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Bats’ Link to Ebola Finally Solved

 

THE DAILY BEAST                                                                                                           Nov. 11, 2014
By Carfrie Arnold

A new paper outlines five steps required for a virus to ‘spill over’ from bats to humans. But don’t just blame the bats—deforestation and hunting are to blame, too.

These nocturnal fliers might do some good, but their association with night, rabies, and All Things Creepy means that, at best, we tolerate them. Adding to their negative aura is recent research showing that bats can be the source of infectious diseases like SARS and Ebola, as well as lesser-known pathogens like Hendra and Nipah virus.

It’s all too easy to blame bats for causing these human pandemics, including the most recent (and deadliest) Ebola outbreak. After all, these viruses hang out in bats in between outbreaks—trace any outbreak of these viruses back far enough and you will find a bat.

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Out of Africa — Caring for Patients with Ebola

NEW ENGLAND JOURNAL OF MEDICINE                                                                  Nov. 12, 2014

Eric J. Rubin, M.D., Ph.D., and Lindsey R. Baden, M.D.

The Journal has now published detailed clinical information about three patients transferred from West Africa to the United States or Germany in the midst of their illness.

See details of the treatment

http://www.nejm.org/doi/full/10.1056/NEJMe1412744

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Out of Africa — Caring for Patients with Ebola

NEW ENGLAND JOURNAL OF MEDICINE                                                                  Nov. 12, 2014

Eric J. Rubin, M.D., Ph.D., and Lindsey R. Baden, M.D.

The Journal has now published detailed clinical information about three patients transferred from West Africa to the United States or Germany in the midst of their illness.

See detais of the treatment

http://www.nejm.org/doi/full/10.1056/NEJMe1412744

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Doctors Without Borders will begin Ebola drug studies by December in Africa

USA TODAY                                         Nov. 12, 2014
by Liz Sazbo

Doctors Without Borders will begin clinical trials of three experimental Ebola therapies in West Africa in December, the aid group announced Wednesday.

The studies, to be conducted at the group's treatment centers in Guinea and Liberia, will test therapies already used in some Ebola patients in the USA and Europe: the antiviral drugs brincidofovir and favipiravir, as well as blood donations from Ebola survivors.

Brincidofovir, made by Chimerix of North Carolina, was given to cameraman Ashoka Mukpo, Liberian national Thomas Eric Duncan and physician Craig Spencer. Mukpo and Spencer survived. Duncan received the drug just a couple days before he died.

Favipiravir, an anti-flu drug made by Japan's Fujifilm Holding Corp., was given to a French nurse who worked with Doctors Without Borders.

And blood donations from Ebola survivors, which contain antibodies against the virus, have been used since the first Ebola outbreak in 1976.

Read complete story
http://www.usatoday.com/story/news/nation/2014/11/12/ebola-clinical-trial/18919401/

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Medical Experts Look For New Ways To Test Ebola Drugs

NPR                                             Nov. 11, 2014
By Richard Harris

Medical experts are meeting today and tomorrow at the World Health Organization in Geneva to figure out how to test potential Ebola drugs in Africa. In addition to determining which experimental drugs should be the highest priority, the experts are sorting through some difficult ethical issues.

In short, they're trying to figure out how to design tests that will provide the fastest and most trustworthy answers — and yet minimize the need for comparison groups who won't be offered the experimental treatments.

Nurses assist a new patient at an Ebola center in Liberia's Lofa County. As drug trials get underway, patients may receive experimental medicines. photo by Trenchard/NPR

Practice in the United States has set an unrealistic standard. When American health care workers fell ill with Ebola in Africa, they flew home and received medical care vastly better than what Africans were getting, including experimental therapies.

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Is The Response in Liberia Succeeding? Positive indications

NEW ENGLAND COMPLEX SYSTEMS INSTITUTE                                                                        Oct. 27, 2014
ABSTRACT
By Kia Hall and Yaneer Bar-Yam
The number of cases of Ebola in West Africa has been growing exponentially, and projections assume that this dynamic will continue. However, recent case reports from Liberia indicate a change. The number of new confirmed cases reported by WHO has actually diminished for five weeks in a row.
The WHO report suggests that this may be due to underreporting under conditions of high levels of stress of the number of cases taking place.

Here we report that there appears to be a sound reason for the decreasing number of cases—a change in response strategy that is working. Understanding this dynamic is of critical importance for addressing the outbreak in Sierra Leone and Guinea. In particular the number of cases in Sierra Leone continues to grow exponentially.

Discussions with a WHO response coordinator in Liberia indicates that a change in strategy from individual reporting and contact tracing to community based screening for early detection and population wide behavior change happened in mid September.

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Exclusive: U.S. Ebola researchers plead for access to virus samples

A transmission electron micrograph shows Ebola virus particles in this undated handout image released by the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) in Fredrick, Maryland. Credit: Reuters/USAMRIID/Handout

Image: A transmission electron micrograph shows Ebola virus particles in this undated handout image released by the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) in Fredrick, Maryland. Credit: Reuters/USAMRIID/Handout

reuters.com - November 5th 2014 - Julie Steenhuysen

Scientists across the United States say they cannot obtain samples of Ebola, complicating efforts to understand how the virus is mutating and develop new drugs, vaccines and diagnostics.

The problems reflect growing caution by regulators and transport companies about handling Ebola as well as the limited resources of West African countries which are struggling to help thousands of infected citizens.

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Infection Secrets of Ebola Explained

By attacking the body's first responders, the virus cripples the immune system before it can mount an effective defense

Researchers often describe the battle between the Ebola virus and the humans it occasionally infects as a race—one that people win only if their immune systems manage to pull ahead before the virus destroys too many of their internal defenses. What they may not know is that the virus is a cheat.

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US Officials Unveil Plan to Test Ebola Drugs

NEW ORLEANS --The quest for an Ebola treatment is picking up speed. Federal officials have unveiled a plan to test multiple drugs at once, in an umbrella study with a single comparison group to give fast answers on what works.

"This is novel for us" and is an approach pioneered by cancer researchers, said Dr. Luciana Borio, head of the U.S. Food and Drug Administration's Ebola response. "We need to learn what helps and what hurts" and speed treatments to patients, she said.

She outlined the plan Wednesday at an American Society of Tropical Medicine and Hygiene conference in New Orleans....

Everyone in the umbrella study would get supportive care, such as intravenous fluids, then be assigned to receive one of several drugs or be in a comparison group. That's needed because without one, there's no way to know if any problems or deaths are from the drug or the disease, Cox said....

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New study sheds light on the importance of supportive care for Ebola patients

                                                                     Nov. 6, 2014

...a WHO-coordinated retrospective study, published in the New England Journal of Medicine, provides evidence that supportive care, especially rehydration and correction of metabolic abnormalities, may contribute to patient survival.

The study analysed clinical data on 37 confirmed Ebola patients admitted for treatment at hospitals in Conakry, Guinea’s capital and most densely populated city.

The cases occurred during the first month of West Africa’s first outbreak of Ebola virus disease. Fourteen of the patients were heath care workers. The majority (12) acquired their infection in a health care setting.

The majority (65%) of patients were male, countering assumptions that women, who are more likely to provide home care for patients and prepare bodies for funerals and burials, are more frequently exposed and infected.

To replace fluids lost through severe diarrhoea, 36 patients (97%) received oral rehydration solution. Additional intravenous fluid resuscitation was given to 28 (76%) patients.

Read complete press release

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