Evening Ebola Update, Wed, 4/22/15: Better communication needed to prevent sporadic outbreaks/’Superspreaders’/Learning from HIV, TB   Leave a comment

4/22/15

Dear Colleagues:

l.  MMWR from the CDC on April 17th reports on sudden increase in cases of EBOV in Guinea between the second and third weeks of December, 2014.  The caseload went from one case to 62 cases between those weeks.  All infected patients had attended a traditional burial  where they all touched or kissed the body of the deceased or a close family member who cared for  deceased.  See the detailed MMWR report at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6414a4.htm?s_cid=mm6414a4_e.  Education about how EBOV is spread has been increased in Guinea since this outbreak.

2.  The Lancet, February, 2015, has Correspondence by Drain of Partners.org explaining how the lessons learned in HIV and TB epidemics apply to EBOV in West Africa.  Specifically, a point of care diagnostic test is needed for all these epidemics; the stigma of any of these diseases must be removed so possibly infected persons identify themselves; contact tracing must be a first-order priority; and health care workers must be protected from infection.  See the Drain Correspondence at: http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(14)71079-5/fulltext

3.  The Lancet, May, 2015, has Correspondence from Althaus of Switzerland re: how a countrywide RO may 1.0 or less, but a single ‘superinfecting’ EBOV patient may start an outbreak on his/her own.  The author uses mathematics to prove his point.  ‘Superinfecting’ EBOV patients are the reason that ‘getting to zero’ is so important and yet so difficult.  These superinfecting EBOV patients may be in rural villages where there is no point of care diagnostic tests and where it takes days for health officers to be notified of a possible EBOV case.  See the Althaus Correspondence at: http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(15)70135-0/fulltext?elsca1=etoc&elsca2=email&elsca3=1473-3099_201505_15_5_&elsca4=Public%20Health%7CInfectious%20Diseases%7CInternal%2FFamily%20Medicine%7CNeuropsychiatry%7CNeurology%7CLancet

4.  ACAPS today issued an report on how surveys of EBOV cases have been conducted in Sierra Leone and Liberia over the past year.  Most of the surveys of a given area or region are single surveys.  Multiple surveys of a given area or region is not typical.  Some areas in Sierra Leone and Liberia have not been surveyed.  Most of the surveys conducted in Liberia have been done by the Liberian government and have been delayed in release, so the Liberian data is suspect.  ACAPS plans to get surveys done in un-surveyed areas and regions of Sierra Leone and Liberia.  See: http://acaps.org/img/documents/t-acaps_mapping_assessments_-identifying_gaps_22_april_2015.pdf

5.  The Paul G. Allen Family Foundation is currently holding an Ebola Innovation Summit in San Francisco to brainstorm on how to incorporate new diagnostics, new vaccines, better communication into the world’s response to the West African EBOV epidemic.  Mr. Allen, who has donated $100 Million to ending the epidemic, is taking the next step-action-and he is following the recommendations of Bill Gates’ article in the NEJM.  See what the Ebola Innovation Summit is brainstorming about at: http://www.pgafamilyfoundation.org/programs/ebola/key-initiatives/ebola-innovation-summit#Groups.

6.  Science, 17 April, has a two page article on ‘broad spectrum’ viral drugs that are ‘One drug, multiple bugs’.  Here is the Abstract of the article on page 282-283: http://www.sciencemag.org/content/348/6232/282.summary.  (Science website does not recognize my password tonight).  The article mentions several anti-virals I have not heard of previously.

RGL, MD

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Posted April 23, 2015 by levittrg in Uncategorized

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