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Ebola survival improving in Sierra Leone

ASSOCIATED PRESS                                    Dec. 26, 2014

One year into the world's worst Ebola outbreak, doctors are reporting an encouraging sign: About 70 percent of patients in a hard-hit area of Sierra Leone now survive.

The Ebola death rate has fallen even though there are no specific medicines or vaccines to fight the virus....

In a letter published online Wednesday by the New England Journal of Medicine, Dr. Kathryn Jacobsen of George Mason University in Fairfax, Virginia, and other doctors tell of 581 patients taken to an Ebola treatment center that opened near Sierra Leone's capital, Freetown, in late September.

They were given antibiotics, malaria medicines, ibuprofen for pain and fever, intravenous nutrients, anti-nausea medicine and other supportive care. About 31 percent died, including 38 people who were dead when they arrived. Among those admitted more recently, since Nov. 5, mortality was less than 24 percent.

That is much lower than the 74 percent death rate other doctors reported for 106 patients who were treated in the eastern Sierra Leone town of Kenema, in May and June, when some health workers were on strike and response to the outbreak was in crisis mode.

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Next in Ebola Plan: UN Teams to Study Lines of Transmission

REUTERS                                                              Dec. 24, 2014

ACCRA—Medical detective work will be the next big phase in the fight against Ebola when the United Nations deploys hundreds of health workers to identify chains of infection as the virus passes from person to person, top U.N. health workers said.
Health workers bury the body of a suspected Ebola victim at a cemetery in Freetown, Dec. 21, 2014.

The health teams will travel to each district and region of Guinea, Sierra Leone and Liberia, the three countries at the center of the epidemic, to trace who each infected person has potentially contacted.

The effort will run in parallel with measures to minimize the spread of infection, such as treating all Ebola patients in specialized centers and burying all victims safely.

But Phase Two of the plan is to contain the virus by understanding its lines of transmission, said World Health Organization Director-General Margaret Chan.

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Sierra Leone declares five-day Ebola lockdown in north

AFP                                                                       Dec. 24, 2015
The Sierra Leone government on Wednesday declared a five-day lockdown in the country's north to step up efforts to contain the Ebola epidemic, while making an exception for Christmas.

"Muslims and Christians are not allowed to hold services in mosques and churches throughout the lockdown except for Christians on Christmas Day (Thursday)," Alie Kamara, resident minister for the Northern Region, told AFP.

The lockdown is designed "to intensify the containment of the Ebola virus," he said, adding: "We are working to break the chain of transmission."

Deputy communication minister Theo Nicol said "the lockdown for five days... is meant for us to get an accurate picture of the situation," adding: "Other districts will carry on with their own individual lockdown after this if they deemed it necessary."

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http://news.yahoo.com/sierra-leone-declares-five-day-ebola-lockdown-north-191910556.html

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Ebola crisis likely to last a year, says expert

BBC                                             Dec. 24, 2014       

West Africa's Ebola crisis is likely to last until the end of 2015, says a leading researcher who helped to discover the virus.

Peter Piot, who has just returned from Sierra Leone, told the BBC that he was encouraged by progress there and by the promise of new anti-viral therapies.

But he also warned that vaccines would take time to develop....

Prof Piot was one of the scientists who discovered Ebola in 1976and is now Director of the London School of Hygiene and Tropical Medicine.

He said that even though the outbreak has peaked in Liberia and was likely to peak in Sierra Leone in the next few weeks, the epidemic could have a "very long tail and a bumpy tail"...

"We need to be ready for a long effort, a sustained effort [for] probably the rest of 2015."

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http://www.bbc.com/news/world-africa-30595352

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Ebola in the 'red zone'

REUTERS    by Emma Farge                                            Dec. 23, 2014

HASTINGS, Sierra Leone-- When Dr Sekou Kanneh goes to work at his Sierra Leonean Ebola clinic, he will probably be in the "red zone" for many hours, ignoring by necessity strict limits that govern foreign colleagues fighting the epidemic.

Doctor Sekou Kanneh speaks during an interview with Reuters TV in the Hastings ebola treatment centre at a neighbourhood in Freetown, December 21, 2014. Credit: Reuters/Baz Ratner 

Conditions at Kanneh's treatment center, the only Ebola unit in the country run by local staff, contrast to the purpose-built facilities where foreign volunteers who have flocked to Sierra Leone, Guinea and Liberia work.

Kanneh has received no official training to treat the virus that has killed over 7,000 people in West Africa. Still, he works up to four hour shifts in the stifling heat of the red zone, a ward where healthcare workers have direct contact with the highly contagious Ebola patients.

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Evaluation of the Benefits and Risks of Introducing Ebola Community Care Centers, Sierra Leone

     

CDC                                                                                                         Dec. 23, 2014    

Abstract of study on usefulness of Ebola community care centers to supplement larger  Ebola treatment centers.

 In some parts of western Africa, Ebola treatment centers (ETCs) have reached capacity. Unless capacity is rapidly scaled up, the chance to avoid a generalized Ebola epidemic will soon diminish. The World Health Organization and partners are considering additional Ebola patient care options, including community care centers (CCCs), small, lightly staffed units that could be used to isolate patients outside the home and get them into care sooner than otherwise possible.

Using a transmission model, we evaluated the benefits and risks of introducing CCCs into Sierra Leone’s Western Area, where most ETCs are at capacity. We found that use of CCCs could lead to a decline in cases, even if virus transmission occurs between CCC patients and the community. However, to prevent CCC amplification of the epidemic, the risk of Ebola virus–negative persons being exposed to virus within CCCs would have to be offset by a reduction in community transmission resulting from CCC use.

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Ebola raises profile of blood-based therapy

NATURE     by  Delcan Butler                                                                                        Dec. 23, 2014

With no drugs available to treat Ebola, eyes are turning to a therapy that had largely been relegated to the history books: transfusing patients with blood plasma donated by survivors, which contains antibodies against the virus.

Survivors of Ebola carry antibodies that might be used to save the lives of those infected with the virus. Michel du Cille/The Washington Post via Getty Images

Clinical trials of convalescent plasma therapy (CPT) have started in the past few weeks in Liberia, and are due to begin soon in Guinea and Sierra Leone. If the therapy saves lives, the approach could quickly be scaled up.

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On the Front Lines of Ebola’s Most Pressing Mystery

WIRED     by   Erika Check Hayden                                                                              Dec. 23, 2014

KENEMA, Sierra Leone—Mohammed Sankoh Yillah, an outreach worker, spent days in the Ebola ward caring for his sister, nurse Mbalu Fonnie. After Fonnie died in July, Yillah tested positive for the virus. He was transported to another hospital for treatment, but asked to come back to Kenema to die.

But Yillah survived.

Today Yillah sits with four colleagues in an office, discussing a new research project. The study is collecting information about survivors like him. The hope is that the study might help explain why he and others beat Ebola, while their friends and colleagues—Alex, Mbalu—did not.

Epidemiologist Lina Moses runs the meeting. Her colleagues back at Tulane University, she says, hope to analyze blood samples from survivors; she collected 29 such samples here in November. “What they want to know in the laboratory,” she says, “is what kind of antibodies Mohammed Yillah has that helped him to survive Ebola.”

 

                                                                             

 

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C.D.C. Head Says Fight on Ebola Will Be Long

NEW YORK TIMES by Denise Grady                             Dec. 23, 2014
There are reasons for both hope and continued worry about the Ebola epidemic in West Africa, Dr. Thomas R. Frieden, director of the Centers for Disease Control and Prevention, said on Monday.

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Ebola vaccine 'promising in African populations'

BBC     By Smitha Mundasad                                Dec. 22, 2014
The first-ever trial of an Ebola vaccine in Africa shows promising initial results, according to a report in the Lancet medical journal.

Scientists say it is a crucial step as other vaccines have shown lower levels of protection in African populations.

Tests involving Ugandan and American volunteers reveal the vaccine is so far safe and generates an immune response in both populations.

It provides reassurance for other trials currently underway, they say.

No proven vaccine exists to prevent people from getting the disease, though several trials are underway.

Researchers from the National Institutes of Health tested this experimental vaccine on healthy adults in Uganda, having first trialled it in the United States.

Dr Julie Ledgerwood, the lead researcher, said: "This is the first study to show comparable safety and immune response of an experimental Ebola vaccine in an African population.

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http://www.bbc.com/news/health-30577776

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