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Ebola’s lessons, painfully learned at great cost in dollars and human lives

In-Depth report on lessons to be learned from the Ebola crisis

THE WASHINGTON POST by By Lena H. Sun, Brady Dennis and Joel Achenbach                            Dec. 29, 2014

A year after it began, the Ebola epidemic in West Africa continues to be unpredictable, forcing governments and aid groups to improvise strategies as they chase a virus that is unencumbered by borders or bureaucracy.

The people fighting Ebola are coming up with lists of lessons learned — not only for the current battle, which has killed more than 7,500 people and is far from over, but also for future outbreaks of deadly contagions.

Alice Jallabah, head of a bushmeat seller group, holds dried bushmeat in Monrovia. (Zoom Dosso/AFP/Getty Images)

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Where Ebola Has Closed Schools, A Radio Program Provides A Faint Signal Of Hope

NATIONAL PUBLIC RADIO by Ofeibea Quist-Arcton        Dec. 25, 2014

MONROVIA -- Working with UNICEF and another nonprofit, Talking Drum, in Monrovia, the capital of Liberia, the government aims to provide lessons to children across the country, hit by the Ebola outbreak. Most schools closed this past summer and will likely remain closed for months....

                            Florence Allen Jones, right, is part of the education ministry's classes-by-radio team.

The radio classes are broadcast on local stations, and on United Nations radio. The Education Ministry acknowledged that the broadcasts are not reaching nationwide. In any case, few children in Liberia's 15 counties have access to a radio, or even the batteries to power one. Wealthy parents have hired home tutors for their kids, but many other youngsters have taken to peddling petty goods, like trinkets or donuts, on the streets of Monrovia, to try to earn a little money for their families while schools are closed.

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Lessons from the Ebola outbreak in West Africa

Editorial  Lessons learned from the Ebola outbreak

  THE WASHINGTON POST                                                                                  Dec. 26, 2014

The Outbreak of the Ebola virus in West Africa this year came as a surprise. Perhaps no one could have predicted that such a terrible scenario would unfold. But over the past decade, there have been four major outbreaks of infectious disease caused by a virus: severe acute respiratory syndrome, or SARS; swine flu; Middle East respiratory syndrome; and now Ebola. Each has taken populations by surprise. Next time, the world should not be gobsmacked. It is possible to be better prepared, be more aware of the potential threats and not start from zero every time the alarm goes off.

...It would be smart to begin thinking of a more agile and effective organization or system for responding to such dire threats, one that could bring together a capability for surveillance, early warning and rapid response; and that would be wired into the pharmaceutical industry.

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Next in Ebola Plan: UN Teams to Study Lines of Transmission

REUTERS                                                              Dec. 24, 2014

ACCRA—Medical detective work will be the next big phase in the fight against Ebola when the United Nations deploys hundreds of health workers to identify chains of infection as the virus passes from person to person, top U.N. health workers said.
Health workers bury the body of a suspected Ebola victim at a cemetery in Freetown, Dec. 21, 2014.

The health teams will travel to each district and region of Guinea, Sierra Leone and Liberia, the three countries at the center of the epidemic, to trace who each infected person has potentially contacted.

The effort will run in parallel with measures to minimize the spread of infection, such as treating all Ebola patients in specialized centers and burying all victims safely.

But Phase Two of the plan is to contain the virus by understanding its lines of transmission, said World Health Organization Director-General Margaret Chan.

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German Ebola treatment center officially opened in Liberia

DW                                                                                                                                    Dec 23, 2014

MONROVIA-- Liberia has hailed the official opening of its first German Ebola treatment center. The ceremony took place one day after global health officials announced that the Ebola death toll had passed 7,500.

The German-Liberia Ebola treatment Center was officially opened by Liberia's Assistant Minister for Health, Tolbert Nyenswah and the German ambassador to Liberia, Ralph Timmermann.

The center has an initial capacity of 50 beds. "There are three different wards - one for suspected cases, another for probable cases and yet another for confirmed cases," Christian Schuh, outgoing head of the German Red Cross told DW at the ceremony in the center in Paynesville on the outskirts of the capital Monrovia on Tuesday.

There are also facilities and space for nurses, doctors, pharmacies, training and teaching....

Timmermann said Germany had so far raised $150 million (123 million euros) to help fight Ebola in the three worst affected countries, Liberia, Sierra Leone and Guinea.

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Evaluation of the Benefits and Risks of Introducing Ebola Community Care Centers, Sierra Leone

     

CDC                                                                                                         Dec. 23, 2014    

Abstract of study on usefulness of Ebola community care centers to supplement larger  Ebola treatment centers.

 In some parts of western Africa, Ebola treatment centers (ETCs) have reached capacity. Unless capacity is rapidly scaled up, the chance to avoid a generalized Ebola epidemic will soon diminish. The World Health Organization and partners are considering additional Ebola patient care options, including community care centers (CCCs), small, lightly staffed units that could be used to isolate patients outside the home and get them into care sooner than otherwise possible.

Using a transmission model, we evaluated the benefits and risks of introducing CCCs into Sierra Leone’s Western Area, where most ETCs are at capacity. We found that use of CCCs could lead to a decline in cases, even if virus transmission occurs between CCC patients and the community. However, to prevent CCC amplification of the epidemic, the risk of Ebola virus–negative persons being exposed to virus within CCCs would have to be offset by a reduction in community transmission resulting from CCC use.

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Ebola raises profile of blood-based therapy

NATURE     by  Delcan Butler                                                                                        Dec. 23, 2014

With no drugs available to treat Ebola, eyes are turning to a therapy that had largely been relegated to the history books: transfusing patients with blood plasma donated by survivors, which contains antibodies against the virus.

Survivors of Ebola carry antibodies that might be used to save the lives of those infected with the virus. Michel du Cille/The Washington Post via Getty Images

Clinical trials of convalescent plasma therapy (CPT) have started in the past few weeks in Liberia, and are due to begin soon in Guinea and Sierra Leone. If the therapy saves lives, the approach could quickly be scaled up.

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On the Front Lines of Ebola’s Most Pressing Mystery

WIRED     by   Erika Check Hayden                                                                              Dec. 23, 2014

KENEMA, Sierra Leone—Mohammed Sankoh Yillah, an outreach worker, spent days in the Ebola ward caring for his sister, nurse Mbalu Fonnie. After Fonnie died in July, Yillah tested positive for the virus. He was transported to another hospital for treatment, but asked to come back to Kenema to die.

But Yillah survived.

Today Yillah sits with four colleagues in an office, discussing a new research project. The study is collecting information about survivors like him. The hope is that the study might help explain why he and others beat Ebola, while their friends and colleagues—Alex, Mbalu—did not.

Epidemiologist Lina Moses runs the meeting. Her colleagues back at Tulane University, she says, hope to analyze blood samples from survivors; she collected 29 such samples here in November. “What they want to know in the laboratory,” she says, “is what kind of antibodies Mohammed Yillah has that helped him to survive Ebola.”

 

                                                                             

 

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World Bank Supports The Gambia’s Ebola Prevention Plan

WORLD BANK PRESS RELEASE                                Dec. 22, 2014

The World Bank has approved a US$500,000 reallocation of existing development funds from on-going health and nutrition projects to support The Gambia prepare a plan in case of  a possible Ebola outbreak.

While there have been no reported cases of Ebola in The Gambia, its Ministry of Health and Social Welfare, working closely with the World Health Organization (WHO) and UNICEF, has nonetheless prepared a disease and Ebola preparedness plan.

 “The Ebola epidemic in neighboring countries has affected tourism in The Gambia as people are afraid to travel to and within Africa, resulting in great economic losses for the country,” said Vera Songwe, the World Bank Country Director for The Gambia. “We acknowledge that the virus is expanding both geographically and in the number of reported cases. The spread from Guinea to Mali highlights the escalating risk to regional security, stability and economic growth.

http://www.worldbank.org/en/news/press-release/2014/12/22/world-bank-the-gambia-ebola-prevention-plan

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Tekmira Inks Deal to Test New Ebola Drug in Humans

GENOMEWEB                                                                                                                        Dec. 22, 2014
NEW YORK -- Tekmira Pharmaceuticals announced today that it has signed a deal that will support the clinical testing of its experimental Ebola therapy designed against the strain of the virus behind the outbreak in West Africa.

Tekmira has long been developing an siRNA-based Ebola drug called TKM-Ebola, but a Phase I study of that agent was suspended by US regulators until the company could provide additional safety data. Earlier this year, Tekmira management indicated that that trial might not restart as early as anticipated since the firm had begun focusing on a version specifically for the Guinea strain of the Ebola virus, which is driving the ongoing outbreak.

Tekmira said it has now inked a manufacturing and clinical trial agreement with the University of Oxford to provide the new drug, called TKM-Ebola-Guinea, for clinical trials in West Africa. The university is the representative of the International Severe Acute Respiratory and Emerging Infection Consortium, which will be testing TKM-Ebola-Guinea in infected individuals with funding from the Wellcome Trust.

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