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The Path to Zero Ebola Cases

Op-ed

NEW YORK TIMES by Jim Yong Kim, President of the World Bank Group      Dec. 11, 2014                                              

MONROVIA, Liberia — In my career as a medical doctor and global health policy maker, I have been in the middle of monumental struggles, including fights to make treatment accessible in the developing world for those living with H.I.V./AIDS as well as multi-drug resistant tuberculosis. But the Ebola epidemic is the worst I’ve ever seen...

Members of District 13 ambulance service disinfect a room in a village north of Monrovia, Liberia. Credit Jerome Delay/Associated Press

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UN Says Several Months Needed to Control Ebola

ASSOCIATED PRESS by EDITH M. LEDERER                       Dec. 11, 2014

UNITED NATIONS-- The U.N. Ebola chief said Thursday it will take several more months before the outbreak in West Africa is under control, an assessment that makes clear the World Health Organization's goal of isolating 100 percent of Ebola cases by Jan. 1 won't be met.

Dr. David Nabarro said there has been "a massive shift" over the last four months in the way affected governments have taken the lead in responding to the epidemic, communities are taking action and the international community has pitched in.

But he said greater efforts are needed to combat Ebola in western Sierra Leone and northern Mali, to reduce the number of new cases in Liberia and to limit transmission to Mali.

WHO conceded that it didn't meet an interim Dec. 1 target of isolating 70 percent of Ebola patients and safely burying 70 percent of victims in hardest-hit Sierra Leone. But it hasn't made clear what that means for its Jan. 1 goal, which it set in September. It has acknowledged that its patchy data could compromise the goal, since the agency does not know how many Ebola patients there actually are and is unable to track all of their contacts.

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UN Says Several Months Needed to Control Ebola

ASSOCIATED PRESS by EDITH M. LEDERER                       Dec. 11, 2014

UNITED NATIONS-- The U.N. Ebola chief said Thursday it will take several more months before the outbreak in West Africa is under control, an assessment that makes clear the World Health Organization's goal of isolating 100 percent of Ebola cases by Jan. 1 won't be met.

Dr. David Nabarro said there has been "a massive shift" over the last four months in the way affected governments have taken the lead in responding to the epidemic, communities are taking action and the international community has pitched in.

But he said greater efforts are needed to combat Ebola in western Sierra Leone and northern Mali, to reduce the number of new cases in Liberia and to limit transmission to Mali.

WHO conceded that it didn't meet an interim Dec. 1 target of isolating 70 percent of Ebola patients and safely burying 70 percent of victims in hardest-hit Sierra Leone. But it hasn't made clear what that means for its Jan. 1 goal, which it set in September. It has acknowledged that its patchy data could compromise the goal, since the agency does not know how many Ebola patients there actually are and is unable to track all of their contacts.

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Ebola response roadmap - Situation report

WHO                                                                                                                       Dec. 10, 2014

A total of 17 942 confirmed, probable, and suspected cases of Ebola virus disease (EVD) have been reported in five affected countries (Guinea, Liberia, Mali, Sierra Leone, and the United States of America) and three previously affected countries (Nigeria, Senegal and Spain) up to the end of 7 December. There have been 6388 reported deaths.

Reported case incidence is slightly increasing in Guinea (103 confirmed and probable cases reported in the week to 7 December), declining in Liberia (29 new confirmed cases in the 3 days to 3 December), and may still be increasing in Sierra Leone (397 new confirmed cases in the week to 7 December). The case fatality rate across the three most-affected countries in all reported cases with a recorded definitive outcome is 76%; in hospitalized patients the case fatality rate is 61%.

Read complete report.
http://www.who.int/csr/disease/ebola/situation-reports/en/

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Ebola outbreak: Virus still 'running ahead of us', says WHO

BBC    by Tulip Mazumdar                                                                                                    Dec. 10, 2014

The Ebola virus that has killed thousands in West Africa is still "running ahead" of efforts to contain it, the head of the World Health Organization has said.
Director general Margaret Chan said the situation had improved in some parts of the worst-affected countries, but she warned against complacency.

The risk to the world "is always there" while the outbreak continues, she said.

She said the WHO and the international community failed to act quickly enough....

"It is fair to say the whole world, including WHO, failed to see what was unfolding, what was going to happen in front of our eyes," said Dr Chan.

"Of course, with the benefit of hindsight, if you ask me now... we could have mounted a much more robust response."

Read complete story.
http://www.bbc.com/news/health-30400304

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Time Magazine Person of the Year: the Ebola fighters

 

TIME MAGAZINE    by Nancy Gibbs                                                                                                      Dec. 10, 2014

They risked and persisted, sacrificed and saved. Editor Nancy Gibbs explains why the Ebola Fighters are TIME's choice for Person of the Year 2014

 Read complete story

http://time.com/time-person-of-the-year-ebola-fighters-choice/

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Senate Foreign Relations Subcommittee hearing on Ebola

President Ellen Johnson Sirleaf of Liberia speaks via video on the international response to the Ebola crisis during a Senate subcommittee hearing on Capitol Hill in Washington on Wednesday. (SAUL LOEB, AFP/Getty Images)

Update Liberian president warns that Ebola still threatens her nation

LOS ANGELES TIMES                                                                                                    Dec. 10, 2014

liberian President Ellen Johnson Sirleaf thanked the Obama administration Wednesday for its efforts in stemming the tide of the country’s Ebola outbreak, but warned that the disease was still a threat in her developing nation.

The American response, a combination of funding and military aid, helped galvanize other countries to join the fight against the epidemic in West Africa, she told the Senate Foreign Relations Committee over video link.

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Ebola Airport Screening Finding Few Suspected Cases in US

MEDSCAPE MEDICAL NEWS by Larry Hand                                                                        Dec. 9, 2014

Airport exit screening in West Africa and entry screening in the United States have identified few persons potentially infected with Ebola virus, according to an article published online December 9 in the Centers for Disease Control and Prevention (CDC) publication Morbidity and Mortality Weekly Report.

 

 Number of travelers arriving from Guinea, Liberia, and Sierra Leone who were screened for Ebola at US airports, by state and county of destination (October 11 - November 10, 2014). Source: CDC

Of 80,000 travelers who have departed from West Africa since Ebola-specific screening began, 1993 people have been screened on arrival at one of five US airports. Of those, 86 passengers were referred to the CDC public health officers; only seven have shown symptoms and been referred for evaluation. None eventually wound up with an Ebola diagnosis.

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High Risk: 100-Fold Ebola Rate for Health Workers in Sierra Leone

NBC NEWS --  by Maggie Fox                                                                                            Dec. 9, 2014

Health care workers have more than 100 times the risk of catching Ebola in Sierra Leone as the general public there does, according to a new report.

And it's not necessarily down to failed protective measures in hospitals. Health care workers form their own community, and when one gets sick or dies, he or she can infect fellow medics, the report finds.

The World Health Organization has been saying that health care workers such as doctors and nurses are at special risk of Ebola. It says 622 health-care workers have been infected and 346 of them have died in all the affected countries.

Dr. Peter Kilmarx of the U.S. Centers for Disease Control and Prevention, who led an investigation into the high infection rate in Sierra Leone...said  "We think of health care worker infections as a failure of personal protective equipment.,"But there are so many different ways that they are exposed there."

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Ebola Infections Fewer Than Predicted by Disease Models

A few months ago the U.S. Centers for Disease Control and Prevention predicted that up to 1.4 million people in Liberia and Sierra Leone could become infected with Ebola by mid-January. In a recent address to the Senate, CDC director Tom Frieden said that worst-case scenario would not pan out.

That is partly because health care workers in the Ebola hot zone are engaged in a battle to contain the epidemic. It is also because of assumptions about human and viral behavior that are built into the mathematical models used to predict the spread of infectious diseases. Assumptions are inherent in these models. “You take islands of data from different places and build bridges of assumptions that link up all these islands,” says Martin Meltzer, senior health economist at the CDC. Meltzer’s model, which predicted the 1.4 million infections in Liberia and Sierra Leone, worked on the assumption that things would not improve. “Our forecasts are based on the idea that nothing will change,” he says.

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