Posted on 08/10/2014 12:46:23 AM PDT by Smokin' Joe
I have spent a little time compiling links to threads about the Ebola outbreak in the interest of having all the links in one thread for future reference.
Please add links to new threads and articles of interest as the situation develops.
Thank You all for you participation.
One more from MSF —
Health authorities repeating mistakes in Ebola fight: MSF
http://thepeninsulaqatar.com/news/international/343723/health-authorities-repeating-mistakes-in-ebola-fight-msf
June 14, 2015
Health authorities are repeating the mistakes of the past in combatting Ebola, more than a year after its onset in Guinea and Sierra Leone, the international president of Doctors Without Borders (MSF) warned Saturday.
Joanne Liu’s remarks come a day after Sierra Leone imposed a three-week daytime curfew in the last Ebola-hit areas in a bid to curb a resurgence of the deadly virus, which has killed about 3,900 people in the country.
Neighbouring Liberia was declared Ebola-free in May, but hopes that Sierra Leone and Guinea would quickly follow suit have been dashed in recent weeks.
“We are still making the same mistakes as we did in the past,” said Liu.
“We know now that engaging the community in the response is essential,” she added. “But we also know that leadership at the government level... is absolutely essential.”
Liu said that when “certain political interests are prioritised over the response to the epidemic, this does not work,” an apparent reference to Guinea, where the issue of combatting Ebola has been a subject of debate between President Alpha Conde and the opposition.
The World Health Organization (WHO) said on Wednesday the retreat of the virus “has stalled”, after a second consecutive weekly increase in incidences of Ebola in Guinea and Sierra Leone.
One of the deadliest viruses known to man, Ebola is spread only through direct contact with the bodily fluids of an infected person showing symptoms, such as fever or vomiting.
PJ Media has an article on the latest outbreak as well —
Ebola Could Be Back
Africa is poised for another disease outbreak and may not do any better than last time.
by James Jay Carafano
June 16, 2015 - 4:28 am
Just about a year ago, an outbreak of the deadly disease started jumping borders. Just about everybody freaked out.
Only a handful of cases made it to American shores. And, mostly what people worried about sounded more like the stuff out of a Hollywood movie. Still, there were legitimate concerns.
What was scarier was a White House response that was slow and wrong-headed. Not much of a confidence builder for folks worried about mass death.
When the outbreak subsided, the president and just about everyone else stopped stressing out.
Well, keep worrying. New cases of Ebola have been reported.
“While the virus is spreading more slowly than at the peak last year and Liberia has defeated the outbreak,” according to one news source, “cases have risen sharply in the past two weeks in Guinea and Sierra Leone.” There are also concerns that the region may not be much better prepared to stem an outbreak than it was last year.
The last time the disease threated to come here from there, the president appointed an Ebola czar when the bad press got really bad. The czar did little and left when the bad press died down.
Meanwhile, there is much needed to improve the U.S. response to a mass disease threat. It is debatable that the Oval Office cares much.
As a result, freaking out about Ebola may become summer fare once again.
This is an article on Ebola mutation rate in humans.
Insight into the most recent Ebola outbreak could inform future intervention.by Roheeni Saxena - Jun 21, 2015 9:00am PDT
Sequencing genetic material from the blood of 179 Ebola patient blood samples has provided insights into the epidemiological and evolutionary course of the current Ebola epidemic. The analysis confirms the path that different viral lineages took through the human populations of West Africa. These findings are important because they can be used in conjunction with epidemiological data to retrospectively test the effectiveness of Ebola control measures.
The virus itself is really nothing special—until it gets inside a human.
For this study, viral genomes were sequenced from blood samples of Ebola infected patients. Each sample was linked to the following data: patient location, sample collection date, disease onset, and disease outcome. The median collection date was four days after the onset of symptoms. The viral gene sequence was derived from RNA sequencing of patient samples (Ebola is an RNA virus).
Phylogenetic analysis, investigating the evolution of viral gene sequences, showed the dynamic nature of the Ebola epidemic and the corresponding molecular changes in viral genome. The analysis included 179 previously unsequenced Ebola genomes from various locations in West Africa, and an additional group of previously sequenced genomes, 78 from Sierra Leone, 3 from Guinea, and 2 from Mali. During this analysis, several distinct genetic lineages of the virus were identified.
The first lineage was linked to early Guinean cases and a single Liberian sequence. This cluster of viral genomes is likely directly associated with the original outbreak in Guinea that was almost successfully contained in May 2014 via interventions from various health agencies. In Sierra Leone, there were two groupings of viral genome, which began to show overlap with viral genomes from both Guinea and Liberia, suggesting continued spread across borders during this time.
After the emergence of the primary lineage in Guinea, a second independent genetic lineage of Ebola spread into Guinea, Liberia, and Sierra Leone, where it become associated with the large epidemic that persisted into 2015. Though the scientists examined the possibility of one genetic strain being more virulent or deadline than another, the data didn’t show an increase or decrease in mortality associated with any particular virus cluster.
A probability analysis of gene evolution over time showed that the actual rate of genetic mutation in this outbreak was lower than the mutation rate that was initially reported, which means that the virus mutated at a slower rate than was initially projected.
In contrast, the observed mutation rate was higher than the non-outbreak rate of mutation for Ebola, meaning that the Ebola genome mutation rate during the outbreak was higher than it is when the virus is circulating in non-human hosts. This is to be expected because during an outbreak, the virus multiplies more rapidly as it spreads to new hosts, leading to a higher rate of mutation.
In considering the difference between in-outbreak mutation rates and non-outbreak mutation rates, it’s important to remember that the non-outbreak mutation rate for Ebola is entirely dependent on its existence in non-human virus reservoirs. During non-outbreak times, there is typically no infection in humans; instead Ebola replicates in primates and bats. The difference in host organism for during-outbreak and non-outbreak periods may mean that the in-outbreak and non-outbreak rates of mutation are not comparable.
The time-dependent genetic analysis of Ebola during this most recent series of infections provides an unprecedented peek into the evolution of an ongoing viral hemorrhagic fever outbreak. When paired with time-stamped data about the interventions that were being used in various affected areas, we could gain additional insight into the relationship between effective intervention and continued viral spread.
In the field disease fighters now fear Ebola will become endemic in West Africa for cultural reasons.
Why Ebola won’t go away in West Africa
http://www.mprnews.org/story/2015/06/20/npr-ebola-west-africa
Health Jason Beaubien Jun 19, 2015
Despite dramatic drops in the overall numbers of reported cases, Sierra Leone and Guinea are still struggling to stop the deadly disease.
Case tallies in both countries have dipped towards zero in the past few months, only to bounce back up. Sierra Leone reported 14 new cases this week and Guinea counted 10.
To try to finally wipe out Ebola once and for all, Sierra Leone President Ernest Bai Koroma ordered the military last week to enforce new community-wide quarantines around the most recent cases.
“The curfew restrictions and the soldier activities will last for a 21-day period,” President Koroma declared on TV last week. Anyone caught violating the quarantine will be arrested, he ordered.
People aren’t allowed to leave the quarantined communities, and the government has imposed a curfew from 6 p.m. to 6 a.m. The new restrictions are aimed at “ending the secret movement of cases, contacts, and dead bodies that has propagated transmission over the past two months,” the World Health Organization said.
Guinea arguably is in a worse position than Sierra Leone. The outbreak has been going on longer in Guinea. Cases are more geographically widespread, and some rural communities in Guinea have blocked health workers from entering.
“I think it’s going to be very difficult to actually get to zero cases and stay at zero cases in Sierra Leone and Guinea,” says Dr. Daniel Lucey, a professor of immunology at Georgetown University, who just returned from Guinea last week.
Lucey has worked as a doctor on Ebola treatment wards in both Sierra Leone and Liberia. He still sees major problems facing the Ebola eradication effort.
One bad sign is that people continue to die from Ebola at home and are only diagnosed as having the disease after death. “That means they’ve been sick for days, possibly weeks, and so they’re contagious,” he says. “Who did they expose? It’s hard to know once they’re dead.”
To gain the upper hand against the outbreak, health officials need to be able to track down anyone who may have been exposed to the virus. Currently they’re monitoring more than 2,000 contacts of Ebola patients in the region. Yet, despite this, sick people keep turning up who aren’t on any known contact list. “We don’t have the degree of control that’s essential to stop the epidemic,” Lucey says.
To get control of this outbreak, health officials need to be able to go visit the contacts who are being monitored for Ebola. They have to get blood samples to laboratories. They have to be able to transport patients to isolation wards and safely bury anyone who’s died of the disease.
In remote parts of West Africa, with poorly-maintained dirt roads, this is difficult in the best of times. It’ll get even more difficult as seasonal rains kick in to full gear, Lucey says. “If we haven’t been able to succeed in the last six months during the dry season, how are we going to succeed in the next six months in the rainy season?”
Lucey concedes that there has been incredible progress against Ebola. At the apex of this outbreak last fall, there were more than a thousand cases being reported each week. Now we are down to only about two dozen new cases each week.
But those last few cases may be the hardest to stamp out, Lucey warns. And if the outbreak doesn’t get completely stopped soon, he says, there’s a danger Ebola could become endemic in the region.
Score one for USMRID!
U.S. Army Medical Research Institute of Infectious Diseases found Zoloft and Vascor were 70% and 100% effective in removing the Ebola virus from the blood of mice.
Drugs to fight Ebola may already be in your medicine cabinet
Posted: Sunday, June 21, 2015 12:00 am
BY KAREN KAPLAN/LOS ANGELES TIMES
Researchers have found two drugs that saved the lives of mice infected with the deadly Ebola virus, and you may have them in your medicine cabinet already.
Zoloft, an antidepressant that has been on the market since 1991, cured 70 percent of mice that had the virus in their blood. Vascor, a heart drug approved by the U.S. Food and Drug Administration in 1990, cured 100 percent of the infected mice.
Zoloft and Vascor were just two of about 2,600 drug compounds tested for their ability to disable Ebola viruses and the closely related Marburg virus, according to a report published in the journal Science Translational Medicine. Both types of viruses cause hemorrhagic fevers that can be fatal in up to 90 percent of cases.
The current Ebola outbreak in West Africa has killed 11,162 people and sickened 27,181 since claiming its first victim in December 2013, according to the World Health Organization.
Researchers in government labs and pharmaceutical companies have been scrambling to develop new drugs to fight the virus, and while they have come up with several promising candidates, all of them have months or years of testing ahead of them.
A team from the U.S. Army Medical Research Institute of Infectious Diseases, the University of Virginia and Horizon Discovery Inc., of Cambridge, Mass., decided to take a different approach. Instead of creating a new drug from scratch, they set out to determine whether an existing drug could be deployed to fight Ebola.
They began with a “library” of 2,635 compounds that included FDA-approved drugs, amino acids, food additives, vitamins and minerals.
Each of the candidates was tested on a version of the Ebola virus that had been engineered to glow green when exposed to ultraviolet light. A candidate was considered successful if it dulled the green signal by at least 40 percent and also did little or no harm to a sample of uninfected cells derived from the kidneys of African green monkeys.
A total of 171 compounds passed this first round of testing. From this list, the researchers picked 30 that seemed most promising and tested them further in the kidney cells and in human liver cancer cells. They found that 25 of the compounds were able to block Ebola’s entry into cells by more than 90 percent.
For the next round, the researchers picked eight compounds to test in mice. Drug treatment began one hour after the animals were infected with a mouse version of Ebola and continued for up to 10 days.
Three of the compounds had no discernible effect, and all of the mice who got them were dead within eight days. Three other candidates allowed 10 percent, 30 percent and 40 percent of the mice to live for 28 days.
But Zoloft (also known by the generic name sertraline) and Vascor (generic name bepridil) had more encouraging results. Of the 10 mice that got Zoloft, seven survived for 28 days. Even better, all 10 of the mice treated with Vascor were alive 28 days after infection. For the sake of comparison, all of the untreated mice that served as controls were dead within nine days.
The two drugs were then tested in cell cultures against a larger group of Ebola and Marburg viruses. Both medications were able to fight all of the viral strains, including a Zaire Ebolavirus, the type now circulating in West Africa.
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Ebola, It’s back.
http://uk.reuters.com/article/2015/06/22/uk-health-ebola-leone-idUKKBN0P225920150622
June 22, 2015
Sierra Leone has recorded two new cases of Ebola in Freetown in the past few days, disproving the assumption that the capital city had already defeated the deadly virus, officials said on Monday.
The worst known Ebola epidemic in history has killed more than 11,000 people in West Africa, about a third of them in Sierra Leone. Liberia became Ebola-free in May, but its neighbours Sierra Leone and Guinea are still struggling to get to zero cases despite hundreds of millions of dollars in aid.
“This is worrisome because we had already closed all Ebola quarantine structures in Freetown since we had gone for weeks without a case,” said Sidi Yahya Tunis, a spokesman for the National Ebola Response Centre (NERC).
Tunis said there were concerns about further infection since the two cases were reported in Magazine, a densely populated slum lacking adequate hygiene facilities.
Health officials said the first case in Freetown since May 29 was a fisherman who caught the hemorrhagic fever from his girlfriend in the northern district of Port Loko.
Shortly afterwards, a family member who lived in the same household also caught the virus. The other six cases recorded in Sierra Leone over the past week were in the northern provinces of Port Loko and Kambia, health ministry data showed.
(Reporting by Umaru Fofana; Writing by Makini Brice; Editing by Emma Farge and Tom Heneghan)
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To get up to speed, go up thread to 4960 or earlier.
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To sum up:
It ain’t over until it’s over.
And it ain’t over.
I talked with a fellow from Liberia in the Walmart in Williston, ND (There are a few Liberians working there), and he was thankful his family had been spared.
All the same, he won't go back to visit family there, even though Liberia has been declared Ebola-free, until the problems have been resolved.
He said it is too easy to literally walk from Liberia to Guinea or Sierra Leone, (or vice-versa) and the borders are not guarded very well. Until it is out of the region, it will not be gone.
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This is from the PFIF —
Liberia: Ebola Virus Survivors Instinct - Sex Eclipses Dog Theory
http://allafrica.com/stories/201507151807.html
Bettie Johnson
A family of 16 residing on the A. B. Tolbert Road in Paynesville is the next home to be quarantined by the Ministry of Health for link to a confirmed case of the deadly Ebola virus, the resurgence of the virus after the country was declared Ebola free on May 9 by the World Health organization. Residing in an unfinished House the family is under quarantine after a family member and friend to a 17 year boy who corpse tested positive ran from Margibi and came to his family in Monrovia.
The suspected case, name withheld by health officials who is currently at the Ebola treatment unit came to his mother in Monrovia and was treated by his mother, a Registered Nurse for malaria. The boy who was later confirmed positive was treated by both his mother and older brother but his mother was more exposed to the virus that led to her death. Following the death of the woman, the family has been placed under quarantine by Health authorities but those under quarantined with no appropriate monitoring in place. Those quarantined are seen roaming from one place to another.
Family faces rejection
The children of the quarantined family are facing rejection as they are denied from playing with other children in the community. Waigolo Mulbah, is a sibling to the late Ebola victim. He says the Ambulance took his sister after his cousin was taken to the ETU. He narrated that though his sister did not experience any signs or symptoms suspected to be Ebola but due to fears, she could not eat upon the visitation of Ebola workers at their home.
“She never showed any signs or symptoms of Ebola. We were here out of fear our sister did not eat for 5 days, she was so scare and so the ETU workers came for her days after they told us she had die,” said Mulbah. Mulbah and 15 others had gone over 11 days, hoping to reach the required 21 days period to be allowed free movement but they had to restart the quarantine process following the death of his sister.
“She went to the ETU, and after she died they started our quarantine again, for what we know now is the boy is still alive”, Mulbah told FPA. He said though the Ministry of Health says they are quarantined, there is nothing to show that they are prevented from moving around in the community.”We are here and stigmatized by the community, but the Health Ministry says we are quarantined, but nothing to show we are being quarantined. The community members are pointing fingers at us the whole day” - Waigolo Mulbah, lamented.
On the issue of movement, he told FPA that he is a student of University of Liberia and other Children under quarantine were going to school initially but community members widely stigmatized them prompting the Ministry of Health to mandate the community dwellers to serve as watchdogs against their movement.
“Here they treat us like dogs, we are not respected, though they bring us water and food but it is a distance from us, even if we throw things down like the gloves that they used today on us, it mistakenly went in the bush which is far from them; but they demanded that the gloves be removed or else they wouldn’t supply us anything, “he added.
Mulbah confirmed that he and his sick cousin (sick boy) lengthily interacted upon his return to Monrovia saying, “Up today’s date I have not experienced signs nor symptoms of Ebola, so where is this Ebola now”.Deputy Incident Manager and Liberia’s Chief Medical Officer, Dr. Francis Kateh told a Ministry of Information regular press briefing Tuesday that since July 12 the country has 6 confirmed Ebola cases.
He said: “What is important is during the fight we have tried to contain the virus in Margibi County but we knew that there were contacts made from the cases in Margibi and a place in Monrovia and so we began an immediate step and that is a voluntary precautionary center put in place.” He boasted that contact tracing is active as all of the contacts are traced and monitored by health authorities.
The Chief Medical Officer said it was shocking that contacts are not honest adding that they are the basis for the increase in cases. “What is shocking is that we have to realize we need to be open and need to be honest with ourselves, and it’s through honesty we can stop this disease.”
Dr. Kateh added “If you are a contact tell the health care workers that you are a contact, then you will have people monitoring you but you have to be honest with them, now we have 4 cases at the ETU and they all doing well, now it is six confirmed cases, two deceased”. The Deputy Health Minister disclosed that there are 124 contacts actively in Margibi, 16 in Monrovia, and said the number could fluctuate on grounds that there is ongoing investigation.
“We have gone a step further because we have asked the county health officers to be on the alert, we are not saying the other counties have contacted it but we need to alert them so that we wouldn’t experience the previous outbreak,” he said. Dr. Kateh continued: “We have been doing this continuously, the rapid response team will be set at all times, we have the expertise and we are asking the public not to conceal information from us because we have the technique and we understand what is it to put under this control.”
Not slipping our control
He said the Ministry has everything under control as the public has been warned not to shield sick or dead people in homes or hospitals. Dr. Kateh added that sometimes the acceptance of health workers to receive critically ill people might also cause the increase of the virus in the country. “From the cases, we have enlightened health care workers because their action could cause a situation to increase cases, we keep saying, if you have fever don’t take Paracetamol, the dishonesty could lead to more problems, we cannot babysit everyone, so if that trust is built the disease will be contained,” he appealed
Not an animal source
Since the new outbreak the Ministry and Health authorities are yet to tell the public the source of the new infection with fingers pointed at a dead dog which those now tested positive were all said to have eaten but Dr. Kateh disclosed that the virus is not linked to eating of the dog by the dead 17 year old boy and others in Margibi. Dr. Kateh said the Ministry is investigating to know the source of the new infection.
“We are conducting investigation; we are getting to the source until we can scientifically proof it. We also established that it has not come from Guinea or Sierra Leone because their strains are different from the new outbreak and hence after getting the result we will inform the public”. The Active Case Finders are credited for finding the new case in Margibi, but Dr. Netty Joe of the United Nations Development Programme, head of Active Case Finders in Montserrado disclosed that finders are now discourage to work as they are told that their job is voluntary.
She said WHO was taking the lead in the program but turned it over to the UNDP to manage but unfortunately, UNDP told her that there is no funding to continue the program something she said will result to the increase of cases as finders are the major source of tracing contacts of Ebola. “We started with a very huge number and so with no funding you have to cut the number down. We did a scale down mostly on the high risk areas namely New Kru Town, Bong Mines Bridge and in Sinkor we reduced that to 50% because no funds,” she added.
Dr. Joe continued: “Frankly speaking we studied the situation thoroughly, we need someone in the community surveillance, and it was done through studies and the UNDP and WHO said they have decided to redirect the efforts to Guinea and Sierra Leone so the project ended June so we are only paying them for May and June”. She said finders and heads were informed of the problem and she has appealed to them to volunteer something she said is challenging, as the Active Case Finding is a job creation for young people.
Said Dr. Joe: “The figure we have was 4, 100 but we cut it down to 1,700 persons so we are covering the entire Montserrado; for July no funding yet, and it is so hard to do, we in the field know the importance of them and if you getting money from donors and they say they can’t do anything, we hope to have new donors to help contain the spread of the virus.
Similar strain, says WHO
The WHO has indicated that as part of the investigation into the source of this new cluster of infections, samples taken from the first person found to have Ebola were sent to the Liberian National Reference Laboratory for genetic sequencing where tests on these samples have shown that the virus is genetically similar to viruses that infected many people in Margibi County more than six months ago, in late 2014.
Stated WHO: “This information provides important insights into the probable origin of the virus responsible for this new flare-up in Liberia. Because the virus appears to be related to the one previously circulating in Liberia, it is unlikely that this recurrence has been caused by virus imported from infected areas of Guinea or Sierra Leone. It also makes it unlikely that this has been caused by a new emergence from a natural reservoir, such as a bat or other animal”. According to the WHO, the genetic sequencing on samples from the four other cases in this new outbreak is underway.
Presently, the WHO says 149 people have been identified as contacts and are being monitored closely. Four of these people have tested positive and are being treated for Ebola virus disease in Ebola treatment centers. As with all cases, the number of contacts has been fluctuating. Some are true contacts, while others are not. When a suspected case is confirmed as negative, all contacts associated with that case are de-listed, which is why the number of contacts has declined this week.
The WHO has disclosed that detailed clinical, epidemiological and laboratory investigations are on-going to identify the initial source of infection. This includes the genetic sequencing that has suggested this virus is linked to virus circulating in earlier chains of transmission in Liberia. Liberia, the WHO said has undertaken the relevant planning to prepare for and respond to the recurrence of Ebola. But the latest death and scores of quarantine going on simultaneously is expected to put the government’s readiness to the test as the resurging virus continues to spread.
This is a comment from the Site Admin over at PFIF. It raises very serious questions as to what is going on in Africa.
Key question: Is the virus constantly replicating in survivors? If so, the virus should change significantly over a year. If the virus is “frozen in time”, then that suggests that this strain of Ebola can go into a latent state and reactivate such that men can infect others through sex although they themselves do not appear ill OR that the virus was literally frozen and then released. The second possibility is just as obvious as the first and should be considered until there is sufficient data to decide between the two explanations.
The significance of this story is understated and, apparently, unappreciated.
The last post from PFIF today, Freetown, Sierra Leone continues to have fresh, uncontained by public health measures, Ebola infections.
And there is still no successful vaccine in site.
Ebola cases rise in Sierra Leone capital
http://www.bbc.com/news/world-africa-33528996
Health officials in Sierra Leone have warned that new cases of Ebola are continuing to emerge, more than year after the major outbreak was first declared.
Despite a decline in cases in recent months, there has been a sudden rise in new infections in the capital Freetown.
Almost 4,000 people have died from Ebola in Sierra Leone since the epidemic broke out in December 2013, making it one of the worst hit countries worst along with Guinea and Liberia.
Experts warn that fear, fatigue and denial are allowing the virus to spread.
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