Situation Report

Guinea's Ebola cases rise sharply, as cases ebb elsewhere

CENTER FOR INFECTIOUS DISEASE RESEARCH AND POLICY by Lisa Schnirring                                March 18, 2015
(Scroll down for link to full WHO Situation Report.)

Though Ebola patterns look promising in Sierra Leone and Liberia, the number of new confirmed cases spiked in Guinea last week, underscoring tough challenges that remain there, such as gaps in contact tracing and unsafe burials, the World Health Organization (WHO) said today.

For the third week in a row, Liberia reported no confirmed Ebola cases, and cases declined slightly in Sierra Leone, the WHO said in its weekly epidemiologic analysis of the outbreak.

Overall, 150 new confirmed Ebola cases were reported in the outbreak region last week, up from 116 the week before. The number of confirmed, probable, and suspected cases in the three countries has risen to 24,666, with death total increasing to 10,179.

...The WHO warned that although Ebola's footprint is now limited to a narrow area, the population is mobile, posing the risk or reseeding the disease to other districts and countries.

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Sierra Leone plans another shutdown to stop Ebola's spread

ASSOCIATED PRESS by Clarence Roy-Macaulay                                                             March 18, 2015

FREETOWN, Sierra Leone  — Sierra Leone is planning another three-day, countrywide shutdown later this month to ferret out Ebola cases, remind people how to protect themselves from the disease and control its transmission.

The West Africa Ebola outbreak that has killed more than 10,000 people is declining but the disease has remained stubbornly entrenched in parts of Guinea and Sierra Leone. Liberia, the third country severely affected, currently has no Ebola cases.

In the drive to zero cases in Sierra Leone, the government will again ask residents to stay in their homes for three days, Alfred Palo Conteh, head of the country's National Ebola Response Center, said Wednesday. The shutdown is expected to take place March 27 through 29, according to Patrick Fatoma, another official with the Ebola response center.

The government has done this before, and some experts said it was unexpectedly effective in providing information about to control the disease.

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FDA panel to discuss Ebola vaccine development in May

REUTERS                                                    March 18, 2015

WASHINGTON ==The U.S. Food and Drug Administration said an advisory panel will discuss the development of Ebola vaccines, days after an American health worker was flown back after being tested positive for Ebola in Sierra Leone.

The federal health regulator would discuss the development of vaccines on May 12, it announced on its website on Wednesday.

The resurgence of the virus last year prompted drugmakers from across the world to develop new treatments that are in different stages of studies....

The World Health Organization said it will decide on mass vaccination against the virus in August.

See full story.

http://www.reuters.com/article/2015/03/18/us-health-ebola-fda-idUSKBN0ME1D520150318
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See Federal Register notice of meeting.

https://www.federalregister.gov/articles/2015/03/17/2015-06116/vaccines-and-related-biological-products-advisory-committee-notice-of-meeting

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Ebola Epidemic: Why a Few Cases Could Threaten Progress

LIVE SCIENCE by Rachel Rattner                                                                                 March 18, 2015

Health officials have made tremendous progress in fighting the Ebola epidemic in West Africa in recent months, but continued efforts are still needed, experts say. That's because the cases that are happening now could be enough to restart the whole epidemic....

Although health officials are trying to trace all of the people who had contact with each Ebola patient, this "contact tracing" is far from perfect in Guinea and Sierra Leone. As a result, cases pop up among people who officials didn't know were at risk. For example, so far this month, just 14 percent of cases in Guinea occurred among people who were known to have had contact with someone who was sick with Ebola, WHO says.

This "shadow epidemic," which is occurring under the radar, is very worrisome, said Dr. Amesh Adalja, a senior associate and infectious disease physician at the Center for Health Security at the University of Pittsburgh.

If this shadow transmission continues, "it will threaten to cause this whole outbreak to reignite again," Adalja said. "You have to make sure you're finding every case, and stopping transmission in every case."

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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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4 more aid workers flown back to US for Ebola monitoring

ASSOCIATED PRESS                                March 17, 2015

NEW YORK — Four more American aid workers arrived back in the United States on Tuesday from West Africa to be monitored for Ebola, health officials said.

The latest arrivals bring to 16 the number of aid workers who have returned from Sierra Leone since Friday. None of them have been diagnosed with Ebola, but they will be isolated and monitored during the next three weeks for signs of the disease.

Officials have released few details, citing patient privacy. But all are connected to — or had direct physical contact with — another American who came down with Ebola last week in Africa. The unidentified man is in critical condition at a National Institutes of Health hospital in Bethesda, Maryland.

The other aid workers are staying near the Maryland hospital or hospitals in Atlanta and Omaha with special isolation units — in case they become sick, according to officials with the Centers for Disease Control and Prevention.

Read complete story.
http://www.bostonherald.com/news_opinion/national/2015/03/4_more_aid_workers_flown_back_to_us_for_ebola_monitoring

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Care Differs for American and African With Ebola

NEW YORK TIMES  by Sheri Fink, MD                                                           March 17, 2015
    
The latest American aid worker to contract Ebola overseas, last week in Sierra Leone, was swiftly evacuated to a specialized treatment center for infected health workers run by the British Defense Ministry in the country’s capital, Freetown, then on to the National Institutes of Health clinical center in Bethesda, Md. Doctors at the center said Monday that his condition had worsened from serious to critical since his arrival on Friday.

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Ebola: Moving from emergency to recovery

DEVEX   by Richard Jones                                                         March 17, 2015

(scroll down for link to EU statement.)

As the death toll from Ebola now tops 10,000 in West Africa, donors and aid implementers are figuring out how to best transition from the emergency to the recovery phase of the crisis.

Top EU and U.N. officials, leaders of Ebola-affected nations and representatives from the African Union, nongovernmental organizations, the private sector and the scientific community met in Brussels, Belgium, earlier this month to make progress on this goal. They agreed to embark on the design of a road map to help the economies of Guinea, Sierra Leone and Liberia get back on track, starting with the priority task of rebuilding health systems.

But that, of course, will be no easy feat.

“We are at a really crucial stage of the real fight against Ebola, because this is a turning point when the emergency stage or the emergency response or medical response to Ebola containment is now turning into coordinating and structuring the long-term recovery program,” European Commissioner for International Cooperation and Development Neven Mimica said in an exclusive interview with Devex at the Palais d’Egmont in Brussels.

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Ebola: Getting to Zero

For communities, for children, for the future

UNICEF                                                                                                             March 16, 2015

As slight hints of recovery begin to surface in West Africa, UNICEF is looking at the impact of Ebola on children and the response and work of the affected communities in the report, Ebola: Getting to zero – for communities, for children for the future.

 The document traces some of the outbreak’s history along with the stories of survivors, health care workers and those working to make things better on the ground. The report also helps map out the actions that urgently must continue to help build resiliency and resuscitate basic services and systems decimated by Ebola.

Read the report

http://www.unicef.org/emergencies/ebola/files/EbolaReport.pdf

Also see additional information in the links below:

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Preparing for Ebola, but Stopping Lassa Fever

NEW YORK TIMES  by Pam Belluck                           March. 17, 2015

Last fall, with the Ebola epidemic raging, the small nation of Benin, a few countries away from the outbreak zone, experienced a cluster of unexplained deaths.

In mid-October, a 12-day-old baby was taken to a hospital in Tanguiéta, in northwest Benin, and died two days later. By early November, three employees of the hospital, St. Jean de Dieu, were dead too.

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