Ebola News 2/6

[Buster's Uncle]

Guinea Ebola infections double as hidden cases discovered
Reuters  2 hours ago



A health worker checks the temperature of a man arriving at Bata Airport, January 14, 2015. REUTERS/Amr Abdallah Dalsh



CONAKRY (Reuters) - The number of people sick with Ebola fever has doubled in Guinea in the past week following the discovery of cases previously unknown to health authorities, a Guinea health official said on Friday.

About two dozen new suspected and confirmed Ebola cases were recorded in the past two weeks, taking the total number to 53 as of Friday, Fode Tass Sylla, a spokesman for Guinea's anti-Ebola task force, said.

Sylla said the increase was expected because health authorities were only now gaining access to faraway villages where inhabitants had previously prevented them from entering.

"This increase in new case numbers is because we are now able to get to villages where we are discovering hidden sick cases," he said.

The new cases highlights difficulties authorities in the three worst-hit West African states -- Guinea, Sierra Leone and Liberia -- face in trying to curb the spread of the epidemic that has killed nearly 9,000 people.

Thought to be declining at the start of 2015, the number of new Ebola cases rose in all three countries for the first time this year in the past week, the World Health Organization said on Thursday.

Some 36 villages in the south and western forest region of Guinea, where the first case of Ebola was recorded, had previously been inaccessible to health officials because villagers sometimes used violence to stop health workers.

"Even in Conakry (Guinea's coastal capital), there are some neighborhoods such as Ratoma where we had the same kind of situation," Sylla said.

Guinea's government on January 10, set a 60-day target to completely eradicate the disease in the nation, a gold, iron ore and bauxite producer but where nearly 60 percent of the population live below the poverty line.

However, there are doubts this could be achieved due to high levels of mistrust of health authorities, the practice of traditional rituals such as burials, and general misinformation about the disease.

(Reporting by Saliou Samb; Writing by Bate Felix; Editing by Angus MacSwan)


http://news.yahoo.com/guinea-ebola-infections-double-hidden-cases-discovered-122340511.html

[Buster's Uncle]

Secret burials thwarting efforts to stamp out Ebola - U.N
Reuters
By Stephanie Nebehay  6 hours ago



Volunteers lower a corpse, which is prepared with safe burial practices to ensure it does not pose a health risk to others and stop the chain of person-to-person transmission of Ebola, into a grave in Kailahun August 2, 2014. REUTERS/WHO/Tarik Jasarevic/Handout via Reuters



GENEVA (Reuters) - Efforts to stamp out West Africa's Ebola epidemic are being thwarted by villagers touching and washing the infectious bodies of dead victims at secret burials and difficulty in tracing those exposed to the virus, U.N. officials said on Thursday.

The number of new cases rose for the first time this year in the past week, coinciding with a looming funding shortfall and the approach of the rainy season that will hamper aid efforts from April, they warned.

"The commonest way in which people are getting Ebola is through the rituals that take place when somebody is buried, particularly the important cleansing and touching that goes on," Dr. David Nabarro, U.N. Ebola special envoy, told a briefing.

Some communities in Guinea, Liberia and Sierra Leone believe traditional practices are needed for the departed's spirit and the society, so it is "asking a lot of them" to change, he said.

"The flares (in new cases) that we're seeing are usually because there has been an unsafe burial, probably done secretly," Nabarro said.

Dr. Bruce Aylward, the World Health Organization's special representative on Ebola, said that the 124 new cases recorded in the week to Feb. 1, up from 99 the previous week, also reflected the virus' spread to border areas near Mali and Senegal.

"The virus has told us this week loud and clear I'm not going to go away the way you are expecting me to based on these (epidemiological) curves. And all I have to do is survive out the next couple of weeks or months until the rains hit, and then you're going to have a very, very difficult situation," he said.

But the WHO, the U.N. agency leading the fight against the year-old epidemic that has killed nearly 9,000 people, faces financial constraints.

"Right now though, our funding for those 800 people out there in the field, it ends at the end of February. That is how precarious the situation is right now in terms of being able to sustain this," Aylward said.

The five new cases reported in Liberia last week were all people on lists of contacts of Ebola patients, he said, noting that the success rate may prove hard to sustain. In Guinea the rate was 54 percent and in Sierra Leone 57 percent.

"As soon as they develop fever and become sick, if you get them into isolation they will not initiate another chain of transmission," Aylward said.

"This is part of the end-game of Ebola, it is trying to monitor those contacts."


http://news.yahoo.com/secret-burials-thwarting-efforts-stamp-ebola-u-n-074605727.html

[Buster's Uncle]

Guinea Ebola infections double as hidden cases discovered
Reuters  1 hour ago



Health workers push a gurney with a dead body at a Red Cross facility in the town of Koidu, Kono district Eastern Sierra Leone December 19, 2014. REUTERS/Baz Ratner



CONAKRY (Reuters) - The number of people sick with Ebola fever has doubled in Guinea in the past week following the discovery of cases previously unknown to health authorities, a Guinea health official said on Friday.

About two dozen new suspected and confirmed Ebola cases were recorded in the past two weeks, taking the total number to 53 as of Friday, Fode Tass Sylla, a spokesman for Guinea's anti-Ebola task force, said.

Sylla said the increase was expected because health authorities were only now gaining access to faraway villages where inhabitants had previously prevented them from entering.

"This increase in new case numbers is because we are now able to get to villages where we are discovering hidden sick cases," he said.

The new cases highlights difficulties authorities in the three worst-hit West African states -- Guinea, Sierra Leone and Liberia -- face in trying to curb the spread of the epidemic that has killed nearly 9,000 people.

Thought to be declining at the start of 2015, the number of new Ebola cases rose in all three countries for the first time this year in the past week, the World Health Organization said on Thursday. [ID:nL6N0VF5NU]

Some 36 villages in the south and western forest region of Guinea, where the first case of Ebola was recorded, had previously been inaccessible to health officials because villagers sometimes used violence to stop health workers.

"Even in Conakry (Guinea's coastal capital), there are some neighbourhoods such as Ratoma where we had the same kind of situation," Sylla said.

Guinea's government on January 10, set a 60-day target to completely eradicate the disease in the nation, a gold, iron ore and bauxite producer but where nearly 60 percent of the population live below the poverty line.

However, there are doubts this could be achieved due to high levels of mistrust of health authorities, the practice of traditional rituals such as burials, and general misinformation about the disease. [ID:nL6N0VF5NU]

(Reporting by Saliou Samb; Writing by Bate Felix; Editing by Angus MacSwan)


http://news.yahoo.com/guinea-ebola-infections-double-hidden-cases-discovered-123629431.html

[Buster's Uncle]

High rates of child deaths from Ebola, special care needed: WHO
Reuters
By Stephanie Nebehay  21 minutes ago



United Nations Children's Fund (UNICEF) Ivory Coast Representative Adele Khudr speaks to children during an Ebola awareness drive in Toulepleu, at the border of Liberia, in western Ivory Coast, in this file photo taken on November 4, 2014. REUTERS/Thierry Gouegnon



GENEVA (Reuters) - Authorities fighting Ebola must do more to tackle a high death rate among young children whose isolation from parents also causes great distress and deprives them of the extra care they need, the World Health Organization (WHO) said on Friday.

Reporting on a meeting of clinicians from Guinea, Liberia and Sierra Leone, it said there was a consensus that the strict "no touch" policy for Ebola patients could be lifted if good measures are in place to protect health workers from infection.

"There is a need to address issues around children and pregnant women. Children under five had a very high rate of mortality, this was often because need a great deal of support to be fed, to be cared for," WHO technical adviser Dr. Margaret Harris told a news briefing.

Mortality in children under five years of age has been 80 percent, meaning four out of five die, and up to 95 percent among under one-year-olds who require intensive nursing and frequent feeding, she said.

"There was quite some suggestion that simply being separated and isolated as happens in an Ebola treatment unit had a devastating psychological effect on children, they did not have parents, they did not have carers," Harris said.



A health worker checks the temperature of a baby entering Mali from Guinea at the border in Kouremale, in this file photo taken on October 2, 2014. REUTERS/Joe Penney


"The complexities of dealing with children, especially children under-one, were not really being met and they need to be met."

At least 21 pregnant women survived the hemorrhagic disease, but their babies or fetuses rarely did, she said.

Nearly 9,000 people have died out of 22,495 known cases in the epidemic that began in December 2013.

Survivors have displayed symptoms including severe muscle pain, headaches, mood swings, depression, loss of concentration and impaired vision, according to the WHO. Reuters reported this week that some of the 5,000 to 10,000 survivors complain of side effects months after their recovery.

The U.N. Children's Fund said 16,600 children in the three countries have lost one or both parents. But communities and extended family members have taken in all but about 500 of them, overcoming initial fears and stigma.

"Having said that, what really struck me when I was visiting the families in Liberia, however strong that family and relative support is, the grief is very raw," Andrew Brooks, UNICEF regional child protection adviser, said by telephone from Dakar.

"The children, it doesn't take much for them to get very, very upset. I don't think we should under-estimate that side of things in addition to the economic and material support."

(Reporting by Stephanie Nebehay)


http://news.yahoo.com/high-rates-child-deaths-ebola-special-care-needed-155504386.html

[Buster's Uncle]

Blood from Ebola survivors could help spur new disease treatments
Reuters
By Julie Steenhuysen  February 4, 2015 1:38 PM



An Ebola trials notebook is seen in a laboratory during trials for an Ebola vaccine in England January 16, 2015. REUTERS/Eddie Keogh



CHICAGO (Reuters) - After successfully treating four Ebola patients last year, Emory University in Atlanta is now leading a government-funded project that will use blood from survivors of the deadly virus to test a novel way of treating infectious disease.

Traditional vaccines boost the immune system’s response to infections. The new project will inject people with genetic material, such as DNA or RNA, in hopes of spurring a person’s own cells to make specific antibodies capable of fighting Ebola or other pathogens.

"The person's body is the factory," said Dr. James Crowe of Vanderbilt University, one of the collaborators on the project. "It's a cool idea."

Experts say the method, if proven to be safe and effective, would be faster and cheaper than conventional drug production and could potentially be used to treat illnesses such as seasonal flu or malaria.

Antibodies are typically grown in large vats of mammal cells or in some cases, tobacco plants, such as Mapp Biopharmaceutical's experimental Ebola treatment ZMapp.

The Defense Advanced Research Projects Agency (DARPA), the Pentagon's elite research arm, has awarded Emory up to $10.8 million over three years to direct the project.

It will include research teams at the U.S. Centers for Disease Control and Prevention, the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), and several academic research labs including the University of Wisconsin-Madison, Rockefeller University, Vanderbilt and Scripps Research Institute.

Getting access to blood samples from survivors of the current Ebola outbreak in West Africa has been challenging, but Emory has a distinct advantage in having treated a small number of patients on U.S. soil.

All four of its former patients agreed to take part in the program, said Rafi Ahmed, director of the Emory Vaccine Center, who is leading the effort.

Ahmed and colleagues intend to isolate antibodies made by these patients in response to the Ebola virus, and through a series of experiments in animals, identify the most effective ones for fighting off an Ebola infection.

The approach is unrelated to an experimental treatment provided to several Ebola patients in the United States, which involved transfusions of blood plasma from Ebola survivors.

Researchers will take two approaches. In one, they will produce large quantities of Ebola-fighting antibodies that could be infused into patients intravenously, a conventional approach known as passive immunization.

Protection using this method has a short half life of about two to three weeks, and the antibodies require refrigeration, which is not always available in countries fighting an infectious disease outbreak.

That is why the team is also testing the new method for making protective drugs based on DNA or RNA, rather than the older vaccine technology using killed or weakened viruses to stimulate an immune response, a process that can take several months to manufacture.

"In this method, we are trying to go in as silently as possible," bypassing the immune response, which may not always work, and directly providing the recipe for a highly effective antibody, said Col. Daniel Wattendorf, program director at DARPA who came up with the new strategy.

Wattendorf said the effort is based on prior, early stage research with drugmakers Novartis and Sanofi looking at whether they could make vaccines out of ribonucleic acid, or RNA.

"What was particularly intriguing about RNA was that it has no chance of integrating into the human genome," he said. The effect was temporary.

Initially, the technology was being developed in hopes of protecting soldiers from seasonal flu or germs that cause diarrhea on the battlefield, but the Ebola outbreak presented an opportunity to accelerate the research.

To succeed, researchers will need to identify an effective delivery system to carry the genetic instructions into the body and learn how to quickly identify the most protective antibodies. The goal is to get the process down to 90 days for most diseases, Wattendorf said.

The group is in the process of characterizing several Ebola antibody candidates to find which are the most potent, Ahmed said. At that point, the researchers and DARPA will seek out drug company partners.

Testing in people could begin within two years, with the goal of having a better weapon for the next Ebola outbreak.


http://news.yahoo.com/blood-ebola-survivors-could-help-spur-disease-treatments-060804064--finance.html

[Buster's Uncle]

Free from Ebola, survivors complain of new syndrome
Reuters
By Emma Farge and James Harding Giahyue  February 5, 2015 2:25 AM



Ebola survivor Romeo Doe poses for a picture at a clinic in Monrovia, February 1, 2015. REUTERS/James Giahyue



DAKAR/MONROVIA (Reuters) - Romeo Doe, a 29-year-old tailor who survived Ebola in Liberia, is struggling to cope with the impact of a disease that killed seven members of his family and now threatens his livelihood.

Since he was released from an Ebola centre in the capital Monrovia in November, pressure is rising in his eyes and affecting his vision - a complaint some doctors say is common among survivors of the West African outbreak.

There are a growing number of survivors of the disease in the region, between 5,000 and 10,000 according to the United Nations, and some complain of side effects months after their recovery - a condition some doctors are calling "post-Ebola Syndrome" (PES).

"Since I was discharged I have felt this pain in my eyes," said Doe. "They, as you can see, are red; they are hurting me. I want the government to help me get back on my feet."

Ebola, which has killed almost 9,000 people across Guinea, Liberia and Sierra Leone, initially causes fever and vomiting, then attacks the immune system and vital organs, often causing internal and external bleeding.

About 60 percent of Ebola patients have died in the current outbreak, typically from shock or organ failure.

Some of those who have survived the disease report a mixture of symptoms after their recovery, including vision problems, joint pain, hair and memory loss and anxiety attacks.

Margaret Nanyonga, a doctor who treated Ebola patients in the town of Kenema in Sierra Leone, said she had seen survivors go blind. Overall about half of those she saw recover reported declining health, she said.

Doctors say it is not yet clear how long the symptoms last. There is also no scientific literature or medical consensus on any new syndrome among West African survivors or how many people might be affected.

Dan Kelly, founder of the non-profit organisation Wellbody Alliance and a doctor specialising in infectious diseases, says the situation can be complicated by poor medical records making it hard to separate any new symptoms from pre-existing conditions. Ebola, like many severe infections, may also weaken survivors and make other illnesses more likely.

Kelly said some Ebola after-effects appear linked to the infection itself, with some patients developing symptoms similar to so-called autoimmune disorders - where the immune system is overstimulated and begins to attack the body's own tissues. Other patients develop symptoms similar to uveitis, he said, an eye inflammation causing blindness.

"With post-Ebola syndrome there is an autoimmune response: it's revved up, and we don't really know why," he told Reuters by telephone from Sierra Leone where he is helping with the Ebola response.


NEGLECT

When Korlia Bonarwolo left an Ebola treatment centre in Monrovia last year, his blood was free of the virus but he had caught two other life-threatening diseases: malaria and pneumonia.

The 26-year old doctor's assistant blames his health problems on poor care, rather than complications related to Ebola infection.

At the John F. Kennedy medical centre in Monrovia, draughts from the open-air corridors left him exposed, he says, while frightened nurses threw him juice boxes which he was often too weak to retrieve.

Back home, medical colleagues shunned him and he had to insert his own intravenous drip. Six months afterwards he has fully recovered but, as president of a survivors' association, wants to ensure others get better support and health information.

"The questions survivors are asking about where they are going to be health-wise in the future deserve answers," Bonarwolo said at a survivors' meeting organised by the United Nations.

The outbreak is now ebbing, and the health ministry says there are fewer than 10 cases in the country, but even survivors with no worrying symptoms say it is hard to get back to normal life with so many unanswered questions about Ebola's impact.

One of the ongoing concerns relates to sexual health. Some female Ebola survivors say they have stopped menstruating. The virus can also remain in semen for months.

The links between Ebola and mental health disorders is also little understood. A friend of Bonarwolo's survived Ebola only to develop a mental illness afterwards.


RESEARCH WINDOW

Ben Neumann, a virologist at Britain's Reading University who studies Ebola and other viruses and their effects, notes that Lassa virus, which comes from West Africa and causes a similar disease to Ebola, has also been reported as having longer-term health effects.

"(Lassa) survivors often report signs of nerve damage such as loss of hearing," he told Reuters, adding that it would be "surprising that something as damaging as Ebola did not have lasting effects".

The current lack of knowledge about post-Ebola health effects is probably "due to Ebola being a rare virus that left few survivors before this outbreak", he said.

Some after-effects of Ebola have been reported in previous outbreaks since the disease was first detected in 1976, but past epidemics were smaller and often more deadly, meaning there were fewer survivors to generate interest to warrant research.

So this outbreak creates a unique opportunity to learn more.

Kelly agrees, and wants swift follow-up.

"We are at risk of missing the window," he said. "We need to start catching survivors as they leave treatment centres."

(Additional reporting by Kate Kelland in London; Editing by Pravin Char)


http://news.yahoo.com/free-ebola-survivors-complain-syndrome-072502629.html