Health - West Africa MPHISE

ASSOCIATED PRESS by MARIA CHENG and RAPHAEL SATTER   July 31, 2015

LONDON — The United Nations Mission for Ebola Emergency Response is officially winding down Friday, handing its leadership role and senior staff to the Geneva-based World Health Organization as efforts to contain the deadly virus continue.

"We have reached an important milestone in the global Ebola response," U.N. Secretary-General Ban Ki-moon said in a statement Friday, while noting that that crisis "is not yet over."

The Ebola mission, also called UNMEER, was established last year as WHO struggled to get a handle on an outbreak that has killed more than 11,000 people, mainly in Guinea, Sierra Leone and Liberia. WHO had been strongly criticized for fumbling its response to the epidemic, and the creation of UNMEER was widely seen as a rebuke to its leadership.

Speaking to reporters Friday, UNMEER chief David Nabarro said he had seen signs that WHO had already absorbed some of the lessons of the Ebola disaster, recovering its coordination role in West Africa and deploying more 1,000 staffers to the field.

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http://www.seattlepi.com/news/medical/article/WHO-works-to-reform-itself-after-fumbling-Ebola-6416880.php

DEUTSCHE WELLE    by Susan Houlton                         July 31, 2015
 
A village in northern Sierra Leone has been placed under quarantine after a post-mortem test revealed a man had died from Ebola. Several hospitals failed to recognize him as a potential victim of the disease.

Earlier this week the World Health Organization (WHO) announced the fewest weekly Ebola infections for over a year in West Africa. However the WHO also said it was bracing for a significant new outbreak in Sierra Leone, which alongside Guinea and Liberia, is one of the worst affected countries.

In the week up to Sunday 26 July, there were four confirmed cases in Guinea and three in Sierra Leone. Those three included a patient who died after travelling from the capital Freetown to the northern district of Tonkolili. He was described by the WHO as posing "a substantial risk of further transmission." The patient had only been confirmed Ebola-positive after post-mortem testing....

According to Hassan Abdul Sesay, a member of parliament from the region where the patient died, the man had traveled to his home village to mark the end of the Muslim holy month of Ramadan.
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who.int - July 29, 2015 - SUMMARY - (See Links to Situation Reports Below)

There were 7 confirmed cases of Ebola virus disease (EVD) reported in the week to 26 July: 4 in Guinea and 3 in Sierra Leone. This is the lowest weekly total for over a year, and comes after 8 consecutive weeks during which case incidence had plateaued at between 20 and 30 cases per week. Although this decline in case incidence is welcome, it is too early to tell whether it will be sustained. There have been several high-risk events in both Guinea and Sierra Leone in the past 14 days, and past experience has shown that it can take a single high-risk case or missed contact to spark a new cluster of cases. In addition, there are over 2000 contacts still within their 21-day follow-up period in Guinea, Liberia, and Sierra Leone, representing a substantial residual risk of further cases. Refinements to the response continue to yield improvements, with recent weeks seeing a higher proportion of cases arising from contacts and a lower proportion of cases identified post-mortem than at any time previously, but the continued occurrence of high-risk transmission events means that an increase in case incidence in the near term is a strong possibility.

Could the international community have done a better job when confronted with the outbreak of Ebola in West Africa? Although the virus appears to be largely contained now, this comes after at least 27,000 people were infected, with 11,000 of them dying. The virus also had the opportunity to spread within the human population for over a year, providing it a potentially dangerous opportunity to adapt to us as hosts.

To find out whether we could have managed the outbreak better, the World Health Organization (WHO) recently convened an Ebola Interim Assessment Panel, which analyzed various aspects of the organization’s response. This panel, commissioned by the WHO Director-General, included the Dean of the Harvard School of Public Health, the founding Director of the UK's national Health Service, and other international public health leaders. It recently released its final report on the crisis.