Ebola News 12/8

[Buster's Uncle]

In Ebola outbreak, bad data adds another problem
Associated Press
By MARIA CHENG and SARAH DiLORENZO  2 hours ago



People carry food aid from a British Navy helicopter after it made a food drop on Sherbro Island, Sierra Leone, Sunday, Dec. 7, 2014. The WFP, World Food Program and British Military took part in a three day food distribution effort to local residents on the remote Sherbro Island, where the amount of sick people due to the Ebola virus have prevented people from farming, fishing or gathering there own food. (AP Photo/Michael Duff)



LONDON (AP) — As health officials struggle to contain the world's biggest-ever Ebola outbreak, their efforts are being complicated by another problem: bad data.

Having accurate numbers about an outbreak is essential not only to provide a realistic picture of the epidemic, but to determine effective control strategies. Dr. Bruce Aylward, who is leading the World Health Organization's Ebola response, said it's crucial to track every single Ebola patient in West Africa to stop the outbreak and that serious gaps remain in their data.

"As we move into the stage of hunting down the virus instead of just slowing the exponential growth, having good data is going to be at the heart of this," Aylward said. "We are not there yet and this is something we definitely need to fix."

"Decisions about prevention and treatment should be data-driven, but we really don't have the data," agreed Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University.

A week ago, the World Health Organization insisted at a media briefing it had mostly met targets to isolate 70 percent of Ebola patients and bury 70 percent of victims safely in Guinea, Liberia and Sierra Leone. But two days later, WHO backtracked and said that data inconsistencies meant they really didn't know how many patients were being isolated. Then the U.N. health agency also conceded that many of the safe burials were of people not actually killed by Ebola.

Aylward said not knowing exactly how many Ebola patients there are in hotspots like western Sierra Leone means health officials might miss potential contacts who could unknowingly cause a surge of cases. Compared to other epidemics like malaria, which is more seasonal and can fade away without huge control efforts, ending the Ebola outbreak will require extraordinary attention to detail.



A local resident awaits the landing of a British Navy helicopter as it drops food aid on Sherbro Island, Sierra Leone, Sunday, Dec. 7, 2014. The WFP, World Food Program and British Military took part in a three day food distribution effort to local residents on the remote Sherbro Island, where the amount of sick people due to the Ebola virus have prevented people from farming, fishing or gathering there own food. (AP Photo/Michael Duff)


"This outbreak started with one case and it will end with one case," Aylward said. "If we can't get 100 percent of the contacts of cases, we will not be on track to shut it down. Unfortunately at the moment, the data right now is not enough for us to get to zero."

In West Africa, where health systems were already broken before Ebola struck, collecting data amid a raging outbreak has been challenging.

"Suddenly you have all these different sources of data that have to be compiled" from different aid agencies, said Ray Ransom, a data expert at the U.S. Centers for Disease Control and Prevention. "The ability to actually collect information is a different challenge than responding to the outbreak, and the energy has been focused on the response."

He said local officials are good at tracking known or suspected Ebola cases and their contacts but not as reliable relaying that information to national authorities.

The software built to track Ebola outbreaks was initially designed by the CDC to have one person entering data into a computer. That "was perfectly fine since the dawn of time up until" the outbreak exploded this summer, said Armand Sprecher, a public health specialist with Doctors Without Borders.



British Navy helicopter operators stand next to their helicopter after they made a food drop on Sherbro Island, Sierra Leone, Sunday, Dec. 7, 2014. The WFP, World Food Program and British Military took part in a three day food distribution effort to local residents on the remote Sherbro Island, where the amount of sick people due to the Ebola virus have prevented people from farming, fishing or gathering there own food. (AP Photo/Michael Duff)


The CDC has redesigned the software so now multiple people can enter data, although that created new problems like possible duplication, Sprecher said.

When the epidemic starts to taper off, health officials should have more time to find every Ebola case and their contacts. But they may find they have to re-establish trust with the community to do that.

"If people were calling in cases for months and no one was coming ... and then suddenly that's no longer a bottleneck, do people suddenly realize that and say, aha, if I call in today, it'll work this time?" asked Sprecher. "If you've lost the community, you don't get anywhere."

___

Sarah DiLorenzo reported from Dakar, Senegal.


http://news.yahoo.com/ebola-outbreak-bad-data-adds-another-problem-151611194.html

[Buster's Uncle]

US doctor gives first interview since surviving Ebola
AFP  15 hours ago



Emory University Hospital, October 15, 2014, in Atlanta, Georgia, where a US doctor Ian Crozier was treated after contracting Ebola in Sierra Leone (AFP Photo/Kevin C. Cox)



Washington (AFP) - A US doctor who contracted Ebola in Sierra Leone and survived after weeks of intensive treatment in Atlanta is speaking out for the first time in an interview published Sunday.

Ian Crozier -- who until now has remained anonymous in news accounts of his treatment, at his request -- said he cannot remember the first three weeks he spent in an isolation ward at Emory Hospital, where he was near death from the hemorrhagic virus.

But the doctor, who was in Sierra Leone to help fight the epidemic that has now killed more than 6,000 in West Africa, has read his chart.

"It's a horrible-looking chart," he told The New York Times.

Crozier and his relatives said they gave the interviews to raise awareness of the continuing epidemic and to thank the medical team who saved his life.

And despite his grave illness and fears of permanent brain damage -- Crozier says he feels his mind working slower than before -- the Zimbabwe-born doctor says he hopes to return to West Africa to continue treating Ebola patients within the next few months.



Tombstones are seen at a cemetery at the Kenama ebola treatment center run by the Red cross Society on November 15, 2014 (AFP Photo/Francisco Leong)


"There's still a great deal left to be done," he said, noting that his recovery should mean he is immune to future infection with the virus.

The latest data on the West African outbreak, the worst known spread of the virus since it was discovered in the 1970s, showed the epidemic was far from over, with an increase in cases reported in Sierra Leone and Guinea, but a drop in Liberia.

Crozier contracted with the World Health Organization and went to Sierra Leone in August.

He describes the horrors of the understaffed isolation wards there, but also tells of patients who helped each other pull through -- including a group of three brothers who he initially thought were too sick to survive.

"They were this little band of brothers," he said, and "they just sort of pushed each other through it." All three boys survived.

Grozier fell ill in September and spent 40 days in the US hospital. He was the "by far sickest patient" Emory has treated for Ebola, Jay Varkey, an infectious-disease specialist, told the Times.

Doctors used aggressive techniques, including dialysis and ventilators, to keep him alive as the virus ravaged his body and shut down his kidneys.

"One of the things Ian taught us was, guess what, you can get sick enough to need those interventions and you can still walk out of the hospital," said Emory team leader Bruce Ribner.

Crozier also received a blood transfusion from a British nurse who had survived Ebola -- an experimental treatment that may help transfer antibodies that fight the illness to the patient.

The 44-year-old is now back in Phoenix with his family, recovering his strength after losing nearly 30 pounds (14 kilograms) of mainly muscle while sick.


http://news.yahoo.com/us-doctor-gives-first-interview-since-surviving-ebola-020057613.html

[Buster's Uncle]

Dallas Ebola patient's ER doctor missed high fever
Associated Press  22 hours ago



This 2011 file photo provided by Wilmot Chayee shows Thomas Eric Duncan, the first Ebola patient diagnosed in the United States, at a wedding in Ghana. The Dallas emergency-room doctor who initially treated Duncan told The Dallas Morning News he didn’t know the man’s home country or that he had a 103-degree fever shortly before he left the hospital. (AP Photo/Wilmot Chayee, File)



DALLAS (AP) — The Dallas emergency-room doctor who initially treated a Liberian man infected with Ebola said he didn't know the man's home country or that he had a 103-degree fever shortly before he left the hospital.

Thomas Eric Duncan was released in the early hours of Sept. 26, about half an hour after his medical records indicate he had a fever that high — a key potential symptom of Ebola.

Dr. Joseph Howard Meier told The Dallas Morning News (http://bit.ly/12Ai2ho ) he didn't see that temperature reading on Duncan's medical chart.

"I was unaware of a 103-degree fever," Meier said in written answers to questions released by his attorney. "It appears in the chart, but I did not see it."

Duncan returned to Texas Health Presbyterian Hospital Dallas two days later in an ambulance and was quickly diagnosed with Ebola. He died Oct. 8.

Duncan's sister and fiancee have said he told medical staff in the emergency room during that first visit that he was from Liberia, though the hospital's medical records only indicate Duncan said he was from Africa.



In this Oct. 8, 2014 file photo, a sign points to the entrance to the emergency room at Texas Health Presbyterian Hospital Dallas, where U.S. Ebola patient Thomas Eric Duncan was treated, in Dallas. The emergency-room doctor who initially treated Duncan told The Dallas Morning News he didn’t know the man’s home country or that he had a 103-degree fever shortly before he left the hospital. (AP Photo/LM Otero, File)


The hospital has already acknowledged mistakes in its care of Duncan and said its records system previously didn't make a patient's travel history clear.

Duncan's case set off a scramble by authorities to monitor dozens of people who potentially had contact with him, including in the days after his release from the hospital. None of those people ended up testing positive for Ebola. Two Presbyterian nurses were infected while treating him, but have since recovered.

Meier said that had he known Duncan was from Liberia, "this would have prompted me to contact the CDC (Centers for Disease Control and Prevention) and begin an evaluation for Ebola."

But he was less sure about the 103-degree reading.

"Given what little information I had, a 103 temperature would most likely not have helped with the diagnosis of Ebola," Meier said. "Although, if it did not quickly improve, he could have possibly been admitted to the hospital."

Asked about whether he would do anything differently, Meier said it was "virtually impossible" to say.

"Based on the information I had at the time, I believe that the care and treatment were appropriate," he said.

___

Information from: The Dallas Morning News, http://www.dallasnews.com

___


http://news.yahoo.com/dallas-ebola-patients-er-doctor-missed-high-fever-191721140.html

[Buster's Uncle]

Sierra Leone doctors strike for better Ebola care
Associated Press
By CLARENCE ROY-MACAULAY  13 minutes ago



FREETOWN, Sierra Leone (AP) — Junior doctors in Sierra Leone went on strike Monday to demand better treatment for health workers who become infected with Ebola, a health official said.

The association representing junior doctors asked the government to make sure life-saving equipment, like dialysis machines, is available to treat infected doctors. The government has promised that a special treatment unit for health care workers will open soon and will be fully equipped. But the doctors began their strike anyway, according to Health Ministry spokesman Jonathan Abass Kamara.

Ten of the 11 Sierra Leonean doctors who have become infected have died. Ebola has killed about 6,200 people, including hundreds of health workers. Throughout the outbreak in West Africa, health care workers have periodically gone on strike to demand better protection or higher pay.

In an effort to make sure health workers get top-notch treatment, special centers dedicated to their treatment have already opened in Liberia and Sierra Leone.

As infection rates in Liberia and Guinea begin to stabilize, Sierra Leoneans and their government have been asking why the disease is picking up pace there and some have lashed out at the British response. In particular, the British charity Save the Children, which is running the first U.K.-built treatment center to open, has been criticized for a slow and disorganized rollout.

The charity defended its actions on Monday, saying that it stepped into a role at the Kerry Town center that no one else wanted and that it has said all along that it does not have experience running an Ebola ward. It said it is slowly opening more beds, as is considered the best practice. A month after the center opened, 40 of 80 planned beds are operational.

The side of the Kerry Town clinic that is for health workers has also been controversial after rumors that it would only accept foreign health workers or only ones working at British-built centers. The clinic is open to any infected frontline health worker, said Andrew Ewoku, a media manager for the charity in Sierra Leone.


http://news.yahoo.com/sierra-leone-doctors-strike-better-ebola-care-174351690.html

[Buster's Uncle]

Sierra Leone overtakes Liberia in number of Ebola cases: WHO
Reuters  45 minutes ago



A woman walks pass an Ebola virus awareness campaign poster in Monrovia, December 8, 2014. REUTERS/James Giahyue



GENEVA (Reuters) - The death toll from the Ebola outbreak in West Africa has risen to 6,331 in the three worst hit countries, with Sierra Leone overtaking Liberia as the country with the highest number of cases, World Health Organization figures showed on Monday.

The cumulative number of cases in Guinea, Liberia and Sierra Leone totalled 17,800, including 7,719 in Liberia and 7,798 in Sierra Leone, WHO said. On Friday, WHO put the three countries' combined death toll at 6,187, out of 17,517 cases.

Just over half the reported deaths were in Liberia, but the true toll in Sierra Leone, with an estimated fatality rate of 70 percent, is likely to be far higher than the figures show, WHO experts say.

(Reporting by Tom Miles; Editing by Susan Fenton)


http://news.yahoo.com/sierra-leone-overtakes-liberia-number-ebola-cases-190447974.html

[Buster's Uncle]

Sierra Leone slams Britain over management of Ebola center
Reuters  16 minutes ago



FREETOWN (Reuters) - Sierra Leone on Monday accused the British government of handing over a new Ebola treatment center to a charity with too little experience to run it, with the result that most of its beds are still empty.

Save The Children was contracted by the British government to manage the 80-bed Kerry Town Ebola center, built by the British military as part of international efforts to contain the worst outbreak of Ebola on record.

The center was opened on Nov. 5 but only around one-third of its beds are occupied despite Ebola spreading fast across Sierra Leone.

The virus has now killed 6,331 people in Sierra Leone, Liberia and Guinea, according to the World Health Organization. Sierra Leone has the highest number of cases.

Palo Conteh, head of Sierra Leone’s Ebola Response Center, said running the facility outside the West African nation's capital was a challenge for the charity.

"Save The Children, they do not have the expertise," Conteh told a news conference. "That is something we must all accept, hands up, and say the Brits got it wrong with Kerry Town, handing over that facility to Save The Children who have never run an Ebola facility."

Save The Children's Global Humanitarian Director Michael Von Bertele, said the criticism stemmed from "a misunderstanding".

"When we were asked to take on the center, we made it absolutely clear that this was new business for us ... We have never run frontline health services at this scale," Von Bertele told journalists.

He said the charity organization had been obliged to recruit and train some 250 local staff and more from around the world.

"We set out a plan that involved us maybe taking just two or three patients in the first week, while we understood the complexity of working in a new environment with a new disease, and that is what we did," he said.

Bertele said the organization was expanding services, with 25 beds occupied, and was on track to fill the remaining beds by the end of the month.

"The British government may have asked lots of other people to do this but no one would say yes," he said. "We are the only charity that said ‘yes we will do it’. The government of Sierra Leone knew that when they approached us."

(Reporting by Umaru Fofana; Writing by Bate Felix; Editing by Daniel Flynn and Andrew Roche)


http://news.yahoo.com/sierra-leone-slams-britain-over-management-ebola-center-193833900.html

[Buster's Uncle]

Malaria death rates fall, Ebola threatens W.Africa progress
Reuters
By Kate Kelland  38 minutes ago

 

LONDON, Dec 9 (Reuters) - Malaria deaths have dropped dramatically since 2000 and cases are falling steadily thanks to more people being diagnosed and treated and more getting bed nets, the World Health Organization (WHO) said on Tuesday.

Yet progress against the mosquito-borne infection remains fragile and West African countries suffering an unprecedented epidemic of Ebola are particularly at risk of seeing a resurgence of malaria, the United Nations health agency said.

In its annual report on the disease, the WHO said the malaria death rate fell by 47 percent worldwide between 2000 and 2013 and by 54 percent in Africa, where about 90 percent of all malaria deaths occur.

In an analysis of malaria's impact across sub-Saharan Africa, it also found that despite a 43 percent increase in population, fewer people in the region are infected every year.

"The next few years are going to be critical to show that we can maintain momentum and build on the gains," said Pedro Alonso, director of the WHO's global malaria program.

In West Africa, the report said, the deadly Ebola outbreak has had a "devastating impact" on malaria treatment and the roll-out of malaria control programs.

In Guinea, Sierra Leone and Liberia -- all severely hit by the Ebola epidemic -- many inpatient clinics are closed and attendance at outpatient facilities is a fraction of rates seen before the outbreak, it said.


TEMPORARY MEASURES

With a major malaria threat in these countries, which together saw some 6.6 million cases and 20,000 malaria deaths in 2013, the WHO called for temporary control measures, including giving malaria drugs to all patients with fever and carrying out mass treatment in areas hard hit by both Ebola and malaria.

"International donor financing is being stepped up to meet the further recommendation that bed nets be distributed to all (Ebola) affected areas," the report said.

Worldwide, malaria killed some 584,000 people in 2013, including some 453,000 children under five years old. Although funding to fight malaria has increased threefold since 2005, it is still only around half the $5.1 billion needed.

WHO director general Margaret Chan said in a statement the data showed the fight against malaria could be won because "we have the right tools and our defenses are working".

"But we still need to get those tools to a lot more people if we are to make these gains sustainable,"

(Editing by Gareth Jones)


http://news.yahoo.com/malaria-death-rates-fall-ebola-threatens-w-africa-000236246.html

[Buster's Uncle]

British charity defends management of Ebola center after criticism
Reuters  43 minutes ago



FREETOWN (Reuters) - British charity Save The Children on Monday defended its management of an Ebola treatment center outside Freetown saying it had informed both the British government and Sierra Leone that it lacked frontline experience in running such facilities.

Sierra Leone's government last week said most of the beds in the treatment center were empty because the British handed the facility over to a charity that was not experienced enough to run it.

Save The Children was contracted by the British government to manage the 80-bed Kerry Town Ebola center, built by the British military as part of international efforts to contain the worst outbreak of Ebola on record.

The center opened on Nov. 5, but only around one-third of its beds are occupied despite Ebola spreading fast across Sierra Leone.

The virus has now killed 6,331 people in Sierra Leone, Liberia and Guinea, according to the World Health Organization. Sierra Leone has the highest number of cases.

Save The Children's Global Humanitarian Director Michael Von Bertele, said the criticism stemmed from "a misunderstanding".

"When we were asked to take on the center, we made it absolutely clear that this was new business for us ... We have never run frontline health services at this scale," Von Bertele told journalists.

Palo Conteh, head of Sierra Leone’s Ebola Response Center, told a news conference last week in the capital Freetown that running the facility outside the West African nation's capital was a challenge for the charity.

"Save The Children, they do not have the expertise," Conteh told a news conference. "That is something we must all accept, hands up, and say the Brits got it wrong with Kerry Town, handing over that facility to Save The Children who have never run an Ebola facility."

Bertele said the charity organization had been obliged to recruit and train some 250 local staff and more from around the world.

"We set out a plan that involved us maybe taking just two or three patients in the first week, while we understood the complexity of working in a new environment with a new disease, and that is what we did," he said.

Bertele said the organization was expanding services, with 25 beds occupied, and was on track to fill the remaining beds by the end of the month.

"The British government may have asked lots of other people to do this but no one would say yes," he said. "We are the only charity that said ‘yes we will do it’. The government of Sierra Leone knew that when they approached us."

(Recasts headline and first two paragraphs to correct that Sierra Leone officials spoke last week)

(Reporting by Umaru Fofana; Writing by Bate Felix; Editing by Daniel Flynn and Andrew Roche)


http://news.yahoo.com/british-charity-defends-management-ebola-center-criticism-001153413.html