Evening Ebola Update, Wed, 12/10: Person of the Year/Entry screening ineffective/Immunocompromised produce pandemics?/Genomic methods for EBOV/MERS-CoV/Influenza   Leave a comment

12/10/14

Dear Colleagues:

1.  Ebola Deeply reports that Junior Doctors in Sierra Leone have ‘struck’ for better care of HCW with EBOV in Sierra Leone treatment centers designated for HCW.  The doctors want renal dialysis machines available and mechanical ventilation available at the HCW treatment center in Sierra Leone.  They also want the centers designated for HCW to care for ALL HCW with EBOV.  See Voice of America’s report at: http://www.voanews.com/content/junior-sierra-leone-doctors-on-a-partial-strike-over-ebola-protection/2552875.html.  This report states that President Koroma has met with the doctors’ association and will provide all they have asked for by December 17th.

2.  The Lancet 6 December has an article by corresponding author Chalkidou, et. al. from London and Cuba reporting on the Cuban approach to EBOV disease.  Cuba has 160 physicians in Sierra Leone and will soon deploy 300 more physicians to Liberia and Guinea.  Cuban medical schools are socially progressive; the schools have a 5 year program and 1 additional year of internship.  All medical students are trained as primary care physicians; specialty training is approved after internship on a case-by-case basis.  After their internship is completed, Cuban physicians are prepared to go anywhere in the world if there is medical need.  In 2013 there were 19,000 Cuban physicians in 66 countries in the world.  Cuba has partnered with African countries to train medical students in Africa.  560 African medical students graduated this year.  5700 more medical students are training in Africa.  See the entire article at: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)62329-1/fulltext

3.  The Lancet 6 December also contains a ‘Hypothesis’ article by Reperant, et. al. from the Erasmus Medical Centre in the Netherlands about how zoonotic influenza viruses are only a few mutations away from becoming both highly pathogenic and highly transmittable.  So why do influenza pandemics occur so infrequently?  The authors postulate that innate (cytokine) immune response and adaptive (cytotoxic T lymphocytes) immune response keep the zoonotic influenza virus from becoming highly transmittable-at least in the immunocompetent host.  The authors have a model which indicates that it is immunocompromised hosts who have the potential to allow pandemics to occur.  See the ‘Hypothesis’ article at: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62425-3/fulltext?_eventId=login.  I post this article because what applies to the influenza virus might also apply to EBOV.

4.  WHO reports the organization is holding a conference in Geneva today and tomorrow on ‘Building A Resilient Health Care System in Ebola Countries’.  Importantly, the World Bank and the African Development Bank Group are sponsors of the meeting.  The agenda for the two day meeting is available at: http://who.int/csr/disease/ebola/health-systems/health-systems-agenda.pdf?ua=1

5.  PLoS Currents Outbreaks has posted an article by Cope, et. al, from the University of Adelaide in South Australia regarding the risk of EBOV being carried to Australia in 2015.  Two scenarios are presented.  Scenario #1 is based on historical travel from EBOV infected countries to Australia; scenario #2 is based on visa restrictions to travel from EBOV infected countries.  In Scenario #1 there is a probability of 34% that a case of EBOV will reach Australia; in Scenario #2 the probability drops to 16%.  See the PLoS article at: http://currents.plos.org/outbreaks/article/assessment-of-the-risk-of-ebola-importation-to-Australia/

6.  Lucy Li. et. al. from the Infection Disease and Epidemiology Departments at Imperial College in London has kindly provided us with a copy of her article in Genome Biology entitled: ‘Genomic Analysis of Emerging Pathogens…’.  The authors discuss the methods to analyze EBOV, MERS-CoV, and Influenza.  I have attached the article to my email to everyone about tonight’s posting.  Thank you Dr. Li.

7.  USA Today reports that U.S. airports screened 2,000 passengers who took flights from EBOV infected countries and eventually ended up deplaning in the U.S.  Seven of these 2,000 passengers met criteria for EBOV testing; none of the 7 passengers tested positive for EBOV.  In India, airports have screened 73,000 arriving passengers and found 73 passengers who needed EBOV testing.  The tests results are not yet available to the public or press.  See the USA Today article at: http://www.usatoday.com/story/news/nation/2014/12/09/ebola-airport-screening/20148019/  These results support an earlier posted research article conclusion that exit screening is more effective in detecting EBOV patients than entry screening.

8.  Time Magazine has announced that EBOV fighters are the Person of the Year.  See the USA Today report at: http://www.usatoday.com/story/news/nation/2014/12/10/time-magazine-person-of-the-year-ebola-fighters/20184807/

RGL, MD

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Posted December 11, 2014 by levittrg in Ebola

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