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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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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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Pitt, Drexel, and NIH team up to study persistence of Ebola virus in wastewater

EUREKEALERT                                                                                                               Aug. 25, 2015
PITTSBURGH--The historic outbreak of Ebola virus disease in West Africa that began in March 2014 and has killed more than 11,000 people since, has raised new questions about the resilience of the virus and tested scientists' understanding of how to contain it. The latest discovery by a group of microbial risk-assessment and virology researchers suggests that the procedures for disposal of Ebola-contaminated liquid waste might underestimate the virus' ability to survive in wastewater.

Current epidemic response procedures from both the World Health Organization and the Centers for Disease Control and Prevention advise that after a period of days, Ebola-contaminated liquid can be disposed of directly into a sewage system without additional treatment.

However, new data recently published by researchers from the University of Pittsburgh, Drexel University, and the National Institutes of Health indicate that Ebola can survive in detectable concentrations in wastewater for at least a week or longer.

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http://www.eurekalert.org/pub_releases/2015-08/uop-pda082515.php

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WHO Director-General addresses the Review Committee of the International Health Regulations focused on the Ebola response

Opening remarks at the Review Committee on the role of the International Health Regulations in the Ebola outbreak and response Geneva, Switzerland by Dr. Margaret Chen Director-General of the World Health Organization
24 August 2015

....Since Ebola first emerged in 1976, WHO and its partners have responded to 22 previous outbreaks of this disease. Even the largest were contained within four to six months....

In West Africa, WHO, and many others, were late in recognizing the potential of the outbreak to grow so explosively. Some warning signals were missed. Why?

Our challenge now is to look for improvements that leave the world better prepared for the next inevitable outbreak.

Managing the global regime for controlling the international spread of disease is a central and historical responsibility of the World Health Organization. We need to pinpoint the reasons why the response fell short,. We need to learn the lessons. We need to put in place corrective strategies just as quickly as possible....

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http://www.who.int/dg/speeches/2015/review-committee-ihr-ebola/en/

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The velocity of Ebola spread in parts of west Africa

THE LANCET by Kate Zinszer and others.                   Aug. 24,2015

In a speed outpacing control efforts, the Ebola virus disease (EVD) epidemic in parts of west Africa spread across Guinea, Liberia, and Sierra Leone infecting an estimated 26 800 individuals and claiming more than 11 000 lives as of May 15, 2015.1 Mobile populations coupled with porous borders1, 2 and commercial air travel patterns3 affected the frequency and breadth of Ebola virus transmission.

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With Many Ebola Survivors Ailing, Doctors Evaluate Situation

ASSOCIATED PRESS  by Carley Petesch              Aug. 23, 2015

DAKAR, Senegal --Lingering health problems afflicting many of the roughly 13,000 Ebola survivors have galvanized global and local health officials to find out how widespread the ailments are, and how to remedy them.

The World Health Organization calls it an emergency within an emergency. Many of the survivors have vision and hearing issues. Some others experience physical and emotional pains, fatigue and other problems. The medical community is negotiating uncharted waters as it tries to measure the scale of this problem that comes on the tail end of the biggest Ebola outbreak in history.

"If we can find out this kind of information, hopefully we can help other Ebola survivors in the future," Dr. Zan Yeong, an eye specialist involved in a study of health problems in survivors in Liberia, told The Associated Press.

About 7,500 people will enroll — 1,500 Ebola survivors and 6,000 of their close contacts — and will be monitored over a five-year period in the study launched by Partnership for Research on Ebola Vaccines in Liberia, or PREVAIL.

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Cheap Paper Test to Screen Patients for Ebola, Yellow Fever, Dengue

MEDGADGET                                                                                   Aug. 20, 2015

BOSTON --At the 250th National Meeting & Exposition of the American Chemical Society this week, researchers from MIT, Harvard Med School, and the FDA are showing off a new field test that can quickly screen people for Ebola, yellow fever, and dengue. While the researchers don’t claim their technique to be as accurate as PCR and ELISA, it is nevertheless an excellent tool in poor areas of the world where these diseases tend to thrive.

The test doesn’t require any water or electricity nor any complicated and expensive equipment. It works similar to pregnancy tests, providing a color readout that signals whether a disease is detected that is easily readable by just about anyone.

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Ebola: What Happened

COUNCIL ON FOREIGN RELATIONS  BY John Campbell
(Scroll down for Laurie Garett's essay "Ebola's Lessons.")

With a rapidly growing and urbanizing population, persistent poverty, and weak governance, Sub-Saharan Africa is likely to be the source of new epidemics that potentially could spread around the world. Understanding the disastrous response of African governments, international institutions, and donor governments to the Ebola epidemic is essential if history is not to be repeated yet again. That makes Laurie Garrett’s essay, “Ebola’s Lessons,” in the September/October 2015 issue of Foreign Affairs, essential reading.

The Ebola virus treatment center where four people are currently being treated is seen in Paynesville, Liberia, July 16, 2015. (Courtesy Reuters/James Giahyue)

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Some Ebola Survivors Still Suffer—And Doctors Don’t Know Why

SCIENCE    by  Katie  M. Palmer                      Aug. 15, 2015

For the communities in Guinea, Sierra Leone, and Liberia where Ebola took the greatest toll last year, the worst is over. After claiming 11,000 lives, the fatal virus has finally begun to retreat. Numbers of new Ebola cases are dwindling. But for some of the survivors—the 50 percent or so of the infected who pull through—Ebola’s effects still linger.

                            Ebola survivor Fayiah, 11, sits with her relatives in Monrovia, Liberia. Jerome Delay/AP

For the communities in Guinea, Sierra Leone, and Liberia where Ebola took the greatest toll last year, the worst is over. After claiming 11,000 lives, the fatal virus has finally begun to retreat. Numbers of new Ebola cases are dwindling. But for some of the survivors—the 50 percent or so of the infected who pull through—Ebola’s effects still linger.

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Handwashing in W.African schools protects children, families from Ebola: UN

REUTERS by Monica MacSwan                                                                     Aug. 12, 2015

LONDON -- Handwashing and giving out soap in schools in Guinea, Liberia and Sierra Leone have helped to keep classrooms Ebola-free this year but schools need to remain vigilant after the summer holidays, the U.N. children's agency said on Wednesday.

UNICEF said there had been no reported cases of students or teachers contracting Ebola at a school this year in the three worst-hit countries in West Africa, where the virus has killed nearly 11,300 people since the outbreak began in late 2013.

In Liberia, where there have been as many as 4,800 deaths, two schools were decontaminated as a precaution after one student died in June and another became infected in July.

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