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Ebola created a public health emergency—and we weren’t ready for it

Could the international community have done a better job when confronted with the outbreak of Ebola in West Africa? Although the virus appears to be largely contained now, this comes after at least 27,000 people were infected, with 11,000 of them dying. The virus also had the opportunity to spread within the human population for over a year, providing it a potentially dangerous opportunity to adapt to us as hosts.

To find out whether we could have managed the outbreak better, the World Health Organization (WHO) recently convened an Ebola Interim Assessment Panel, which analyzed various aspects of the organization’s response. This panel, commissioned by the WHO Director-General, included the Dean of the Harvard School of Public Health, the founding Director of the UK's national Health Service, and other international public health leaders. It recently released its final report on the crisis.

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Sierra Leone President unveils Ebola "battle plan"

AFP    July 26, 2015
Freetown  - Sierra Leone's President Ernest Bai Koroma has unveiled a post-Ebola "battle plan" to help the west African country turn the page on the devastating epidemic.

Sierra Leone's President Ernest Bai Koroma speaks at an International Ebola Recovery Conference on July 10, 2015 at the United Nations headquarters in New York (AFP Photo/Eduardo Munoz Alvarez)

"Beyond the immediate nine-month recovery period, we will commence a two-year plan during which we must resolve to restore Sierra Leone to the path to prosperity," Koroma said in a statement released Friday.

"We will work to reinvigorate the private sector as a source of growth, create jobs and livelihoods in our economy," he said, emphasising the need to improve roads and market access.

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Ebola study notes afebrile patients, calls into question WHO criteria


(Also scroll down for: Ebola case definition quandary; Public health worker Ebola unease)

Researchers found that the World Health Organization (WHO) Ebola case definition has a specificity of only 31.5%, and they noted that 9% of Ebola patients reported neither a fever nor any Ebola risk exposure, calling into question WHO norms, according to a large study yesterday in The Lancet Infectious Diseases.

Researchers from Britain and Sierra Leone analyzed data on 850 suspected and 724 lab-confirmed Ebola patients who presented to the holding unit of Connaught Hospital in Freetown from May 29 to Dec 8, 2014. Fever or history of fever (n=599, 83%), intense fatigue or weakness (495, 68%), vomiting or nausea (365, 50%), and diarrhea (294, 41%) were the most common presenting symptoms in suspected cases.

Based on data from these patients, the investigators found the sensitivity of the WHO case definition to be 79.7%, which means about 20% of true Ebola cases would be missed (false-negatives). They found the specificity of the case definition to be 31.5%, which means 68.5% of patients who would be selected for admission would not actually have Ebola virus disease (false-positives).

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Ebola's not done with West Africa


This map, dated July 15, shows the number of days since active cases were discovered in the three countries where ebola is still a threat. CDC

SCIENCE  by Nick Stockton                               July 23, 2015

Officially, it’s called the Ebola Outbreak of 2014. But it’s 2015 now, and the disease is still infecting people. For the past two months, that rate was about 15 people a week. But in the past two weeks, the rate has doubled.....

What’s behind the continued spread? Depends on where you go. In Guinea and Sierra Leone, Ebola never died, and the new cases are a continuation of the same strain that first emerged in December of 2013. In Liberia—which declared itself ebola-free on May 12—experts believe the new outbreak was transmitted through sexual intercourse, from latent viral bodies that were alive in a man’s sperm.

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Ebola cases ebb a bit, with Conakry, Freetown as hot spots

CENTER FOR INFECIOUS DISEASE AND POLICY  by Lisa Schnirring     July 22, 2015

The number of new Ebola cases in Guinea and Sierra Leone declined a bit last week, with much of the disease activity centered in the two capital cities for the second week in a row, the World Health Organization (WHO) said in its weekly epidemiologic update today.

Tests confirmed 26 Ebola cases among the two countries, 22 in Guinea and 4 in Sierra Leone. The total is down from 30 reported the previous week, but progress against the disease has been stagnant over the past several weeks, hovering around 25 to 30 cases. Officials, however, said they saw more hopeful signs in contact tracing.

No new cases were reported in Liberia.

Overall, the total in the three countries has reached 27,705 confirmed, probable, and suspected cases, including 11,269 deaths, according to the WHO.

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WHO:  Ebola Situation Report - 22 July 2015

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UK relaxes Ebola screening measures

BBC                                                             July 23, 2015

LONDON --The screening measures put into place to prevent Ebola arriving in the UK are being relaxed.

The UK carried out emergency exercises to plan for what would happen if a case arrived

Public Health England said there will no longer be specialist staff based at Birmingham and Manchester airports or at the Eurostar terminal at St Pancras.

It said the threat was now "significantly lower" as the situation improved in West Africa.

The measures at Heathrow and Gatwick, the two main routes of entry from the affected countries, remain in place.

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Campaign group accuses Liberia palm oil firm of exploiting Ebola crisis

REUTERS by  Makini Brice                                 July 23, 2015

DAKAR --Anti-corruption campaign group Global Witness on Thursday accused palm oil company Golden Veroleum of taking advantage of the Ebola epidemic in Liberia to double the size of its plantation.

 The Ebola virus treatment center where four people are currently being treated is seen in Paynesville, Liberia, July 16, 2015. Reuters/James Giahyue

Golden Veroleum, controlled by Singapore-listed Golden Agri-Resources, signed a deal with Liberia in 2010 to develop a 220,000 hectare plantation. However, the company also has to reach agreement with local communities that have customary titles over the land.

The company denied any wrongdoing.

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Ebola-Affected Countries Brainstorm Infection Prevention Control - by Bettie K. Johnson / Monica Melton - July 20, 2015

Monrovia - Liberia, Sierra Leone and Guinea are the worst affected countries from the 2014 to 2015 Ebola outbreak, the worse ever in the history of the virus. The three countries are currently struggling to reach to zero infection of the Ebola virus. The World Health Organization and health practitioners from Sierra Leone, Guinea and Liberia gathered Monday to discuss infection prevention and control in all three countries. . . .

. . . The three day consultative meeting is expected to discuss the current status of IPC and WASH in health care facilities in each country describing the progress achieved so far during the response and transition phase. It will also share the strategic plans for the IPC and WASH improvement in the context of health systems recovery, for both the current early phase and the medium/term. The consultative meeting is sponsored by World Bank and Centers for Disease Control, among others.


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Experimental Ebola drug shelved; study explores virus clearance


Tekmira Pharmaceuticals  announced that it has suspended development of TKM-Ebola, a drug cocktail that showed disappointing human trial results in West Africa, as a convalescent plasma trial at a Doctors Without Borders (MSF) facility in Guinea proceeded with no ill effects in patients so far...

In suspending TKM-Ebola development, the company said that a joint reevaluation of its contract with the US Department of Defense is under way.

In another development, MSF said a convalescent serum trial at its facility in Nongo, Guinea, has enrolled 101 people over the last few months, with no ill effects reported so far, according to a Jul 17 update on the outbreak. Patients at the Nongo treatment unit have the option to receive plasma donated by Ebola survivors....

Meanwhile, detailed testing at a Swiss hospital on a 43-year-old doctor infected with Ebola in Sierra Leone found that viral decay occurred in two phases, once starting 72 hours after symptom onset before any antiviral interventions, with acceleration in viral load decay after ZMAb infusion and oral favipiravir treatments began..

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Last four Ebola cases in Liberia discharged from clinic

REUTERS by James Giahyue                  July 20, 2015

MONROVIA  - The last four cases of Ebola in Liberia were discharged from a treatment clinic in the capital of Monrovia on Monday, meaning there were no more confirmed carriers of the deadly virus in the West African country.

The group of four, released from the ELWA treatment unit to cheers and applause, were part of new wave of Ebola infections in Margibi County just outside Monrovia discovered in late June.

Two other confirmed cases have since died, including the sister of one of the released patients.

"The (Ebola treatment unit) is not a death camp; you can come here and survive," said Tolbert Nyenswah, head of Liberia's Ebola response. "This is what we can demonstrate even if Ebola comes back...."

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