Evening Ebola Update, Sat, 5/15: WHO World Assembly to define funding, new mission/ Conflict over low number of EBOV pts for vaccine testing/Need for 15 min. EBOV dx in all health centers   Leave a comment

5/16/15

Dear Colleagues:

l.  CDC MMWR 15 May has a report by Nyenswah, et. al. from the Ministry of Health, Liberia, and WHO and CDC about the last cluster of EBOV cases in Liberia last January.  Most interesting fact to me was the large number of contacts (745 persons) was established by the lack of immediate EBOV diagnostics at health care clinics in Liberia.  Thus, the index case spread EBOV to her family and friends who in turn by hiding themselves or crossing borders or refusing to seek help spread EBOV widely.  The immediate EBOV paper tests need to be widely available for the case count in West Africa to go to zero.  See the report at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6418a5.htm?s_cid=mm6418a5_e

2.  A disturbing report re: Phase 3 vaccine trials in West Africa appears in The Lancet 12 May under World Report.  The author reports on conflict between NIH and WHO because of a shortage of EBOV patients in Liberia.  NIH has a Phase 3 vaccine trial going on in Liberia and wishes to move the trial to Guinea where more EBOV patients are located.  Problem is that WHO is conducting its own Phase 3 vaccine trials in Guinea and says that moving the NIH trial to Guinea from Liberia will confound both trials.  See: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60938-2/fulltext?elsca1=etoc&elsca2=email&elsca3=0140-6736_20150516_385_9981_&elsca4=Public%20Health%7CInfectious%20Diseases%7CHealth%20Policy%7CInternal%2FFamily%20Medicine%7CGeneral%20Surgery%7CLancet

3.  WHO World Health Assembly will meet in Geneva on 18 May.  Dr. Chan will present her agenda for WHO for the near future.  This agenda will include: a call for member countries to make good on their mandatory and voluntary contributions to WHO; full funding for a Rapid Response Team for emerging pathogens; recognition of WHO’s new ‘job description’ going beyond ‘coordination’ between member countries.  See the WHO announcement at: http://www.who.int/en/  Note that the announcement provides a means to get daily updates from WHO on the World Health Assembly.  Nature 13 May has a summary of what they think will be discussed at the 18 May meeting: http://www.nature.com/news/ebola-failures-prompt-who-rethink-1.17528?WT.ec_id=NEWS-20150514.  (I’d like to see ‘universal’ flu vaccine put on the agenda and ramped up.  See: http://www.sciencemag.org/site/special/h5n1/index.xhtml)

4.  PLoS One has an article by Barlow, et. al. from the University of California at Merced re: how to cycle antibiotics to reduce antibiotic resistance to commonly used hospital antibiotics.  The authors used a mathematical formula to determine how to best cycle antibiotics.  See: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0122283

5.  For those readers like me who do not have a strong math background, an explanatory summary of the PLoS One article appears in Laboratory Equipment at: http://www.laboratoryequipment.com/news/2015/05/researchers-reverse-antibiotic-resistance. 

RGL, MD

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Posted May 17, 2015 by levittrg in Uncategorized

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