Africa

CENTER FOR DISEASE RESEARCH AND POLICY        July 24, 2015

(Also scroll down for: Ebola case definition quandary; Public health worker Ebola unease)

Researchers found that the World Health Organization (WHO) Ebola case definition has a specificity of only 31.5%, and they noted that 9% of Ebola patients reported neither a fever nor any Ebola risk exposure, calling into question WHO norms, according to a large study yesterday in The Lancet Infectious Diseases.

Researchers from Britain and Sierra Leone analyzed data on 850 suspected and 724 lab-confirmed Ebola patients who presented to the holding unit of Connaught Hospital in Freetown from May 29 to Dec 8, 2014. Fever or history of fever (n=599, 83%), intense fatigue or weakness (495, 68%), vomiting or nausea (365, 50%), and diarrhea (294, 41%) were the most common presenting symptoms in suspected cases.

Based on data from these patients, the investigators found the sensitivity of the WHO case definition to be 79.7%, which means about 20% of true Ebola cases would be missed (false-negatives). They found the specificity of the case definition to be 31.5%, which means 68.5% of patients who would be selected for admission would not actually have Ebola virus disease (false-positives).

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CENTER FOR INFECIOUS DISEASE AND POLICY  by Lisa Schnirring     July 22, 2015

The number of new Ebola cases in Guinea and Sierra Leone declined a bit last week, with much of the disease activity centered in the two capital cities for the second week in a row, the World Health Organization (WHO) said in its weekly epidemiologic update today.

Tests confirmed 26 Ebola cases among the two countries, 22 in Guinea and 4 in Sierra Leone. The total is down from 30 reported the previous week, but progress against the disease has been stagnant over the past several weeks, hovering around 25 to 30 cases. Officials, however, said they saw more hopeful signs in contact tracing.

No new cases were reported in Liberia.

Overall, the total in the three countries has reached 27,705 confirmed, probable, and suspected cases, including 11,269 deaths, according to the WHO.

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http://www.cidrap.umn.edu/news-perspective/2015/07/ebola-cases-ebb-bit-conakry-freetown-hot-spots

WHO:  Ebola Situation Report - 22 July 2015

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REUTERS by  Makini Brice                                 July 23, 2015

DAKAR --Anti-corruption campaign group Global Witness on Thursday accused palm oil company Golden Veroleum of taking advantage of the Ebola epidemic in Liberia to double the size of its plantation.

 The Ebola virus treatment center where four people are currently being treated is seen in Paynesville, Liberia, July 16, 2015. Reuters/James Giahyue

Golden Veroleum, controlled by Singapore-listed Golden Agri-Resources, signed a deal with Liberia in 2010 to develop a 220,000 hectare plantation. However, the company also has to reach agreement with local communities that have customary titles over the land.

The company denied any wrongdoing.

CENTER FOR INFECTIOUS DISEASE POLICY AND RESEARCH by Lisa Schnirring     July 20, 2015

Tekmira Pharmaceuticals  announced that it has suspended development of TKM-Ebola, a drug cocktail that showed disappointing human trial results in West Africa, as a convalescent plasma trial at a Doctors Without Borders (MSF) facility in Guinea proceeded with no ill effects in patients so far...

In suspending TKM-Ebola development, the company said that a joint reevaluation of its contract with the US Department of Defense is under way.

In another development, MSF said a convalescent serum trial at its facility in Nongo, Guinea, has enrolled 101 people over the last few months, with no ill effects reported so far, according to a Jul 17 update on the outbreak. Patients at the Nongo treatment unit have the option to receive plasma donated by Ebola survivors....

Meanwhile, detailed testing at a Swiss hospital on a 43-year-old doctor infected with Ebola in Sierra Leone found that viral decay occurred in two phases, once starting 72 hours after symptom onset before any antiviral interventions, with acceleration in viral load decay after ZMAb infusion and oral favipiravir treatments began..

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