh Adalja, senior associate at the Center for Health Security at the University of Pittsburgh Medical Center.

In some ways, Ebola is a different disease in the USA and Europe than it is in Africa, just as cancer is a different disease here than in developing countries, says Jeffrey Duchin, a professor at the University of Washington-Seattle and spokesman for the Infectious Diseases Society of America. Both conditions are fearsome and dangerous, but experience shows that cancer and Ebola can often be survived if caught early and treated aggressively.

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What Employers Are Doing To Counter Ebola

FORBES MAGAZINE                              NOV. 11, 2014
By Tevi Troy, President, American Health Policy Institute

Ebola has killed over 5,000 people, roiled U.S. hospitals, and shaken the faith of Americans in the government’s ability to respond. At the same time, and below the radar, U.S. companies are responding to Ebola with a variety of steps to protect themselves, their employees, and their operations.

The most important element of communicating the threat of the Ebola outbreak for both the government and corporate leaders is to provide factual information while also preventing panic and fear. There have been 5,000 false alarm cases of Ebola as people flock to U.S. emergency rooms out of fear that their common cold or seasonal flu symptoms are early manifestations of the Ebola virus. This hysteria not only has potential mental and physical health implications, but also economic implications. Fear may incentivize some people to change their behavior, whether through cancelling flights and vacation plans or visiting the doctor and stocking up on medications. Furthermore, treating suspected Ebola patients, even if they don’t pan out, is expensive and labor intensive for hospitals.

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Another Sierra Leonean Doctor Infected With Ebola

ASSOCIATED PRESS                                                                        Nov. 11, 2014
By CLARENCE ROY-MACAULAY
FREETOWN, Sierra Leone --A doctor in Sierra Leone has tested positive for Ebola, dealing yet another blow to the country's fight against the deadly outbreak, an official announced Tuesday.

Dr. Martin Salia, a specialist surgeon at a major hospital in the capital of Freetown, is the sixth Sierra Leonean doctor to become infected in this outbreak. Salia is receiving treatment, said Dr. Brima Kargbo, Sierra Leone's chief medical officer. He offered no other details.

.. Even with the proper protection, staying safe while treating Ebola patients requires rigorous attention to detail, and the smallest mistake can lead to an infection.

 Former British Prime Minister Tony Blair met with officials in Sierra Leone on Tuesday and urged the international community not to let up the fight against the disease.

"More beds, more medical personnel and laboratory testing need to be done, faster, to be on top of this situation," said Blair, who founded the Africa Governance Initiative to help leaders make reforms and meet development goals.

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Medical Experts Look For New Ways To Test Ebola Drugs

NPR                                             Nov. 11, 2014
By Richard Harris

Medical experts are meeting today and tomorrow at the World Health Organization in Geneva to figure out how to test potential Ebola drugs in Africa. In addition to determining which experimental drugs should be the highest priority, the experts are sorting through some difficult ethical issues.

In short, they're trying to figure out how to design tests that will provide the fastest and most trustworthy answers — and yet minimize the need for comparison groups who won't be offered the experimental treatments.

Nurses assist a new patient at an Ebola center in Liberia's Lofa County. As drug trials get underway, patients may receive experimental medicines. photo by Trenchard/NPR

Practice in the United States has set an unrealistic standard. When American health care workers fell ill with Ebola in Africa, they flew home and received medical care vastly better than what Africans were getting, including experimental therapies.

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Governments, groups striving to become as agile as the Ebola virus

THE WASHINGTON POST                                                                                        Nov. 11, 2014
By Lena H. Sun, Brady Dennis and Joel Achenbach

The news out of West Africa in recent days — good and bad — has demonstrated a fundamental challenge in the fight against Ebola: The virus is more nimble than the human response to it. The landscape of infection and disease has changed dramatically in recent weeks, even as institutions have largely stuck to blueprints drafted months ago.

Archie C. Gbessay, coordinator of the Active Case Finders and Awareness Team in West Point, a large slum in Monrovia, Liberia, discusses efforts to combat Ebola with his team in a school classroom in September. (Michel du Cille/The Washington Post)

The looming question now is whether governments and other organizations can find a way to become as agile as the virus, which has vanished suddenly in some hard-hit places while erupting just as quickly in new locations.

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The Ebola Hot Zone - CBS - 60 MINUTES

cbsnews.com - November 9, 2014 - Lara Logan travels to Liberia to report on Americans working on the frontline of the Ebola outbreak

The following is a script of "The Ebola Hot Zone" which aired on Nov. 9, 2014. Lara Logan is the correspondent. Max McClellan, Massimo Mariano and Richard Butler, producers.

No country has been harder hit by Ebola than Liberia, a hot zone for the outbreak, where more people have died from the virus than anywhere else.

That's where most of the U.S. effort is focused, with more than 2,000 Americans now leading the international response and more on the way -- soldiers, doctors, nurses and relief workers -- who're running mobile labs, building hospitals and treating patients.

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Ebola Finds New Hotspots Outside Liberian Capital

ASSOCIATED PRESS                                                                                               Nov. 10, 2014
By Wade Williams

JENEWONDE, Liberia --The community of Jenewonde has become a new hotspot for the Ebola outbreak in Liberia. With cases on the decline in the capital, officials must now turn their attention to hard-to-reach places where the disease is flaring.

 

In this photo, a woman reacts, rear, as Health Care workers load the body of a family member suspected of dying from Ebola, onto the back of a truck in Jene-Wonde, Liberia. A schoolteacher brought his sick daughter from Liberia’s capital to this small town of 300 people. Soon he was dead along with his entire family, all buried in the forest nearby. (AP Photo/ Wade Williams)

Jenewonde, in Grand Cape Mount County near the border with Sierra Leone, has reportedly lost about 10 percent of its population to Ebola since late September. Markets and farms nearby have been abandoned.

Ebola is also hitting the town of Gorzohn in Rivercess County, which lies on Liberia's central coast, said Assistant Health Minister Tolbert Nyenswah, who heads Liberia's Ebola response.

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Ebola was here

Cases are dropping so rapidly that Liberians are talking about the disease in the past tense. They shouldn’t be.

 FOREIGN POLICY                                                                               Nov. 7, 2014

By Laurie Garrett

MONROVIA --

...The U.S. Centers for Disease Control and Prevention (in September) predicted that unless the world mobilized on a scale unprecedented in the history of disease outbreaks, the countries of Liberia and Sierra Leone could by Feb. 1, 2015 have a combined 1.4 million cases, including 980,000 deaths.

Just six weeks later, the picture is so markedly different that some Liberians talk about the epidemic using the past tense. And that worries Alex Gasasira, the acting director of the WHO in Liberia, deeply.

"Over the last six weeks efforts by everybody have resulted in a scaled-up response. So now we are slightly ahead of the virus," Gasasira told

But we are nowhere where we need to be. We are still in a very dangerous situation."

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Ebola: Hard-won gains in Liberia must not be undermined

Liberia:  MSN warns that gains must not be underminded. Meanwhile U.S opens the first of its 17 treatment centers.  

(Two stories, scroll down)

 DOCTORS WITHOUT BORDERS                                                     Nov. 10, 2014

Monrovia – While the number of new Ebola cases reported in Liberia has declined in recent weeks, the outbreak is far from over and new hotspots continue to emerge across the country, the international medical humanitarian organization Médecins Sans Frontières (MSF) said today, warning that the international aid response must rapidly adapt to this new phase of the epidemic, or risk undermining progress made against Ebola.

Unlike in neighbouring Guinea and Sierra Leone, where cases are on the rise, MSF teams in Liberia are witnessing a decline in the number of Ebola patients admitted to case management centres (CMCs) for the first time since the beginning of the Ebola epidemic.... Case numbers could again rise, as they have in Guinea, where, following two significant dips in admissions to MSF facilities, patient numbers are again increasing.

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Ebola cases in Sierra Leone show sharp rise

THE GUARDIAN                                        Nov. 10, 2014
By Lisa O'Caroll

The number of new cases of Ebola in Sierra Leone has jumped dramatically, putting paid to any hopes that the infection rate is slowing.

Official figures released by the minister of health and sanitation show there were 111 new cases registered on Sunday, the highest daily rate since the ministry started publishing figures in August.

There were 45 new cases the day before, including 24 in the capital, Freetown. Laboratory results for patients in Freetown, which include the new British army-built Ebola hospital, showed 40 new cases on Sunday.

There was also a spike in the number of cases in Port Loko, a district north of Freetown where there is still no treatment centre and where, until recently, corpses were left lying on verandahs, in hospitals and in houses for days before collection.

The figures come days after warnings by the UN that Ebola cases in Sierra Leone are being underreported by up to 50%.

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Is The Response in Liberia Succeeding? Positive indications

NEW ENGLAND COMPLEX SYSTEMS INSTITUTE                                                                        Oct. 27, 2014
ABSTRACT
By Kia Hall and Yaneer Bar-Yam
The number of cases of Ebola in West Africa has been growing exponentially, and projections assume that this dynamic will continue. However, recent case reports from Liberia indicate a change. The number of new confirmed cases reported by WHO has actually diminished for five weeks in a row.
The WHO report suggests that this may be due to underreporting under conditions of high levels of stress of the number of cases taking place.

Here we report that there appears to be a sound reason for the decreasing number of cases—a change in response strategy that is working. Understanding this dynamic is of critical importance for addressing the outbreak in Sierra Leone and Guinea. In particular the number of cases in Sierra Leone continues to grow exponentially.

Discussions with a WHO response coordinator in Liberia indicates that a change in strategy from individual reporting and contact tracing to community based screening for early detection and population wide behavior change happened in mid September.

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Q. and A. With Sheri Fink on Covering Ebola in Liberia

NEW YORK TIMES                                                                                Nov. 6, 2014

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Ebola’s Mystery: One Boy Lives, Another Dies

Medical discussion of why some children suvive Ebola and others do not

NEW YORK TIMES                                   Nov. 10, 2014
By Sheri Fink, MD

... Over and over, doctors here have been confounded by the divergent paths of patients whose cases appeared similar at first. “No matter how long we were there, we didn’t know how to predict it,” said Dr. Steve Whiteley, a California emergency physician who volunteered.

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Why It's Not Enough to Just Eradicate Ebola

NBC NEWS                                              Nov. 9, 2014
by Maggie Fox

The new U.S. plan to spend $6 billion fighting Ebola has a hidden agenda that aid workers approve of: not only stamping out the epidemic in West Africa, but starting to build a health infrastructure that can prevent this kind of thing from happening again.

Liberian nurses escort a suspec ted patient into the JFK nursing center in Monrovia, Sept. 18, 2014. Ahamed Jallanzo/EPA file  

President Barack Obama's $6.18 billion request is an enormous amount of money — six times what the U.S. has already committed and far more even than what the World Health Organization says is needed.

Most is going for full frontal assault on Ebola — one that hasn’t really gotten off the ground yet...

But billions are also being quietly allocated to building a health care system in the countries suffering the most — a less sexy approach that could prevent another epidemic in the future. 

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7 Key Insights in Using ICT to Improve Ebola Response

Image: A billboard that reads 'Stop the Ebola Virus'

Image: A billboard that reads 'Stop the Ebola Virus'

ictworks.org - October 31st 2014 - Wayan Vota

Yesterday, we had the 85th Technology Salon in Washington, DC, this one focused on How Can ICTs Improve Our Ebola Response? Be sure to sign up to get invited to our next event.

In the lively morning-long discussion with 35 key thought leaders and decision makers from across the technology and development sectors, we came to several interesting conclusions.

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