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Offline: A pervasive failure to learn the lessons of Ebola

THE LANCET by Richard Horton                         Sept. 12, 2015

LONDON-- Post-Ebola reverie has given birth to a plethora of expert panels to consider what went wrong. The latest parade of global health specialists appointed to learn lessons gathered at the Wellcome Trust in London last week.
 Under the auspices of the US Institute of Medicine (IOM), a Commission to “deliberate and evaluate options to strengthen global, regional, and local systems to better prepare, detect, and respond to epidemic diseases” spent 2 days amassing evidence.

 There was no shortage of experience brought to bear on these important matters. Here were Margaret Chan, Jeremy Farrar, Ilona Kickbusch, David Heymann, Larry Gostin, Joy Phumaphi, Joanne Liu, and Peter Piot all wrestling with a seemingly intractable challenge. The statements offered to the Commission were arresting. But  the purpose of the meeting was not to talk. It was to identify the best system for an epidemic response....
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http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2900152-X/fulltext

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Guinea passes one week with no new Ebola cases: WHO

AFP   Sept. 9, 2015

Geneva -- Guinea has notched up a week without a new case of Ebola, a first since March 2014, the head of the UN's response to the epidemic, Bruce Aylward, said on Wednesday.

Health workers with a patient under quarantine at the Nongo Ebola treatment centre in Conakry, Guinea on August 21, 2015 (AFP Photo/Cellou Binani)

"As of today, they have gone seven days without a (new) case of Ebola," said Aylward, the World Health Organization's special envoy for the epidemic.

"That is the longest period since March of last year that Guinea has gone without an Ebola case," he added.

There are two people in the country who have Ebola, but they tested postive before September 2.

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http://news.yahoo.com/guinea-passes-one-week-no-ebola-case-142016881.html


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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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Scientists Discover New Use for an Old Therapy Inhibiting Deadly Pathogens Including Ebola and Anthrax

                                                     

CLICK HERE - RESEARCH - Identification of agents effective against multiple toxins and viruses by host-oriented cell targeting

prweb.com - by Cynthia Lujan - September 1, 2015

A new host-based therapy for Ebola, anthrax and other deadly infectious diseases has been discovered by researchers at the Keck Graduate Institute and its collaborators. The discovery has the potential to speed to market treatments for previously untreatable diseases.

The findings were published online on August 27 by Scientific Reports, an open access research journal from the publishers of Nature.

The lead authors of the story were Leoor Zilberminitz and William Leonardi, doctoral students in KGI laboratory of assistant professor Mikhail Martchenko. The researchers screened a library of 1,581 drugs previously approved by the FDA for in vitro protection of mammalian cells against Bacillus anthracis lethal toxin and diphtheria toxin, which normally kill 50-70% of unprotected cells. They then investigated the 1% most promising compounds that both provided the best protection against the two toxins and were not toxic to uninfected cells.

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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.

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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....

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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.

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