Deep in the jungle, hunting for the next Ebola outbreak

THE WASHINGTON POST by Kevin Sieff                   March 20, 2015

NOUABALE-NDOKI NATIONAL PARK, Congo Republic — More than 3,000 miles from the fading Ebola crisis in West Africa, a team of U.S.-funded researchers is hunting deep in a remote rain forest for the next outbreak.

Kinshasa, capital of the Democratic Republic of the Congo, is seen just across the Congo River from Brazzaville, capital of Congo Republic. Researchers have come to Congo Republic to explore the role wild pigs may play in the transmission of Ebola from wildlife to humans. Nichole Sobecki/For The Washington Post

 They aren’t looking for infected people. They’re trying to solve one of science’s great mysteries: Where does Ebola hide between human epidemics?

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WHO urges mass vaccination against measles, other diseases in Ebola areas

REUTERS   by Kate Kelland                                       March 21, 2015

LONDON--The World Health Organization warned on Friday of a risk of outbreaks of measles, whooping cough and other diseases in West African countries hit by Ebola and urged a rapid intensification of routine immunizations....

The epidemic has disrupted delivery of routine childhood vaccines against measles, polio and tuberculosis, and of a combined shot against meningitis, pneumonia, whooping cough, tetanus, hepatitis B and diphtheria.

Jean-Marie Okwo-Bele, the WHO's vaccines director, told a briefing in Geneva that the health agency wanted an intensification of immunization services, and mass measles vaccination campaigns in all areas where feasible.

"Campaigns will only be conducted in areas that are free of Ebola virus transmission," he said, stressing that clinics and health workers administering vaccines would be required to adhere to very strict infection control measures.

The WHO sent a warning note to affected countries this week saying: "Any disruption of immunization services, even for short periods ... will increase the likelihood of vaccine-preventable disease outbreaks."

Read complete story.

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Emails: UN health agency resisted declaring Ebola emergency

ASSOCIATED PRESS   by   Maria Cheng and Raphael Satter                                        March 20, 2015

GENEVA  — In a delay that some say may have cost lives, the World Health Organization resisted calling the Ebola outbreak in West Africa a public health emergency until last summer, two months after staff raised the possibility and long after a senior manager called for a drastic change in strategy, The Associated Press has learned.

Among the reasons the United Nations agency cited in internal deliberations: worries that declaring such an emergency — akin to an international SOS — could anger the African countries involved, hurt their economies or interfere with the Muslim pilgrimage to Mecca.

Those arguments struck critics, experts and several former WHO staff as wrong-headed.

"That's like saying you don't want to call the fire department because you're afraid the fire trucks will create a disturbance in the neighborhood," said Michael Osterholm, a prominent infectious diseases expert at the University of Minnesota.

In public comments, WHO Director-General Dr. Margaret Chan has repeatedly said the epidemic caught the world by surprise.

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Energy Agency Sees More Oil Declines, Potential for Conflict

         

FILE - In this Tuesday, Oct. 14, 2014, file photo, oil pumps work at sunset in the desert oil fields of Sakhir, Bahrain. Oil prices have further to drop with no signs of slowing production in the U.S., according to the International Energy Agency, Friday, March 13, 2015. (AP Photo/Hasan Jamali, File) - Associated Press

ABC News - AP - March 13, 2015

Oil prices have further to drop with few signs of slowing production in the U.S., according to a global energy agency.

The International Energy Agency, a watchdog group based in Paris that represents the world's main oil-importing nations, said in its monthly report Friday that the recent stabilization in oil prices is "precarious."

"Behind the facade of stability, the rebalancing triggered by the price collapse has yet to run its course," it said.

That may be playing out right now. Oil prices tumbled 10 percent this week, including a 5 percent drop Friday.

The IEA cautioned that risks of oil supply disruptions are growing. Low prices could raise the risk of social disruption in some countries dependent on oil, the agency said, and the ongoing conflict in Iraq and Libya hasn't slowed down.

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3 ways mobile helped stop the spread of Ebola in Nigeria

BROOKINGS TECH TANK   by Joshua Bleiberg and Darrell M. West                                       March 19, 2015

...There were a variety of factors that contributed to Nigeria’s success at combating the (Ebola)  disease. One important factorwas the use of mobile electronic health records programs.

1. Training Healthcare Workers

Training health care providers was a priority at the beginning of the Ebola outbreak. A survey found that 85 percent of health care workers in the country believed you could avoid Ebola by abstaining from handshakes or touching. Correcting these myths about the disease was a critical part of the response effort, especially for health care workers.

2. Rapid Deployment

One of the virtues of mHealth is its speed and flexibility. Mobile allows officials to quickly disseminate the latest information to front line health care workers. Increasing the speed of communication is a general boon to any large public health response.

3. Virtual Records

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How to Prevent the Next Ebola

THE ATLANTIC  by                 Mar 18 2015 

(Scroll down for additional links

Brian D'Cruz, a Virginia emergency-room doctor, spent the winter volunteering in a Doctors Without Borders Ebola treatment center in Conakry, Guinea. One of the myriad obstacles he encountered was that the yellow hazmat suits Ebola doctors wear take 45 minutes to don, yet are so stifling that a doctor can only spend an hour in one before risking dehydration. Having to frequently drop everything to pull off the suits made it even more difficult to stretch their already meager staff, D'Cruz told me in an interview at the Washington Health Forum this morning.

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Violence against women rises in Ebola-hit nations: ministers

REUTERS  By Maria Caspani                                       March 18, 2015

 UNITED NATIONS - The Ebola epidemic in West Africa exacerbated violence against women and rolled back access to reproductive healthcare in the region, ministers from Guinea and Liberia said on Wednesday.

In Guinea, data indicates a 4.5 percent increase in cases of gender-based violence since before the epidemic including twice as many rapes, Sanaba Kaba, the country's minister of social action, women and children, said on a panel at the United Nations 59th Commission on the Status of Women.

Liberia also saw more cases of gender-based violence as a result of the outbreak, said Julia Duncan Cassell, minister of gender and development in that country.

She said some men were not respecting the recovery protocol that Ebola survivors should observe and were infecting their spouses and female partners through unprotected sex.

Sierra Leone also has seen an increase in violence against women, said panel moderator Awa Ndiaye Seck, Liberian country representative for UN Women, the agency responsible for gender equality and women's empowerment.

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The case for EOCs post-Ebola

DEVEX    by  By Jenny Lei Ravelo                        March 19, 2015
Emergency operation centers have been critical in stemming potential Ebola outbreaks in several West African countries like Nigeria and Mali, but there remain doubts about whether countries would keep them post-Ebola. Ismail Ould Cheikh Ahmed, special representative of the secretary-general and head of the U.N. Mission for Ebola Emergency Response, meets with UNMEER staff at the Ebola Operation Center in Bamako, Mali. Should EOCs be retained post-Ebola? Photo by: Pierre Peron / UNMEER / CC BY-ND

This is largely because of its potential to cause “institutional turf wars” within the government structure, according to Madji Sock, partner at global development advisory firm Dalberg.

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Guinea's Ebola cases rise sharply, as cases ebb elsewhere

CENTER FOR INFECTIOUS DISEASE RESEARCH AND POLICY by Lisa Schnirring                                March 18, 2015
(Scroll down for link to full WHO Situation Report.)

Though Ebola patterns look promising in Sierra Leone and Liberia, the number of new confirmed cases spiked in Guinea last week, underscoring tough challenges that remain there, such as gaps in contact tracing and unsafe burials, the World Health Organization (WHO) said today.

For the third week in a row, Liberia reported no confirmed Ebola cases, and cases declined slightly in Sierra Leone, the WHO said in its weekly epidemiologic analysis of the outbreak.

Overall, 150 new confirmed Ebola cases were reported in the outbreak region last week, up from 116 the week before. The number of confirmed, probable, and suspected cases in the three countries has risen to 24,666, with death total increasing to 10,179.

...The WHO warned that although Ebola's footprint is now limited to a narrow area, the population is mobile, posing the risk or reseeding the disease to other districts and countries.

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Cadre Harmonisé for Identification of Areas and Populations in Food Insecurity in Guinea, Liberia and Sierra Leone

fao.org - March 2015

CLICK HERE - Cadre Harmonisé for Identification of Areas and Populations in Food Insecurity in Guinea, Liberia and Sierra Leone (5 page .PDF file)

Overview

In March 2014, the first Ebola virus disease (EVD) case was confirmed in Guinea and quickly spread to the neighbouring countries of Sierra Leone and Liberia. In September, the EVD outbreak was declared a global emergency by the UN assembly and national governments in the region, resulting in the implementation of measures to contain the outbreak including border and market closures, road blocks and quarantines. The measures and behaviours related to the outbreak directly disrupted many economic activities leading to major economic losses in almost all sectors.

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Sierra Leone plans another shutdown to stop Ebola's spread

ASSOCIATED PRESS by Clarence Roy-Macaulay                                                             March 18, 2015

FREETOWN, Sierra Leone  — Sierra Leone is planning another three-day, countrywide shutdown later this month to ferret out Ebola cases, remind people how to protect themselves from the disease and control its transmission.

The West Africa Ebola outbreak that has killed more than 10,000 people is declining but the disease has remained stubbornly entrenched in parts of Guinea and Sierra Leone. Liberia, the third country severely affected, currently has no Ebola cases.

In the drive to zero cases in Sierra Leone, the government will again ask residents to stay in their homes for three days, Alfred Palo Conteh, head of the country's National Ebola Response Center, said Wednesday. The shutdown is expected to take place March 27 through 29, according to Patrick Fatoma, another official with the Ebola response center.

The government has done this before, and some experts said it was unexpectedly effective in providing information about to control the disease.

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FDA panel to discuss Ebola vaccine development in May

REUTERS                                                    March 18, 2015

WASHINGTON ==The U.S. Food and Drug Administration said an advisory panel will discuss the development of Ebola vaccines, days after an American health worker was flown back after being tested positive for Ebola in Sierra Leone.

The federal health regulator would discuss the development of vaccines on May 12, it announced on its website on Wednesday.

The resurgence of the virus last year prompted drugmakers from across the world to develop new treatments that are in different stages of studies....

The World Health Organization said it will decide on mass vaccination against the virus in August.

See full story.

http://www.reuters.com/article/2015/03/18/us-health-ebola-fda-idUSKBN0ME1D520150318
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See Federal Register notice of meeting.

https://www.federalregister.gov/articles/2015/03/17/2015-06116/vaccines-and-related-biological-products-advisory-committee-notice-of-meeting

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Ebola Epidemic: Why a Few Cases Could Threaten Progress

LIVE SCIENCE by Rachel Rattner                                                                                 March 18, 2015

Health officials have made tremendous progress in fighting the Ebola epidemic in West Africa in recent months, but continued efforts are still needed, experts say. That's because the cases that are happening now could be enough to restart the whole epidemic....

Although health officials are trying to trace all of the people who had contact with each Ebola patient, this "contact tracing" is far from perfect in Guinea and Sierra Leone. As a result, cases pop up among people who officials didn't know were at risk. For example, so far this month, just 14 percent of cases in Guinea occurred among people who were known to have had contact with someone who was sick with Ebola, WHO says.

This "shadow epidemic," which is occurring under the radar, is very worrisome, said Dr. Amesh Adalja, a senior associate and infectious disease physician at the Center for Health Security at the University of Pittsburgh.

If this shadow transmission continues, "it will threaten to cause this whole outbreak to reignite again," Adalja said. "You have to make sure you're finding every case, and stopping transmission in every case."

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How to Fight the Next Epidemic

The Ebola Crisis Was Terrible. But Next Time Could Be Much Worse.

 

NEW YORK TIMES OPINION PAGE by Bill Gates                                                           March 18, 2015

(Scroll down for fuller Bill Gates article in the New England Journal of Medicine)

SEATTLE — The Ebola epidemic in West Africa has killed more than 10,000 people. If anything good can come from this continuing tragedy, it is that Ebola can awaken the world to a sobering fact: We are simply not prepared to deal with a global epidemic.

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4 more aid workers flown back to US for Ebola monitoring

ASSOCIATED PRESS                                March 17, 2015

NEW YORK — Four more American aid workers arrived back in the United States on Tuesday from West Africa to be monitored for Ebola, health officials said.

The latest arrivals bring to 16 the number of aid workers who have returned from Sierra Leone since Friday. None of them have been diagnosed with Ebola, but they will be isolated and monitored during the next three weeks for signs of the disease.

Officials have released few details, citing patient privacy. But all are connected to — or had direct physical contact with — another American who came down with Ebola last week in Africa. The unidentified man is in critical condition at a National Institutes of Health hospital in Bethesda, Maryland.

The other aid workers are staying near the Maryland hospital or hospitals in Atlanta and Omaha with special isolation units — in case they become sick, according to officials with the Centers for Disease Control and Prevention.

Read complete story.
http://www.bostonherald.com/news_opinion/national/2015/03/4_more_aid_workers_flown_back_to_us_for_ebola_monitoring

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