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Ebola upsurge could undo progress in blink of an eye, warns expert

THE GUARDIAN by Sam Jones                           March 26, 2015

Despite the massive push to bring the number of new Ebola cases down to zero as quickly as possible, there will inevitably be “flare-ups” that could reverse the overall downward trend and prove difficult to contain, the UN’s response co-ordinator has warned.

Dr David Nabarro, the UN’s special envoy for Ebola, said the huge medical, administrative and logistical operation to fight the disease could still be set back by individuals ignoring official advice.

“There will be flare-ups, there will be disappointments; there will be people who evade quarantine – because nobody likes being told to stay put – there will be people who choose not to declare that they’ve got a relative ill, there will be people who get ill and just misdiagnose themselves,” he said....

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Strengthening the Detection of and Early Response to Public Health Emergencies: Lessons learned from, the Ebola outbreake

PLOS MEDICINE by Mark J. Siedner, Lawrence O. Gostin, Hilarie H. Cranmer,and John D. Kraemer                        March 24, 2015

In-depth paper on lessons learned from the West Africa Ebola outbreak

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Pandemic Disease: Never again

As the Ebola epidemic draws gradually to its close, how should the world arm itself against the risks of insurgent infections?

 THE ECONOMIST                                                                                        March 21,  2015

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Ebola Diaries: Hitting the Ground Running

INFECTION CONTROL TODAY                                      March 24, 2015
The World Health Organization (WHO) is publishing a series, "Ebola Diaries," with first-person accounts of WHO staff and others deployed to the field for Ebola response since the first cases were reported in West Africa on March 23, 2014.
 
Dr. Stéphane Hugonnet, team lead for gobal capacities, alert and responses for the World Health Organization (WHO), was one of the first WHO experts sent to Guinea to investigate cases of Ebola reported in late March 2014. A medical doctor who has spent the past 20 years working for WHO, MSF and others, managing outbreaks ranging from cholera, measles and yellow fever, to Lassa, Ebola and meningitis, Hugonnet found a very different sort of outbreak when he arrived in Guinea.

"We were following this rumor of a small cluster of unexplained deaths in Guinea," he says. "Some thought it could be Lassa    phane fever, but the transmission pattern was very compatible with Ebola. When the lab results came back, we learned that there was Ebola Zaire in West Africa.            

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Ebola outbreak 'over by August', UN suggests

BBC   by  Smitha Mundasad                                                                                        March 23, 2015

The Ebola outbreak in West Africa will be over by August, the head of the UN Ebola mission has told the BBC.

 

 Ismail Ould Cheikh Ahmed admitted the UN had made mistakes in handling the crisis early on, sometimes acting "arrogantly".

A year after the outbreak was officially declared, the virus has killed more than 10,000 people...

The head of the UN Ebola response mission told the BBC, when the virus first struck, "there was probably a lack of knowledge and there was a certain degree of arrogance, but I think we are learning lessons.

"We have been running away from giving any specific date, but I am pretty sure myself that it will be gone by the summer."

Read complete story.
http://www.bbc.com/news/health-32009508

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Slow International Response to Ebola Epidemic Cost Thousands of Lives: MSF

TIME MAGAZINE  by Helen Regan                                March 23, 2015
(Scroll down for link to full MSF report.)

Paris-based Doctors Without Borders (MSF) has slammedthe international community’s slow response to the Ebola outbreak in West Africa, saying it cost thousands of lives that could otherwise have been saved.

A Doctors Without Borders (MSF), health worker in protective clothing carries a child suspected of having Ebola in the MSF treatment center on October 5, 2014 in Paynesville, Liberia.

The leading international medical charity released a report Monday coinciding with the one-year anniversary of the outbreak’s start. It said warnings that the disease’s spread was out of control were dismissed as alarmist and that early calls for help were ignored by local governments and the World Health Organization (WHO), reports Reuters.

“For the Ebola outbreak to spiral this far out of control required many institutions to fail. And they did, with tragic and avoidable consequences,” said MSF’s general director Christopher Stokes in the report.

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How to stop the next epidemic

THE ECONOMIST                                                                                    May 19, 2015

..when the next epidemic breaks out, how do we prevent it from spreading around the world? It is easier said than done.
 
First: Early detection is critical, and it relies on good surveillance. But only 64 of the 194 member states of the World Health Organisation (WHO) have the surveillance procedures, laboratories and data-management capabilities required by the International Health Regulations. Improvements in things like basic public health infrastructure are needed...

Second: A swift response to an outbreak – which might involve getting skilled people, equipment and money to the right places – can potentially save more lives than drugs and vaccines. ... The World Health Organisation and the global community were slow to recognise that there was an international public health emergency.

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WHO urges mass vaccination against measles, other diseases in Ebola areas

REUTERS   by Kate Kelland                                       March 21, 2015

LONDON--The World Health Organization warned on Friday of a risk of outbreaks of measles, whooping cough and other diseases in West African countries hit by Ebola and urged a rapid intensification of routine immunizations....

The epidemic has disrupted delivery of routine childhood vaccines against measles, polio and tuberculosis, and of a combined shot against meningitis, pneumonia, whooping cough, tetanus, hepatitis B and diphtheria.

Jean-Marie Okwo-Bele, the WHO's vaccines director, told a briefing in Geneva that the health agency wanted an intensification of immunization services, and mass measles vaccination campaigns in all areas where feasible.

"Campaigns will only be conducted in areas that are free of Ebola virus transmission," he said, stressing that clinics and health workers administering vaccines would be required to adhere to very strict infection control measures.

The WHO sent a warning note to affected countries this week saying: "Any disruption of immunization services, even for short periods ... will increase the likelihood of vaccine-preventable disease outbreaks."

Read complete story.

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Emails: UN health agency resisted declaring Ebola emergency

ASSOCIATED PRESS   by   Maria Cheng and Raphael Satter                                        March 20, 2015

GENEVA  — In a delay that some say may have cost lives, the World Health Organization resisted calling the Ebola outbreak in West Africa a public health emergency until last summer, two months after staff raised the possibility and long after a senior manager called for a drastic change in strategy, The Associated Press has learned.

Among the reasons the United Nations agency cited in internal deliberations: worries that declaring such an emergency — akin to an international SOS — could anger the African countries involved, hurt their economies or interfere with the Muslim pilgrimage to Mecca.

Those arguments struck critics, experts and several former WHO staff as wrong-headed.

"That's like saying you don't want to call the fire department because you're afraid the fire trucks will create a disturbance in the neighborhood," said Michael Osterholm, a prominent infectious diseases expert at the University of Minnesota.

In public comments, WHO Director-General Dr. Margaret Chan has repeatedly said the epidemic caught the world by surprise.

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How to Fight the Next Epidemic

The Ebola Crisis Was Terrible. But Next Time Could Be Much Worse.

 

NEW YORK TIMES OPINION PAGE by Bill Gates                                                           March 18, 2015

(Scroll down for fuller Bill Gates article in the New England Journal of Medicine)

SEATTLE — The Ebola epidemic in West Africa has killed more than 10,000 people. If anything good can come from this continuing tragedy, it is that Ebola can awaken the world to a sobering fact: We are simply not prepared to deal with a global epidemic.

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