Ebola: limitations of correcting misinformation

THE LANCET                                                                                                              Dec.18, 2014
Communication and social mobilisation strategies to raise awareness about Ebola virus disease and the risk factors for its transmission are central elements in the response to the current Ebola outbreak in west Africa.1 A principle underpinning these efforts is to change risky "behaviour" related to "traditional" practices and "misinformation".

 Populations at risk of contracting Ebola virus disease have been exhorted to “put aside, tradition, culture and whatever family rites they have and do the right thing”....Such messages follow logically from clinical and epidemiological framings of contagion.

They pay little attention, however, to the historical, political, economic, and social contexts in which they are delivered....

Read the complete article.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2962382-5/fulltext

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GSK Ebola vaccine trial seen moving to wider phase in February

REUTERS                                                                                              Dec. 19, 2014

Trials of GlaxoSmithKline's experimental Ebola vaccine are likely to move to a second phase in February, later than previously suggested, after a meeting of national regulators said they needed more information.

The World Health Organization, which hosted a meeting of national regulatory authorities and ethics committees earlier this week, said they had thoroughly discussed all aspects of the proposed trials at the two-day meeting.

"Reviewing countries requested additional documentation from the manufacturer of the vaccine, GlaxoSmithKline, before authorization of the trials," the WHO said in a statement.

Countries where the trials are planned -- Cameroon, Ghana, Mali, Nigeria and Senegal -- should receive and review the additional information by the end of January.

"If these steps are completed to the satisfaction of the national authorities, Phase II trials are likely to begin in February," the statement said.

The GSK vaccine is already undergoing Phase I trials, to check its safety in humans, in Switzerland, Britain, Mali and the United States, and is one of the two leading candidate vaccines for Ebola already undergoing tests.

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The Ebola Treatment You Haven't Heard Of

FORBES       by David Kroll                                                                                              Dec. 19, 2014

Pharmaceuticals and biotechnology-derived products have attracted the greatest public and professional interest in treating victims of Ebola virus disease. But a privately-held, small company with a treatment for shock and multi-organ failure may be the dark horse victor in the race to stop the West African outbreak. LB1148 from San Diego-based Leading BioSciences is starting Phase 2 clinical trials that build on 12 years of NIH-funded research to address an underappreciated, common denominator in shock and organ failure, including shock caused by Ebola infection.

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http://www.forbes.com/sites/davidkroll/2014/12/19/the-ebola-treatment-you-havent-heard-of/

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Ebola total tops 18,000, with hints of slowing in Sierra Leone

CENTER FOR INFECTIOUS DISEASE RESEARCH AND POLICY   by Lisa Schnirring                                   Dec. 17, 2014
            
Sierra Leone's rising Ebola activity seems to be slowing as a major effort to knock down the disease gets under way; disease incidence is still fluctuating in Guinea and cases continue to decline in Liberia, the World Health Organization (WHO) said today in its latest update.

The global Ebola total as of Dec 14 has reached 18,603 cases, along with 6,915 reported deaths, the WHO said. Numbers reflect an increase of 661 infections and 527 deaths since the last report Dec 10. Sierra Leone, with 327 new cases, accounted for more than half the increase, while Guinea reported 76 more. Liberia reported eight new confirmed cases, but its total includes only those reported as of Dec 9.

The WHO said progress is occurring in all three of the hardest-hit countries toward the United Nations' goal of isolating and treating 100% of Ebola patients and safely burying 100% of those who die from the disease by Jan 1. All countries now have enough treatment beds, though some are unevenly distributed, resulting in shortages in some areas, the WHO said.

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Ebola leaves hundreds of thousands facing hunger in three worst-hit countries

FOOD AND AGRICULTURE ORGANIZATION (FAO)                                                            Dec. 17, 2014

The number of people facing food insecurity due to the Ebola epidemic in Guinea, Liberia and Sierra Leone could top one million by March 2015 unless access to food is drastically improved and measures are put in place to safeguard crop and livestock production, two UN agencies warned today.

The disease's impact is potentially devastating in the three countries already coping with chronic food insecurity, the UN Food and Agriculture Organization (FAO) and the World Food Programme (WFP) said in three country reports published today.

Border closures, quarantines, hunting bans and other restrictions are seriously hindering people's access to food, threatening their livelihoods, disrupting food markets and processing chains, and exacerbating shortages stemming from crop losses in areas with the highest Ebola infection rates, the FAO-WFP reports stressed.

Read complete report.
http://www.fao.org/emergencies/fao-in-action/stories/stories-detail/en/c/273018/

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11th Sierra Leonean Doctor Dies From Ebola

ASSOCIATED PRESS by Clarence Roy-Macaulay                                                 Dec. 18, 2014

 ...Dr. Victor Willoughby tested positive for Ebola on Saturday and was being treated at a clinic near the capital run by the medical charity Emergency, said Dr. Brima Kargbo, the country's chief medical officer....

The 67-year-old died Thursday morning, just hours after an experimental drug arrived in the country for him. The arrival of ZMAb, developed in Canada, had raised hopes for Willoughby's survival. But he died before a dose could be administered, said Kargbo. ZMAb is related to ZMapp, another experimental drug that has been used to treat some Ebola patients. The drugs' efficacy in treating Ebola has not yet been proven....

Read complete story.
http://abcnews.go.com/Health/wireStory/11th-sierra-leonean-doctor-dies-ebola-27684697

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Lessons From an Outbreak: How Ebola Shaped 2014

Interviews with experts on what to take away from the devastation of the disease.

THE ATLANTIC   by Julie Beck                                                                                                 Dec. 17, 2014

...While some in the Western media criticized West Africans' fear of health workers and resistance to public-health measures, the United States got a small taste of Ebola panic when Thomas Eric Duncan became the first case diagnosed in the country in September, followed by three other cases this fall. Duncan was the only patient to die in the U.S., and the panic died down quietly.

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Inside the cultural struggle to stamp out Ebola

A front-line report from Sierra Leone examines efforts to change hearts and minds in West Africa’s villages.

NATURE   by Erika Check Hayden                                                                             Dec. 17, 2014

Bombali District, Sierra Leone --Since September, the Ebola virus has stalked the villages and towns along the Kamakwie–Makeni Road, a rutted, red-dirt track that serves as the main artery for a string of villages in the western part of Sierra Leone’s Bombali District.

Yeli Sanda, a village just a few kilometres outside the district’s capital city of Makeni, was the first place to be hit. Over the following months, more than 40 people in the settlement of about 700 became infected; 22 died. In November, the virus infected a woman in Tambiama, about 11 km up the road. A friend who visited her acquired the virus and carried it another 1.5 km to the village of Mayata. She and at least five others there have died.

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Challenges in Responding to the Ebola Epidemic — Four Rural Counties, Liberia, August–November 2014

 

                CDC Morbidity and Mortality Weekly Report (MMWR)                                                                   

 by Aimee Summers, PhD1,2, Tolbert G. Nyenswah, MPH 3, Joel M. Montgomery, PhD2,4, John Neatherlin, MPH2,4,       Jordan W. Tappero, MD                                                                                                              Dec. 16, 2014

...The Ebola epidemic in Liberia presents unique challenges not only from its spread into crowded urban environments (10) but also its occurrence in remote communities. As in urban counties, county and district health teams in rural counties with remote regions need adequate training in 1) case reporting; 2) case investigation; 3) case management; 4) contact tracing; 5) safe burials; 6) safe collection, processing, and transport of blood specimens for testing; and 7) development of a county-level incident management system.

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Screening Test Finds Drugs That Show Promise Against Ebola

U.S. NEWS AND WORLD REPORT HEALTH TODAY   by   Dennis Thompson                            Dec. 17, 2014

A screening test has identified more than 50 drugs that could be helpful in treating people with Ebola, researchers report.

"These drugs are all approved (by the FDA) so they could be deployed quickly if follow-up research proves that they are effective," said study author Adolfo Garcia-Sastre, director of the Global Health and Emerging Pathogens Institute with the Icahn School of Medicine at Mount Sinai in New York City.

The study was published online Dec. 17 in the journal Emerging Microbes and Infections.

The screening test involves a laboratory-engineered fake Ebola virus. The fake virus contains two proteins from the deadly pathogen, but does not include the infectious genetic material that makes Ebola so dangerous, Garcia-Sastre said.

Read complete story.

http://health.usnews.com/health-news/articles/2014/12/17/screening-test-finds-drugs-that-show-promise-against-ebola

Read Emerging Microbes and Infections paper.

http://www.nature.com/emi/journal/v3/n12/full/emi201488a.html

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Morbidity and Mortality Weekly Report (MMWR)

Update: Ebola Virus Disease Epidemic — West Africa, December 2014

CDC                                                                                                                         Dec. 16, 2014

...There were 4,281 new Ebola cases reported during the 4-week period of November 9–December 6, compared with the 2,705 new cases reported during the 3-week period of October 19–November 8.. Cases were widely distributed geographically among districts in all three countries, with the prefecture of Mamou in Guinea reported to be newly affected.

During both periods, counts of reported Ebola cases were highest in the area around Monrovia, including Grand Cape Mount, Liberia; the Western Area and northwest districts of Sierra Leone, particularly Bombali and Port Loko; and Conakry, Guinea .

Read Complete report.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm63e1216a1.htm?s_cid=mm63e1216a1_x

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Here’s How Much the Next Ebola Will Cost Us

Why saving the environment can help prevent it

TIME MAGAZINE     by Alexandra Sifferlin                                                                         Dec. 16, 2014

The global community cannot withstand another Ebola outbreak: The World Bank estimates the two-year financial burden price tag of the current epidemic at $32.6 billion. Unfortunately, the virus has revealed gaping holes in our preparedness for major infectious disease epidemics. Because of these, plus the urbanization of rural communities and globalization of travel and trade, more of these epidemics are expected.

In a new report from the EcoHealth Alliance published in the journal Proceedings of the National Academy of Sciences (PNAS), experts estimate that the world will see about five new emerging infectious diseases each year and that we need new prevention strategies to cut economic losses.

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Endless Ebola Epidemic? That's The 'Risk We Face Now,' CDC Says

NATIONAL PUBLIC RADIO  by Michaeleen Doucleff                                                               Dec. 16, 2014

Speed. That's key to ending the Ebola epidemic, says the director of the U.S. Centers for Disease Control and Prevention.

Dr. Thomas Frieden is visiting West Africa this week to figure out how to reduce the time it takes to find new Ebola cases and isolate them.

Otherwise, Ebola could become a permanent disease in West Africa.

 

Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, talks with Doctors Without Borders staff during a visit in August to an Ebola treatment center in Monrovia, Liberia. Tommy Trenchard for NPR

"That's exactly the risk we face now. That Ebola will simmer along, become endemic and be a problem for Africa and the world, for years to come," Frieden tells NPR. "That is what I fear most."

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Fewer Ebola Cases Go Unreported Than Thought, Study Finds

NEW YORK TIMES    by Donald G. McNeil, Jr.                                                                 Dec. 16, 2014

Transmission of the Ebola virus occurs mostly within families, in hospitals and at funerals, not randomly like the flu, Yale scientists said Tuesday, and far fewer cases go unreported than has previously been estimated.

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Ebola Survivors Crucial to Containing the Epidemic: Experts

      

Survivors of the Ebola virus pose for a picture outside a clinic near Tubmanburg, October 15, 2014.
REUTERS/James Giahyue

CLICK HERE - RESEARCH - To hasten Ebola containment, mobilize survivors

uk.reuters.com - by Magdalena Mis - December 10, 2014

LONDON (Thomson Reuters Foundation) - Thousands of Ebola survivors with little to no risk of re-infection are critical to controlling the epidemic and training them has the potential to save thousands of lives and decrease the spread of the virus, experts said on Wednesday.

Survivors have developed immunity and are effectively the only people in the world protected from the virus, which could allow them to care for the sick without risking their lives, said experts in the International Journal of Epidemiology.

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(ALSO SEE SAME ARTICLE HERE)

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