l. WHO is holding another vaccine meeting in Geneva tomorrow to ‘ramp up’ EBOV testing in West Africa so that HCW and the African population can be vaccinated in early 2015. Dr. Fauci will be present at the meeting. The dispute over RCT vs. stepped-wedge testing of EBOV vaccines present at the September vaccine meeting may be resolved tomorrow. You will be able to read a summary of the meeting at: http://who.int/en/ under Situation Assessment tomorrow afternoon U.S. time because of the time change between the U.S. and Geneva.
2. NY Times reports that the vaccine testing and development is ‘gathering steam’. Two vaccines will be tested in West Africa in January. Three more vaccines are being tested elsewhere; one of the vaccines is oral. Reuters reports that Johnson & Johnson will contribute $200 Million to labs developing EBOV vaccines and may combine with GSK in production of vaccines. See: http://www.reuters.com/article/2014/10/22/us-health-ebola-johnson-johnson-idUSKCN0IB0N420141022 for full details (Thank you, J & J and GSK).
3. NY Times reports that the U.S. is tracking all arriving air passengers from Liberia, Sierra Leone, and Guinea for at least 21 days. These passengers must report to the CDC daily their temperatures and symptoms for the day.
4. NEJM on-line tonight published a Brief Report on the hospital course of the Sierra Leone HCW who contracted EBOV and was evacuated to Hamburg, Germany for treatment. The report by Kreuels, et. al. can be read in full at: DOI: 10.1056/NEJMoa1411677. The patient was successfully treated for EBOV and Gram negative sepsis. He required high volume fluid resuscitation (10 L/day) for the first 3 days in order to maintain his circulatory status. His fluid balance was +30 L at the end of Week #1. Authors believe his Gram negative sepsis was secondary to inflammation of his GI tract. The RT-PCR test of his serum was negative at Day #14, but his urine was not negative until Day #26, and his sweat was not negative until Day #40. The Brief Report is written for clinicians and contains Supplementary Material.
Today everything seems to be coming up roses.