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Health Care Worker Quarantine for Ebola: To Eradicate the Virus or Alleviate Fear?

ANNALS OF EMERGENCY MEDICINE                                                                               Dec. 11, 014
By Kristi Koenig, MD, Center for Disaster Medical Sciences, University of California at Irvine

Despite our global experience with emerging infectious diseases, politicians empowered with making health policy decisions and even some scientists have created confusion, fear, and stigmatization of health care workers by inconsistent use of quarantine....

Instead of trying to allay public fears by misapplication of quarantine, we should instead educate according to rigorous science and apply evidence-based policies and procedures. Modern technologies exist for robust public health monitoring that can replace an antiquated system of quarantine for exposed persons who have no potential to transmit disease before symptom onset. Health care workers who have cared for Ebola patients and are asymptomatic should not be restricted from work or other activities as long as they can be effectively monitored for symptoms and then isolated and tested if those develop. Politicians must heed their scientific advisors and not be swayed by misinformed public fear. In addition, we should seek out and apply these simple modern technologic solutions that maximize public health and safety.

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Horror in Sierra Leone: A Single Spark Gives Ebola New Life

NBC NEWS      by  Maggie Fox                                                                                               Dec. 15, 2014
In especially deadly outbreak of Ebola burned unseen in a remote part of Sierra Leone for several weeks, giving public health experts a reality check. It's also a perfect embodiment of the warning that they've been giving for months: that a single spark can set off a conflagration of disease and death.

It happened in Kono, a remote district bordering Guinea. World Health Organization workers heard rumors of deaths and traveled there to find scenes out of a horror movie. At least 87 people had died and been hastily buried, often without the precautions needed to stop the corpses from infecting the living....

What happened in Kono illustrates just how fragile any success is.

It's likely that just one person carried the virus there from an affected area, and without precautions in place, it spread like wildfire.

Read complete story.

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Sierra Leone’s Ebola Epidemic Is Spiraling Out of Control

Why has Liberia -- once the epicenter of the outbreak -- been able to stop a rampaging killer disease, while the country next door can't even count its dead?

       

foreignpolicy.com - by Laurie Garrett - December 10, 2014

FREETOWN, Sierra Leone — It was a terribly disturbing sight. At first glance, Connaught Hospital in central Freetown looked unremarkable; the Sierra Leone facility featured a walk-in and ambulance entrance that led to typical hospital hallways and a central patients’ garden. But the entry was flanked by tented structures — on the left, a table at which sat three men, sweating in full protection suits, goggles, gloves, and masks. On the right was what appeared to be a wood-fenced pen with a sun-shading tarp over it, suitable for livestock. Patients and visitors were required to approach the suited men on the left for triage: If they had a fever or nausea they were sent to the pen.

(READ COMPLETE ARTICLE)

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They survived Ebola only to become social outcasts

USA TODAY  by Greg Zoroya                                                                                          Dec. 13, 2014

MONROVIA, Liberia — Landlords won't rent to them. Employers won't hire them. Taxi drivers won't give them a lift. Barber shops refuse to cut their hair without gloves.

Juliet Boima, 19, a survivor who works at the ebola clinic since she is immune now. Despite being unable to contract ebola, she still must wear protective gear to eliminate the chance that she could carry the virus to someone else.(Photo: Gregory H Stemn for USA TODAY)

They are Ebola survivors. In one place where they are desperately needed as workers, Ebola treatment clinics, many survivors have nightmarish memories of barely staying alive.

Thousands of West Africans have beaten the odds and survived Ebola. More than 6,500 people have died in the outbreak, and only 30% who have contracted Ebola have survived the aggressive disease that robs the body of fluids and causes major organs to fail.

Most who emerge from the clinics fully recovered discover a cruel society eager to distance itself from them and the plague.

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Ebola’s Spread in Sierra Leone Puts Diamond Mines at Risk

More blows to Sierra Leone economy

BLOOMBERG by Thomas Biesheuvel and Makiko Kitamura                                                             Dec. 12, 2014

As Ebola rages in Sierra Leone, the outbreak has claimed almost 2,000 lives and contributed to the collapse of the iron ore industry. Now the virus is hitting the diamond mines.

At the latest hotspot, in the gem-rich Kono district along the Guinea border, two workers at Octea Ltd.’s Koidu mine, Sierra Leone’s largest, were infected last week and are being treated. The outbreak may mean that production at the mine will miss its annual target -- measured in carats -- by as much as 20 percent, Chief Executive Officer Brett Richards said.

“Everyone thought this was under control and we were seeing the top of the curve,” Richards said in a phone interview yesterday. “It completely went out of control a couple of weeks ago. We may be uncovering a bit of an iceberg here.”

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Ebola outbreak: weaknesses in health-care systems in Liberia, Sierra Leone revealed

CANADIAN BROADCASTING CORP                                                                                               Dec. 11, 2014

GENEVA --Ebola in West Africa has made it almost impossible for people to get treatment for other ailments, health ministers from the three worst affected countries say.

The health systems in Sierra Leone, Liberia and Guinea were barely functional before the Ebola outbreak struck.

Liberia's Chief Medical Officer, Bernice Dahn, said the country's Ebola outbreak needs to be contained and routine health-care services need to be revived.

Liberia's Chief Medical Officer, Bernice Dahn, said the country's Ebola outbreak needs to be contained and routine health-care services need to be revived. (Martial Trezzini/Keystone/Associated Press)

"We want to expand the health workforce because it's crucial for providing quality health care," Dr. Bernice Dahn, Liberia’s chief medical officer, told World Health Organization in Geneva today....

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Ebola vaccine trial suspended for checks after joint pains

THE GUARDIAN   by Lisa O'Carroll                                Dec. 11, 2014
GENEVA --A clinical trial of an Ebola vaccine has been suspended in all 59 volunteers in Geneva a week early “as a measure of precaution” after four patients complained of joint pains in hands and feet, the University of Geneva hospital said.

“They are all fine and being monitored regularly by the medical team leading the study,” it said on Thursday.

The human safety trials of the vaccine being developed by the pharmaceutical firms Merck and NewLink are scheduled to resume on 5 January in up to 15 volunteers after checks to ensure that the joint pain symptoms were “benign and temporary”, the hospital added.

Read complete story
http://www.theguardian.com/world/2014/dec/11/ebola-vaccine-trial-suspended-joint-pains

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Ebola's ability to survive in the environment poorly understood

MEDICAL NEWS TODAY                                   Dec. 11, 2014

The means by which Ebola virus transmits through direct contact with body fluids of infected individuals is well covered in scientific literature. But little is known about the life the virus has - if any - outside the body. For example, does Ebola remain active on glass surfaces and countertops? Does it persist in sewage and wastewater systems?

Such questions are rarely addressed in currently published literature, say engineers from the University of Pittsburgh (Pitt) and Drexel University, Philadelphia.

A team of engineers says scientific literature contains little information about how well Ebola survives outside the body. They call for research to investigate its persistence in the environment so correct guidance can be given on disinfection and waste handling.

They report their findings - or lack of them - and why it is important to find some answers, in a paper published in the journal Environmental Science & Technology Letters....

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COMMENTARY: When the next shoe drops — Ebola crisis communication lessons from October

CENTER FOR INFECTIOUS DISEASE AND POLICY                                                                   Dec. 9, 2014          
By  Peter M. Sandman, PhD, and Jody Lanard, MD  

In contrast to the Ebola crisis in West Africa, which started in late 2013 and will last well into 2015 or longer, the US "Ebola crisis" was encapsulated in a single month, October 2014. But there may well be US Ebola cases to come, brought here by travelers or returning volunteers. And other emerging infectious diseases will surely reach the United States in the months and years ahead.

So now is a propitious time to harvest some crisis communication lessons from the brief US Ebola "crisis."

We're putting "crisis" in quotation marks because there was never an Ebola public health crisis in the United States, nor was there a significant threat of one. But there was a crisis of confidence, a period of several weeks during which many Americans came to see the official response to domestic Ebola as insufficiently cautious, competent, and candid—and therefore felt compelled to implement or demand additional responses of their own devising....

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