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How to Beat the Next Ebola

submitted by George Hurlburt

             

Graves dug in Freetown, Sierra Leone, to cope with those dying from Ebola in late 2014.  Mads Nissen/Panos

The world is ill-prepared for the next epidemic or pandemic. But the horror of the Ebola outbreak in West Africa may drive change.

nature.com - by Declan Butler - August 5, 2015

If there was one point last year when public-health experts held their breath, it was when a Liberian man infected with Ebola virus flew to Lagos, Nigeria, in July. Ebola was already raging uncontrolled through impoverished countries in West Africa, killing half of those it infected. Now a vomiting man had carried it straight to the heart of Africa's largest megacity — with 21 million inhabitants, many of whom live in slums. Experts were horrified at the prospect that the virus might rip through the city — and then, because Lagos is an international travel hub, spread farther afield.

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Physicians: Global Vaccine Development Fund Could Save Billions

PHARMACEUTICAL PROCESSING by  Princeton University, Woodrow Wilson School of Public and International Affairs   Aug. 6, 2015

Ebola is a preventable disease, and yet a safe and effective vaccine has not been deployed. As with many vaccines, financial barriers persist: pharmaceutical companies see high costs with limited market potential, and government support is lacking. But there may be a solution to this vaccine crisis with the ability to save at-risk populations, according to a perspective piece written by physicians based at Princeton University, University of Pennsylvania and the Wellcome Trust.

The article, published in the New England Journal of Medicine, proposes the creation of a $2 billion global vaccine-development fund - supported by governments, foundations and pharmaceutical companies - that would carry promising vaccines through development to deployment. With initial support, the global vaccine fund could help make vaccines available for emergency use.

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Home > International Sierra Leone Ebola Head Says Country Has 4 Cases

ASSOCIATED PRESS by CLARENCE ROY-MACAULAY  Aug. 6, 2015

FREETOWN -- Sierra Leone has only four recorded cases of Ebola, the West African nation's head of Ebola said Thursday, adding that he is hopeful the countdown to zero can soon begin.

Two of the cases have proven negative after treatments, and the other two, in the north Tonkolili district, are in treatment, said National Emergency Response Center chief Alfred Palo Conteh....

The Tonkolili district remains a worry, he said. Authorities last week quarantined 500 people after a man died from Ebola. The district had not had a single case of Ebola in five months. The victim contracted the disease in the capital, traveled to his home village, and was treated for a fever at the local hospital but authorities didn't call the Ebola emergency number.

He didn't have a burial that followed special procedures required for Ebola victims, and the man's mother and brother contracted the virus.

Read complete story.
http://abcnews.go.com/International/wireStory/sierra-leone-ebola-head-country-cases-32920853

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Only two Ebola cases reported in past week, but risks remain: WHO

REUTERS  by Stephanie Nebehay                           Aug. 4, 2015

Guinea and Sierra Leone each recorded a single cases of Ebola in the past week, putting a year-end goal of ending the deadly epidemic within reach, although risks remain, the World Health Organization (WHO) said on Tuesday.

Tight surveillance and tracing contacts of infected people remain crucial, WHO Assistant-Director Bruce Aylward said. They are especially challenging during the heavy rains in August.

In the previous week to July 26, the two countries had seven confirmed cases, which was the lowest in the past year up until then, according to the WHO.

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http://www.reuters.com/article/2015/08/04/us-health-ebola-who-idUSKCN0Q91JM20150804

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CDC head says Sierra Leone in strong place with Ebola

ASSOCIATED PRESS by Clarence Roy-Macaulay                                                  Aug. 3, 2015

FREETOWN, Sierra Leone  — Sierra Leone is in a stronger place than it was six months ago to fight Ebola, but the new challenge is to get to zero cases, the director of the U.S. Centers for Disease Control and Prevention said Monday during a visit, as new cases emerged in the city and in an area that had not seen the deadly virus for months.

Two new cases of Ebola surfaced in Sierra Leone's Northern Tonkolili District after a man died last week. The district had not had a single case of Ebola in five months. The victim contracted the disease in the capital, traveled to his home village, and was treated for a fever at the local hospital but authorities didn't call the Ebola emergency number. He didn't have a burial that followed special procedures required for Ebola victims....

Dr. Thomas Frieden, CDC director, said it was important that the case was identified and not missed, and he was impressed with the speed of the response.

"The challenge now is to get to zero cases and that is not going to be easy," he said. "Authorities must not let down their guard. The country should keep its guard up."

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What ‘100 Percent Effective’ Means for That Ebola Vaccine

Analysis
WIRED.COM by Katie M. Palmer                                                            Aug. 4, 2015

Last week, the medical journal the Lancet published preliminary results on the efficacy of an Ebola vaccine in Guinea, and everybody got really excited—especially about one particular figure. The vaccine, the results suggested, was 100 percent effective at protecting against Ebola, a thrilling prospect in the face of an epidemic that has killed more than 11,000 people. ...

But that number probably means less than you think it does. It’s based on incomplete data, so it doesn’t have the statistical clout it should. And it never will. Based on the vaccine’s early success, the trial’s runners decided that all participants in the study should get it immediately after exposure. That’s a perfectly reasonable, humane reaction, but it also means that the researchers will never be able to collect better data on the vaccine’s efficacy, which is what regulators look for when they’re deciding to approve a drug. In other words, the vaccine’s early success could make it harder for people to get it down the line.

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More than 70,000 children born during the Ebola outbreak in Liberia at risk of exclusion if not registered, warns UNICEF

UNICEF PRESS OFFICE                                                 July 31, 2015

MONROVIA, Liberia -- UNICEF is supporting a drive by the Liberian Government to register more than 70,000 children whose births were not recorded during the Ebola crisis, leaving them vulnerable to marginalization and exclusion.

Birth registrations in 2014 and 2015 dropped sharply from pre-Ebola levels, according to Ministry of Health data. In 2013, before the onset of the virus, the births of 79,000 children were registered. In 2014, when many health facilities had closed or had reduced services due to the Ebola response, the number of registrations fell to 48,000 – a 39 per cent decrease over the previous year.

Just 700 children are reported to have had their births registered between January and May 2015. 

 

                                                                               © UNICEF/UNI190366/Grile Three month old Success Sumois,     strapped to her mother’s back, waits to be registered through the mobile birth registration team at the Totota Clinic in Liberia.

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UN Ebola mission winds down, WHO takes reins in West Africa

ASSOCIATED PRESS by MARIA CHENG and RAPHAEL SATTER   July 31, 2015

LONDON — The United Nations Mission for Ebola Emergency Response is officially winding down Friday, handing its leadership role and senior staff to the Geneva-based World Health Organization as efforts to contain the deadly virus continue.

"We have reached an important milestone in the global Ebola response," U.N. Secretary-General Ban Ki-moon said in a statement Friday, while noting that that crisis "is not yet over."

The Ebola mission, also called UNMEER, was established last year as WHO struggled to get a handle on an outbreak that has killed more than 11,000 people, mainly in Guinea, Sierra Leone and Liberia. WHO had been strongly criticized for fumbling its response to the epidemic, and the creation of UNMEER was widely seen as a rebuke to its leadership.

Speaking to reporters Friday, UNMEER chief David Nabarro said he had seen signs that WHO had already absorbed some of the lessons of the Ebola disaster, recovering its coordination role in West Africa and deploying more 1,000 staffers to the field.

Read complete story.
http://www.seattlepi.com/news/medical/article/WHO-works-to-reform-itself-after-fumbling-Ebola-6416880.php

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WHITE HOUSE FACT SHEET: The Global Health Security Agenda

The U.S. Government announces it intends to invest more than $1 billion in resources to expand the Global Health Security Agenda to prevent, detect, and respond to future infectious disease outbreaks overseas.

THE WHITE HOUSE PRESS OFFICE                       July 28, 2015

The Ebola epidemic in West Africa continues to galvanize global attention and resources as the international community strives to eliminate active cases and help the affected countries recover.  African leaders and African Union officials have shown extraordinary leadership in addressing the outbreak. The epidemic highlighted the urgent need to establish global capacity to prevent, detect, and respond to biological threats – to prevent future outbreaks from becoming epidemics. 

Beginning with the release of the National Strategy for Countering Biological Threats in 2009, and outlined in his 2011 speech at the United Nations General Assembly, President Obama has called upon all countries to come together to prevent, detect, and respond to infectious disease threats, whether naturally occurring, accidental or deliberately spread.  Today, the President underscored the unwavering U.S. commitment to partnering with Africans, their governments, and all who will join the effort to improve health security across the continent and for all people.

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Ebola death in Sierra Leone leads to mass quarantine

DEUTSCHE WELLE    by Susan Houlton                         July 31, 2015
 
A village in northern Sierra Leone has been placed under quarantine after a post-mortem test revealed a man had died from Ebola. Several hospitals failed to recognize him as a potential victim of the disease.


Earlier this week the World Health Organization (WHO) announced the fewest weekly Ebola infections for over a year in West Africa. However the WHO also said it was bracing for a significant new outbreak in Sierra Leone, which alongside Guinea and Liberia, is one of the worst affected countries.

In the week up to Sunday 26 July, there were four confirmed cases in Guinea and three in Sierra Leone. Those three included a patient who died after travelling from the capital Freetown to the northern district of Tonkolili. He was described by the WHO as posing "a substantial risk of further transmission." The patient had only been confirmed Ebola-positive after post-mortem testing....

According to Hassan Abdul Sesay, a member of parliament from the region where the patient died, the man had traveled to his home village to mark the end of the Muslim holy month of Ramadan.
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