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The reassuring news in the Texas Ebola cases

WASHINGTON POST

By Todd C. Frankel                         October 14

....The Dallas nurse, 26-year old Nina Pham,who helped treat Thomas Eric Duncan, the Liberian man who was the first person diagnosed with the dreaded disease in the United States became the first – and so far only – person infected by Duncan. In the wake of her infection, U.S. health officials have pledged to review how future Ebola cases are handled.

But the case is also noteworthy for another, potentially positive reason: Nearly 50 people were exposed to Ebola before the nurse, and none of them has been diagnosed with the disease.

This group of neighbors, family members and first responders are being watched carefully by health authorities. They had some degree of close contact with Duncan during the four-day period when he was contagious – from when he started showing Ebola symptoms on Sept. 24 to when the hospital finally admitted him on Sept. 28. They didn’t take any Ebola-specific precautions. They didn’t know he was infected.... Yet, so far, they have not gotten sick. And their 21-day Ebola incubation period started before Pham’s.

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WHO and Partners agree on a common approach to strengthen Ebola preparedness in unaffected countries

Brazzaville, 10 October 2014 - The World Health Organization (WHO) and partner organizations meeting in Brazzaville have agreed on a range of core actions to support countries unaffected by Ebola in strengthening their preparedness in the event of an outbreak.

Building on national and international existing preparedness efforts, a set of tools is being developed to help any country to intensify and accelerate their readiness.

One of these tools is a comprehensive checklist of core principles, standards, capacities and practices, which all countries should have or meet. The checklist can be used by countries to assess their level of preparedness, guide their efforts to strengthen themselves and to request assistance. Items on the checklist include infection prevention control, contact tracing, case management, surveillance, laboratory capacity, safe burial, public awareness and community engagement and national legislation and regulation to support country readiness.

“While we rightly focus on stopping the outbreak in affected countries, we should not forget that all other countries are at risk, albeit at varying levels”, said WHO Regional Director for Africa, Dr Luis Sambo.

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FIVE ITEMS ON EFFORTS TO IMPROVE TRAINING FOR HEALTH WORKERS

Scroll down for the stories and link to CDC check list

CDC TAKES NEW STEPS TO IMPROVE TRAINING FOR HOSPITAL WORKERS

NEW YORK TIMES                   Oct. 13, 2014
By Pam Belluck

The Centers for Disease Control and Prevention is taking new steps to help hospital workers protect themselves, providing more training and urging hospitals to run drills to practice dealing with potential Ebola patients.

In response to the news that a health care worker in Dallas had contracted Ebola, a spokeswoman said the agency would also issue more specific instructions and explanations for putting on and removing protective equipment and would urge nurses and doctors to enlist a co-worker or “buddy” to watch them do so....

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Working with Communities is the Key to Stopping Ebola

who.int - October 2014

When Dr Peter Clements arrived in Lofa County, Liberia eight weeks ago, from the WHO country office in Monrovia, 20-30 patients were arriving at the MSF hospital with Ebola-like symptoms every day. People living in the community were afraid, civil unrest was simmering, and an ambulance and health workers were being targeted

Although UN security advised him not to, Dr Clements traveled the 12 hours over dirt roads to the area nearest the Guinea border. Once there, he walked into the hostile communities and went straight to the chiefs.

“In many years, you have not fought with these people,” he said. “Now you attack them. They are not the enemy, Ebola is the enemy. If we don’t chase Ebola, it will kill us. You have to know Ebola to fight Ebola. Mobilize your people. Let’s get to know Ebola.”

Dr Clements said the key to working with a hostile community is listening first. So he patiently listened to the community to understand their fears, then he started to explain about the virus and how people become sick, and people can prevent themselves.

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Doctors Without Borders Evolves as It Forms the Vanguard in Ebola Fight

Detailed description of Médecins Sans Frontières struggle to counter Ebola

NEW YORK TIMES
By SHERI FINK, ADAM NOSSITER and JAMES KANTER.  OCT. 10, 2014

But it, too, has been overwhelmed by the scale of this disaster. In Sierra Leone, it has been strained by the caseload, though it was wary of a decision by other health and government officials on Friday to treat most patients at home because of a shortage of clinic beds. In Guinea the day before, it reported that its two treatment centers were stretched to the limit....

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Fighting Ebola with Data, Satellites and Drones

Healthcare workers in Sierra Leone spray disinfectant to prevent the spread of the Ebola virus in Kenema, on September 24, 2014.

Image: Healthcare workers in Sierra Leone spray disinfectant to prevent the spread of the Ebola virus in Kenema, on September 24, 2014.

defenseone.com - September 25th, 2014 - Patrick Tucker

Current Centers of Disease Control estimates suggest that the disease could infect more than 1.4 million people by January. To limit Ebola’s spread, researchers need better on-the-ground intelligence about where it’s moving. But the virus’s deadly mortality rate, 70 percent for this strain, makes up-close observation as difficult as gathering data on a deadly human adversary. 

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Here's How Nigeria Beat Ebola

 

  MOTHER JONES                       Oct. 10, 2014

—By

LAGOS -- Nigeria's success in stopping the outbreak could have implications for other countries, including the United States. That's why the Centers for Disease Control and Prevention (CDC) dispatched a team to the country this week to learn what went right.

So how did local and international health authorities curb Ebola in Nigeria while infections have continued to rise dramatically in Liberia, Sierra Leone, and Guinea?

Read full article, with charts and posters

http://www.motherjones.com/politics/2014/10/nigeria-ebola-cdc

An Ebola warning at the Murtala Muhammed International Airport in Lagos

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Structural Adaptivity Facilitation Examples - Part III

Here are my last three Facilitation Examples, proposed activities by planners and others to influence the development of the built environment toward structural adaptivity and resilience as we progress into an ever more uncertain and unpredictable future. 

 

Rethinking Homeownership.  Conventional owner-occupied land and buildings in the US many times tie the owners into long-term tenures.  It makes moves, to other locations, overly cumbersome even when such moves are in the occupants’ best interests.  Adaptivity requires the ability to make quicker changes than in the past, including the self-initiated movement of people and businesses to other locations when beneficial.  Alternative types of ownership or tenure must be facilitated, types which are more adaptable to quick change.

 

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The fight to save the last Ebola-free district in Sierra Leone

THE WASHINGTON POST                               OCT. 10, 2014

... The last region in Sierra Leone untouched by Ebola sits in the rugged, mountainous north, in a place called the Koinadugu district. It is a poor place, dependent on small farms and gold mines, the largest of the country’s 14 districts by land size and home to 265,000 residents. The district borders Guinea, where the current Ebola outbreak began and first spilled over into Sierra Leone. Koinadugu is surrounded by districts dealing with hundreds of Ebola cases.

But Koinadugu has kept the virus at bay.

Momoh Konte, shown at his office in Freetown,  returned to Sierra Leone from Washington to help his home district fight against Ebola. (Photo by Tanya Bindra for The Washington Post)

It is a remarkable feat, a source of pride for district residents, a source of hope for the entire struggling nation, and a curiosity to epidemiologists tracking the worst Ebola outbreak in history...

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Small drugmakers can't scale up quickly enough to get ahead of the virus

Two overviews of efforts by drug makers to produce Ebola medication.

WASHINGTON POST                 Oct. 10, 014

by Lenny Bernstein and Brady Dennis

WASHINGTON ..."It takes time. You end up with a situation where the companies weren't set up to ramp up productio. You don't just go from that to making 10,000 does overnight."  -- Prof. Thomas Galsbert, University of Texas Medical Branch at Galveston.

Read full story

http://www.washingtonpost.com/national/health-science/small-drugmakers-try-to-scale-up-to-meet-ebola-crisis/2014/10/09/a594dec2-4fee-11e4-babe-e91da079cb8a_story.html

SCIENCE INSIDER                                        Oct. 8, 2014

By Jon Cohen and  Kai Kupferschmidt

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