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We’ve Learnt Many Lessons from This Outbreak and From the Response – Dr. David Nabarro, Special Envoy on Ebola

          

Dr. David Nabarro, Special Envoy on Ebola, at a press conference in New York in November 2015. UN Photo/Loey Felipe

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10 December 2015 – In August 2014, amid a rapidly growing outbreak of Ebola, Dr. David Nabarro was tasked with providing strategic guidance for an enhanced international response, and galvanizing essential support for affected communities and countries. As the Secretary-General’s Special Envoy on Ebola, Dr. Nabarro played a key role in responding to the outbreak, which mainly affected Guinea, Liberia and Sierra Leone, and claimed more than 11,300 lives to date.

While the Ebola outbreak in West Africa has declined significantly in recent months, it is not completely over, making it all the more vital for everyone involved in the response to remain vigilant and focused on stopping the outbreak, staying at zero cases and preventing re-emergence. The Office of the Special Envoy will end its mandate on 31 December 2015, but the UN system will continue to remain fully engaged with the affected countries. 

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Liberia’s Ebola Outbreak Largely Traced to One Source

            

BRANCHING OUT  In Liberia, a single lineage of Ebola virus (middle dot) split into subgroups as it passed from person to person and mutated. Each dot is a slightly different version of the virus within the subgroups. Dot size indicates how many people carried that version. Researchers tracked the virus as it spread from Liberia (blue) into Guinea (red) and Mali (yellow).  J.T. Ladner et al/Cell Host & Microbe 2015

CLICK HERE - STUDY - Evolution and Spread of Ebola Virus in Liberia, 2014–2015

Genetic analysis of third hard-hit country fills in gaps in virus’ spread and evolution

sciencenews.org - by Tina Hesman Saey - December 9, 2015

A single introduction of the Ebola virus led to most cases of the deadly disease in Liberia, a new genetic study suggests.

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Mathematical Modeling of the West Africa Ebola Epidemic

eLife 2015;10.7554/eLife.09186 - December 8, 2015
DOI: http://dx.doi.org/10.7554/eLife.09186

Abstract

As of November 2015, the Ebola virus disease (EVD) epidemic that began in West Africa in late 2013 is waning. The human toll includes more than 28,000 Ebola virus disease (EVD) cases and 11,000 deaths in Guinea, Liberia, and Sierra Leone, the most heavily-affected countries. We reviewed 66 mathematical modeling studies of the EVD epidemic published in the peer-reviewed literature to assess the key uncertainties models addressed, data used for modeling, public sharing of data and results, and model performance. Based on the review, we suggest steps to improve the use of modeling in future public health emergencies.

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Identification of NPC1 as the Target of U18666A, an Inhibitor of Lysosomal Cholesterol Export and Ebola Infection

eLife 2015;10.7554/eLife.12177 - DECEMBER 8, 2015
DOI: http://dx.doi.org/10.7554/eLife.12177

Abstract

Niemann-Pick C1 (NPC1) is a lysosomal membrane protein that exports cholesterol derived from receptor-mediated uptake of LDL, and it also mediates cellular entry of Ebola virus. Cholesterol export is inhibited by nanomolar concentrations of U18666A, a cationic sterol. To identify the target of U18666A, we synthesized U-X, a U18666A derivative with a benzophenone that permits ultraviolet-induced crosslinking. When added to CHO cells, U-X crosslinked to NPC1. Crosslinking was blocked by U18666A derivatives that block cholesterol export, but not derivatives lacking blocking activity. Crosslinking was prevented by point mutation in the sterol-sensing domain (SSD) of NPC1, but not by point mutation in the N-terminal domain (NTD). These data suggest that the SSD contains a U18666A-inhibitable site required for cholesterol export distinct from the cholesterol-binding site in the NTD. Inasmuch as inhibition of Ebola requires 100-fold higher concentrations of U18666A, the high affinity U16888A-binding site is likely not required for virus entry. 

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Another American Ebola Survivor Had Eye Problems

Ebola survivor Dr. Richard Sacra experienced eye problems, including vision loss, pain and redness, shortly after he recovered from the disease.

Credit: Chancellor JR, Padmanabhan SP, Greenough TC, Sacra R, Ellison RT III, Madoff LC, et al. Uveitis and systemic inflammatory markers in convalescent phase of Ebola virusdisease. Emerg Infect Dis. 2016 Feb

CLICK HERE - STUDY - CDC - Uveitis and Systemic Inflammatory Markers in Convalescent Phase of Ebola Virus Disease

livescience.com - by Rachael Rettner - November 25, 2015

Ebola survivor Dr. Ian Crozier wasn't the only American to experience eye problems following the disease — a new report describes eye problems in another American doctor who lived through the disease.

Dr. Richard Sacra, who works for the Christian mission organization SIM USA, contracted Ebola last year while caring for pregnant women in Liberia during the rise of the Ebola outbreak there. He was evacuated to the United States for treatment in early September 2014, and was declared Ebola-free after spending about a month in the hospital.

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Panels Advise Bolstering W.H.O. for Crises Like Ebola

nytimes.com - by Sheri Fink - November 22, 2015

In recent months, numerous groups of health experts have gathered to debate how to prevent another crisis like the Ebola epidemic in West Africa, which jumped borders, spread fear across the globe, and directly killed more than 11,000 people. Many more died as hospitals and clinics closed for months.

Now two of those groups — one independent and the other convened by the World Health Organization — have released specific recommendations and called for urgent action. Both concluded that the W.H.O.’s outbreak and emergency response capacities should be strengthened and consolidated, protected from political meddling and independently overseen. The health organization is a United Nations agency.

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CLICK HERE - WHO - Advisory Group on Reform of WHO’s Work in Outbreaks and Emergencies with Health and Humanitarian Consequences

CLICK HERE - WHO - First report of the Advisory Group on Reform of WHO’s work in outbreaks and emergencies (20 page .PDF report)

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Interferon-γ Inhibits Ebola Virus Infection

submitted by George Hurlburt

                                                         

CLICK HERE - STUDY - Interferon-γ Inhibits Ebola Virus Infection

scicasts.com - November 19, 2015

The recent Ebola outbreak in West Africa has claimed more than 11,300 lives and starkly revealed the lack of effective options for treating or preventing the disease. Progress has been made on developing vaccines, but there is still a need for antiviral therapies to protect health care workers and local populations in the event of future outbreaks.

A new study led by University of Iowa virologist Dr. Wendy Maury, suggests that gamma interferon, which is an FDA-approved drug, may have potential as an antiviral therapy to prevent Ebola infection when given either before or after exposure to the virus.

The study, published in the journal PLOS Pathogens, found that gamma interferon, given up to 24 hours after exposure, can inhibit Ebola infection in mice and completely protect the animals from death.

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CDC - Ebola Virus RNA Stability in Human Blood and Urine in West Africa’s Environmental Conditions

cdc.gov

Janvier F, Delaune D, Poyot T, Valade E, Mérens A, Rollin PE, et al.

CLICK HERE - Ebola virus RNA stability in human blood and urine in West Africa’s environmental conditions
Emerg Infect Dis. 2016 Feb. http://dx.doi.org/10.3201/eid2202.151395

DOI: 10.3201/eid2202.151395

Abstract

We evaluated RNA stability of Ebola virus in EDTA blood and urine samples collected from infected patients and stored in West Africa’s environmental conditions. In blood, RNA was stable for at least 18 days when initial cycle threshold values were <30, but in urine, RNA degradation occurred more quickly.

 

 

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Ebolavirus Evolution: Past and Present

PLOS PATHOGENS  by Marc-Antoine de La Vega,  Derek Stein, and GaryKopinger, University of Manitoba, Canada , Nov. 12, 2015    

Winnipeg, Manitoba, Canada The past year has marked the most devastating Ebola outbreak the world has ever witnessed, with over 28,000 cases and over 11,000 deaths. Ebola virus (EBOV) has now been around for almost 50 years. In this review, we discuss past and present outbreaks of EBOV and how those variants evolved over time. We explore and discuss selective pressures that drive the evolution of different Ebola variants, and how they may modify the efficacy of therapeutic treatments and vaccines currently being developed. Finally, given the unprecedented size and spread of the outbreak, as well as the extended period of replication in human hosts, specific attention is given to the 2014–2015 West African outbreak variant (Makona).

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http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1005221

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Guinea Releases Last 68 People from Ebola Quarantine

reuters.com - Reporting by Saliou Samb; Writing by Makini Brice; Editing by Digby Lidstone - November 14, 2015

The final 68 people who had been in contact with an Ebola patient were released from quarantine on Saturday, said a senior health official, raising hopes of an end to the disease in the last West African country with confirmed cases.

The world's worst Ebola epidemic, which hopped borders to kill more than 11,300 people and devastate already fragile West African economies, has already been declared over in Liberia and Sierra Leone. But Guinea, where the outbreak began, has had a more difficult time eradicating the disease.

Dr. Abdourahmane Bathily, head of the Ebola center in Forecariah in western Guinea, said the 68 contacts had emerged from quarantine at midnight on Saturday morning.

"There are no longer any people who had contact with a person infected by the Ebola virus," said Bathily.

He added that the last confirmed Ebola case was a baby in isolation, who should be released from a treatment center next week, allowing for the West African nation to begin its own countdown clock.

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