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Survey Finds Many Physicians Overestimate Their Ability to Assess Patients’ Risk of Ebola

massgeneral.org - August 27, 2015

While most primary care physicians responding to a survey taken in late 2014 and early 2015 expressed confidence in their ability to identify potential cases of Ebola and communicate Ebola risks to their patients, only 50 to 70 percent of them gave answers that fit with CDC guidelines when asked how they would care for hypothetical patients who might have been exposed to Ebola. In addition, those who were least likely to encounter an Ebola patient – based on their location and characteristics of their patients – were most likely to choose overly intense management of patients actually at low risk.  The results of the survey, conducted by a team of Massachusetts General Hospital (MGH) investigators, have been published online in the Journal of General Internal Medicine.

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CLICK HERE - RESEARCH - Ebola Risk and Preparedness: A National Survey of Internists 

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CDC - HHS - Ebola Concept of Operations (ConOps) Planning Template

Source:Centers for Disease Control and Prevention (CDC) - Date Published:08/20/2015

Annotation:This 38-page document provides a standard format for creating an Ebola Concept of Operations (ConOps) plan at the state, territorial, or major metropolitan area government level. It provides information on measures local governments, agencies, and organizations can take to support the plan. The ConOps in the template describes strategic, high-level considerations for establishing a regional tiered system to safely and effectively manage persons under investigation (PUIs) or patients confirmed with Ebola.

(38 page .PDF document)
URL: http://www.cdc.gov/phpr/documents/ebola-concept-of-operations-planning-template-8-20-2015.pdf

Authors:Dugas, Robert; Lamoureux, Joe; Mangieri, William; et al.
Type:Guideline/Assessment Tool
ID:11129. From Disaster LitTM, a database of the U.S. National Library of Medicine.

http://disasterlit.nlm.nih.gov/record/11129

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CDC Updates Ebola PPE Guidance for U.S. Health Care Facilities

CDC - American Hospital Association - August 27, 2015

The Centers for Disease Control and Prevention today issued updated guidance regarding personal protective equipment for health care personnel caring for suspected and confirmed Ebola patients in U.S. health care facilities. The changes clarify the use of fluid-resistant and impermeable gowns and coveralls, and provide specifications to assist facilities in selecting and ordering the recommended garments. The updates also provide additional explanation related to PPE for confirmed Ebola patients. For more information, see the updated PPE Frequently Asked Questions.

http://news.aha.org/article/150827-cdc-updates-ebola-ppe-guidance-for-us-health-care-facilities

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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.

Read complete story.
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....

Read complete speech.

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.

Read complete story.

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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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