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6 Challenges to Stamping Out Ebola

Despite a recent sharp drop in the overall number of Ebola cases, the situation remains precarious in West Africa

NATURE MAGAZINE  by Declan Butler                                                                    Feb. 24, 2015
More than a year since the start of one of the worst public health crises in recent history, Ebola cases have been tumbling in West Africa. But the epidemic is far from over: the risk of flare ups and further geographical spread will remain until there are no new cases.

The ease in case numbers means that public-health countermeasures and resources can be shifted in many places, from curbing runaway outbreaks to aggressively targeting the remaining, often smaller outbreaks....

At the same time, there is a danger of complacency. Reducing the number of cases to zero demands identifying and breaking all new chains of transmission, a task that still faces major obstacles—not least the fast approaching rainy season.

Highlighting the precariousness of the current situation, on February 20, the officials leading the United Nations' Ebola response efforts warned that the gains of the past few months risked unravelling.

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2 leading Ebola vaccines appear safe, WHO says

ASSOCIATED PRESS by Maria Cheng                                                                                 Feb. 23, 2015

LONDON – The World Health Organization says the two leading Ebola vaccines appear safe and will soon be tested in healthy volunteers in West Africa.

After an expert meeting this week, WHO said there is now enough information to conclude that the two most advanced Ebola vaccines — one made by GlaxoSmithKline and the other licensed by Merck and NewLink — have "an acceptable safety profile."

In a press briefing Friday, Dr. Marie-Paule Kieny, who heads WHO's Ebola vaccine efforts, said "the cupboard (for Ebola vaccines) is filling up rapidly."

She said further trials in healthy people in West Africa, including health workers, are scheduled to start soon. Kieny added several other vaccines were being developed in the U.S., Russia and elsewhere.

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http://www.baxterbulletin.com/story/life/health/2015/02/23/leading-ebola-vaccines-appear-safe-says/23901829/

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Limited Promise in early results from Ebola drug trial

AFP                                                                                                                     Feb. 23, 2015
Los Angeles  - Early results from an Ebola trial using the experimental drug Avigan (favipiravir) showed Monday it was somewhat effective at saving lives if given early in the illness, but not later.

Early results from an Ebola trial using the experimental drug Avigan (favipiravir) show it is somewhat effective at saving lives if given early in the illness (AFP Photo/George Frey)

The antiviral treatment is being developed by the Japanese company Toyama Chemical, and has been shown safe and effective against some other viruses including influenza, West Nile and yellow fever.

An ongoing clinical trial in Guinea is testing the drug's use in patients with the Ebola virus, which causes severe vomiting, diarrhea and sometimes fatal bleeding.

Results from only 80 people are available so far, but they show that among those who received the drug early in their illness, 15 percent died of Ebola.

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Ebola crisis: Sierra Leone orphanage quarantined

BBC            by Umaru Fofana                                        Feb. 23, 2015

FREETOWN, Sierra Leone --An orphanage run by a UK charity in Sierra Leone has been quarantined after one of its local staff was diagnosed with the deadly Ebola virus.

Augustine Baker is said to be in a stable condition at a local treatment centre after becoming ill last week....

St George Foundation orphanage co-founder Philip Dean told the BBC that 33 children and seven staff were now in isolation.

The BBC's Umaru Fofana in the capital, Freetown, says that the quarantine at the St George Foundation orphanage is self-imposed, and is expected to last for three weeks.

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http://www.bbc.com/news/world-africa-31587180

                                                             St George Foundation has helped about 200 children orphaned by Ebola.

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Funding to Fight Ebola: Not Too Little, but Definitely Too Late

Center for Global Development - cgdev.org -by Karen A. Grépin and Amanda Glassman - February 4, 2015

. . . In a new paper out today in the BMJ, Karen investigated the level and speed of the international response to the Ebola outbreak and contrasted it with the appeals made by international leaders to curb the spread of the disease. Contrary to widespread belief, Karen finds that, overall, the level of donations to the response were actually robust: as of December 31st, 2,104 donors had pledged almost $3 billion towards controlling the epidemic. Notably, this is actually larger than the official appeals for upwards of $1.5 billion. In addition, the data used underestimate total donations, in particular those given by the World Bank, which mobilized at least $1 billion in financing to help support affected countries.

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UK Ebola medics under investigation

BBC                                                                      Feb.23, 2015

Five UK Ebola nurses and doctors are under investigation by regulators, Public Health England says.

They are looking into the screening of medics who flew back to England on 28 December after treating patients in Sierra Leone.

                  Pauline Cafferkey was diagnosed with Ebola in December after volunteering work in Sierra Leone

On this flight was Scottish nurse Pauline Cafferkey - who developed Ebola - and some of her colleagues.

Questions have arisen over the health assessments and protocols that were followed.

Media reports have suggested Ms Cafferkey may have had signs of Ebola before leaving Sierra Leone but regulators have not commented on this.

http://m.bbc.com/news/health-31586074

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Life After Ebola: What It Takes For A Village To Be Resilient

NATIONAL PUBLIC RADIO INTERVIEW by Laura Starecheski                                     Feb. 20, 2015
BARKEDU,  LIBERIA --If you'd like to get an idea of what resilience is all about, take a lesson from Mamuedeh Kanneh.

She lost her husband to Ebola. But she's stayed strong. She's caring for 13 children, her own and orphans whose parents died of the virus.

Mamuedeh Kanneh was married to Laiye Barwor, the man who brought Ebola to Barkedu, Liberia. He died of the virus. She now cares for her children as well as children who lost their parents to the disease. John W. Poole/NPR

Kanneh lives in Barkedu, a village of about 6,000 in northern Liberia. Ebola took more than 150 lives. In her neighborhood there were many deaths, so people in other parts of Barkedu are scared of the orphans.

Kanneh has a strategy to help these children — and the village overall — get back to normal life. She sends the youngsters on errands so people can get used to seeing them and get over their fear. And the children can start to feel they're part of the community again....

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Leaders of Ebola Fight at U.N. Express Worry About Eradication

NEW YORK TIMES  by Rick Gladstone                                    Feb. 20, 2015

The top two health officials managing the Ebola epidemic cast doubt Friday on a pledge by West African leaders to reduce new cases to zero by mid-April, and expressed concern about a possible rebound of the disease.

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Finishing Off Ebola

NEW YORK TIMES  OP-ED BY Ron Klain, the former White House Ebola response coordinaor                                    FEB. 20, 2015

...The world needs to do a better job of quickly detecting and responding to future outbreaks in unlikely places. The President’s Global Health Security Agenda, the government’s strategy to combat infection disease around the world, will help. But vulnerable countries, including those in Africa, need their own version of our Centers for Disease Control and Prevention, so that they are not so dependent on ours.

For the hardest task of front-line epidemic fighting, our planet is too reliant on courageous and talented — but underfunded, under-equipped and volunteer-dependent — nongovernmental organizations. The world needs a permanent standing force — or a ready reserve that can be quickly organized — of public health emergency responders who have the training, gear and resources to race into a region in the early phases of epidemic control. The United States military cannot do that job every time; future outbreaks might occur in countries where our troops will not be welcomed as they were in West Africa.

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WHO approves breakthrough 15-minute Ebola test

REUTERS    by Tom Miles                             FeB. 20, 2015
GENEVA --The World Health Organization has approved the first rapid test for Ebola in a potential breakthrough for ending an epidemic that has killed almost 10,000 people in West Africa, it said on Friday.

The test, developed by U.S. firm Corgenix Medical Corp, is less accurate than the standard test but is easy to perform, does not require electricity, and can give results within 15 minutes, WHO spokesman Tarik Jasarevic said.

"It's a first rapid test. It's definitely a breakthrough," he said.

The standard laboratory test has a turnaround time of 12-24 hours. While the Corgenix test is not failsafe, it could quickly identify patients who need quarantine and make it much easier to verify rapidly any new outbreaks.

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http://www.reuters.com/article/2015/02/20/us-health-ebola-testing-idUSKBN0LO0R920150220

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