Africa

THE NEW REPUBLIC                                                                      Oct. 29, 2014
ByJonathan Cohen
.... “An Ebola diagnosis need not be a death sentence,” Paul Farmer, an infectious disease specialist at Harvard, wrote in an influential essay for the London Review of Books. “If patients are promptly diagnosed and receive aggressive supportive care—including fluid resuscitation, electrolyte replacement and blood products—the great majority, as many as 90 percent should survive.”

The survival rate in West Africa has been a lot lower than 90 percent...

Discussion of conflicting quarantine guidelines

HOMELAND SECURITY NEWSWIRE                     Oct. 30, 1014
Earlier this week, the Centers for Disease Control and Prevention(CDC) issued new guidelines on how states should deal with travelers from Ebola-stricken regions, but a lack of federal authority to mandate such guidelines has led to conflicting strategies, varying from state to state, which includes mandatory at-home quarantine for some travelers. Under current U.S. law, the states have the authority to issue quarantine or isolation policies, and they also control the enforcement of these policies within their territories.

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http://www.homelandsecuritynewswire.com/dr20141030-lack-of-federal-authority-makes-fashioning-coherent-national-ebola-policy-difficult

NPR                                                  Oct. 29, 2014
By Gregory Warner

There are all kinds of theories why Ebola hasn't arrived in Ivory Coast, despite the fact that it shares a long and very porous border with two Ebola-afflicted countries, Liberia and Guinea....

  Mumadou Traore, a field coordinator for CARE International, says the Ivory Coast's French bureaucracy is a "blessing"    when it comes to Ebola.

Dr. Seydou Coulibaly is the regional health director of Tompki county, which shares the longest border with Liberia and Guinea. He says that in the first weeks of the outbreak, before official prevention directives were issued from the capital, he was telling clinics and hospitals to send him daily Ebola watch reports. He gets a hundred a day. Even before the borders were sealed, he was sending health workers to take people's temperature when they crossed. He's also arranged trainings for schoolteachers and soldiers.

All these efforts will help, he says — maybe not to prevent the virus from coming to the country but at least the first eventual case will be well-managed. That's the main objective.

JOURNAL OF AMERICAN MEDICICAL ASSOCIATION      Oct. 28, 2014
Michael B. Edmond, MD, MPH, MPA¹; Daniel J. Diekema, MD, MS¹; Eli N. Perencevich, MD, MS

"...it is clear that reengineering of personal protecion equipment is required, both in US hospitals but more critically for the outbreak zones in Africa. The use of cumbersome PPE in the extreme heat and difficult working conditions of Ebola treatment centers in Africa places great stress on health care workers and limits the time they can spend providing patient care.

" A novel approach to PPE that provides an impermeable fluid barrier that is both more comfortable and easier to don and remove would be a substantial step forward.

"This will require new materials and designs. Indeed, the US Agency for International Development, White House Office of Science and Technology Policy, CDC, and US Department of Defense have recently announced a campaign to develop and test innovations for PPE in response to the Ebola outbreak."

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http://jama.jamanetwork.com/article.aspx?articleid=1920943