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Clinical Illness and Outcomes in Patients with Ebola in Sierra Leone

NEW ENGLAND JOURNAL OF MEDICINE

A study and analayisis of patients in Siere Leone suspected of Ebola infections, tested between May 25 and June 18, 2014
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http://www.nejm.org/doi/full/10.1056/NEJMoa1411680#t=articleTop

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Lack of federal authority makes fashioning coherent national Ebola policy difficult

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

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Home> Health Ebola: Danger in Sierra Leone, Progress in Liberia

UPDATE WITH TEXT OF LATEST WHO REPORT

http://apps.who.int/iris/bitstream/10665/137376/1/roadmapsitrep_29Oct2014_eng.pdf

 

ASSOCIATED PRESS                                                                      Oct. 30, 2014
By CLARENCE ROY-MACAULAY and JONATHAN PAYE-LAYLEH

FREETOWN, Sierra Leone --Liberia is making some progress in containing the Ebola outbreak while Sierra Leone is "in a crisis situation which is going to get worse," the top anti-Ebola officials in the two countries said.

The people of both countries must redouble efforts to stop the disease, which has infected more than 13,000 people and killed nearly 5,000, the officials said. Their assessments underscore that Ebola remains a constant threat until the outbreak is wiped out. It can appear to be on the wane, only to re-emerge in the same place or balloon elsewhere if people don't avoid touching Ebola patients or the bodies of those who succumb to the disease.

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No Ebola, S'il Vous Plait, We're French: The Ivory Coast Mindset

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.

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Rate of new Ebola infections in Liberia is slowing, WHO says

OVERVIEW OF DEVELOPMENTS DURING PAST DAY

WASHINGTON POST                            Oct. 30, 2014
By Lena H. Sun, Brady Dennis and Joel Achenbach
New Ebola infections in virus-ravaged Liberia appear to be declining for the first time in months, the World Health Organization said Wednesday.

Until now, officials have been suspicious of this encouraging trend, thinking it might be an artifact of poor data collection, a symptom of chaos in countries that were overwhelmed by the crisis. But Bruce Aylward, a top WHO official, said Wednesday that the decline in new cases “is real,” measured by scores of empty beds in Ebola clinics, fewer cases confirmed by laboratory tests and a drop in burials by specially trained teams.

Still, the WHO and other officials remain wary because the nature of this outbreak has been one of unpredictable surges and declines.

“It’s like saying your pet tiger is under control,” Aylward said. “This is a very, very dangerous disease.”

Meanwhile President Obama continued to criticize the calls for mandatory quarantines for returning volunteers

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Ebola Virus Disease and the Need for New Personal Protective Equipment

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

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Ebola: California is latest state to impose 21-day quarantine for those exposed to Ebola

SAN JOSE MERCURY NEWS                                                        Oct. 29, 2014

By Julia Prodis Sulek

California on Wednesday became the latest state to order a 21-day quarantine for travelers who have been in close contact with Ebola patients.

In an attempt to avoid the criticism lodged against New York, New Jersey and Maine that had blanket quarantine orders, however, California will allow county health agencies to impose the quarantine on a case-by-case basis.

By working with county health departments to assess the individual risks, the California Department of Public Health said it "respects the individual circumstances of each traveler while protecting and preserving the public health."

Quarantine can range from observation and monitoring to the "limitation on his or her freedom of movement."

In the Bay Area, a Stanford doctor who returned last week from Liberia where he was treating Ebola patients was already being monitored by the San Mateo County Department of Public Health. The department coordinated with the CDC and San Francisco International Airport when Dr. Colin Bucks arrived late last week. He had no symptoms of the disease and came to an agreement with health officials to avoid contact with others but can leave the house for limited activities, such as jogging alone.

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Assessing the Science of Ebola Transmission

THREE ARTICLES DESCRIBING DETAILS OF THE EBOLA VIRUS AND OTHER VIRUSES.
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Advances in microscopy have allowed scientists like Sriram Subramaniam and colleagues at the National Cancer Institute to look at the workings of tiny viruses. In this case, microscopy was used to illustrate the complex process in which human cells infected with HIV-1, green and blue, are linked to uninfected cells. Credit Illustration by Donald Bliss/N.I.H, from The Journal of Virology/American Society for Microbiology

The research on how the virus spreads is not as ambiguous as some have made it seem

THE ATLANTIC                                                                                                          Oct. 28, 2014

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How Ebola quarantines actually work, explained

A young man, dressed in a biohazard costume, stands on the corner of 546 West 147th Street in New York City. Bryan Thomas/Getty Images

VOX                                                                       Oct. 29, 2014
By Julia Bellez
As Ebola fears wash over America, some state governors are turning to mandatory quarantines: locking up healthy workers returning from West Africa for 21 days, Ebola's incubation period. The policy in New Jersey made national headlines after it resulted in a nurse who had no Ebola symptoms — and had been fighting the disease in West Africa, no less — being isolated in a poorly heated tent with no running shower or toilet.

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US Health Care Unprepared for Ebola

      

The U.S. health care apparatus is so unprepared and short on resources to deal with the deadly Ebola virus that even small clusters of cases could overwhelm parts of the system, according to an Associated Press review of readiness at hospitals and other components of the emergency medical network.

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