Beating Ebola Means Drinking, Last Thing Patient Wants to Do

BLOOMBERG BUSINESSWEEK                                Nov. 17, 2014
by Jason Gale

The best medical advice for surviving Ebola right now might fit in one word: drink.

Dr. Fadipe Akinniyi Emmanuel, Ebola survivor, shows the daily dose of oral rehydration salts, or ORS, he and other survivors took to survive in Nigeria. Photographer: Andrew Esiebo/World Health Organization via Bloomberg

With targeted drugs and vaccines at least months away, doctors and public health experts are learning from Ebola survivors what simple steps helped them beat the infection. Turns out drinking 4 liters (1 gallon) or more of rehydration solution a day -- a challenge for anyone and especially those wracked by relentless bouts of vomiting -- is crucial. “When people are infected, they get dry as a crisp really quickly,” said Simon Mardel, an emergency room doctor advising the World Health Organization on Ebola in Sierra Leone. “Then the tragedy is that they don’t want to drink.”

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Fearing Ebola surge, Mali widens virus watch to 440 people

AFP                                                                                                         Nov.17,2014                                 

Fearful of a surge of Ebola cases, Mali has placed more than 440 people under surveillance..

Officials in Mali met to consider increasing security at its border following two confirmed cases of Ebola due to infection in neighboring Guinea.

 

Police officers stand in front of the quarantined Pasteur clinic in Bamako on November 12, 2014 ©Habibou Kouyate (AFP/File)

Mali has been scrambling to prevent a minor outbreak from turning into a major crisis after the deaths of a Guinean imam and the Malian nurse who treated him in the capital Bamako.

"The number of contacts followed by health services amounts to 442. They have all been placed under observation for health control," Samba Sow, of the Ebola emergency operations center, said in a statement late Sunday.

Teams of investigators have been tracking health workers and scouring Bamako and the imam's village of Kouremale, which straddles the Mali-Guinea border, for people who could have been exposed.

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Ambassador John Hoover: Ebola a challenge for U.S. diplomatic team in Sierra Leone

WASHINGTON POST                                                                                                Nov. 17, 2014

By Joel Achenbach

John Hoover, the U.S amabassador to Sierre Leone, .... noted that the response to the epidemic in Sierra Leone poses a management challenge, and he sees a need to “sharpen coordination.”

                                                           Ambassador John Hoover. (Courtesy of State Department)

“There are a great deal of players on the ground,” Hoover said in an interview from Freetown.  “Lots of people doing lots of things. It’s a question of sharpening that coordination so that we’re not missing gaps and not overlapping and tripping over one another.”

He sees progress in that battle in the eastern part of Sierra Leone, but the epidemic is flaring in the western part of the country. Sierra Leone is the country with the highest infection rate, according to the World Health Organization’s most recent update. About 70 employees of the Centers for Disease Control and Prevention have deployed to Sierra Leone to fight Ebola. The U.S. military has focused on neighboring Liberia; Britain has a leading role in Sierra Leone....

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Fear of Ebola Opens Wary Villages to Outsiders in Guinea

In-depth description of the Ebola situation in remote villages in Guinea

A man with symptoms of Ebola walked to the center of Dandano after the chief of the village ordered the removal of sick people from homes. “Bring out your sick!” the chief shouted at the crowd, shaking his fist and warning of illness and death for the whole village if they did not obey. Samuel Aranda for The New York Times

NEW YORK TIMES                                                                                                             Nov. 17, 2014
By Adam Nossiter

DANDANO, Guinea--

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A doctor’s mistaken Ebola test: ‘We were celebrating. . . . Then everything fell apart’

WASHINGTON POST                                                                                          Nov. 17, 2014

By Kevin Sieff

...The doctors who tended to him in Freetown appeared to be unaware that an early Ebola test — taken within the first three days of the illness — is often inconclusive. In a country where information about the disease continues to move slowly, it was another potentially tragic mistake.

In many cases, a negative test at that stage means nothing because “there aren’t enough copies of the virus in the blood for the test to pick up,” said Ermias Belay, the head of the CDC’s Ebola response team in Sierra Leone.

But M’Briwa and others treated the test as definitive, even though Salia remained feverish and weak. The first results were delivered by a team of Chinese lab technicians who had opened a nearby hospital. (The technicians declined Sunday to speak about Salia’s case.)...

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http://www.washingtonpost.com/world/a-doctors-mistaken-ebola-test-we-were-celebrating--then-everything-fell-apart/2014/11/16/946a84da-6dd5-11e4-a2c2-478179fd0489_story.html

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Ebola-infected doctor dies in Nebraska hospital

LOS ANGELES TIMES                                                                                         Nov. 17, 2014
By Julie Westfall

Dr. Martin Salia, who contracted Ebola in Sierra Leone and was being treated at a Nebraska hospital, has died, a hospital spokesman confirmed Monday.

Martin Salia, 44, was taken to Nebraska Medical Center in Omaha to be treated for Ebola after contracting the disease in Sierra Leone. (UBCentral.org)

"It is with an extremely heavy heart that we share this news," Dr. Phil Smith, medical director of the biocontainment unit at Omaha's Nebraska Medical Center, said in a statement. "Dr. Salia was extremely critical when he arrived here, and unfortunately, despite our best efforts, we weren't able to save him."

Salia was a member of the Church of the United Bretheren in Christ and was working as a surgeon at Kissy United Methodist Hospital in Freetown, Sierra Leone, treating Ebola patients as the disease spread in West Africa.

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In Ebola fight, private foundations provide critical financial aid

Description of the way the CDC Foundation, the Allen Foundation and large donors are playing an important role in countering Ebola.

THE WASHINGTON POST                                                                                                          Nov. 17, 2014
By Ariana Eunjung Cha

"...The unpredictable nature of the Ebola virus has made the government’s partnerships with private donors critically important in the crisis response. Working outside the politically charged federal appropriations process and the sometimes sluggish bureaucracy, foundations and private individuals have been able to offer much-needed relief for those on the front lines...."

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http://www.washingtonpost.com/national/health-science/in-ebola-fight-private-foundations-provide-critical-financial-aid/2014/11/16/b57ec57e-6109-11e4-9f3a-7e28799e0549_story.html

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New Ebola Patient in Nebraska in Critical Condition

Martin Salia Treated After Being Transported From Sierra Leone

WALL STREET JOURNAL                                     Nov. 16, 2014 ByBetsy McKay and Scott Calvert

A surgeon under treatment for Ebola in Omaha, Neb., is in extremely critical condition, the hospital said early Sunday.

Martin Salia was admitted on Saturday to the Nebraska Medical Center’s biocontainment unit after a medical evacuation from Freetown, Sierra Leone.

 

Dr. Martin Salia poses for a photo in Freetown, Sierra Leone, in April. Associated Press

“This is an hour-by-hour situation,” said Philip Smith, medical director of the biocontainment unit and a professor of infectious diseases at the University of Nebraska Medical Center, the hospital’s academic partner. “He is extremely ill. We have multiple highly-trained specialists who are experts in their fields targeting his most serious medical issues.”

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Dr. David Nabarro (UN Special Envoy on Ebola) on Ebola - General Assembly, Informal Meeting, 69th Session (13 November 2014)

webtv.un.org

13 Nov 2014 - Statement by Dr. David Nabarro, UN Special Envoy on Ebola at the General Assembly Informal meeting of the plenary briefing on the Ebola virus outbreak.

(CLICK HERE - VIDEO - Statement by Dr. David Nabarro, UN Special Envoy on Ebola)

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U.N. scraps clinic contract as Ebola exposes Mali readiness gaps

REUTERS                                                  Nov. 16, 2014
By David Lewis

DAKAR - The United Nations mission in Mali has canceled plans to renew a contract with a private clinic providing care to its peacekeepers after a case of Ebola was missed and spread from there.

Children watch as a health worker sprays disinfectant outside a mosque in Bamako, Mali November 14, 2014.Credit: Reuters/Joe Penney

This second Ebola alarm in Mali, coming just as it seemed to have contained its first case last month, raised doubts about the country's ability to protect itself from the epidemic ...

The U.N. mission in Mali, whose peacekeepers are helping to protect the nation against Islamist rebels, reversed on Saturday a decision taken earlier in the week to renew the contract with the Pasteur Clinic in Bamako to care for sick or injured troops.

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Ebola: Democratic Republic of Congo says its outbreak is over

BBC                                                                                                              Nov. 15, 2014

A three-month Ebola outbreak in the Democratic Republic of Congo has ended after claiming at least 49 lives, the country's health minister says.

Health workers are trained in managing Ebola in the Democratic Republic of Congo

Felix Kabange said no new cases had been registered since 4 October, though he warned against complacency.

The country's outbreak is unrelated to the one in West Africa which has claimed more than 5,000 lives.

Ebola was first detected in 1976 near the Ebola River in what is now the Democratic Republic of Congo.

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http://www.bbc.com/news/world-africa-30068324

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G20 leaders call for global action to tackle Ebola

IMF to provide additional funds to counter Ebola while NGO's criticizes the G20 statement as lacking  substance
(Two stories, scroll down.)
THE GUARDIAN                                                                                                      Nov. 15, 2014
By Patrick Wintour

BRISBANE, AUSTRALIA --The G20 has welcomed a commitment from the IMF to provide $300m (£190m) in extra funding to help fight Ebola in the three worst-affected west African countries.

The IMF money for Sierra Leone, Guinea and Liberia will come through “a combination of concessional loans, debt relief, and grants”, according to a statement issued by the world leaders’ summit, being held in Brisbane.

U.S. President Barack Obama and other leaders gather for a group photo at the G20 summit in Brisbane November 15, 2014.Credit: Reuters/Pablo Martinez Monsivais/Pool

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MSF - Crisis Update: Ebola in West Africa

doctorswithoutborders.org

Doctors Without Borders/Médecins Sans Frontières (MSF) - November 13 at 8:00 PM EST - a special update on the Ebola crisis in West Africa.

MSF has been responding to the current outbreak since March, and the organization's response has grown to include more than 3,000 MSF staff and 600 beds throughout Sierra Leone, Liberia, and Guinea.

With nearly 10,000 cases and 5,000 deaths, this Ebola outbreak is unprecedented. Despite promises of greater assistance from many quarters, MSF is still seeing critical gaps in all aspects of the response—while continuing to see and treat as many patients as possible.

The panel will include MSF aid workers recently returned from assignments in Guinea and Liberia, along with members of MSF headquarters staff. This wide-ranging discussion will include first-hand accounts of working with patients and communities, the ongoing problem of fear and stigma in West Africa and here in the US, and the challenges facing the international community going forward.

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Ebola Virus Disease Cases Among Health Care Workers Not Working in Ebola Treatment Units — Liberia, June–August, 2014

cdc.gov - Early Release - November 14, 2014

(CLICK HERE - READ COMPLETE REPORT - ADDITIONAL INFORMATION)

Almea Matanock, MD1, M. Allison Arwady, MD1, Patrick Ayscue, DVM1, Joseph D. Forrester,MD1, Bethany Gaddis, MPH2, Jennifer C. Hunter, DrPH1, Benjamin Monroe, MPH3, Satish K. Pillai, MD4, Christie Reed, MD5, Ilana J. Schafer, DVM6, Moses Massaquoi, MD7, Bernice Dahn, MD8, Kevin M. De Cock, MD9 (Author affiliations at end of text)

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Ebola cases plummet in Liberian hot spot as aid groups gain community trust

WASHINGTON POST                                               Nov. 14, 2004
By Lena H. Sun

WASHINGTON --The number of new Ebola patients has fallen to practically zero in one of Liberia’s hardest-hit areas because aid workers gained the trust of the community so the sick were able to be treated quickly and the dead were buried safely, according to a report released Friday by the U.S. Centers for Disease Control and Prevention.

                            Number of newly reported Ebola cases in Lofa County, Liberia. (CDC)

That strategy put in place in Lofa County by Doctors Without Borders has been so effective that it could serve “as a model to implement in other affected areas to accelerate control of Ebola,” the report said.

The measures are aimed at reducing fear of everything associated with the disease, from the health-care workers, who looked like astronauts in their protective gear, to the way treatment facilities are designed.

At the Ebola treatment unit in the town of Foya, for example, the facility’s high walls were replaced with transparent fences so people could see what was happening at the center....

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