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Ebola’s lessons, painfully learned at great cost in dollars and human lives

In-Depth report on lessons to be learned from the Ebola crisis

THE WASHINGTON POST by By Lena H. Sun, Brady Dennis and Joel Achenbach                            Dec. 29, 2014

A year after it began, the Ebola epidemic in West Africa continues to be unpredictable, forcing governments and aid groups to improvise strategies as they chase a virus that is unencumbered by borders or bureaucracy.

The people fighting Ebola are coming up with lists of lessons learned — not only for the current battle, which has killed more than 7,500 people and is far from over, but also for future outbreaks of deadly contagions.

Alice Jallabah, head of a bushmeat seller group, holds dried bushmeat in Monrovia. (Zoom Dosso/AFP/Getty Images)

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Year in Review: Efforts to stop Ebola are gaining ground, but the fight isn't won

Ebola: Year in Review of 2014 developments
LOS ANGELES TIMES      by Alexandra Zavis                   Dec. 28, 2014

...As 2015 approaches, there is reason to hope that what at first was a plodding international response is finally catching up with the virus. In Liberia, where just a few months ago bodies were left in the streets for days and patients were turned away from treatment facilities because there weren't enough beds or personnel, the number of cases has been dropping rapidly. There are also signs that the disease may be slowing in Sierra Leone, which has overtaken Liberia as the country with the biggest caseload.

...Although the tactics being used have stemmed smaller Ebola outbreaks, some experts are beginning to question whether this one has spread too far to be fully contained without a vaccine or cure.

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Ebola death toll rises to 7,588 globally, WHO says

AFP                                                                                         Dec. 26, 2014

The global death toll from Ebola has risen to 7,588 out of 19,497 confirmed cases recorded in the year-old epidemic raging in West Africa, the World Health Organization (WHO) says.

The virus is still spreading intensely in Sierra Leone, especially in the north and west, with 315 new confirmed cases reported in the former British colony in the week to December 21, it said. These included 115 cases in the capital Freetown.

"The neighbouring district of Port Loko experienced a surge in new cases, reporting 92 confirmed cases compared with 56 the previous week," the WHO said.

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http://www.cbc.ca/news/business/ebola-death-toll-rises-to-7-588-globally-who-says-1.2884197

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

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GSK Ebola vaccine trial seen moving to wider phase in February

REUTERS                                                                                              Dec. 19, 2014

Trials of GlaxoSmithKline's experimental Ebola vaccine are likely to move to a second phase in February, later than previously suggested, after a meeting of national regulators said they needed more information.

The World Health Organization, which hosted a meeting of national regulatory authorities and ethics committees earlier this week, said they had thoroughly discussed all aspects of the proposed trials at the two-day meeting.

"Reviewing countries requested additional documentation from the manufacturer of the vaccine, GlaxoSmithKline, before authorization of the trials," the WHO said in a statement.

Countries where the trials are planned -- Cameroon, Ghana, Mali, Nigeria and Senegal -- should receive and review the additional information by the end of January.

"If these steps are completed to the satisfaction of the national authorities, Phase II trials are likely to begin in February," the statement said.

The GSK vaccine is already undergoing Phase I trials, to check its safety in humans, in Switzerland, Britain, Mali and the United States, and is one of the two leading candidate vaccines for Ebola already undergoing tests.

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Mali says has no remaining Ebola cases as last patient recovers

REUTERS                                                                                  Dec. 11, 2014
BAMAKO-Mali has no remaining cases of the Ebola virus as the last patient in the country has recovered and left hospital, the Ministry of Health said on Thursday.

Six people have died of Ebola in Mali, while two others have recovered. The country is the sixth West African state to be hit by the worst outbreak on record of the hemorrhagic fever.

Ebola first entered Mali through an infant girl who died of the disease in October after arriving from neighboring Guinea. Later that month, an imam who also arrived from Guinea with the disease died in Mali. He infected other people.

"The only remaining case in treatment has recovered and has been released today so there are no more people sick with Ebola in Mali," said Ministry of Health spokesman Markatié Daou.

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http://www.reuters.com/article/2014/12/11/us-health-ebola-mali-idUSKBN0JP2HG20141211

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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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Experts call for faster mobilisation of “overlooked” survivors to contain Ebola epidemic

OXFORD UNIVERSITY PRESS                                                                                  Dec, 10, 2014

In an editorial published online today in the International Journal of Epidemiology, experts from the Departments of Psychiatry and Epidemiology at Columbia University, New York, are calling for survivors of the Ebola epidemic to be mobilised in a bid to hasten containment of the disease.

We already know that the current Ebola outbreak is unique in its magnitude and for its dispersion in dense, mobile populations. Physicians and nurses face high mortality, and foreign aid in the form of medical supplies and staff continues to be unequal to the scope of the problem. With a case recovery rate of around 30% at the present time in West Africa, survivors already number in the thousands.

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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 still spreading in western Sierra Leone, Guinea's forest: U.N

REUTERS    By Stephanie Nebehay                                                                                 Dec. 9, 2014
GENEVA --More foreign health workers are needed to help tackle the Ebola epidemic, which is spreading quickly in western Sierra Leone and deep in the forested interior of Guinea, a senior U.N. official said on Tuesday.

A woman walks pass an Ebola virus awareness campaign poster in Monrovia, December 8, 2014. Credit: Reuters/James Giahyue

The death toll from the Ebola outbreak in West Africa has risen to 6,331 in the three worst hit countries, with Sierra Leone overtaking Liberia as the country with the highest number of cases, the World Health Organization says.

"We know the outbreak is still flaming strongly in western Sierra Leone and some parts of the interior of Guinea. We can't rest, we have to still push on," said David Nabarro, the U.N. Special Envoy on Ebola.

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