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Social Pathways for Ebola Virus Disease in Rural Sierra Leone, and Some Implications for Containment

PLOS     by Paul Richards and others                                                          April. 17,  2015                  
The current outbreak of Ebola Virus Disease in Upper West Africa is the largest ever recorded. Molecular evidence suggests spread has been almost exclusively through human-to-human contact.

 Social factors are thus clearly important to understand the epidemic and ways in which it might be stopped, but these factors have so far been little analyzed.

 The present paper focuses on Sierra Leone, and provides cross sectional data on the least understood part of the epidemic—the largely undocumented spread of Ebola in rural areas. Various forms of social networking in rural communities and their relevance for understanding pathways of transmission are described. Particular attention is paid to the relationship between marriage, funerals and land tenure.

 Funerals are known to be a high-risk factor for infection. It is suggested that more than a shift in awareness of risks will be needed to change local patterns of behavior, especially in regard to funerals, since these are central to the consolidation of community ties.

http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003567

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Sole Australian-run Ebola treatment centre to close

SYDNEY MORNING HERALD by Dan Harrison                                                                       April 20, 2015
The Australian-funded Ebola treatment centre in Sierra Leone will shut its doors at the end of the month, following a stabilisation of the outbreak in West Africa.                           Health care workers at the Kenema Government Hospital in Sierra Leone. Photo: AP

Australian Foreign Minister Julie Bishop announced on Monday that Australia's sole facility, at Hastings airfield, near Sierra Leone's capital Freetown, would close on April 30.

Ms Bishop said the decision followed a process led by the government of Sierra Leone to rationalise and consolidate Ebola treatment centres.

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http://www.smh.com.au/federal-politics/political-news/sole-australianrun-ebola-treatment-centre-to-close-20150420-1moysj.html

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WHO leadership admits failings over Ebola, promises reform

REUTERS   by Tom MIles                                                                     April 19, 2015

GENEVA--The World Health Organization has admitted serious failings in its handling of the Ebola crisis and pledged reforms to enable it to do better next time, its leadership said in a statement seen by Reuters on Sunday.

"We have learned lessons of humility. We have seen that old diseases in new contexts consistently spring new surprises," said the statement, attributed to the WHO Director-General Margaret Chan and the deputy director-general and regional directors.

"We have taken serious note of the criticisms of the Organization that, inter alia, the initial WHO response was slow and insufficient, we were not aggressive in alerting the world ... we did not work effectively in coordination with other partners, there were shortcomings in risk communications and there was confusion of roles and responsibilities...," it said.

The statement listed eight lessons learned, including areas where the WHO's response to Ebola could have been better, such as information sharing and communication....

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Signs Ebola Spreads in Sex Prompt a C.D.C. Warning

NEW YORK TIMES  by SHeri Fink                                                                                  April 20, 2015
The Centers for Disease Control and Prevention revised its guidelines on Ebola transmission on Sunday night, urging survivors to abstain from all forms of sex or use condomsevery time “until more information becomes available,” rather than three months as previously recommended.

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Pesticides likely behind 'mysterious killer disease' in Nigeria

Deutsche Welle                                                                            April 19, 2015

 Eighteen people died under mysterious circumstances in southwest Nigeria this week, sparking fears of a new infectious disease outbreak. Weed killer was the likely cause, the World Health Organization has now said.

When over a dozen men in the village of Ode Irele in southwestern Ondo state who complained of similar symptoms all died within a day, alarm bells began to ring. However, according to the World Health Organization (WHO), there is no reason to suspect any outbreak of infectious disease, such as Ebola, which has claimed over 10,000 lives in Sierra Leone, Guinea and Liberia.

The "current hypothesis is herbicides," WHO spokesman Gregory Hartl said on Sunday, adding: "Tests done so far are negative for viral and bacterial infection."

The victims began showing symptoms between April 13 and 15, including blurred vision and loss of consciousness, and Ondo spokesman Kayode Akinmade said it was due to a "mysterious killer disease."

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Nigeria Hit With Mysterious Epidemic In Ondo State, More Deadly Than Ebola: Report

INTERNATIONAL BUSINESS TIMES  by Morgan Winsor        April 17, 2015

A strange disease has ravaged a small community in western Nigeria, killing at least 14 people in the last 10 days. Residents of the Ikale community in Ondo state have described the mysterious epidemic as more deadly than Ebola and many are afraid to touch the dead, the Daily Post in Nigeria reported.

“We are worried. Our people are dying. We don’t know this sickness,” resident Mary Omogbehinla told the Daily Post on Thursday. “We can’t touch those who have been killed. I have counted about 19, others said 14. God please, have mercy on us.”

Four new patients with symptoms of the strange disease were isolated at a local hospital in Ode Irele. The state’s health commissioner, Dayo Adeyanju, said Thursday the government launched an awareness campaign to encourage residents to report any potential cases of the mysterious ailment. The World Health Organization (WHO), Nigeria’s health ministry and other health agencies were also contacted to help identify the disease and to ensure the cases do not spread, the Daily Post said Thursday.

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Ebola: World Bank Group Provides New Financing to Help Guinea, Liberia and Sierra Leone Recover from Ebola Emergency

THE WORLD BANK                                                                           April 17, 2015

New GDP Estimates Show International Support Vital to Speed Recovery

WASHINGTON--The World Bank Group (WBG) announced today that it would provide at least US$650 million during the next 12 to 18 months to help Guinea, Liberia and Sierra Leone recover from the devastating social and economic impact of the Ebola crisis and advance their longer-term development needs. The new WBG pledge brings the organization’s total financing for Ebola response and recovery efforts to date to US$1.62 billion.

The additional funding announcement comes as the WBG releases new GDP estimates showing that the Ebola epidemic continues to cripple the economies of Guinea, Liberia and Sierra Leone. Estimated GDP losses for the three countries in 2015 rose to US$2.2 billion: US$240 million for Liberia, US$535 million for Guinea and US$1.4 billion for Sierra Leone. In addition to the severe effects of Ebola, the economic downturn in the three countries is aggravated by the sharp decline in global iron ore prices, as well as the collapse of the mining sector in Sierra Leone...

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"Exhausted" Liberia struggles with long Ebola 'to do' list -

REUTERS  by Astrid Zweynert                                                                 April 17, 2015

OXFORD, England-- Treating trauma and the mental health issues of Ebola survivors is one of the many challenges facing "exhausted" Liberia, a senior health ministry official said.

Liberia has weathered the worst ever outbreak of Ebola, which has killed more than 10,600 people and infected 25,791, more successfully than its neighbours Sierra Leone and Guinea....

"Our country is exhausted. We still have huge needs," said Miatta Gbanya, deputy incident manager of Ebola response at the Liberian healthy ministry.

"The mental health of survivors, of health care workers need addressing. That's just one thing - there is still a lot to be done," she told the Thomson Reuters Foundation....

 The Liberian government has been analysing its response to the Ebola epidemic and ways it could prevent similar outbreaks in the future, including investing some of the aid it has received into the healthcare system, Gbanya said.

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Dramatic’ progress in fighting Ebola must be followed by long-term recovery efforts

UNITED NATIONS NEWS CENTRE                                                      April 16, 2015

WASHINGTON  --Intense efforts to control the Ebola outbreak in the three most-affected West African countries in will continue, the United Nations health chief said in Washington, DC today, adding that the international community is also looking for ways to build on dramatic recent progress by aiding with efforts aimed at recovery from the outbreak.

Tuesday 14 April 2015 was a happy day in Sierra Leone as children returned to school after many months             away, due to the Ebola outbreak. Photo: WHO/N. Alexander

“The goal is to help people and their communities to return to a normal life again,” said Margaret Chan, Director-General of the World Health Organization (WHO). “It means that children are going back to school, women can once again shop in their local markets, and livelihoods are restored.”

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Ebola on the wane, Sierra Leone braces for a whole new crisis

WASHINGTON POST  by Todd C. Frankel                                                        April 16, 2015

Sierra Leonean President Ernest Bai Koroma was ready to talk about something besides Ebola.

Sierra Leonean President Ernest Bai Koroma, left, and Liberian President Ellen Johnson Sirleaf listen as U.S. President Barack Obama delivers a statement to the news media in the Cabinet Room at the White House April 15, 2015 in Washington, DC. Obama and his counterparts discussed their progress in the fight against the Ebola virus and their efforts to create long-term economic recovery for the West African countries. (Photo by Chip Somodevilla/Getty Images)

His West African nation is not yet Ebola-free. It is still fighting to rid itself of the feared pathogen, which has killed more than 10,000 people in Sierra Leone, Guinea and Liberia since March 2014. But today the number of new Ebola cases in Sierra Leone has slowed to a trickle. The country recorded just seven new confirmed infections last week. Last November, Sierra Leone was reporting 550 new cases a week.

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