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Health - US

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This working group is focused on discussions about health.

The mission of this working group is to focus on discussions about health.

Members

Corey Watts John Girard jonber37 Kathy Gilbeaux Lisa Stelly Thomas Maeryn Obley
mdmcdonald MDMcDonald_me_com mike kraft

Email address for group

health-us@m.resiliencesystem.org

WHO May Lose Credibility After Ebola

Agency seeks a new model after flaws revealed by Ebola crisis.

COMMENTARY MEDPAGE TODAY by Michael Smith            Feb. 15, 2015 

As the Ebola epidemic drags on, the World Health Organization is in danger of losing its credibility as a bulwark against infectious disease.

The West African epidemic is a "mega-crisis (that) overwhelmed the capacity of WHO," according to Director-General Margaret Chan, MD, speaking to reporters in late January.

To prevent a similar crisis in the future, Chan has proposed a package of reforms, including a large contingency fund for emergencies, an increase in the number of trained people able to deploy quickly to a crisis site, and structural changes to streamline the famously unwieldy organization.

Whether those get anywhere is the vital question, according to Lawrence Gostin, JD, of the O'Neill Institute for National and Global Health Law at Washington's Georgetown University.

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Human trial of 4th Ebola vaccine launches in Australia

CENTER FOR INFECTIOUS DISEASE AND POLICY by  Lisa Schnirring                                                      Feb. 13, 2015

Novavax yesterday announced the launch of the first human trial of its recombinant Ebola vaccine, which will make it the fourth candidate vaccine to be tested in phase 1 trials.

Novavax's product is a glycoprotein recombinant nanoparticle vaccine adjuvanted with Matrix M (Ebola GP) to boost immune response. Conducted in Australia, the study will test the safety and immunogenicity of the vaccine, with and without the adjuvant, in 230 healthy adults ages 18 to 50. Subjects will be given two intramuscular injections 3 weeks apart....

Three other Ebola vaccines are in clinical trials. Phase 2 and 3 studies of the two vaccines that are furthest along in trials got under way in Liberia at the end of January. They include two vector virus vaccines, ChAd3, developed by the National Institutes of Health (NIH) and GlaxoSmithKline (GSK), and VSV-EBOV, developed by the Canadian government and licensed by NewLink Genetics and Merck.

A phase 1 trial of a prime-boost Ebola vaccine regimen from Johnson & Johnson launched in early January in the United Kingdom.

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Ebola virus evolution tracked by genetic data

SCIENCE NEWS by Ashley Yaeger                               Feb. 14, 2015
SAN JOSE, Calif. — Genetic data are beginning to reveal how the Ebola virus causing the epidemic in Western Africa is evolving.

            LITTLE TWEAKS  A detailed look at genomes of the Ebola virus has pinpointed mutations that may make one type  of experimental therapy less effective. Cynthia Goldsmith/CDC

Scientists have deciphered the entire catalog of genetic data for 96 Ebola viruses taken from patients infected in 2014 during the first four months of the outbreak.

The results show that one particular clade, or type of the virus, is dominant among patients in Sierra Leone, suggesting that two other clades that dominated early on in the outbreak have died out.

This third clade appears to have evolved starting with a single mutation in the genetic catalog, or genome, of the virus, said Stephen Gire of Harvard University and the Broad Institute in Cambridge, Mass. He presented the preliminary findings February 14 at the annual meeting of the American Association for the Advancement of Science.

Read full article.

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Ebola: UN health agency turns to foreign medical teams in last phase of combat against virus

UNITED NATIONS NEWS CENTRE                                      Feb. 13, 2015
The United Nations World Health Organization (WHO) announced Friday that it will huddle with medical teams from outside the Ebola-affected countries next week in Geneva to see how they can help in the last phases of the fight to bring the number of cases down to zero.
UN Development Program (UNDP) Administrator Helen Clark washes her hands on arrival in Ebola-affected Monrovia, Liberia. Photo: UNDP/Dylan Lowthian

Earlier, UN Development Program (UNDP) Administrator Helen Clark... met with a number community groups in Conakry, Guinea, where she stressed the vital importance of community advocacy in stopping the outbreak. Her mission will conclude with a visit to Sierra Leone early next week.

UNDP is working with the national authorities and local, regional and international partners, including the African Development Bank, the European Union and the World Bank, on an Ebola Recovery Assessment, and in support of national strategies, as part of its mandate to the lead the UN system in the Ebola-related recovery efforts.

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Obama uses war on Ebola to illustrate fight against non-conventional threats

WASHINGTON POST by Juliet Eilperin and Steven Mufson                             Feb. 13, 2015

WASHINGTON --If there is to be war, the fight against Ebola is President Obama’s type of war. The enemy fires no bullets and carries no bombs; it doesn’t use social media to recruit fighters and rally supporters. And the fighting can best be done by intelligent professionals who don’t try to kill people, but to save them.

On Wednesday, Obama celebrated the progress against the deadly virus since the administration launched a military and civilian effort in September. While the president emphasized it was too soon to declare “mission accomplished” — as President George W. Bush did about Iraq in 2003 — Obama said “we’re shifting our focus from fighting the epidemic to now extinguishing it.”

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Doctors Who Treat Ebola Feel More Socially Isolated

LIVESCIENCE.COM   by Rachael Rettner                                                                         Feb. 13, 2015

Doctors who take care of very sick Ebola patients may feel socially isolated, but surprisingly, they may not feel more stressed than usual, a new study from Germany suggests.

Researchers surveyed 46 health care workers who treated Germany's first Ebola patient in August 2014, as well as 40 health care workers who worked in the same hospital but did not treat the Ebola patient.

The researchers who did the study hypothesized that the people who treated the Ebola patient would have more symptoms of psychological distress because they were working in a challenging environment that presented a risk that they could become infected with the deadly virus.

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Ebola in west Africa: learning the lessons

THE LANCET  by  Anna  Petherick  Volume 385, No. 9968, p591–592, 14 February 2015
The (West Africa) region has presented unforeseen challenges, and the three worst affected countries have put in place different response strategies. Anna Petherick reviews some of the lessons learned so far.

The early history of the ongoing Ebola outbreak in west Africa is a salutary statement about the lack of infectious disease surveillance capacity in one of the world's poorest regions....

Opportunities to contain the virus were lost soon after, largely because of a lack of trust between local communities and the officials and medical professionals trying to nip the epidemic in the bud.

Read complete story

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2960075-7/fulltext

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Why Didn't Ebola Kill Me?

An ambulance transports the author to the Nebraska Medical Center in October. (Sait Serkan Gurbuz/Reuters)

THE ATLANTIC by Ashoka Mukpo                                                                          Feb. 12, 2015

Like the majority of patients taken to Western hospitals, I recovered from the disease—but health authorities are still struggling to figure out how to bring up the much-lower survival rate in West Africa.

...the 80-percent survival rate among patients who were evacuated to Western hospitals shattered the idea that an Ebola diagnosis spelled near-certain death. I know this all too well, as I’m one of those patients myself. In October, I contracted Ebola while covering the outbreak as a freelance journalist in Liberia. I was airlifted to a hospital in Nebraska, where aggressive treatment likely saved my life....
Read complete story.

http://www.theatlantic.com/health/archive/2015/02/why-didnt-ebola-kill-me/385335/

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Lack of Effect of Lamivudine on Ebola Virus Replication

CDC EID JOURNAL by  Lisa E. Hensley, Julie Dyall, Gene G. Olinger, and Peter B. Jahrlin (NIH)                     Feb. 12, 2015

The unprecedented number of Ebola virus disease (EVD) cases in western Africa has compelled the world to consider experimental and off-label therapeutics to mitigate the current outbreak. For clinicians, approved drugs are an attractive solution because of known safety profiles and availability.

Oral lamivudine (GlaxoSmithKline, Brentford, UK), a US Food and Drug Administration–approved anti-HIV drug, has been suggested as a possible antiviral agent against Ebola virus (EBOV). In September 2014, a Liberian physician, Dr. Gorbee Logan, reported positive results while treating EVD with lamivudine (1). Thirteen of 15 patients treated with lamivudine survived presumed EVD and were declared virus free. Clinical confirmation of EVD in these cases remains to be verified....

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Postmortem Stability of Ebola Virus

CDC  EID JOURNAL                                              Feb. 12, 2015                                   
Study by Joseph Prescott, Trenton Bushmaker, Robert Fischer, Kerri Miazgowicz, Seth Judson, and Vincent J. Munster

The ongoing Ebola virus outbreak in West Africa has highlighted questions regarding stability of the virus and detection of RNA from corpses. We used Ebola virus–infected macaques to model humans who died of Ebola virus disease.

Assessing the stability of corpse-associated virus and determining the most efficient sampling methods for diagnostics will clarify the safest practices for handling bodies and the best methods for determining whether a person has died of EVD and presents a risk for transmission. To facilitate diagnostic efforts, we studied nonhuman primates who died of EVD to examine stability of the virus within tissues and on body surfaces to determine the potential for transmission, and the presence of viral RNA associated with corpses.

http://wwwnc.cdc.gov/eid/article/21/5/15-0041_article

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