Offline: A pervasive failure to learn the lessons of Ebola

THE LANCET by Richard Horton                         Sept. 12, 2015

LONDON-- Post-Ebola reverie has given birth to a plethora of expert panels to consider what went wrong. The latest parade of global health specialists appointed to learn lessons gathered at the Wellcome Trust in London last week.
 Under the auspices of the US Institute of Medicine (IOM), a Commission to “deliberate and evaluate options to strengthen global, regional, and local systems to better prepare, detect, and respond to epidemic diseases” spent 2 days amassing evidence.

 There was no shortage of experience brought to bear on these important matters. Here were Margaret Chan, Jeremy Farrar, Ilona Kickbusch, David Heymann, Larry Gostin, Joy Phumaphi, Joanne Liu, and Peter Piot all wrestling with a seemingly intractable challenge. The statements offered to the Commission were arresting. But  the purpose of the meeting was not to talk. It was to identify the best system for an epidemic response....
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http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2900152-X/fulltext

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Nepal Hasn't Spent Any Of The $4 Billion In Donations Since Earthquake

             

KATHMANDU, NEPAL - AUGUST 13: A young boy plays in the mud in a flooded lane inside the Chuchepati displacement camp on August 13, 2015 in Kathmandu, Nepal. About 7,144 people, hailing from different affected districts by the earthquake that hit Nepal, currently live in Chuchepati camp, with access to only 35 toilets and the help of only a few NGOs. Approximately 60,000 people are still living in over 100 official displacement camps throughout the affected districts.  OMAR HAVANA VIA GETTY IMAGES

huffingtonpost.com - by Eleanor Goldberg - September 3, 2015

It’s been four months since Nepal’s deadliest earthquake hit. Yet, the country still has yet to dole out a cent of the $4.1 billion in donations it received, Reuters reported. . . .

. . . According to the news outlet, the government won’t start spending the relief funds until October. The delay is due to reluctance to start building work during monsoon season and the fact that plans still require approval.

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Grim Snapshot Reveals Complex Health Issues for Ebola Survivors [Infographic]

(CLICK ON IMAGE TO ENLARGE)

submitted by George Hurlburt

Sleeplessness, along with abdominal and joint pain are common even months after recovery from the dreaded virus

scientificamerican.com - by Dina Fine Maron - September 9, 2015

The first snapshot of health complications facing Ebola survivors in Sierra Leone presents a dismal picture of their road to recovery. A new study has found that up to four months after blood tests indicated that they were Ebola-free, more than half of survivors continue to suffer from joint pain, headaches or muscle pain. And more than 40 percent of survivors complain of sleeplessness and visual problems. Perhaps most worryingly, almost all the survivors—96 percent—reported being rejected by their communities after they were released from the hospital. The majority said they were still too scared to return home.

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WHO Vaccine-Preventable Diseases: Monitoring System - Country Summaries

                                       

apps.who.int

WHO Vaccine-Preventable Diseases: Monitoring System
(Click on the country of interest - then click "OK")
http://apps.who.int/immunization_monitoring/globalsummary

Country Summaries - WHO UNICEF Review of National Immunization Coverage, 1980-2014
(Click on the country of interest)
http://apps.who.int/immunization_monitoring/globalsummary/wucoveragecountrylist.html

 

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Ebola Outbreak Update - Sept. 8, 2015 - National Ebola Response Centre - Sierra Leone

submitted by Gavin Macgregor-Skinner

Ebola Outbreak update dated Sep 8 from the National Ebola Response Centre in Sierra Leone.

The four new Sierra Leone cases are in Sella Kaffta, a village in Kambia district in the northwest part of the country on Guinea's border. All the newly reported patients had contact with a 67-year-old woman whose death from Ebola was announced last week. After she died her body was washed before burial. There are 50 high-risk close contacts being monitored. Experimental ring vaccine campaign by WHO began Sep 4 and the newly diagnosed Ebola patients were not among the 116 people who received post-exposure VSV-EBOV vaccine.

Ebola Virus Disease (EVD) Update
http://health.gov.sl/?p=617

Ebola Virus Disease – Situation Report
http://health.gov.sl/?p=537

Ministry of Health and Sanitation - The Republic of Sierra Leone
http://health.gov.sl

National Ebola Response Centre (NERC) - Sierra Leone
http://www.nerc.sl

National Ebola Response Centre (NERC) - Sierra Leone - Evening Briefings
http://nerc.sl/?q=document-types/nerc-briefings

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Guinea passes one week with no new Ebola cases: WHO

AFP   Sept. 9, 2015

Geneva -- Guinea has notched up a week without a new case of Ebola, a first since March 2014, the head of the UN's response to the epidemic, Bruce Aylward, said on Wednesday.

Health workers with a patient under quarantine at the Nongo Ebola treatment centre in Conakry, Guinea on August 21, 2015 (AFP Photo/Cellou Binani)

"As of today, they have gone seven days without a (new) case of Ebola," said Aylward, the World Health Organization's special envoy for the epidemic.

"That is the longest period since March of last year that Guinea has gone without an Ebola case," he added.

There are two people in the country who have Ebola, but they tested postive before September 2.

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http://news.yahoo.com/guinea-passes-one-week-no-ebola-case-142016881.html


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3 New Ebola Patients Found in Sierra Leone

VOICE OF AMERICAN by James Butty  Sept. 9, 2015
Three more people have tested positive for Ebola from the same village in Sierra Leone's northern Kambia district of the country where a 67-year-old woman died last week from the virus, Sierra Leone health officials said.

Chief medical officer Dr. Brima Kargbo told VOA Tuesday the three new patients came from among the 50 high-risk persons identified as close relatives of the deceased woman. 

Sierra Leone has had nearly 14,000 cases of Ebola and about 4,000 deaths since the outbreak began in 2014.  But Dr. Kargbo said the latest outbreak is containable because its origin is traceable....

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http://www.voanews.com/content/new-ebola-patients-found-in-sierra-leone/2953488.html

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WHO - Polio Outbreak Confirmed in Mali

                                            

afro.who.int

Bamako, 7 September 2015 – A case of circulating vaccine-derived poliovirus type 2 (cVDPV2) has been confirmed in Bamako, the capital and largest city of Mali. The country is on high alert after national authorities detected a paralysis case with onset 20 July 2015. The patient is a 19-month old child of Guinean nationality whose paralysis occurred 7 days prior to the child’s arrival in Bamako to seek health care. The last case of wild polio virus (WPV) in Mali dates back to June 2011 in Goundam, Timbuktu Region.

The current detected virus is genetically linked to a confirmed VDPV detected in Siguiri district, in the Kankan Region of Guinea in August 2014, and has been circulating across international borders for more than 2 years without detection. 

The risk of spread of this virus is deemed high and it has the capacity to cause paralytic disease in humans or kill. The emergence and circulation of VDPV2 reveals low population immunity against the virus due to low rates of vaccination coverage in Guinea. Consequently, oral polio vaccine (OPV) must be administered multiple times to stop the outbreak and protect children. 

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Fossil Fuels Losing Cost Advantage Over Solar, Wind, IEA Says

      

Photographer - Andrew Harrer / Bloomberg

bloomberg.com - by Tara Patel - August 31, 2015

  • Renewable technologies no longer cost outliers, report says
  • No single technology is cheapest under all circumstances

The cost of producing electricity from renewable sources such as solar and wind has dropped significantly over the past five years, narrowing the gap with power generated from fossil fuels and nuclear reactors, according to the International Energy Agency.

“The costs of renewable technologies -- in particular solar photovoltaic -- have declined significantly over the past five years,” the Paris-based IEA said in a report called Projected Costs of Generating Electricity. “These technologies are no longer cost outliers.”

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WHO To Vaccinate 200 Individuals Following Recent Sierra Leone Ebola Death

TECH TIMES by rina Maria Doctor     Sept. 3, 2015
The World Health Organization (WHO) is set to vaccinate about 200 people in Sierra Leone, who were believed to have been directly or indirectly exposed to a woman who succumbed to death due to the virus on Saturday, Aug. 29.

The 67-year-old woman, whose diagnostic test results came positive for Ebola, was a merchant from the Kambia District, which is close to the border of Guinea. She died five days after Sierra Leone has begun a countdown projected to last for 42 days before the country may be declared free from the deadly virus. Before her diagnosis, the last patient diagnosed with the disease was reported on Aug. 8....

WHO will immunize the people in the area of Tonko Limba who have had direct and indirect exposures to the deceased, says Margaret Harris, a spokesperson from WHO. This effort will also include people who have had close contacts with the said exposed individuals....

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Survey Finds Many Physicians Overestimate Their Ability to Assess Patients’ Risk of Ebola

massgeneral.org - August 27, 2015

While most primary care physicians responding to a survey taken in late 2014 and early 2015 expressed confidence in their ability to identify potential cases of Ebola and communicate Ebola risks to their patients, only 50 to 70 percent of them gave answers that fit with CDC guidelines when asked how they would care for hypothetical patients who might have been exposed to Ebola. In addition, those who were least likely to encounter an Ebola patient – based on their location and characteristics of their patients – were most likely to choose overly intense management of patients actually at low risk.  The results of the survey, conducted by a team of Massachusetts General Hospital (MGH) investigators, have been published online in the Journal of General Internal Medicine.

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CLICK HERE - RESEARCH - Ebola Risk and Preparedness: A National Survey of Internists 

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Warming Oceans Putting Marine Life ‘In a Blender’

 A lobsterman threw back a lobster near Mount Desert, Me. in 2012. The catch in the area has reached record highs. Credit Robert F Bukaty/Associated Press

Image:  A lobsterman threw back a lobster near Mount Desert, Me. in 2012. The catch in the area has reached record highs. Credit Robert F Bukaty/Associated Press

nytimes.com - September 3rd, 2015 - Carl Zimmer

Up in Maine, lobsters are thriving. The Atlantic States Marine Fisheries Commission reported last month that stocks there have reached a record high.

Down the coast, however, the story is different.

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A Vaccinated Man Has Been Emitting Virulent Polio for 28 Years

Children after an India polio-vaccination event, 2012. Courtesy CDC.gov

Image: Children after an India polio-vaccination event, 2012. Courtesy CDC.gov

phenomena.nationalgeographic.com - September 2nd, 2015 - Maryn McKenna

At the end of the decades-long global battle to eradicate polio from the planet, there is what looks like a simple goal: Render every person immune, by vaccination, for long enough that the disease can find no host in which to breed, and thus dies out. That was the strategy behind the eradication of smallpox, and since polio like smallpox affects only humans, it is supposed to work for that disease too.

Of course, it’s a little more complicated, and a paper published last week reveals one of the most challenging complications.

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CDC - HHS - Ebola Concept of Operations (ConOps) Planning Template

Source:Centers for Disease Control and Prevention (CDC) - Date Published:08/20/2015

Annotation:This 38-page document provides a standard format for creating an Ebola Concept of Operations (ConOps) plan at the state, territorial, or major metropolitan area government level. It provides information on measures local governments, agencies, and organizations can take to support the plan. The ConOps in the template describes strategic, high-level considerations for establishing a regional tiered system to safely and effectively manage persons under investigation (PUIs) or patients confirmed with Ebola.

(38 page .PDF document)
URL: http://www.cdc.gov/phpr/documents/ebola-concept-of-operations-planning-template-8-20-2015.pdf

Authors:Dugas, Robert; Lamoureux, Joe; Mangieri, William; et al.
Type:Guideline/Assessment Tool
ID:11129. From Disaster LitTM, a database of the U.S. National Library of Medicine.

http://disasterlit.nlm.nih.gov/record/11129

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Budapest Migrant Standoff Enters Second Night

         

Hundreds of families have set up camp underneath Budapest's eastern station

Hundreds of migrants are in a standoff with police for a second night outside a Budapest railway station.

bbc.com - September 2, 2015

Earlier, scuffles broke out between the two sides as frustration among migrants boiled over outside Keleti station.

Many of the migrants have tickets and are insisting they be allowed to travel on to Germany and other countries, but Hungary says it is enforcing EU rules.

Meanwhile, Germany, Italy and France have called for "fair distribution" of refugees throughout the EU.

In a joint declaration, the country's three foreign ministers also called for Europe's asylum laws to be revised, the Italian foreign ministry said in a statement (in Italian).

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