Evening Ebola Update, Sat, 1/24: Lancet article answers Lee, et. al. questions on ‘nitty-gritty’ of vaccine trials/ Cool processes involving villagers to reduce R0   Leave a comment

1/23/15

Dear Colleagues:

l.  The Lancet 17 January has an Offline by editor Richard Horton addressing WHO weaknesses and possible solutions.  This is Part 2 of the editor’s series on WHO.  The author notes that Dr. Chan cannot ‘hire and fire’ her regional directors (appointed by member countries).  Dr. Chan also does not have sufficient funds due to non-fulfillment of voluntary country contributions to perform all of WHO’s core functions.  The author suggests a separate wholly funded agency within WHO to tackle global health emergencies.  This agency would be directed by WHO and several diverse partners.  See his entire Offline at: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60034-4/fulltext

2.  The Lancet 17 January has a World Report by Mohammadi containing detailed information on how clinical trials of 3 vaccines will be performed in West Africa the next 3 months.  The author’s World Report directly answers the previously posted Lee, et. al. article: ‘Is the World Ready for an Ebola Vaccine?’  See Mohammadi’s detailed report at: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60035-6/fulltext

3.  CDC’s MMWR 23 January has one article re: how to monitor airplane passengers travelling on an airplane with a symptom-free EBOV patient and two articles on how to reduce EBOV infections within rural villages in Liberia and Sierra Leone.  Regan, et. al. from the CDC report that it is only necessary to monitor passengers within a 3 foot radius of the symptom-free EBOV patient and the crew.  The authors’ subject was one of Mr. Duncan’s nurses who later developed EBOV.  See: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm64e0123a1.htm?s_cid=mm64e0123a1_e

4.  The second report in MMWR 23 January re: the benefits of setting up EBOV treatment centers and/or community centers in villages in Liberia to isolate possible, probable, and confirmed EBOV patients as soon as EBOV symptoms develop.  Washington, et. al. from the CDC compute that during one month of isolation in village EBOV treatment centers or community centers throughout Liberia (both at the periphery of villages) over 9,000 EBOV cases were prevented.  See: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm64e0123a1.htm?s_cid=mm64e0123a1_e

5.  The third report in MMWR 23 January by Crowe, et. al. of the CDC  re: the benefits of establishing community surveillance workers in villages to ‘spot’ possible EBOV patients in villages based on a ‘trigger list’ of dangerous situations.  These dangerous situations include: illness or death of HCW; illness or death of traveler to village; illness or death of person attending funeral within last 3 weeks; and other situations.  The community surveillance workers notify the local health ministry official immediately; isolate the patient; give the isolated patient a packet of rehydration salts; give bleach pads to the family of the isolation patient to clean their home.  See: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm64e0123a3.htm?s_cid=mm64e0123a3_e for the entire report and complete list of ‘triggers’.

6.  Telegraph U.K. reports that the Scottish nurse with EBOV hospitalized at the Royal Free Hospital has been released after a full recovery.  She was treated with convalescent blood from William Poole and an experimental anti-viral drug (? which one).  Thank you Dr. Jacobs.

RGL, MD

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Posted January 25, 2015 by levittrg in Ebola

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