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Ebola Crisis
Topic Started: 23 Mar 2014, 12:52 AM (2,800 Views)
skibboy
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22 March 2014

Guinea deaths: Ebola blamed for deadly fever outbreak

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Ebola was first identified in the Democratic Republic of Congo in 1976

The Ebola virus has been identified as the cause of an outbreak of haemorrhagic fever now believed to have killed nearly 60 people in southern Guinea, government officials say.

Scores of cases have been recorded since the outbreak began early last month.

There is no known cure or vaccine for the highly contagious Ebola virus.

It is spread by close personal contact with people who are infected and kills between 25% and 90% of victims.

Symptoms include internal and external bleeding, diarrhoea and vomiting.

Outbreaks of Ebola occur primarily in remote villages in Central and West Africa, near tropical rainforests, the World Health Organization says.

Analysts suggest it has never been recorded in Guinea before.

Recent years have seen outbreaks in Uganda and Democratic Republic of Congo.

'Overwhelmed'

"We got the first results from Lyon yesterday (Friday) which informed us of the presence of the Ebola virus as the cause of this outbreak," Guinean health ministry official Sakoba Keita told AFP.

"The Ebola fever epidemic raging in southern Guinea since 9 February has left at least 59 dead out of 80 cases identified by our services on the ground."

"We are overwhelmed in the field, we are fighting against this epidemic with all the means we have at our disposal with the help of our partners but it is difficult."

Medical aid charity Medecins sans Frontieres said on Saturday it would strengthen its team in Guinea and fly some 33 tonnes of drugs and isolation equipment in from Belgium and France.

Dr Armand Sprecher, an emergency physician and epidemiologist working with MSF in Guinea, told the BBC that doctors had to identify all patients with the disease and monitor anyone they had been in contact with during their illness.

The latest outbreak could be brought under control if people acted quickly, he said.

"Based on our history with these sorts of outbreaks it will happen. Ideally, sooner rather than later," said Dr Sprecher.

"The more quickly we can contain this the fewer cases we'll have, then the smaller the scale of the epidemic. That's the idea of going in as strong as we can early on."

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skibboy
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30 December 2014

First Ebola boy likely infected by playing in bat tree

By Michelle Roberts
Health editor, BBC News online

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Other researchers have been testing bats in West Africa for Ebola virus

The Ebola victim who is believed to have triggered the current outbreak - a two-year-old boy called Emile Ouamouno from Guinea - may have been infected by playing in a hollow tree housing a colony of bats, say scientists.

They made the connection on an expedition to the boy's village, Meliandou.

They took samples and chatted to locals to find out more about Ebola's source.

The team's findings are published in EMBO Molecular Medicine.

Ebola trail

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Meliandou is a small village surrounded by farmland and large trees

Meliandou is a small village of 31 houses.

It sits deep within the Guinean forest region, surrounded by towering reeds and oil palm cultivations - these are believed to have attracted the fruit bats carrying the virus passed on to Emile.

During their four-week field trip in April 2014, Dr Fabian Leendertz and colleagues found a large tree stump situated about 50m from Emile's home.

Villagers reported that children used to play frequently in the hollow tree.

Emile - who died of Ebola in December 2013 - used to play there, according to his friends.

The villagers said that the tree burned on March 24, 2014 and that once the tree caught fire, there issued a "rain of bats".

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Children from the village used to play in and around the tree

A large number of these insectivorous free-tailed bats - Mops condylurus in Latin - were collected by the villagers for food, but disposed of the next day after a government-led ban on bushmeat consumption was announced.

While bushmeat is thought to be a possible source of Ebola, the scientists believe it didn't trigger the outbreak.

Instead, it was Emile's exposure to the bats and their droppings as he played with his friends in the hollowed tree.

Pest control

The scientists took and tested ash samples from the tree and found DNA traces that were a match for the animals.

While they were unable to test any of the bushmeat that the villagers had disposed of, they captured and tested any living bats they could find in and around Meliandou.

No Ebola could be detected in any of these hundred or so animals, however.

But previous tests show this species of bat can carry Ebola.

Dr Leendertz, from the Robert Koch Institute in Germany, and his colleagues say this must be a pretty rare occurrence though.

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Dr Leendertz said: "That is also obvious when you think about how many tonnes of bat meat is consumed every year.

"If more bats carried the virus, we would see outbreaks all the time."

He says it is vital to find out more about the bats.

"They have moved into human settlements. They do not just live in the trees but also under the roofs of houses in the villages.

"The Ebola virus must jump through colonies from bat to bat, so we need to know more."

But culling the animals is not the answer.

"We need to find ways to live together with the wildlife. These bats catch insects and pests, such as mosquitoes. They can eat about a quarter of their body weight in insects a day.

"Killing them would not be a solution. You would have more malaria."

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30 December 2014

Ebola nurse may be offered recovered patients' plasma

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Nurse Pauline Cafferkey, who is battling Ebola at a London hospital, could be offered plasma from patients who have survived the virus.

The treatment contains antibodies that should help fight the infection.

British nurse William Pooley has donated plasma, Chief Medical Officer Dame Sally Davies confirmed.

Other available treatments include antiviral drugs, but there are no stocks left of ZMapp - the drug used to treat Mr Pooley.

He recovered from Ebola in September after being treated at the Royal Free Hospital, in Hampstead, north London, where Ms Cafferkey is currently being cared for.

Having fought off the infection, his blood should help others do the same.

Dame Sally said it would be up to Ms Cafferkey and her doctor to decide which treatments to use, adding: "The cornerstone of treatment remains fluid and electrolyte treatment."

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Ms Cafferkey left hospital in Glasgow in the early hours of Tuesday

Ms Cafferkey was diagnosed with Ebola after returning to Glasgow from Sierra Leone, where she had travelled with a group of healthcare workers from Save the Children.

She was said to be doing "as well as can be expected under the circumstances" by Scotland's First Minister Nicola Sturgeon.

Another healthcare worker who was recently in West Africa and fell ill in the Scottish Highlands has tested negative for the disease.

Dame Sally said that Ms Cafferkey was in the early phase of the disease when she made the journey to the UK from Sierra Leone, via Casablanca, and her fellow passengers were at "very low risk" of being infected.

She had no detectable fever or symptoms.

Anyone displaying symptoms at screening, either in Sierra Leone or in the UK, would not have been allowed to travel.

One-third of the 132 other passengers on the flight from Casablanca to Heathrow have been contacted by Public Health England, while advice has been given to more than half the 72 passengers from Heathrow to Glasgow, officials said.

Those sitting in the two rows adjacent to, ahead and behind Ms Cafferkey will be advised to keep a check on their temperature for the next few weeks and to contact officials if they get a fever or feel unwell.

Screening 'chaotic'

Concerns about the Ebola screening process at Heathrow have been raised by Dr Martin Deahl, a consultant psychiatrist who travelled back on the same flight as Ms Cafferkey.

He described the screening as "chaotic", claiming there were too few staff on duty and the rooms where returning volunteers were held were too small.

Dame Sally said procedures for detecting the disease are being reviewed, but said the correct protocols had been followed.

Save the Children, the charity with which Ms Cafferkey volunteered, issued a statement saying: "We have robust and strict protocols in place to protect our staff.

"Save the Children also asks staff to be careful outside of the treatment centre, where exposure to risks can be less obvious."

Ms Cafferkey had her temperature checked seven times while at Heathrow before she was cleared to continue on her journey to Glasgow.

Ebola is transmitted by direct contact with the bodily fluids of an infected person, such as blood, vomit or faeces.

The virus has killed more than 7,800 people, mostly in West Africa, since it broke out a year ago.

The World Health Organization says the number of people infected by the disease in Sierra Leone, Liberia and Guinea has now passed 20,000.

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01 January 2015

Italy doctor with Ebola has recovered: media

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© AFP/File | The main entrance of the Lazzaro Spallanzani Institute in Rome, November 25, 2014

ROME (AFP) - An Italian doctor who contracted Ebola in west Africa has recovered from the disease after undergoing experimental treatment, local media reported on Thursday.

The 50-year-old from Sicily, who has not been named, has been in isolation at Rome's Spallanzani institute since he was evacuated from Sierra Leone in mid-November.

Doctors reported ten days ago that he could breathe, walk and eat unassisted.

Since then he has reportedly made further progress and a press conference has been called for Friday at which it is expected to be confirmed that he is moving into a convalescence stage of his recovery and will be able to leave his isolated room at the clinic that specialises in infectious diseases.

The doctor had been working for Italian charity Emergency in Sierra Leone when he contracted the disease.

Emergency President Cecilia Strada and Health Minister Beatrice Lorenzin are expected to attend Friday's press conference.

A British nurse who contracted Ebola working as a volunteer in Sierra Leone is also being treated with an experimental anti-viral drug and the blood plasma of someone who survived the virus.

Pauline Cafferkey is being treated at the Royal Free hospital in London, which has the only isolation ward in Britain equipped for Ebola sufferers.

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2 January 2015

Ebola outbreak will end in 2015 - UN's Anthony Banbury

The deadly Ebola outbreak will be ended in 2015, the outgoing head of the UN team fighting the disease has said.

Anthony Banbury said the number of Ebola cases would be brought down to zero by the close of this year, but admitted that the end was "not close".

"We are engaged in an epic battle," he said.

The virus has killed nearly 8,000 people, mostly in Sierra Leone, Liberia and Guinea, where the disease started in December 2013.

Mr Banbury admitted his three month mission had failed to hit its target of 100% safe burials and treatment of 70% of infected people.

But he praised international efforts and insisted "the global response to the Ebola crisis has been extremely successful".

"Going forward it's going to be extremely hard for us to bring it down to zero [cases], but that is what we will do," he told reporters, adding: "I believe we will end Ebola in 2015."

Earlier this week, the World Health Organization said the number of people infected by the virus in Liberia, Sierra Leone and Guinea had passed 20,000.

The WHO said more than a third of the 20,000 cases in West Africa were in Sierra Leone, which has become the worst-hit country.

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3 January 2015

UK Ebola nurse Pauline Cafferkey 'in critical condition'

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Pauline Cafferkey works as an associate public health nurse at Blantyre Health Centre, South Lanarkshire

A British nurse who was diagnosed with Ebola after returning from Sierra Leone is now in a critical condition, the London hospital treating her has said.

The Royal Free Hospital said it was "sorry to announce that the condition of Pauline Cafferkey has gradually deteriorated over the past two days".

Ms Cafferkey, from South Lanarkshire, was given an experimental anti-viral drug and blood from disease survivors.

Meanwhile a patient in Swindon is currently being tested for Ebola.

Great Western Hospitals NHS Foundation Trust confirmed it was testing an individual with a history of travel to west Africa as a "precautionary measure" - but said those using the hospital should not be concerned.

'Best possible care'

Ms Cafferkey, a public health nurse, was diagnosed with Ebola in December after volunteering with Save the Children in Sierra Leone.

On Saturday Prime Minister David Cameron said on Twitter: "My thoughts and prayers are with nurse Pauline Cafferkey who is in a critical condition with Ebola."

Health Secretary Jeremy Hunt also expressed his concern, adding: "I know Dr Mike Jacobs and his team at the Royal Free Hospital are working tirelessly to provide her with the best possible care."

Scotland's First Minister Nicola Sturgeon tweeted: "My thoughts are with Pauline & her family at this extremely difficult time. Thanks to all who are caring for her."

Ms Cafferkey had travelled home via Casablanca, Morocco, and London's Heathrow Airport.

She was screened for the disease at Heathrow where she told officials she believed a fever might be developing.

Her temperature was taken seven times in total, six of which were within 30 minutes, and was normal each time, so she was allowed to fly home to Scotland.

The government's chief medical officer, Dame Sally Davies, has said the case raises questions about airport screening procedures.

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Ms Cafferkey was part of a group of up to 50 NHS healthcare workers who volunteered in Sierra Leone

Ms Cafferkey was later placed in an isolation unit at Glasgow's Gartnavel Hospital after becoming feverish, before being transferred by RAF Hercules plane to London and on to the Royal Free's specialist treatment centre.

Officials from Health Protection Scotland have spoken to all 71 people aboard the British Airways flight from Heathrow to Glasgow that Ms Cafferkey took - a Public Health England (PHE) spokeswoman has said.

And all 101 UK-based passengers and crew aboard the Royal Air Maroc flight from Casablanca to Heathrow have been contacted by PHE officials.

The remaining 31 international passengers on the flight were being traced by international health authorities, the spokeswoman added.

'Critical period'

Ms Cafferkey's is the second UK case of Ebola. Another nurse - William Pooley - recovered from Ebola in September after also being treated at the Royal Free Hospital.

He donated some blood plasma and was treated with the anti-viral drug ZMapp, of which there are no stocks left.

Microbiologist Professor Hugh Pennington said patients responded to Ebola treatment differently.

"Some patients with Ebola get sick and then they get better. Not everybody dies," he said.

For this reason, he said, it was "very difficult" to tell how effective treatments would be - especially when "relatively small numbers of people are being treated with these various experimental approaches".

'Critical period'

David Mabey, an expert in communicable diseases from the London School of Hygiene and Tropical Medicine, also said Mrs Cafferkey's reaction to the virus would have been hard to predict.

"A proportion of people don't get severely ill; Will Pooley was an example - he was never very sick and he recovered fully within a few days.

"The critical period is in the first four or five days after it's diagnosed, because, you know, if you are going to get worse then that's when it happens, and I'm very sorry to hear that seems to have been the case."

Dr Chris Smith, a consultant virologist at Cambridge University, said symptoms usually develop "abruptly" and peak after "about seven days".

After 10 days, he added: "Usually they've turned the corner and they begin to improve."

Ebola is transmitted by direct contact with the bodily fluids of an infected person, such as blood, vomit or faeces.

The virus has killed more than 7,800 people, almost all in West Africa, since it broke out a year ago.

The World Health Organization says the number of people infected by the disease in Sierra Leone, Liberia and Guinea has now passed 20,000.

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03 January 2015

Somalia dismisses Ebola scare

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© UN/AFP/File | A medic at an Ebola medical unit in Monrovia on December 19, 2014

MOGADISHU (AFP) - The government of war-torn Somalia has moved to reassure residents that there was no outbreak of Ebola in the country, dismissing rumours that a man had brought the virus back with him from Guinea.

"As soon as we heard the rumours of a case of Ebola virus in Somalia, we acted quickly and decisively to isolate the alleged victim, a Somali citizen named Abdulkadir Jinow Barow, and those who had been in contact with him," Health Minister Ali Mohamed Mohamud told reporters.

The minister hit out at "irresponsible reporting without the checking of facts or sources by some elements of the media, combined with the wildfire spreading of rumours on social media", saying the rumours "could have caused widespread panic" in the Horn of Africa nation.

"The man did not have the Ebola virus," the minister told reporters, speaking alongside the purported Ebola victim -- who also insisted he was "perfectly healthy".

"He has now been given the all clear and we can state categorically that there has been no outbreak of Ebola in Somalia," the minister said.

The man falsely reported to have been infected with Ebola in Guinea, where he ran a business, said he was "very confused and upset" by the rumours.

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04 January 2015

New Ebola lockdown in Sierra Leone as airport checks upped

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© AFP/File | Medical staff wearing protective clothing treat the body of an Ebola victim at their facility in Kailahun, on August 14, 2014

FREETOWN (AFP) - The Ebola lockdown in the northern Tonkolili district of Sierra Leone was extended on Sunday for two weeks as authorities stepped up the fight to contain the epidemic.

The move comes as the government imposed "additional screening measures" at Freetown International Airport after two workers apparently caught the disease.

A five-day lockdown had been declared by the government across the badly-hit north of the country last month.

More than 70 cases of the virus had been confirmed in Tonkolili during a five-week locked down there ordered by local authorities, District Coordinator Salieu Bah told journalists.

"The lockdown is extended for another two weeks to intensify monitoring efforts by all sectors in the district as we need this mopping up operation until January 17," he added.

He said people had been "reluctant to comply with health rules such as late reporting of suspected Ebola cases and undertaking secret burials."

Meanwhile, Health Minister Dr Abubakarr Fofanah said screening of workers at the airport in Freetown will now be done "on a 24-hour basis to detect any suspicion of Ebola on a worker or traveller".

The National Ebola Response Centre (NERC) said "a case of Ebola was detected and confirmed by laboratory test on Friday involving a person who worked at the airport up to mid-December but had not worked since that time."

Another airport employee who had been in contact with the person has not come to work since Christmas Day. "Due to these developments, additional measures have been put in place to enhance robust screening," NERC said in a statement.

"These include documentation of employees temperatures at the airport front gate and entry to the terminal."

Sierra Leone has overtaken Liberia as the country worst hit by the virus, with 2,758 confirmed deaths out of 9,446 cases, according to the UN.

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5 January 2015

UK Ebola nurse Pauline Cafferkey has 'stabilised'

By James Gallagher
Health editor, BBC News website

A British nurse who was diagnosed with Ebola after returning from Sierra Leone is still in a critical condition, but has stabilised, Health Secretary Jeremy Hunt says.

He said Pauline Cafferkey was getting the "best possible care" at the Royal Free Hospital in London.

He went on to say "she stands for the very best of NHS values" and that the whole country was proud of her.

Mr Hunt said screening measures had been "strengthened" at airports.

Ms Cafferkey, a public health nurse, was diagnosed with Ebola in December after volunteering with Save the Children in Sierra Leone.

She is being treated with experimental drugs and Mr Hunt confirmed she had received blood plasma from another British nurse, William Pooley, who recovered from an Ebola infection.

Speaking in the Commons, Mr Hunt said: "I have this morning spoken to Dr Mike Jacobs, an expert in infectious diseases who is leading the team of doctors and nurses caring for Pauline at the Royal Free.

"As has been reported, Pauline's condition has deteriorated to a critical state although she stabilised yesterday and continues to receive the best possible care."

Screening

Ms Cafferkey had travelled home via Casablanca, Morocco, and Heathrow Airport in London.

She was initially screened at Heathrow, but her temperature was normal.

She told officials at the airport that she believed a fever might be developing and her temperature was taken a further six times within 30 minutes.

It was normal each time and she was cleared to fly home to Scotland.

Mr Hunt insisted this was the correct decision and that there was no risk of transmitting the virus to fellow passengers.

However, he did say screening was not "as smooth as it needed to be" and that over Christmas "we probably didn't have as many people as needed".

He said screening had been enhanced: "We have also, as of last Monday, strengthened our guidance to ensure anyone from a higher risk group who feels unwell will be reassessed.

"Advice will be immediately sought from an infectious disease specialist and the passenger will be referred for testing, if appropriate."

Investigation

Earlier, the charity Save the Children said "no stone will be left unturned" in its investigation into how Ms Cafferkey contracted the disease.

The charity's Sierra Leone director, Rob MacGillivray, told the BBC the investigation would "ensure that we do everything, leave no stone unturned, to be able to as far as possible identify the source of this infection".

The review is being conducted by a panel that includes independent health experts and will scrutinise training, safety protocols, how protective equipment is used, and working practices.

______________________________________________________________________________________________________________________________________________________________________


Kerrytown treatment centre

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By Tulip Mazumdar, BBC global health correspondent, Sierra Leone

Kerrytown was built by the British Army Royal Engineers over two months and opened on 5 November.

It's a sprawling facility on the outskirts of Freetown with the capacity to treat around 80 patients.

It also includes a 12-bed centre specifically for treating health workers.

Medics at the centre have so far treated more than 200 patients. More than 70 have survived.

The facility is mainly staffed by local health workers - around a fifth are volunteers from overseas.

Fourteen are NHS volunteers, and there are around 40 NHS volunteers stationed throughout Sierra Leone at the moment.

This is the second time a foreign medic has been infected here.

In November, a Cuban doctor became unwell and was flown to Geneva for treatment.

He survived.

Save the Children says health workers are given rigorous training before treating patients, but points out it's impossible to reduce the risk altogether.

It says it will focus some of the investigation on the use of personal protective equipment.

More than 600 health workers have become infected with Ebola during this outbreak in the three worst-affected countries, of whom over 300 have died - the vast majority of them have been west African.

______________________________________________________________________________________________________________________________________________________________________

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7 January 2015

Ebola drug trial starts in Liberia

By Smitha Mundasad
Health reporter, BBC News

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Drugs, vaccines and blood products are being tried against the disease

A trial of a potential drug to treat Ebola has started at a Medecins Sans Frontieres centre in Liberia.

The antiviral - brincidofovir - is being tested on Ebola patients on a voluntary basis.

People who do not consent to it receive standard care.

Oxford University scientists leading the research say initial results are expected in the next few months.

A study involving a similar drug - favipiravir - began in Guinea in December.

Compassionate use

More than 8,000 people have died from Ebola during this outbreak, the majority in the worst-affected countries of Guinea, Sierra Leone and Liberia.

While a handful of experimental drugs, including brincidofovir and favipiravir, have been given on an ad hoc, compassionate basis in the last year, none has yet been proven to work against the virus in scientific human trials.

A huge international effort - involving the World Health Organization, MSF, drug companies, the Wellcome Trust, and other global health organisations - aims to fast-track treatments that have been identified as potential options.

Prof Peter Horby, one of the chief investigators at Oxford University, said: "Conducting clinical trials of investigational drugs in the midst of a humanitarian crisis is a new experience for us all, but we are determined not to fail the people of West Africa.

"We are trying a number of different approaches simultaneously as there is only a short window of opportunity to tackle this virus during the outbreak."

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Blood tests are used to establish whether a patient has Ebola

Scientists at Oxford say brincidofovir was chosen because it is effective against Ebola-infected cells in laboratories, has been deemed safe in more than 1,000 patients in trials against other viruses and can be given conveniently as a tablet.

Researchers aim to recruit more than 100 people and will compare death rates at the centre before and after the trial.

'No guarantees'

The other antiviral drug, favipiravir, being tested by the French National Institute of Health, is already used to treat influenza.

It is offered to all patients who receive care at the MSF treatment centre in Gueckedou, Guinea, and early results are expected in a few months' time.

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Survivors' blood is screened for diseases before it is used

Other Ebola therapies

Scientists are testing other drugs and treatments.

Oxford University and the company Tekmira hope to establish a further study of a potential treatment which aims to interrupt the genetic code of the virus called TKM-Ebola.

Another approach is to use blood plasma from patients who have recovered from the disease.

Trials of this are under way in Guinea's capital, led by the Antwerp Institute of Tropical Medicine.

This treatment is also being given to the British nurse Pauline Cafferkey in hospital in London.

And trials involving three separate vaccines designed to prevent people from getting the disease, are taking place in Switzerland, UK, US and Mali.

But while a number of different pharmaceutical attempts are being made to tackle this virus, experts say other strategies - including early and adequate hydration and nutrition - are extremely important.

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08 January 2015

Ebola countries miss treatment, burial targets: WHO

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© AFP/File | Red cross workers wearing protective suits carry the body of a person who died from Ebola during a burial with relatives of the victims of the virus, in Monrovia, on January 5, 2015

GENEVA (AFP) - The west African countries ravaged by Ebola have made great strides to stem the spread of the deadly virus but missed key January 1 targets towards halting the epidemic, the World Health Organization said Wednesday.

The United Nations set a 90-day target on October 1 to isolate and treat all Ebola patients in Guinea, Sierra Leone and Liberia, and to ensure safe burials for all bodies, which are highly infectious.

WHO acknowledged in its latest situation report that the goals had not been met by the set deadline, but stressed that "efforts to attain each target will continue until the epidemic has been brought to an end."

Meeting the treatment and burial targets, and meticulously tracing people who have been in contact with Ebola patients, are seen as essential to reining in the epidemic, which has infected 20,747 people in just over a year, of whom 8,235 have died.

The three west African countries, which account for all but 15 of those deaths, have dramatically scaled up the number of beds available in Ebola treatment centres and now have the capacity to isolate and treat all patients, WHO said in its latest situation report.

In Liberia, which was long the hardest-hit country and still counts the most deaths at 3,496, a steep drop in transmission paired with a rapid scale-up in treatment means the country now counts 15.1 beds for every confirmed and probable case of the virus.

In Guinea, where the epidemic began in December 2013 and which counts 1,781 deaths, there are 2.1 available beds for each infected person.

And in Sierra Leone, which currently has the most infections - 9,780 - of whom 2,943 have died, there are 4.6 beds for each patient, WHO said.

But "the uneven geographical distribution of beds and cases, and the under-reporting of cases, means that the UNMEER (UN Mission for Ebola Emergency Response) target of isolating and treating 100 percent of (Ebola) cases is still not met in some areas," the UN health agency said.

In Guinea, for instance, the virus has continued to spread to geographically but almost all of the country's treatment centres are based in the capital, WHO said.

"An increasing emphasis will be put on the rapid deployment of smaller treatment facilities to ensure that capacity is matched with demand in each area," it said.

The UN agency meanwhile found that all three countries now had the capacity to ensure safe burials for all people known to have died from Ebola.

But it warned that "the under-reporting of deaths means that the UNMEER target of 100 percent safe burial was not met."

WHO has acknowledged that the true number of Ebola deaths is likely far higher than the recorded figures, given that many deaths go unreported.

- Spike in healthcare workers infected -

The UN agency also reported a significant jump in the number of infected healthcare workers: as of January 4, 838 healthcare workers had been infected and 495 of them had died.

Just a week earlier, the tally stood at 678 cases and 382 deaths, but WHO stressed the hike was mainly due to previously unreported cases in Sierra Leone and not to a surge in new infections.

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16 January 2015

Possible Ebola cases flown to UK

By Smitha Mundasad
Health reporter, BBC News

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Two volunteers have been transferred to the UK after potential contact with the Ebola virus in separate incidents.

Public Health England said the patients' risk of having the virus was low and the measure was a precaution.

Authorities said the individuals - one of whom is Australian - had not been diagnosed with Ebola and did not currently have symptoms of the disease.

Experts emphasised the risk to the public was low and said the volunteers would be monitored for 21 days.

Australian authorities confirmed an Australian nurse was flown to the UK after a low risk clinical incident while working in Sierra Leone.

'Precautionary step'

The Australian department of Foreign Affairs and Trade said in a statement: "The individual, who for privacy reasons has not been named, has not been diagnosed with Ebola, and the transfer to the UK for a 21-day observation period is a precautionary step.

"The Australian-funded Ebola treatment centre has strict infection prevention protocols in place, and the safety of staff and patients is paramount."

Public Health England (PHE) said one volunteer arrived on an RAF flight after damage to personal protective equipment.

They have left hospital and will now be monitored in private accommodation for 21 days.

The second volunteer had potential exposure through contact with a healthcare worker who recently died and was subsequently diagnosed with Ebola.

The individual will undergo full checks in hospital.

Dr Jenny Harries, of PHE, said: "The risk to the public posed by these and indeed any of the returning workers is extremely low.

"We are confident that all appropriate public health actions have been taken, and will continue to be taken, to support these individuals and to protect the public's health.

"It is important to remember, in choosing to volunteer, that these individuals have taken a courageous step not only to help those affected in West Africa, but also prevent the spread of Ebola any wider."

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18 January 2015

Ebola crisis: Mali says it has no more cases

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Mali recorded its first case of Ebola in October

Mali's health minister says the country is now free of the Ebola virus, after 42 days without a new case of the disease.

"I declare this day... the end of the epidemic of the Ebola virus in Mali," said Ousmane Kone.

The last Ebola-infected patient in Mali recovered and left hospital in early December.

Latest figures show the three West African countries worst affected have all seen a decline in new Ebola cases.

Sierra Leone and Guinea both recorded the lowest weekly total of confirmed Ebola cases since August, according to UN figures on Thursday.

Liberia, which reported no new cases on two days last week, had its lowest weekly total since June.

The overall death toll has reached 8,429 with 21,296 cases so far.

Mali recorded its first case of Ebola in October, when a two-year-old from Guinea fell ill and died.

At its worst, there were 300 contact cases under investigation in the country.

But the country has now "come out" of the epidemic, said Ibrahima Soce Fall, the head of the Malian office of the United Nations Mission for Ebola Emergency Response (UMEER).

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22 January 2015

Falling Ebola cases show 'turning point'

By James Gallagher
Health editor, BBC News website

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There has been a "turning point" in the Ebola crisis, with cases falling in the three affected countries, World Health Organization officials say.

Just eight cases were detected in Liberia in the last week down from a peak of 500-a-week in September.

Guinea and Sierra Leone have also seen falls.

The WHO said the figures were the "most promising" since the outbreak started.

But it continues to urge caution, and to highlight the need to find those who had contact with Ebola patients.

The largest outbreak of Ebola in human history has infected 21,724 people and killed 8,641 - largely in just three countries, Sierra Leone, Liberia and Guinea.

All are now showing falls in weekly cases:

-Cases in Liberia stand at eight-per-week down from a peak of 509

-Cases in Guinea stand at 20 per week down from a peak of 292

-Cases in Sierra Leone stand at 117-per-week down from a peak of 748

There are now some days in Liberia where no cases are reported at all.

Dr Christopher Dye, the director of strategy in the office of the director general, told the BBC News website: "The incidence is pretty clearly going down in all three countries now.

"Each of the last three weeks has been the most promising we've seen so far, the message is reductions in all places.

"I would have identified the turning point as the beginning of the decline, first in Liberia and then later in Sierra Leone and Guinea."

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The WHO says patient database figures give the best representation of the history of the epidemic. However, data for more recent weeks are sometimes less complete than in the regular situation reports

Resurgence

However, he argued there was "no basis for complacency" due to the risk of a resurgence in cases.

It is also uncertain whether the downward trends will continue unless there are improvements in "contact tracing".

A single case is enough to start an entire outbreak so identifying everyone who comes into contact with Ebola is vital.

Yet the latest WHO situation report says the number of people being traced "remains lower than expected in many districts".

Dr Dye added: "Contact tracing to find every last case needs to be intensified and we need all guns blazing on all fronts."

Western Sierra Leone remains another problem.

Of the 145 cases reported across all affected countries last week, more than 100 were in that region, which includes the capital Freetown.

Speaking earlier this week, the UN system co-ordinator for Ebola, David Nabarro, said: "We have a very attractive and promising situation that leads us to believe that perhaps we are beginning to see the end of the outbreak.

"Unfortunately it's not quite as simple and the reason for that is any case of Ebola in the region can restart an outbreak very quickly."

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23 January 2015

Sierra Leone ends Ebola bonuses for health workers

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© AFP/File | A health worker wearing protective equipment assists an Ebola patient at the Kenama treatment centre run on November 15, 2014

FREETOWN (AFP) - Sierra Leone said on Thursday it was ending the "risk allowances" it has been paying to thousands of healthcare workers on the front line of its battle with Ebola.

Steven Gaojia, the co-ordinator of the government's response to the outbreak, told reporters the payments of up to 500,000 leones ($118, 102 euros) a week on top of regular salaries would finish by the end of March.

The move comes with Sierra Leone, one of three west African countries at the epicentre of the epidemic, seeing a decrease in new cases across most of its territory.

Officials registered 117 last week against 184 the week before, according to the World Health Organization's latest situation update.

"We have developed an exit strategy in the fight against Ebola. If there are still cases beyond that, we will re-contract people. Now the hazard payment has become a dependency issue, making too many depend on it," said Ngauja.

Sierra Leone estimates that 26,000 healthcare workers -- either state employees or volunteers -- are involved in its fight against Ebola, while 221 have died after catching the deadly virus.

"The incidence of health worker infections has fallen in Liberia and Sierra Leone, but rose in Guinea throughout December," the WHO said on Wednesday.

The risk payments have represented a lucrative sideline for the workers in Sierra Leone, one of the world's poorest countries where the vast majority earn less than a dollar a day, according to the World Bank.

But the withdrawal of the incentive has not generally been greeted negatively since it was always viewed as a temporary measure and many healthworkers see it as a symbol that the worst of the epidemic is over.

David Koroma, who works with an Ebola burial team in the capital Freetown, said however he expected to be out-of-pocket when the crisis ended.

"It will be a disappointment for me when the job folds up. It will mean going back to search for any job, as I have been unemployed for four years now after leaving school," he told AFP.

A nurse at a Freetown treatment centre said she and her colleagues were not surprised by the allowance being stopped.

"I shall miss that as it has covered some day-to-day expenses," she told AFP.

"However, the news that new cases are scaling down makes me happy and when the disease is eventually eradicated, it will bring all of us back to normal life."

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23 January 2015

Ebola crisis: Experimental vaccine 'shipped to Liberia'

By Smitha Mundasad
Health reporter, BBC News

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The Ebola vaccine has been safety tested on 200 volunteers so far

The first batch of an experimental vaccine against Ebola is on its way to Liberia.

The shipment will be the first potentially preventative medicine to reach one of the hardest hit countries.

But experts say that, with Ebola cases falling, it may be difficult to establish whether the jab offers any protection against the virus.

It has been produced by British company GlaxoSmithKline (GSK) and the US National Institutes of Health.

GSK said a plane carrying some 300 initial doses of the vaccine was expected to arrive in Monrovia on Friday.

And the company hopes the first volunteer will be immunised in the next few weeks.

The chief executive of GSK, Sir Andrew Witty, said the pace of development was almost unparalleled and was comparable to only the development of a pandemic flu vaccine or new medicines for HIV.

He told the BBC: "As an example we have delayed two other vaccine development programmes to free up the space to do this work, so this has come with a significant amount of disruption."

Scientists aim to involve 30,000 volunteers in the trial in total, including frontline health workers.

If all regulations are met, 10,000 volunteers will be given the GSK vaccine.

A matching number will get a placebo, dummy vaccine.

And there are plans for a further 10,000 people to get a separate experimental jab.

The results will be compared to see if either vaccine offers any meaningful protection against the virus.

A version of the vaccine has already been tested on 200 healthy volunteers across the UK, US, Switzerland and Mali.

GSK says it has been found to have an acceptable safety profile so far.

But it is only in affected countries that experts can determine whether it provides adequate protection against the virus.

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The virus is spread through close contact with infected bodily fluids

Dr Moncef Slaoui, of GlaxoSmithKline said: "Shipping the vaccine today is a major achievement and shows that we remain on track with the accelerated development of our candidate Ebola vaccine.

"The initial phase one data we have seen are encouraging and give us confidence to progress to the next phases of clinical testing."

Falling opportunities

The company stresses the vaccine is still in development and the World Health Organization, and other regulators, would have to be satisfied the vaccine is both safe and effective before any mass immunisation campaigns could be considered.

Field trials of other promising vaccines - for example one involving the company Merck - are planned in Guinea, Liberia and Sierra Leone in the months to come.

And there are reports that a trial of an experimental drug called Zmapp might start in the next few weeks.

However, experts say with the number of Ebola cases falling opportunities to test vaccines and drugs could be limited.

Prof Jonathan Ball, a virus expert based at Nottingham University, told the BBC: "Because case numbers are starting to come down it will become harder and harder to show if the vaccine is having any impact.

"Ultimately we may be in position in a few months time where we don't know whether this vaccine is effective in humans.

"But it is important to get answers if we can - if not for this outbreak, for future outbreaks. We need to be prepared."

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24 January 2015

Ebola nurse: Pauline Cafferkey 'happy to be alive'

UK nurse Pauline Cafferkey has said she is "very happy to be alive", having been discharged from hospital after making a full recovery from Ebola.

Speaking to the BBC in her first broadcast interview, Ms Cafferkey, 39, admitted she had felt like "giving up" as her condition became critical.

She said she was now looking forward to returning to "normal life" and had no current plans to return to West Africa.

She is the second Briton to recover from Ebola during the current outbreak.

Speaking after being discharged from the Royal Free Hospital, in London, Ms Cafferkey, from Cambuslang, in South Lanarkshire, thanked staff who she said had saved her life.

"I am just happy to be alive. I still don't feel 100%, I feel quite weak, but I'm looking forward to going home," she added.

'Definitely frightened'

Ms Cafferkey - who had volunteered with Save the Children at a treatment centre in Kerry Town, in Sierra Leone - was diagnosed with Ebola on 29 December, after returning to Glasgow via London.

Her temperature was tested seven times before she flew from Heathrow to Glasgow and she was cleared to travel, before later falling ill.

She was placed in an isolation unit at Glasgow's Gartnavel Hospital after becoming feverish, before being transferred by a RAF Hercules plane to London on 30 December.

She was then transferred to the specialist isolation unit at the Royal Free, where she has been treated since.

Speaking to BBC health correspondent Branwen Jeffreys, she said: "My first few days I was very well - I just couldn't understand all the fuss."

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Ms Cafferkey travelled to Sierra Leone with a group of NHS workers in November last year

However, she said she was "definitely frightened" having witnesses the virus first hand in Sierra Leone.

"Obviously at the back of my mind I had seen what could happen and what could potentially happen to me."

After three or four days Ms Cafferkey said her condition began to deteriorate, with the hospital announcing she had become critically ill on 4 January.

Asked if there was a point she felt she would not make it, Ms Cafferkey said: "There was a point, which I remember clearly. I do remember saying: 'That's it, I've had enough'."

She said she had "no sense of time" in hospital and cannot remember an entire week when the virus took hold.

'Selflessness and courage'

She said she received letters and cards from people around the world, including people in Sierra Leone and from other nurses who wrote to say she made them proud of their profession.

Asked if she wanted to return to Sierra Leone, she said: "I would have to think seriously about it. I am definitely going to give aid work a break for a while.

"I just want to go back to my normal job, my normal life and I think my family will be happy with that as well."

Dr Michael Jacobs, from the hospital's infectious diseases team, said Ms Cafferkey had now completely recovered and was "not infectious in any way".

He said Ms Cafferkey was treated with blood plasma from an Ebola survivor and an experimental treatment drug closely related drug to ZMapp, which UK nurse Will Pooley was treated with after he contracted Ebola.

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She was diagnosed with the deadly disease after returning to Glasgow, and was then transferred to London

Nurses and patients at the Blantyre Health Centre, in South Lanarkshire, where Ms Cafferkey works as a public health nurse, were "overjoyed" to hear the news of her recovery, BBC Scotland reporter Laura Bicker said.

Prime Minister David Cameron said Ms Cafferkey had been "extraordinarily brave" and that it was "great" to see her "looking so well".

Health Secretary Jeremy Hunt said he was "delighted" the nurse had been discharged from hospital, hailing her "selflessness and courage".

"She represents the very best of NHS values," he added.

Chief medical officer, Dame Sally Davies, said Ms Cafferkey's recovery was testament to the "hard work and dedication" of the team at the Royal Free who had "worked around the clock to help bring about this happy outcome".

Meanwhile, Scotland's First Minister Nicola Sturgeon said her recovery was "a tremendous tribute to the work of the NHS staff who have been committed to her care over the last few weeks".

Chief executive of Save The Children, Justin Forsyth, described Ms Cafferkey as a "dedicated humanitarian" and said he was "delighted" for her and her family.

Save the Children is investigating how Ms Cafferkey contracted the disease.

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25 January 2015

Ebola crisis: 'Too slow' WHO promises reforms

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Ebola testing at the African Cup of Nations football tournament in Bata, Equatorial Guinea

The World Health Organization (WHO) has set out plans for reform, admitting that it was too slow to respond to the deadly Ebola outbreak in West Africa.

At an emergency session in Geneva, director-general Margaret Chan said Ebola had taught the world and the WHO how they must act in the future.

She said the corner had been turned on infections but warned over complacency.

More than 8,500 people have died in the outbreak, the vast majority in Sierra Leone, Guinea and Liberia.

Contingency fund

Dr Chan said: "This was West Africa's first experience with the virus and it delivered some horrific shocks and surprises.

"The world, including WHO, was too slow to see what was unfolding before us. Ebola is a tragedy that has taught the world, including WHO, many lessons about how to prevent similar events in the future."

Dr Chan said that although disease outbreaks would continue to deliver shocks, "never again should the world be caught by surprise, unprepared".

The reforms announced included a "dedicated contingency fund to support rapid responses to outbreaks and emergencies".

There would also be improvements in international co-ordination and greater support for countries that needed to respond quickly to emergencies.

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Dr Chan: "We must maintain the momentum and guard against complacency"

This would also require vaccines and drugs to be brought to the market more speedily.

Liberia announced on Friday that it was down to just five confirmed cases - there were 500 a week in September.

Guinea and Sierra Leone have both also experienced falls in infection rates.

Dr Chan said the worst-case scenario had been avoided, but warned: "We must maintain the momentum and guard against complacency and donor fatigue."

WHO figures show 21,724 reported cases of Ebola in the outbreak , with 8,641 deaths.

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27 January 2015

Senegal opens Guinea border as Ebola recedes

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© AFP/File | Vehicles are loaded with household items on September 3, 2014, at the border town of Diaobe in Senegal's southern border region of Kolda as they ready to drive across into neighbouring Guinea

DAKAR (AFP) - Senegal reopened its land border with Guinea on Monday, pointing to the "significant efforts" of its neighbour in fighting an Ebola outbreak that has claimed thousands of lives.

People and goods can now "move freely by land between the two countries," the interior ministry said in a statement cited by the state-run Senegalese Press Agency.

Guinea, Liberia and Sierra Leone have been devastated by the outbreak, which began in December 2013, but all have seen recent signs that the virus is retreating, with the number of new cases dropping weekly.

Senegal said it would put in place measures at its land crossings to ensure people entering from Guinea were Ebola-free, the report said.

The news was met with applause in the Guinean capital Conakry, according to an AFP correspondent on the street, with car horns sounding and pedestrians chanting as local radio announced the reopening.

"This is an important and good piece of news that we have just learned today ... Praise God," said shopkeeper Mariama Barry.

"See my shop. It is half empty -- or, if you prefer, half full -- because of this closure that almost ended up choking us."

El-Hajj Abdoulaye Biro Diallo, an owner of two clothing shops who imports from Dakar, described his relief, saying the closure had hit traders who couldn't afford to source clothing from farther afield.

At the international bus station in Conakry, drivers quickly resumed service to Diawbhe in Senegal, while union officials confirmed taxis would begin ferrying passengers to Dakar the following day.

Senegal initially closed its land border with Guinea in March last year as the number of people infected with the deadly disease escalated at an alarming rate.

The order affected crossings in southern Senegal which were heavily used by traders, particularly during a weekly market attended by thousands from neighbouring countries.

The border reopened in May but was closed again in August after an infected student crossed over from Guinea.

Senegal was declared Ebola-free after the student recovered without spreading the virus, and air as well as sea crossings from the three other nations have been permitted since November.

The worst-ever outbreak of the haemorrhagic fever has officially killed nearly 9,000 in a year, although experts believe the real toll could be significantly higher.

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28 January 2015

Ebola crisis: World 'dangerously unprepared' for future pandemics

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Jim Yong Kim was delivering the inaugural Global Futures Lecture at Georgetown University

The world is "dangerously unprepared" for future deadly pandemics like the Ebola outbreak in West Africa, the president of the World Bank has warned.

Jim Yong Kim, speaking in Washington, said it was vital that governments, corporations, aid agencies and insurance companies worked together to prepare for future outbreaks.

He said they needed to learn lessons from the Ebola crisis.

More than 8,500 people have died, most in Sierra Leone, Guinea and Liberia.

"The Ebola outbreak has been devastating in terms of lives lost and the loss of economic growth," Mr Kim told an audience at Georgetown University.

"We need to make sure that we get to zero cases in this Ebola outbreak. At the same time, we need to prepare for future pandemics that could become far more deadly and infectious than what we have seen so far with Ebola. We must learn the lessons from the Ebola outbreak because there is no doubt we will be faced with other pandemics in the years to come."

'Insurance policy'

Mr Kim said the World Bank Group had been working with the World Health Organisation (WHO), other UN agencies, academics, insurance company officials and others to work on a concept of developing a financial "pandemic facility".

He said he expected a proposal for this to be presented to leaders of developed and developing countries in the coming months.

Mr Kim said the proposal would probably involve a combination of bonds and insurance plans but that, in some ways, the facility could be similar to a homeowner's insurance policy.

"This could work like insurance policies that people understand, like fire insurance," he said.

"The more that you are prepared for a fire, such as having several smoke detectors in your house, the lower the premium you pay.

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The WHO says there have been more than 21,700 reported cases of Ebola in the outbreak

"The more that countries, multi-lateral institutions, corporations and donors work together to prepare for future pandemics - by building stronger health systems, improved surveillance and chains of supply and transportation, and fast-acting medical response teams - the lower the premium as well.

"That would benefit donors and others who would pay the premium, but the greatest benefit would be that market mechanisms would help us to push improvements in our preparedness for epidemics."

He said that one possible outcome of a pandemic facility would be a stronger World Health Organisation.

He said disease-control agencies in developing countries could also develop greater capacity.

Mr Kim said informal talks on the subject had also been held at last week's World Economic Forum in Davos, Switzerland.

Slow response

His talk, "Lessons from Ebola: Toward a post-2015 strategy for pandemic response", was the inaugural Global Futures Lecture at Georgetown.

Correspondents say there is general acknowledgement among governments and global health agencies that the international response to the Ebola crisis was belated and disorganised.

The WHO recently announced a series of reforms, admitting that it had been too slow to respond to the outbreak in West Africa.

At an emergency session in Geneva, director-general Margaret Chan said Ebola had taught the world and the WHO how they must act in the future.

She said the corner had been turned on infections but warned against complacency.

Reforms announced included a dedicated contingency fund "to support rapid responses to outbreaks and emergencies".

There would also be improvements in international co-ordination and greater support for countries that needed to respond quickly to emergencies.

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29 January 2015

Ebola outbreak: Virus mutating, scientists warn

By Tulip Mazumdar
Global health reporter

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Hundreds of blood samples are being analysed to keep track of the virus

Scientists tracking the Ebola outbreak in Guinea say the virus has mutated.

Researchers at the Institut Pasteur in France, which first identified the outbreak last March, are investigating whether it could have become more contagious.

More than 22,000 people have been infected with Ebola and 8,795 have died in Guinea, Sierra Leone and Liberia.

Scientists are starting to analyse hundreds of blood samples from Ebola patients in Guinea.

They are tracking how the virus is changing and trying to establish whether it's able to jump more easily from person to person

"We know the virus is changing quite a lot," said human geneticist Dr Anavaj Sakuntabhai.

"That's important for diagnosing (new cases) and for treatment. We need to know how the virus (is changing) to keep up with our enemy."

It's not unusual for viruses to change over a period time.

Ebola is an RNA virus - like HIV and influenza - which have a high rate of mutation.

That makes the virus more able to adapt and raises the potential for it to become more contagious.

"We've now seen several cases that don't have any symptoms at all, asymptomatic cases," said Anavaj Sakuntabhai.

"These people may be the people who can spread the virus better, but we still don't know that yet. A virus can change itself to less deadly, but more contagious and that's something we are afraid of."

______________________________________________________________________________________________________________________________________________________________________


Latest figures

There were fewer than 100 new cases in a week for the first time since June 2014.

In the week to 25 January there were 30 cases in Guinea, four in Liberia and 65 in Sierra Leone.

The World Health Organization says the epidemic has entered a "second phase" with the focus shifting to ending the epidemic.

______________________________________________________________________________________________________________________________________________________________________


But Prof Jonathan Ball, a virologist at the University of Nottingham, says it's still unclear whether more people are actually not showing symptoms in this outbreak compared with previous ones.

"We know asymptomatic infections occur… but whether we are seeing more of it in the current outbreak is difficult to ascertain," he said.

"It could simply be a numbers game, that the more infection there is out in the wider population, then obviously the more asymptomatic infections we are going to see."

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The current outbreak began in south-eastern Guinea and spread to Liberia and Sierra Leone

Another common concern is that while the virus has more time and more "hosts" to develop in, Ebola could mutate and eventually become airborne.

There is no evidence to suggest that is happening.

The virus is still only passed through direct contact with infected people's body fluids.

Infectious disease expert Professor David Heyman said: "No blood borne virus, for example HIV or Hepatitis B, has ever shown any indication of becoming airborne. The mutation would need to be major."

Virologist Noel Tordo is in the process of setting up a new from the Institut Pasteur in the Guinea capital Conakry.

He said: "At the moment, not enough has been done in terms of the evolution of the virus both geographically and in the human body, so we have to learn more. But something has shown that there are mutations,"

"For the moment the way of transmission is still the same. You just have to avoid contact (with a sick person)"

"But as a scientist you can't predict it won't change. Maybe it will."

Researchers are using a method called genetic sequencing to track changes in the genetic make-up of the virus.

So far they have analysed around 20 blood samples from Guinea.

Another 600 samples are being sent to the labs in the coming months.

A previous similar study in Sierra Leone showed the Ebola virus mutated considerably in the first 24 days of the outbreak, according to the World Health Organization.

It said: "This certainly does raise a lot of scientific questions about transmissibility, response to vaccines and drugs, use of convalescent plasma.

"However, many gene mutations may not have any impact on how the virus responds to drugs or behaves in human populations."

'Global problem'

The research in Paris will also help give scientists a clearer insight into why some people survive Ebola, and others don't.

The survival rate of the current outbreak is around 40%.

It's hoped this will help scientists developing vaccines to protect people against the virus.

Researchers at the Institut Pasteur are currently developing two vaccines which they hope will be in human trials by the end of the year.

One is a modification of the widely used measles vaccine, where people are given a weakened and harmless form of the virus which in turn triggers an immune response.

That response fights and defeats the disease if someone comes into contact with it.

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The research may explain why some people survive Ebola and others do not

The idea, if it proves successful, would be that the vaccine would protect against both measles and Ebola.

"We've seen now this is a threat that can be quite large and can extend on a global scale," said Professor James Di Santo, and immunologist at the Institut.

"We've learned this virus is not a problem of Africa, it's a problem for everyone."

He added: "This particular outbreak may wane and go away, but we're going to have another infectious outbreak at some point, because the places where the virus hides in nature, for example in small animals, is still a threat for humans in the future.

"The best type of response we can think of… is to have vaccination of global populations."

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31 January 2015

UK healthcare worker returns for Ebola monitoring

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The person has been admitted to the Royal Free Hospital in north London

A British military healthcare worker has been flown back to the UK from Sierra Leone for Ebola monitoring.

The individual suffered a needle-stick injury while treating a patient in the West African country, which is among those affected by the Ebola outbreak.

The person has been admitted to the Royal Free Hospital in north London, Public Health England (PHE) said.

More than 22,000 people have been infected with Ebola and 8,795 have died in Sierra Leone, Guinea and Liberia.

The individual, who is being treated in isolation, does not have symptoms but is likely to have been exposed to the virus, the Royal Free said.

The patient arrived back in the UK on Saturday on board an RAF flight and will be monitored for the remainder of their 21-day incubation period.

'Well-tested protocols'

Professor Paul Cosford, PHE's director for health protection, said: "Our thoughts are with this person, who has been courageous in helping those affected in West Africa, and in preventing the wider spread of Ebola.

"We have strict, well-tested protocols in place for this eventuality and we are confident that all appropriate actions have been taken to support the healthcare worker concerned and to protect the health of other people."

Needle-stick injuries involve a piercing of the skin by a sharp instrument or object, typically a needle.

Jonathan Ball, a professor of molecular virology at the University of Nottingham, said such injuries were "one of the most dangerous risks for infection" as the virus could be delivered directly into the bloodstream.

"Careful monitoring and Ebola virus testing will determine if the person has been exposed and infected," he added.

The Royal Free is home to a specialist unit for infectious diseases patients.

Two other Britons who contracted the virus - nurses Pauline Cafferkey and Will Pooley - have been successfully treated there, both of whom had worked in West Africa.

Ms Cafferkey was discharged last week.

She said she was now looking forward to returning to "normal life" and had no current plans to return to West Africa.

She was treated with blood plasma from an Ebola survivor and an experimental treatment drug closely related to ZMapp, which Mr Pooley was treated with after he contracted Ebola.

Up until 5 January the Imported Fever Service (IFS) - which is a specialist diagnostic service for medical professionals managing travellers who have returned to the UK with fever - said it had received 258 calls regarding Ebola, and 148 tests had been carried out, with only two confirmed cases of the virus.

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31 January 2015

Ebola reveals shortcomings of African solidarity

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© AFP/File / by Karim Lebhour with Frankie Taggart in Dakar | A health worker checks the body temperature of a fan during Ebola before the African Cup of Nations match between Cameroon and Ivory Coast in Malabo on January 28, 2015

ADDIS ABABA (AFP) - As Africa's leaders meet in Ethiopia to discuss the Ebola crisis, expectations of firm action will be tempered by criticism over the continent's poor record in the early stages of the epidemic.

The outbreak is a priority on the agenda of the 54-nation African Union (AU) summit in Addis Ababa on Saturday, yet the bloc is still smarting from criticism that it reacted too slowly to the outbreak.

Health workers and cash have flooded in from the United States, Britain and even Cuba as part of a UN-led surge to battle an epidemic which has seen nearly 9,000 deaths in Liberia, Guinea and Sierra Leone.

Yet it was only in September -- 10 months after the virus emerged and a month after it was declared a "health emergency of international concern" -- that the AU held an emergency summit.

The three hardest-hit nations have expressed disappointment that their continental neighbours seemed initially to be much quicker to shut borders and ban flights than to deploy resources.

Sierra Leone President Ernest Bai Koroma hinted at his disillusionment in August when he greeted a $500,000 donation from Gambia with an ill-disguised dig at his other African neighbours.

"In moments like this, we will remember our friends including those that are rallying round us and those that show true spirit of African solidarity," he said.

He added that "we expect African countries and organisations including ECOWAS and the African Union to rally round and show solidarity which the Gambian president has demonstrated".

- 'Un-African travel bans' -

A week earlier Ibrahim Ben Kargbo, a senior official, had expressed "shock" that South Africa had donated a mobile testing laboratory on one hand while banning Sierra Leoneans on the other.

The hurt was shared in Liberia where Musa Bility, head of the national football association, told AFP in August that travel bans imposed by several neighbours were "un-African".

Nelson Mandela's widow Graca Machel was more explicit when she blasted African leaders in November for an "inadequate" response to Ebola which demonstrated a lack of regard for human life.

The AU itself has recognised its shortcomings.

At the height of the epidemic, members had deployed just 100 volunteers to west Africa, a quarter of the number provided by Cuba alone.

"With the wisdom of hindsight, our responses at all levels -- continental, global and national -? were slow, and often knee-jerk reactions that did not always help the situation," the bloc's chairwoman Nkosazana Dlamini-Zuma admitted at a meeting with the heads of the United Nations and World Bank on October 28.

Politicians and aid agencies have noted a better response since, however, with 800 of 1,000 volunteers pledged in October now in place.

- Danger of complacency -

In November, the AU set up a crisis fund alongside the African Development Bank and regional business leaders, with some $28 million pledged.

AU leaders in Ethiopia are discussing the economic recovery of countries affected by Ebola, setting up a "solidarity fund" and planning a proposed African Centre for Disease Control.

The World Health Organization (WHO) said on Thursday laboratory-confirmed Ebola infections had dropped below 100 new cases a week for the first time in more than six months.

The WHO said it had shifted its efforts from slowing the spread to stamping it out completely.

Meanwhile Guinea's President Alpha Conde has warned that the retreat of the virus has brought with it the danger of complacency.

"We have to see how to compensate for the damage that Ebola has inflicted on our economy and our finances," he told AFP last week on the sidelines of the World Economic Forum in Davos, which brings together 2,500 of the world's most influential business and political leaders.

He called on the International Monetary Fund, which is owed $480 million ($557 million) by the Ebola-hit nations, to forgive the debt, a request which has been backed in part by the United States, IMF's largest shareholder.

"The consequences are extremely serious for our economy. Business executives no longer come to our country," he said.

by Karim Lebhour with Frankie Taggart in Dakar

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2 February 2015

Ebola crisis: First major vaccine trials in Liberia

The first large-scale trials of two experimental vaccines against Ebola have begun in Liberia.

The potentially preventative medicines were taken under strict security to a secret location in the West African country.

Scientists aim to immunise 30,000 volunteers, including front-line health workers.

More than 8,500 people have died in the Ebola outbreak, the vast majority in Guinea, Liberia and Sierra Leone.

The total number of reported cases is more than 22,000.

In Liberia alone, more than 3,600 people have died from the disease.

But the number of Ebola cases in Liberia has been steadily decreasing, with only four confirmed cases in the week leading up to 25 January.

According to the World Health Organization (WHO), the epidemic has entered a "second phase" with the focus shifting to ending the epidemic.

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Ebola deaths

Figures up to 31 January 2015

8,936 Deaths - probable, confirmed and suspected
(Includes one in the US and six in Mali)

3,710 Liberia

3,274 Sierra Leone

1,937 Guinea

8 Nigeria

Source: WHO

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The trial, which began on Monday, involves injecting 12 volunteers with a vaccine that contains a small, harmless fragment of the Ebola virus.

The aim is to trick the body into producing an immune response.

More volunteers will be immunised as the trial progresses.

However, it is not yet clear whether the trial vaccines will offer protection against the disease.

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The vaccine is still experimental and it is not clear whether it will definitely provide protection against Ebola

Vaccines train the immune systems of healthy people to fight off any future infection.

They often contain a live but weakened version of the virus.

Correspondents say the trials are testing two vaccines created by two different drug companies who are hoping that the international community will eventually seek to stockpile large quantities of a working vaccine.

Thumbs-up

The first man to receive the vaccine was a middle-aged Liberian, the BBC's Mark Doyle reports from the Liberian capital Monrovia.

Asked how he felt after his jab, he smiled and gave me the thumbs-up, our correspondent says.

The senior Liberian scientist involved in the trials, Stephen Kennedy, told the BBC the volunteers were safe.

"There is no danger because the piece of the Zaire strain that has been put into the vaccine is a weak strain and it cannot and will not cause Ebola, so it is impossible that any one of the volunteers will contract Ebola from the vaccine," Mr Kennedy said.

The scientists are well aware of how important the support of local people will be if this trial is to work, our correspondent says.

Community nurses are being trained in how to monitor volunteers in the months after they have their injections.

Parts of the largest Ebola treatment centre in the world, on the edge of Monrovia, are being knocked down, our correspondent says.

Survival rate for the current outbreak is around 40%.

The scale of the outbreak has sparked a race to find a cure for the disease, with many vaccines and drugs being fast-tracked for human testing.

Safety trials for potential vaccines have taken place in the UK and in Switzerland and two potential drugs have been tested at Ebola treatment facilities run by medical charity Medecins Sans Frontieres.

Doctors have also been trialling serum therapy, a treatment made from the blood of Ebola survivors who have recovered.

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skibboy
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03 February 2015

Low infection rate halts Ebola vaccine trials in Liberia

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© AFP/File | A doctor holds a seringe containing the Ebola vaccine ChAd3 during trials on November 4, 2014

LONDON (AFP) - Britain's Wellcome Trust said that clinical trials it was funding for a new Ebola vaccine in Liberia were halted on Tuesday due to a fall in new cases.

"The current position is that there is no realistic prospect of the trial enrolling sufficient patients to be able to reach a conclusion about the efficacy of the drug," the Wellcome Trust, Britain's biggest scientific research charity, said in a statement.

"Therefore the trial has been terminated," it added.

The Wellcome Trust said the decision was taken on Tuesday after the pharmaceutical company Chimerix, which manufactures the brincidofovir vaccine, said it was withdrawing from the trial on Friday.

The first large-scale trials of two other Ebola vaccines -- GlaxoSmithKline's Chad3-EBO-Z and rVSV-ZEBOV, manufactured by Merck and Newlink -- began in Liberia on Monday.

Tuesday's decision was taken by the Trial Steering Committee, which includes scientists from Liberia, the University of Oxford and Medecins Sans Frontieres.

"We're delighted that infections are falling, but fewer patients makes it more difficult to carry out the robust scientific studies needed," Peter Horby from the University of Oxford, who was leading the trial, said in a statement.

Jeremy Farrar, director of the Wellcome Trust, which is funding a multi-million pound therapeutics platform for experimental Ebola treatments, said it was "disappointing" that the trial could not continue.

"It is essential that other studies of potential treatments and vaccines continue and hopefully will still be able to deliver meaningful results for this and the inevitable future epidemics of Ebola," he said.

Stephen Kennedy, a study investigator from the Pacific Institute for Research and Evaluation in Liberia added: "The scientific community will move on without any clear evidence regarding the role of brincidofovir in the management of Ebola."

Weekly Ebola infections in west Africa have dropped to below 100 for the first time in more than six months, the WHO said last week, raising hopes the worst-ever outbreak of the virus is coming to an end.

The World Health Organisation said it had now shifted its efforts in Guinea, Liberia and Sierra Leone -- the countries worst-hit by the epidemic -- from slowing the spread to stamping it out completely.

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skibboy
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4 February 2015

New Ebola cases show first rise in 2015

The number of new cases of Ebola has gone up in all three of West Africa's worst-hit countries in the last week of January, the World Health Organization (WHO) said on Wednesday.

It is the first weekly increase in 2015, ending a series of encouraging declines.

The WHO says Sierra Leone registered 80 of the 124 new cases, Guinea 39 and Liberia the remaining five.

Almost 9,000 people have died from Ebola since December 2013.

Dr David Nabarro, the United Nations special envoy on Ebola, said the small rise in Ebola cases was a concern but they knew there would be flare-ups.

"We're on a good path, this is coming down, but we really have to be vigilant because there are still pockets of infection," he said.

Only a week ago the WHO announced its lowest weekly tally of new cases since June 2014, raising hopes that a turning point in the battle against the disease might have been reached.

But suspicion of aid workers, especially in Guinea, and unsafe local practices were continuing to hamper efforts to contain the virus, the United Nations agency said.

Eleven new cases were blamed on one unsafe burial that took place in eastern Guinea on the border with Cote d'Ivoire, where a rapid response team has now been deployed, the WHO adds.

Mourners have caught the disease in the past by touching the highly-contagious bodies of dead loved ones.

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A burial team in Liberia getting ready to deal with more highly infectious bodies

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Liberia has come further than the other countries in raising awareness of the disease

Nearly one-third of Guinea's 34 prefectures had reported at least one security incident or other form of refusal to cooperate with health workers in the previous week.

The WHO emphasised the need to step up efforts before the start of the April-May rainy season, when downpours can block roads and make it difficult for health teams to travel.

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