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Where Antibiotic Resistance Is Worst Around the World

Staphylococcus. Getty Images.

Image: Staphylococcus. Getty Images. September 17th, 2015 - Sarah Zhang

Instead of the usual doom and gloom about antibiotic resistance, let’s begin with the good news. A new global report on antibiotic use, released yesterday, actually found a drop in Staph bacteria resistant to the antibiotic methicillin in countries seriously tackling drug resistance—places across Europe, the US, Canada, and South Africa. The boring stuff like handwashing and antibiotic stewardship? It works.


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Don't Take A Deep Breath: Outdoor Pollution Kills 3.3 Million A Year

A masked man walks past trees shrouded with pollution haze in Beijing, China. Andy Wong/AP

Image: A masked man walks past trees shrouded with pollution haze in Beijing, China. Andy Wong/AP - September 16th, 2015 - Susan Brink

More people die prematurely because of the air they breathe than the 2.8 million who die each year of HIV/AIDS and malaria combined.

That's the startling statistic from a new study in this week's journal Nature. The annual global death toll from outdoor air pollution is 3.3 million. (Premature death is a medical term that means a usually preventable death that occurs before expected — for instance, earlier than the life expectancy of age 78 in the U.S.).


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The velocity of Ebola spread in parts of west Africa

THE LANCET by Kate Zinszer and others.                   Aug. 24,2015

In a speed outpacing control efforts, the Ebola virus disease (EVD) epidemic in parts of west Africa spread across Guinea, Liberia, and Sierra Leone infecting an estimated 26 800 individuals and claiming more than 11 000 lives as of May 15, 2015.1 Mobile populations coupled with porous borders1,2 and commercial air travel patterns3 affected the frequency and breadth of Ebola virus transmission.

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Cheap Paper Test to Screen Patients for Ebola, Yellow Fever, Dengue

MEDGADGET                                                                                   Aug. 20, 2015

BOSTON --At the 250th National Meeting & Exposition of the American Chemical Society this week, researchers from MIT, Harvard Med School, and the FDA are showing off a new field test that can quickly screen people for Ebola, yellow fever, and dengue. While the researchers don’t claim their technique to be as accurate as PCR and ELISA, it is nevertheless an excellent tool in poor areas of the world where these diseases tend to thrive.

The test doesn’t require any water or electricity nor any complicated and expensive equipment. It works similar to pregnancy tests, providing a color readout that signals whether a disease is detected that is easily readable by just about anyone.

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Physicians: Global Vaccine Development Fund Could Save Billions

PHARMACEUTICAL PROCESSING by  Princeton University, Woodrow Wilson School of Public and International Affairs   Aug. 6, 2015

Ebola is a preventable disease, and yet a safe and effective vaccine has not been deployed. As with many vaccines, financial barriers persist: pharmaceutical companies see high costs with limited market potential, and government support is lacking. But there may be a solution to this vaccine crisis with the ability to save at-risk populations, according to a perspective piece written by physicians based at Princeton University, University of Pennsylvania and the Wellcome Trust.

The article, published in the New England Journal of Medicine, proposes the creation of a $2 billion global vaccine-development fund - supported by governments, foundations and pharmaceutical companies - that would carry promising vaccines through development to deployment. With initial support, the global vaccine fund could help make vaccines available for emergency use.

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What ‘100 Percent Effective’ Means for That Ebola Vaccine

WIRED.COM by Katie M. Palmer                                                            Aug. 4, 2015

Last week, the medical journal the Lancet published preliminary results on the efficacy of an Ebola vaccine in Guinea, and everybody got really excited—especially about one particular figure. The vaccine, the results suggested, was 100 percent effective at protecting against Ebola, a thrilling prospect in the face of an epidemic that has killed more than 11,000 people. ...

But that number probably means less than you think it does. It’s based on incomplete data, so it doesn’t have the statistical clout it should. And it never will. Based on the vaccine’s early success, the trial’s runners decided that all participants in the study should get it immediately after exposure. That’s a perfectly reasonable, humane reaction, but it also means that the researchers will never be able to collect better data on the vaccine’s efficacy, which is what regulators look for when they’re deciding to approve a drug. In other words, the vaccine’s early success could make it harder for people to get it down the line.

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The Individualised versus the Public Health Approach to Treating Ebola

PLOS/Medicine   by  Tom H. Boyles                            July 28, 2015

The mortality rate for patients with Ebola virus disease (EVD) in West Africa is approximately 65% [1]. There are no published figures for high-resource settings, but media sources and individual case reports suggest it is much lower and approaches 0% for those who receive this level of care from the beginning of their illness.

In their article “Ebola Viral Disease: Experience and Decision Making for the First Cases outside of Africa,” David Stephens and colleagues give insight into the care that can be provided when available resources are not the limiting factor [2]. They describe the decision to open the Serious Communicable Diseases Unit (SCDU) of Emory University Hospital (EUH) when two United States patients contracted EVD while working in West Africa. Using a large specialist team, they provided high-quality care in a safe working environment and disseminated their knowledge and experience widely.....

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Addressing therapeutic options for Ebola virus infection in current or future outbreaks

AMERICAN SOCIETY FOR MICROBIOLOGY  by Azizul Haque and others                                July  27, 2015

 Ebola virus can cause severe hemorrhagic disease with high fatality rates. Currently, no specific therapeutic or vaccine has been approved for treatment and prevention of Ebola infection of humans. Although the number of Ebola cases has fallen in the last few weeks, multiple outbreaks of Ebola virus infection and the likelihood of future exposure highlight the need for development and rapid evaluation of pre- and post-exposure treatments.

In this manuscript we briefly review the existing and future options for anti-Ebola therapy, based on the data coming from rare clinical reports, studies on animals and results from in vitro models....

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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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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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