Additonal  Nigerian and British health workers arrive in Liberia and Sierra Leone to help counter Ebola

(Two stories, scroll down)

REUTERS  by James Harding Giahyue and Umaru Fofana   Dec. 5, 2014
MONROVIA/FREETOWN --More than 175 Nigerian medics arrived in Liberia and Sierra Leone on Friday to join the fight against Ebola, the first of 600 volunteers promised by the regional giant which contained its own outbreak earlier this year.

An army medic teaches NHS staff how to dispose of potentially contaminated waste last month, before their deployment to Sierra Leone. Photograph: Simon Davis/AFP/Getty Images

The medics will boost weak local health systems that are also struggling to contain other preventable diseases as Ebola discourages people from going to clinics for fear of contracting the fever.

"This is the African spirit you are showing, this is the Nigerian spirit,” Nigeria's ambassador to Liberia, Chigozie Obi-Nnadozie, told 76 Nigerian medics who landed there.

Another 100 volunteers landed in Freetown, Sierra Leone. Months into the Ebola response, experts say they are still short of medical personnel to staff treatment centers.

ASSOCIATED PRESS by EDITH M. LEDERER                                                                             Dec. 5, 2014

UNITED NATIONS -- Sierra Leone said Friday that between 80 and 100 new cases of Ebola are being reported every day and the country now hardest-hit by the deadly virus desperately needs over 1,000 beds to treat victims.

Sierra Leone's Finance Minister Kaifalah Marah painted a grim picture to the U.N. Economic and Social Council Friday of the challenges facing his West African nation which failed to meet a World Health Organization interim goal of isolating 70 percent of Ebola patients and safely burying 70 percent of victims by Dec. 1.

The two other hard-hit countries, Liberia and Guinea, did meet the deadline, and the U.N.'s Ebola chief Dr. David Nabarro said the number of new cases in Liberia has dropped from 60 per day in September to 10 per day. ...

THE ASSOCIATED PRESS By JONATHAN PAYE-LAYLEH and MIKE CORDER                                                Dec. 5, 2014

MONROVIA- A U.N. peacekeeper who contracted Ebola in Liberia will be flown to the Netherlands for treatment, a Dutch Health Ministry spokeswoman said Friday.

The Nigerian soldier is expected to arrive in the Netherlands this weekend and will go into isolation at the University Medical Center Utrecht, according to Inge Freriksen.

This is the third infection for the mission, which comprises about 7,700 troops and police. The previous two died.

Sixteen people who came into contact with the Nigerian soldier have been quarantined, the mission said.

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http://abcnews.go.com/International/wireStory/peacekeeper-liberia-tests-positive-ebola-27383914

THE GUARDIAN  by Sarah Boseley in Freetown and Lisa O'Carroll
Dec. 5, 2014

Basic medical interventions such as giving Ebola patients rehydration salts and fluids from bigger bags could cut the death toll in west Africa in the absence of a proven cure, experts in tropical diseases write on Friday in the Lancet.

The doctors say it is “therapeutic nihilism” to assume there is no treatment for Ebola just because there are no drugs. It is likely, they say, that many patients die because of dehydration.

UPDATE: Liberia court suspends ban on mass gatherings in Monrovia

REUTERS  By James Harding Giahyue                                                         Dec. 7, 2014                                                                                    

MONROVIA --Liberia's top court issued a stay on a government order banning public gatherings in the capital ahead of Senate elections next week that was imposed because electioneering risks spreading Ebola, Information Minister Lewis Brown said on Sunday.

Presiding Associate Justice Philip

On Monday, the court will hear a petition by civil society groups, prominent citizens and some political parties who seek a delay to the Senate elections, now set for Dec. 16, until Ebola is eradicated.

On Wednesday, the court will hear a separate petition by independent Senate candidate Robert Sirleaf, the son of President Ellen Johnson Sirleaf.

issued the stay pending two Supreme Court hearings this week, Brown said.

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UNITED NATIONS NEWS CENTRE                                                                             Dec. 4, 2014
Four hundred motorbikes equipped with cooler boxes will help speed up deliveries of blood samples to laboratories from remote areas of Guinea, Liberia and Sierra Leone and reduce the waiting time for Ebola test results, thanks to a donation today from Germany to the United Nations.

Four hundred cooler box-equipped motorbikes for the Ebola Response were officially handed over to the UN Humanitarian Response Depot by German Ambassador to Ghana Ruediger John, and will be used to bring blood samples to labs in the most affected areas of Sierra Leone, Liberia, and Guinea. UNMEER Photo/Martine Perret

At UN Headquarters, meanwhile, UN Secretary-General Ban Ki-moon told reporters that the immediate priorities of the United Nations are to stop the virus and to treat all the people who have Ebola. “We have to ensure that all essential services are provided, and also we have to help them preserve their social and political stability, and keeping a further outbreak from happening.”

WASHINGTON POST  by Lena H. Sunand and Kevin Sieff                                               Dec. 14, 2014

The United States is weighing an increase in aid, including a possible military component, to help fight the Ebola outbreak in Sierra Leone, the country in West Africa where the deadly virus is spreading the fastest, officials said Thursday.

“We are looking at what more can be done in Sierra Leone, recognizing that is the forefront when it comes to the virus, and we’re clearly looking at all options,” said a senior administration official who spoke on the condition of anonymity because he was not authorized to discuss policies that are being formulated.

“Nothing is off the table,” he said. “If we determine that only the U.S. military with its unique capabilities can bring this under control, it is something we are willing to consider.”

Among the options is shifting foreign medical teams from­ ­Liberia to Sierra Leone, said ­Andrew Weber, the State Department’s deputy coordinator for Ebola response, in an interview.

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WIRED     Essay by David Burris                                                                                        Dec. 14, 2014

...Deadly and infectious viruses such as Ebola are an inevitable and unavoidable fact of nature. In other words, they are examples of a Hard Trend. And they demand new innovations in order to combat them.

...the deadly force of Ebola is the kind of imminent threat that inspires human minds to new heights. It teaches us that Hard Trends come at us fast and provide the catalyst to overcome inertia and bring about technological innovations.

NIAID/Flickr

Communication is key to mobilizing populations in countries affected by Ebola. In order to treat the sick and prevent the spread of the disease, healthcare workers need to be able to coordinate with people on the frontline and know where to send supplies. At the moment, telecommunications technologies are not keeping pace with the intense demands that Ebola creates.

NEW YORK TIMES --by Gardiner Harris                                                                                 Dec. 4, 2014

AMRAVATI, India — A deadly epidemic that could have global implications is quietly sweeping India, and among its many victims are tens of thousands of newborns dying because once-miraculous cures no longer work.

Everybody and his uncle, it seems, has an idea of something that might work to cure people infected with the deadly virus

 SCIENTIFIC AMERICAN    By Helen Branswell                        Dec. 4, 2014

When it comes to treatments for Ebola, there has been a nearly four-decade-long drought. Nothing in the medical arsenal attacks the virus directly....

Dr. John M. Dye, Jr., U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) Viral Immunology branch chief, works in a laboratory at the USAMRIID headquarters in Frederick, Maryland. Dr. Dye is leading a team that is conducting a study with nonhuman primates involving the experimental drug ZMapp, an experimental treatment for Ebola patients. Credit: CDC

MILITARYNEWS.COM  by Richard Sisk                            Dec. 3, 2014

The U.S. military was scaling back its efforts against Ebola in Liberia amid encouraging signs of progress against the epidemic, Army Gen. David Rodriguez said Wednesday.

U.S. personnel construct the Monrovia Medical Unit site in Monrovia, Liberia. The MMU is being constructed in the event any medical workers in the area catch Ebola while assisting in Operation United Assistance. Craig Philbrick/Army

The military initially planned to construct 17 treatment centers of 100 beds each in Liberia, but will now set up 10 centers for virus victims. The first three centers will have 100 beds, but the remaining seven will have 50 beds, Rodriguez, head of U.S. Africa Command, said at a Pentagon briefing.

Rodriguez also said the military was looking at possibly easing the 30-day quarantine period for troops returning from West Africa. However, he stressed that no decisions had been made.

November 21, 2014 - A family behind a bright orange quarantine rope learns of the death of a family member.
Nikki Kahn/The Washington Post

WASHINGTON POST--by Kevin Sieff                                                                 Dec. 4, 2014
KOINADUGU, Sierra Leone --
...Six months after the world’s largest Ebola outbreak began, experts say one of their biggest challenges is persuading people to trust the medical system. Families still hide suspected Ebola victimsor refuse to take them to health facilities. The problem exists in Liberia, but some foreign health officials say it’s even more daunting in Sierra Leone, where the transmission rate continues to climb even as it declines in the neighboring country.

In rural areas like Koinadugu, a district bordering Guinea, the problem is especially severe. There is no electricity or running water, let alone a modern hospital. Medicine usually means local herbs, generic malaria pills or the advice of a local healer. People whisper that disinfectant spreads the disease rather than kills it.

BLOOMBERG--By Andrew Pollack and Doni Bloomfield                                                                  Dec.4, 2014

ATLANTA-- An American health worker who may have been exposed to the Ebola virus arrived at an Atlanta hospital today for possible treatment after being evacuated by air from West Africa, where the outbreak is at its worst.

The health worker, who hasn’t been publicly identified, was admitted this morning at Emory University Hospital, which has successfully treated four other Ebola patients, the hospital said in an e-mail.

“Emory cannot share more details out of respect for patient privacy and in accordance with the patient’s wishes,” the hospital said. Phoenix Air, a medical charter company, flew the patient from West Africa, according to the statement. Earlier this week, Emory was named one of 35 U.S. hospitals designated to treat Ebola patients.

Emory didn’t say in what country the health worker may have been exposed.
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http://www.bloomberg.com/news/2014-12-04/health-care-worker-who-may-have-ebola-headed-to-u-s-.html

VOICE OF AMERICA                                      Dec. 3, 2014

New data shows the Ebola outbreak intensifying in Sierra Leone, even as it stabilizes or drops off in other West African countries.   (Scroll down for link to WHO roadmap.)

The World Health Organization says Sierra Leone reported 537 new confirmed cases in the week ending November 30, a jump of more than 150 over the week before.  

In its latest update Wednesday, the WHO says "transmission remains persistent and intense across the country with the exception of the south."  The worst affected area was the capital, Freetown, where more than 200 new cases were reported.  

According to the WHO, the number of Ebola cases worldwide is more than 17,000, with all but a few dozen in Sierra Leone, Guinea and Liberia.  The overall death toll is up to 6,070.

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http://www.voanews.com/content/ebola-spreading-faster-in-sierra-leone/2544743.html?utm_source=December+4+2014+EN&utm_campaign=12%2F4%2F2014&utm_medium=email

THE NEW ENGLAND JOURNAL OF MEDICINE                                                                                 Dec. 3, 2014
By Edward Cox, M.D., M.P.H., Luciana Borio, M.D., and Robert Temple, M.D.

...Studying investigational therapies for EVD presents scientific, practical, and ethical challenges. Not surprisingly, there has been substantial debate about the best and most appropriate study approaches.2,3 It is generally agreed that a trial with a concurrent control group, in which patients are randomly assigned to receive the test drug plus the best available supportive care (BASC) or to BASC alone, would be the most efficient and reliable way to evaluate the safety and effectiveness of candidate products.

 Some people in the health care community, however, have argued against such trials, urging instead use of a historical control — that is, making investigational drugs as widely available as their supply allows and then comparing mortality rates among treated patients with rates that would have been expected absent the drugs, on the basis of past experience with EVD.