In-Depth report on lessons to be learned from the Ebola crisis

THE WASHINGTON POST by By Lena H. Sun, Brady Dennis and Joel Achenbach                            Dec. 29, 2014

A year after it began, the Ebola epidemic in West Africa continues to be unpredictable, forcing governments and aid groups to improvise strategies as they chase a virus that is unencumbered by borders or bureaucracy.

The people fighting Ebola are coming up with lists of lessons learned — not only for the current battle, which has killed more than 7,500 people and is far from over, but also for future outbreaks of deadly contagions.

Alice Jallabah, head of a bushmeat seller group, holds dried bushmeat in Monrovia. (Zoom Dosso/AFP/Getty Images)

Ebola death rate compared to other diseases

BBC   by James Gallagher Health editor, BBC News website         Dec. 27, 2014

The world has witnessed the largest-ever epidemic of Ebola claim thousands of lives in West Africa in 2014....

Outbreaks such as Ebola have an ability to spread fear around the world, often through the prism of sensationalist media reporting.

So how does Ebola actually compare to previous outbreaks and other diseases? And while the world focuses on Ebola, are we guilty of ignoring much bigger killers?

Analysing the death rates from different viruses shows Ebola is certainly one of the most deadly infections ever encountered.
Read complete report
http://www.bbc.com/news/health-29953765

ASSOCIATED PRESS by  JONATHAN PAYE-LAYLEH             Dec. 29, 2014

MONROVIA --  Dozens of new Ebola cases have erupted in Liberia, near the border with Sierra Leone, Liberian health officials warned Monday, marking a setback amid recent improvements.

The flare-up is due to a number of factors including people going in and out of Liberia and traditional practices such as the washing of bodies, said Liberia's Assistant Health Minister Tolbert Nyenswah.

Forty-nine cases were reported in in western Grand Cape Mount County between December 1 and 25, Nyenswah told state radio.

"In a very small population, an increase in the number of (Ebola) cases raises high level of concerns that we need to take very seriously as people of Liberia and people of Grand Cape Mount in particular," he said.

Read complete story.
http://abcnews.go.com/Health/wireStory/liberia-reports-dozens-ebola-cases-border-27873523

ASSOCIATED PRESS  by By Michelle Faul                        Dec. 29, 2014

GUECKEDOU, Guinea – West Africa’s fight to contain Ebola has hampered the campaign against malaria, a preventable and treatable disease that is claiming many thousands more lives than the dreaded virus.

Woman in the Guinean village of Meliandou, above, near the area considered to be Ebola's ground zero. The fight against Ebola in West Africa is holding back efforts to prevent and treat malaria. Jerome Delay / AP Photo

In Gueckedou, near the village where Ebola first started killing people in Guinea’s tropical southern forests a year ago, doctors say they have had to stop pricking fingers to do blood tests for malaria.

HUFFINGTON POST   by  Jenifer Bendery

 WASHINGTON -- White House Ebola czar Ron Klain warned Sunday that the virus is still a global threat and will continue to be until it is completely wiped out.

This won't be done until we get all the way to zero," Klain said on CBS' "Face the Nation." "It's like a forest fire. A few embers burning and the thing can re-ignite at any time."

He said the United States has made "significant strides" to prepare for the occasional case of Ebola, but West Africa is still struggling with its outbreak. While Liberia has reduced new cases of Ebola from 50 to 100 a day to five to 10 a day, Sierra Leone and Guinea aren't having the same success.

"We're nearing a pivot point in this," Klain said.

Read complete story.
http://www.huffingtonpost.com/2014/12/28/ebola-ron-klain_n_6387194.html

Ebola: Year in Review of 2014 developments
LOS ANGELES TIMES      by Alexandra Zavis                   Dec. 28, 2014

...As 2015 approaches, there is reason to hope that what at first was a plodding international response is finally catching up with the virus. In Liberia, where just a few months ago bodies were left in the streets for days and patients were turned away from treatment facilities because there weren't enough beds or personnel, the number of cases has been dropping rapidly. There are also signs that the disease may be slowing in Sierra Leone, which has overtaken Liberia as the country with the biggest caseload.

...Although the tactics being used have stemmed smaller Ebola outbreaks, some experts are beginning to question whether this one has spread too far to be fully contained without a vaccine or cure.

THE DALLAS MORNING NEWS  by Sue Ambrose                                     Dec. 27, 2014

DALLAS, Texas --When Ebola surfaced in the U.S., federal guidelines to protect medical workers here were weaker than the ones that the Centers for Disease Control and Prevention had in place 15 years earlier, The Dallas Morning News has found.

It’s not known exactly how nurse Nina Pham contracted Ebola while caring for patient Thomas Eric Duncan. Shown here at Texas Health Presbyterian Hospital in Dallas, she was later successfully treated at a National Institutes of Health hospital in Maryland. Agence France-Presse

A review of CDC documents and archived Web pages shows that a 1998 protocol originally written for health care workers in Africa had more protective measures than the one for U.S. caregivers when Thomas Eric Duncan became the first patient diagnosed with Ebola in this country.

Two Dallas nurses were infected with the deadly virus while treating Duncan at Texas Health Presbyterian Hospital Dallas, where he died in early October....

Doctor who survived describes the misery of being an Ebola patient in Liberia

NATIONAL PUBLIC RADIO  by Didrik Schanoh and Sami Yenigun                              Dec. 25, 2014

Dr. Senga Omeonga met us under a huge mango tree outside the St. Joseph's Catholic Hospital in Monrovia, Liberia. Behind the main building, several dozens of disinfected rubber boots worn by health care workers were propped upside down on stakes planted on a patch of lawn.

This is the hospital where he works as general surgeon and the head of Infection Prevention Control. It's also where he came down with Ebola on August 2.

He says his days in treatment were "a living hell." And the experience has changed his view of the world — and the way he treats patients.

Read full interview.

BIOPREPWATCH   by Shaun Zinck                                                 Dec. 26, 2014

SES, a satellite communications company, announced on Monday that it was teaming up with a collaborative group that runs a mobile laboratory to improve response time in the fight against the Ebola virus.

B-LiFE, a mobile laboratory, is run through a consortium between the public, private and academic sectors in Belgium. The group is trying to increase identification of diseases for a quicker response to crisis situations such as the Ebola epidemic.

“B-LiFE demonstrates the relevance of satellite for medical purposes,” Gerhard Bethscheider, managing director of SES TechCom, said. ...It is anticipated that the lab, which left Belgium on Saturday, will be stationed at an Ebola treatment center in Guinea that was set up by ALIMA, a French non-government organization

http://bioprepwatch.com/news/ses-joins-consortium-to-fight-ebola-with-mobile-lab/340396/

AFP                                                                                         Dec. 26, 2014

The global death toll from Ebola has risen to 7,588 out of 19,497 confirmed cases recorded in the year-old epidemic raging in West Africa, the World Health Organization (WHO) says.

The virus is still spreading intensely in Sierra Leone, especially in the north and west, with 315 new confirmed cases reported in the former British colony in the week to December 21, it said. These included 115 cases in the capital Freetown.

"The neighbouring district of Port Loko experienced a surge in new cases, reporting 92 confirmed cases compared with 56 the previous week," the WHO said.

Read full story
http://www.cbc.ca/news/business/ebola-death-toll-rises-to-7-588-globally-who-says-1.2884197

Read  Full WHO report
http://www.who.int/csr/disease/ebola/situation-reports/en/

THE INDEPENDENT by Charlie Cooper                                                               Dec. 26, 2014

NATIONAL PUBLIC RADIO by Ofeibea Quist-Arcton        Dec. 25, 2014

MONROVIA -- Working with UNICEF and another nonprofit, Talking Drum, in Monrovia, the capital of Liberia, the government aims to provide lessons to children across the country, hit by the Ebola outbreak. Most schools closed this past summer and will likely remain closed for months....

                            Florence Allen Jones, right, is part of the education ministry's classes-by-radio team.

The radio classes are broadcast on local stations, and on United Nations radio. The Education Ministry acknowledged that the broadcasts are not reaching nationwide. In any case, few children in Liberia's 15 counties have access to a radio, or even the batteries to power one. Wealthy parents have hired home tutors for their kids, but many other youngsters have taken to peddling petty goods, like trinkets or donuts, on the streets of Monrovia, to try to earn a little money for their families while schools are closed.

Editorial  Lessons learned from the Ebola outbreak

  THE WASHINGTON POST                                                                                  Dec. 26, 2014

The Outbreak of the Ebola virus in West Africa this year came as a surprise. Perhaps no one could have predicted that such a terrible scenario would unfold. But over the past decade, there have been four major outbreaks of infectious disease caused by a virus: severe acute respiratory syndrome, or SARS; swine flu; Middle East respiratory syndrome; and now Ebola. Each has taken populations by surprise. Next time, the world should not be gobsmacked. It is possible to be better prepared, be more aware of the potential threats and not start from zero every time the alarm goes off.

...It would be smart to begin thinking of a more agile and effective organization or system for responding to such dire threats, one that could bring together a capability for surveillance, early warning and rapid response; and that would be wired into the pharmaceutical industry.

Editorial urging U.S. academic medical centers to do more to fight Ebola
in West Africa

NEW ENGLAND JOURNAL OF MEDICINE                            Dec. 24, 2014
By Jeffrey M. Drazen, M.D., Edward W. Campion, M.D., Eric J. Rubin. M.D., Ph.D., Stephen Morrissey, Ph.D., and Lindsey R. Baden, M.D.

... As the Ebola outbreak has burned its way deep into Guinea, Liberia, and Sierra Leone, in one of the worst acute public health crises in 50 years, our academic medical centers have sat largely on the sidelines.

...The leaders of academic medical centers that have put roadblocks in the path of those wishing to serve need to rethink their priorities. They should be making it easier, not harder, for altruistic physicians, nurses, and other health care providers to help care for the sick and control the Ebola epidemic in West Africa. ... Something is wrong when some of the greatest health care centers in the world are not helping in the fight against this disastrously dangerous threat to human health. We ask the leaders of every medical center in the country to figure out how to make it possible for their staff, and even qualified trainees, to help on the ground in West Africa.

Read full editorial

ASSOCIATED PRESS                                    Dec. 26, 2014

One year into the world's worst Ebola outbreak, doctors are reporting an encouraging sign: About 70 percent of patients in a hard-hit area of Sierra Leone now survive.

The Ebola death rate has fallen even though there are no specific medicines or vaccines to fight the virus....

In a letter published online Wednesday by the New England Journal of Medicine, Dr. Kathryn Jacobsen of George Mason University in Fairfax, Virginia, and other doctors tell of 581 patients taken to an Ebola treatment center that opened near Sierra Leone's capital, Freetown, in late September.

They were given antibiotics, malaria medicines, ibuprofen for pain and fever, intravenous nutrients, anti-nausea medicine and other supportive care. About 31 percent died, including 38 people who were dead when they arrived. Among those admitted more recently, since Nov. 5, mortality was less than 24 percent.

That is much lower than the 74 percent death rate other doctors reported for 106 patients who were treated in the eastern Sierra Leone town of Kenema, in May and June, when some health workers were on strike and response to the outbreak was in crisis mode.