PLOS  Current Outbreaks  by Nadia Wauquier and others                                             April 20, 2015

The initial steps of emergence and spread of a virus are critical in the development of a potential outbreak and need to be thoroughly dissected and understood in order to improve on preventative strategies. In the current West African outbreak of EVD, a unique index case has been identified, pinpointing the geographical origin of the epidemic in Guinea.

Herein, we provide an accounting of events that serve as the footprint of EVD emergence in Sierra Leone and a road map for risk mitigation fueled by lessons learned....

...Continuous active surveillance is needed and must be organized by specialized centers joined in local, regional, and international networks. Surveillance centers must be connected to public health systems and also to research teams for increased understanding and awareness to permit identification and implementation of rapid intervention strategies....

Read complete study  and see maps.

GIZMODO by Mark Honigsbaum - Mosaic                                                 April 21, 2015

The worst of the Ebola epidemic may be over but the World Health Organization has declared that life in Sierra Leone, as in other Ebola-affected West African countries, can only return to normal when transmission of the virus ceases and cases drop to zero. Unfortunately, not everyone in Sierra Leone is so concerned...

Dr Ernest Bai Koroma, the President of the Republic of Sierra Leone, was having trouble ‘getting to zero’, and his underlings were getting antsy. “We need one more push,” said Major Palo Conteh, the commander of Sierra Leone’s National Ebola Response Centre (NERC) and a former Olympic quarter miler. “It’s like in the 400 metres when you’re 20m from the finish line, that’s the time to kick hard.”

REUTERS by Kate Kelland                     April 21, 2015

LONDON, April 21 - Genetic sequence data on two of the deadliest yet most poorly understood viruses are to be made available to researchers worldwide in real time as scientists seek to speed up understanding of Ebola and MERS infections.

The project, led by British scientists with West African and Saudi Arabian collaboration, hopes to encourage laboratories around the world to use the live data -- updated as new cases emerge -- to find new ways to diagnose and treat the killer diseases, and ideally, ultimately, prevent them.

"The collective expertise of the world's infectious disease experts is more powerful than any single lab, and the best way of tapping into this...is to make data freely available as soon as possible," said Jeremy Farrar, director of the Wellcome Trust global health charity which is funding the work.

The gene sequences, already available for MERS cases and soon to come in the case of Ebola, will be posted on the website virological.org for anyone to see, access and use.

Read complete story.

http://af.reuters.com/article/topNews/idAFKBN0NC19W20150421?sp=true

Prince George's County Health Department to be Presenting

CAPITOL HEIGHTS, MARYLAND, April 20 - Restoration Chapel International, in its disaster relief mission, is collaborating with the US-Africa Ebola Working Group, under the sponsorship of Miss Africa Foundation, to hold an Intercessory Prayer Service and Community Dialogue on Ebola on April 26, 2015 from 1:30 p.m. to 2:30 p.m. at 9113 Hampton Overlook; Capitol Heights, Maryland 20743. The objective is to provide a spiritual platform for those with ties to the affected countries and African ambassadors to come together and mourn their loss, share stories and mobilize relief efforts for Ebola survivors in Guinea, Liberia and Sierra Leone. The event is co-chaired by Prophet Frank Sarpong and Dr. Rodney Sadler, with Prince George's County providing tactical support.

U.S. citizens, the African Diplomatic Corps, local officials, community leaders and nationals from at least 30 African countries will attend. Survivors of the deadly virus will participate via skype. Other speakers include:

NEW YORK TIMES by Pam Belluck and William J. Broad     April 20, 2015

A growing body of scientific clues — some ambiguous, others substantive — suggests that the Ebola virus may have lurked in the West African rain forest for years, perhaps decades, before igniting the deadly epidemic that swept the region in the past year, taking more than 10,000 lives.

Around 2004 at a government hospital in Kenema, Sierra Leone, a team of American scientists and West African medical personnel found what appeared to be Ebola antibodies in nearly 9 percent of blood samples. Credit Carl De Souza/Agence France-Presse — Getty Images

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

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.

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

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....

Read complete story.

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.

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."

Read complete story

WASHINGTON POST EDITORIAL                             Aug. 18, 2015

THE RAVAGING of populations in Liberia, Sierra Leone and Guinea by the Ebola virus over the past year has been devastating. The virus killed 10,702 people and left behind vast economic and emotional tolls. The rest of the world responded slowly to the outbreak but eventually rallied. Now it is time to do the same with the aftermath and extend a hand for rebuilding...

The outbreak has receded, but weak local health-care systems proved inadequate when the virus began to spread last year, and improvements are vital in all three countries, especially a much-strengthened system of surveillance to spot any resurgence. Trained health-care workers are in short supply. A small but important step was taken recently in the announcement that the Centers for Disease Control and Prevention will help set up an African CDC that could keep the continent one step ahead of another scourge. But the rest of the world also has a stake in making sure that the region builds a better firewall against infectious disease....

NEWSWEEK  by Conner Gaffey                               April 16, 2015
Diseases such as HIV and Ebola are on the verge of being diagnosed almost instantly using paper-based technology costing less than $1.

                                       Diseases may soon be tested for via paper and smartphones Getty

The devices, known as biosensing platforms, are made from cheap materials including plastic film and cellulose paper. Results are captured using a smartphone camera and sent back to hospitals or clinics for immediate diagnosis.

Current HIV diagnosis can cost up $48 (45) for a negative test and $64 (60) for a positive test. Checks for Ebola cost some $100 (95), take up to six hours to produce a result and require sophisticated diagnostic equipment, the type of which is often unavailable in western Africa where the disease is especially prevalent.

CGN                                                    April 17, 2015

(Scroll down for underlying press release.)

The Centers for Disease Control and Prevention announced a free smartphone application that provides intuitive coaching on CDC's guidelines for proper use of personal protective equipment (PPE) to prevent transmission of Ebola.

Powered by 22otters, a mobile patient engagement platform, CDC's PPE app is an animated, speech-enabled, step-by-step mobile coaching tool to help healthcare workers access easy-to-follow directions for putting on and removing PPE and respirators in accordance with CDC guidelines to prevent transmission of Ebola. Following the initial Ebola app release, 22otters will release a variant of the app allowing training progress tracking and content modules customized for providers.

PLOS MEDICINE   by Ben Cooper and others                                                             April 14, 2015
Experimental treatments for Ebola virus disease might reduce EVD mortality. There is uncertainty about the ability of different clinical trial designs to identify effective treatments, and about the feasibility of implementing individually randomised controlled trials during an Ebola epidemic

A treatment evaluation programme for use in EVD was devised using a multi-stage approach (MSA) with two or three stages, including both non-randomised and randomised elements. The probabilities of rightly or wrongly recommending the experimental treatment, the required sample size, and the consequences for epidemic outcomes over 100 d under two epidemic scenarios were compared for the MSA, a sequential randomised controlled trial (SRCT) with up to 20 interim analyses, and, as a reference case, a conventional randomised controlled trial (RCT) without interim analyses.

Read complete study.

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001815

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.