Ebola’s Newest Casualty: Health Care

      

Baz Ratner/Reuters

thedailybeast.com - by Sheldon Yett - April 3, 2015

The worst of the Ebola epidemic may be over in Liberia, but the damage it inflicted on an already weak health care system could have catastrophic consequences.

Here in Liberia, the goal of zero Ebola cases is tantalizingly close. Only one new case has been recorded since 19 February, and 13 of the country’s 15 counties have not reported any new cases for over 42 days. But Ebola’s impact will be felt long after the last case has been treated.      

As the battle against Ebola continues, the threat of outbreaks of measles, whooping cough and other vaccine-preventable diseases remains high. Given the mobility of Liberia’s population, the danger is that these diseases could spread with the same devastating rapidity that Ebola did.

Malnutrition rates have also increased, and a large proportion of the population is still not using health facilities for fear of contracting Ebola.

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Ebola Upsurge Could Undo Progress in Blink of an Eye, Warns Expert

‘Flare-ups occur and, frankly, before you can blink, we could be back to a situation where Ebola starts climbing up again,’ says the UN special envoy for Ebola, David Nabarro. Photograph: Salvatore Di Nolfi/EPA

UN special envoy for Ebola sounds cautionary note amid fears that individuals who ignore official advice could cause spike in infection rate

theguardian.com - by Sam Jones - March 26, 2015

Despite the massive push to bring the number of new Ebola cases down to zero as quickly as possible, there will inevitably be “flare-ups” that could reverse the overall downward trend and prove difficult to contain, the UN’s response co-ordinator has warned.

Dr David Nabarro, the UN’s special envoy for Ebola, said the huge medical, administrative and logistical operation to fight the disease could still be set back by individuals ignoring official advice. . . .

. . . “It’s [about] getting the full geographical coverage and linking everyone together with the most excellent data systems so the databases are comparable and we don’t end up with a mess because different people can’t talk to each other,” he explained.

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WHO - Ebola Situation Report - 1 April 2015

                                       

who.int - April 1, 2015

SUMMARY

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Liberia, Sierra Leone gain in Ebola crisis; Guinea struggles

ASSOCIATED PRESS  by Sarah DiLorenzo                                                               April 2, 2015      

(Scroll below for related Wall Street Journal story.)   

DAKAR, Senegal (AP) — When will the world's largest and longest Ebola outbreak end? The West African countries of Sierra Leone and Liberia both appear to be on steady paths to ending the epidemic. The wild card is Guinea, where Ebola hasn't burned as hot but remains stubbornly entrenched.

 

In this file photo dated Friday, March. 27, 2015, a usually busy street is deserted as Sierra Leone enters a three day country wide lockdown on movement of people due to the Ebola virus in the city of Freetown, Sierra Leone. Sierra Leone's 6 million people were told to stay home for three days, except for religious services, beginning Friday as the West African nation attempted a final push to rid itself of Ebola. (AP Photo/ Michael Duff, FILE)

Liberia's last Ebola patient died March 27; it is now counting down the 42 days it must wait to be declared free of Ebola. Meanwhile, Sierra Leone recorded no new infections Wednesday for the second time; on average, it has logged a handful each day in recent days.

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App enables self-reporting of possible Ebola symptoms in Maryland

ASSOCIATED PRESS                                                                                     April 1, 2015

BALTIMORE — A Baltimore company and Maryland public health officials are announcing a smartphone and Web application for self-reporting possible Ebola symptoms.

Emocha Mobile Health Inc. said Wednesday that people returning from affected West African nations can use the app to report their temperature and any symptoms twice daily to the Department of Health and Mental Hygiene. The federal government recommends such reporting for 21 days.

The state health agency has operated a call center since October for monitoring people known to have been in affected countries. The app eventually will link to the state's database of such individuals to automate the reporting of data to Maryland and federal authorities.

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Faulty modeling studies led to overstated predictions of Ebola outbreak

MEDICAL EXPRESS                                                                       MARCH 31, 2015

(scroll down for complete paper.)

Frequently used approaches to understanding and forecasting emerging epidemics—including the West African Ebola outbreak—can lead to big errors that mask their own presence, according to a University of Michigan ecologist and his colleagues.

Last September, the U.S. Centers for Disease Control and Prevention estimated—based on computer modeling—that Liberia and Sierra Leone could see up to 1.4 million Ebola cases by January 2015 if the viral disease kept spreading without effective methods to contain it. Belatedly, the international community stepped up efforts to control the outbreak, and the explosive growth slowed.

"Those predictions proved to be wrong, and it was not only because of the successful intervention in West Africa," King said. "It's also because the methods people were using to make the forecasts were inappropriate."

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Guinea finds three Ebola cases in the alumina hub of Fria

REUTERS   by Saliou Samb                              March 31, 2105

CONAKRY --Guinea has detected at least three new cases of Ebola in the alumina hub of Fria, according to the national coordination of the fight against the disease, as authorities blamed popular resistance for hampering the battle against the virus.

Fria is home to the only alumina smelter in the West African country, Friguia, which produced some 630,000 tonnes of alumina a year until it was shuttered by Russian aluminium giant RUSAL in 2012.

The report noted the refusal by the local population in Conakry to hand over two other suspected cases, despite the intervention of local authorities. It said families in the town of Coyah, 50 km ( miles) from Conakry had refused to follow contacts of an Ebola case.

The resistance of local communities, which refuse to admit the existence of the disease, has dogged efforts to eradicate Ebola in Guinea since it was detected in March 2014

Read complete story.
http://www.reuters.com/article/2015/03/31/us-health-ebola-guinea-idUSKBN0MR1TL20150331

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The End of Ebola? Lessons at the Epidemic's One Year Anniversary

Columbia University                                            March 30, 2015

One year ago, the current Ebola epidemic was announced to the world. Since then, we have learned and accomplished an enormous amount....

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Ebola rapid diagnostic kit developed by UK scientists in Sierra Leone

Doctors says the kit, if approved by health authorities, could transform the admissions process with its capacity to deliver results within 20 minutes

THE GUARDIAN    by Lisa O'Carroll                              March 29, 2015

A rapid Ebola diagnostic kit similar to a pregnancy kit has been developed by British military scientists and NHS medics in Sierra Leone.

Health care workers prepare to entering a high risk zone at an Ebola virus clinic in Sierra Leone, where the diagnostic kit has been undergoing tests. Photograph: Michael Duff/AP

It can be administered at the bedside and return its first results within 20 minutes, slashing dramatically the normal 24-hour turnaround for lab results.

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Home> Health Guinea Deploys Police as Sierra Leoneans Flee Ebola Lockdown

ASSOCIATED PRESS  By CLARENCE ROY-MACAULAY AND BOUBACAR DIALLO                  March 28, 2015

FREETOWN, Sierre Leone --Guinea has deployed security forces to the country's southwest in response to reports that Sierra Leoneans are crossing the border to flee an Ebola lockdown intended to stamp out the deadly disease, an official said Saturday.

A team of Sierra Leone health workers walk as they look for people suffering from Ebola virus symptoms or people they can educate about the virus as their country enters a three day country wide lockdown on movement of people due to the Ebola virus in the city of Freetown, Sierra Leone, Friday, March. 27, 2015. Sierra Leone's 6 million people were told to stay home for three days, except for religious services, beginning Friday as the West African nation attempted a final push to rid itself of Ebola. (AP Photo/ Michael Duff) Close The Associated Press

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Liberia Recommends Ebola Survivors Practice Safe Sex Indefinitely

THE NEW YORK TIMES  by Sheri Fink                                                                          March 29, 2015

The Liberian government recommended on Saturday that survivors of Ebola practice safe sex indefinitely, until more information can be collected on the length of time the virus might remain present in body fluids including semen. Previously, male survivors were advised to abstain from sexual intercourse or to use condoms for three months, reflecting that the active virus had been detected for up to 82 days in semen.

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Guinea president announces new emergency measures in Ebola fight

REUTERS                                                 March 28, 2015

CONAKRY - Guinea's President Alpha Conde announced on Saturday new emergency measures enabling authorities to restrict movements in western Guinea where Ebola transmission continues a year after the epidemic was declared.

More than 10,300 people have died from Ebola in West Africa and while cases are thought to have peaked, Guinea is struggling to stamp out the virus partly due to often violent resistance to officials working to end it.

Following a dip in new cases in January, they have spiked again since early March in and around the capital, prompting officials to announce a new phase of the epidemic in Guinea.

"I declare in the districts of Forecariah, Coyah, Dubreka, Boffa and Kindia a reinforcement of emergency measures for a period of 45 days," Conde said on state television late on Saturday.

Read complete story.

http://news.yahoo.com/guinea-president-announces-emergency-measures-ebola-fight-230310066.html

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Police fire tear gas on crowd during Sierra Leone Ebola lockdown

REUTERS by Josephus Olu-Mammah and Umaru Fofana                                                              March 28, 2015
FREETOWN, Sierra Leone --Police fired tear gas at an angry crowd in Sierra Leone on Saturday after they threw stones at officials during a three-day national lockdown that the government hopes will accelerate the end of the Ebola epidemic, residents said.

Sierra Leone has reported nearly 12,000 Ebola cases and more than 3,000 deaths since the worst epidemic in history was detected in neighbouring Guinea a year ago. New cases have fallen sharply since a peak of more than 500 a week in December but the government says the lockdown, its second, is necessary to identify the last cases and to buck a worrying trend towards complacency.

Officials have ordered the six million residents to stay inside on pain of arrest as hundreds of health official go door-to-door looking for hidden patients and educating residents about the haemorrhagic fever.

Hundreds of people left their homes in the Devil Hole neighbourhood outside the capital to gather at a food collection point. Some residents complained they had not received food and fighting broke out until police arrived to scatter the crowd.

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Combatting Rumors About Ebola: SMS Done Right

When misinformation is a case of life or death, aid workers and communities need an ear to the ground

INTERNEWS   by  Anahi Ayala Iacucci                                                March 26, 2015

 What is now clear to healthcare organizations working on the ground in West Africa is that the Ebola epidemic has been driven as much by misinformation and rumors as by weaknesses in the health system. It is common sense that information is a critical element in combatting disease, particularly when contagion from common social practices, such as bathing the corpses of the deceased, were central to so much of the early spread of the disease. But in the context of a massive disease outbreak, when hundreds of international organizations and billions of dollars flood into a region whose fragile infrastructure has been damaged by years of civil war, information dissemination becomes a powerful challenge.

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The State of Vaccine Confidence

The Vaccine Confidence Project    2015
LONDON SCHOOL OF HYGIENE AND TROPICAL MEDICINE 

Lead Authors:  Heidi Larson, PhD and Will Schulz, MPH
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