Africa

Health workers spray themselves with chlorine disinfectants after removing the body a woman who died of Ebola virus in the Aberdeen district of Freetown, Sierra Leone, October 14, 2014.  Credit: Reuters/Josephus Olu-Mammah

reuters.com - by Emma Farge - November 26, 2014

(Reuters) - Sierra Leone appealed to the United States on Wednesday to send military aid to help it battle Ebola as it falls behind its West African neighbors Guinea and Liberia in the fight against the virus.

The worst recorded Ebola outbreak has killed at least 5,689 people, the World Health Organization said on Wednesday, as the virus has overwhelmed African countries with weak infrastructure and healthcare systemS.

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NATIONAL PUBLIC RADIO   By Kelly Mcevers                                                  Nov. 25, 2014
There's a new phase of Ebola in Liberia. Epidemiologists call it pingponging.

Back in March, the disease was found in the rural areas. Then as people came to the capital to seek care, it started growing exponentially there. Now, some sick people are going back to their villages, and the disease has pingponged to the rural areas again.

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http://www.npr.org/blogs/goatsandsoda/2014/11/25/366381386/as-ebola-ping-pongs-in-liberia-cases-disappear-into-the-jungle

SCIENCE        By Jon Cohen                                                                                         Nov. 21, 2014

...Just a handful of basic interventions to fight the killer effects of Ebola, including dehydration and secondary infections, could dramatically lower the CFR there, says Michael Callahan, an infectious disease specialist at Massachusetts General Hospital in Boston..

With so much room for improvement in supportive care, the current international focus on drugs is “misguided,” says Callahan, who has recently worked in Monrovia and provided care in four previous Ebola outbreaks. “While we wait for months for forthcoming experimental therapies, many lives can be saved, certainly hundreds and possibly thousands, using inexpensive and simple therapies,” he says.

Callahan is helping an international team develop guidelines dubbed Maximum Use of Supportive Therapy (MUST), aimed at keeping more patients alive. It includes intravenous (IV) drips to replace massive fluid loss from diarrhea and vomiting, a risk factor for shock; balancing of electrolytes such as calcium or potassium, which prevents kidney and heart failure; nasogastric tubes for feeding; and testing and treatment of secondary infections such as malaria. Introducing MUST will also make it easier to study new treatments, Callahan says...

PLOS CURRENT OUTBREAKS                                                                              Nov. 21, 2014
By David Fisman and Ashleigh Tuite, Dalla Lana School of Public Health, University of Toronto

As removal of population-level susceptibility through vaccination could be a highly impactful control measure for this epidemic, we sought to estimate the number of vaccine doses and timing of vaccine administration required to reduce the epidemic size. Our base model was fit using the IDEA approach, a single equation model that has been successful to date in describing Ebola growth. We projected the future course of the Ebola epidemic using this model. Vaccination was assumed to reduce the effective reproductive number. We evaluated the potential impact of vaccination on epidemic trajectory under different assumptions around timing of vaccine availability.