EBOLAWEB » English | EBOLAWEB http://www.ebolaweb.org Selected papers on Ebola Virus outbreak and its Responses Tue, 16 Dec 2014 11:13:27 +0000 en-US hourly 1 https://wordpress.org/?v=4.0.24 Caring as existential insecurity: quarantine, care, and human insecurity in the Ebola crisis http://www.ebolaweb.org/?p=388 http://www.ebolaweb.org/?p=388#comments Tue, 25 Nov 2014 10:57:04 +0000 http://www.ebolaweb.org/?p=388 Published by and , in Somatosphere’s Ebola fieldnotes, November 24, 2014.

 

In August of this year, when the Ebola outbreak escalated in Liberia and a state of emergency had been declared for the country, Fatu Kekula, a young Liberian nursing student, improvised personal protective equipment (PPE) to care for her father, mother, sister, and cousin. After three of the relatives survived, her method was featured prominently in the international news media as the “trash bag method” (CNN, 2014). The reports were meant to ignite a spark of hope in the Ebola epidemic in Guinea, Sierra Leone, and Liberia. International organizations, like UNICEF, even started to promote this ‘better-than-nothing’ method. In most other Ebola reports, by contrast, health workers in white or yellow PPEs, collecting dead bodies or admitting sick patients to isolation units, have come to symbolize the grim and desperate situation in the region. What strikes us most in the story of Kekula’s improvised PPE is how notions of security and safety are reinscribed into gloves, trash bags, and rubber boots to enable a form of care in the context of a broken health system. When we recall that during the first months of the epidemic many people were caring for their sick relatives without any protection measures, then Kekula’s trash bag method reveals quite dramatically how care itself has become a source of existential insecurity.

In this piece we pull together a set of observations on quarantine measures and care to ask how security is embodied in everyday practices of care in a public health system which is short of the beds and basic equipment needed to address Ebola. To follow this question, it is necessary to ask how global health has transformed the intricate relationship between security and care, turning care into a source of existential insecurity. Moreover, are there alternative views on security and care which may help to orient global health approaches to the Ebola epidemic?

 

Read the full article
http://somatosphere.net/2014/11/caring-as-existential-insecurity.html
]]> http://www.ebolaweb.org/?feed=rss2&p=388 0 Experimental therapies: growing interest in the use of whole blood or plasma from recovered Ebola patients (convalescent therapies) http://www.ebolaweb.org/?p=385 http://www.ebolaweb.org/?p=385#comments Tue, 18 Nov 2014 12:10:17 +0000 http://www.ebolaweb.org/?p=385 Published on who.int, 26 September 2014

The current evidence base: limited data – from 1976 up to now

Convalescent therapy was first used for a young woman infected with Ebola in the Democratic Republic of Congo (then Zaire) in 1976 – the year the virus first emerged. The woman was treated with plasma from a person who survived infection with the closely-related Marburg virus. She had less clinical bleeding than other Ebola patients, but died within days.

During the 1995 Ebola outbreak in Kikwit, Democratic Republic of Congo, whole blood collected from recovered patients was administered to eight patients. Seven of the eight recovered.

 

Technical guidance for experts

Guidance document: Use of convalescent whole blood or plasma collected from patients recovered from Ebola virus disease

WHO issued new interim guidance on “Use of convalescent whole blood or plasma collected from patients recovered from Ebola virus disease for transfusion during outbreaks”. The document is addressed to national health authorities and blood transfusion services.

 

Read the full article
http://www.who.int/mediacentre/news/ebola/26-september-2014/en/
]]> http://www.ebolaweb.org/?feed=rss2&p=385 0 Ebola vaccines, therapies, and diagnostics – WHO update http://www.ebolaweb.org/?p=381 http://www.ebolaweb.org/?p=381#comments Tue, 18 Nov 2014 11:58:19 +0000 http://www.ebolaweb.org/?p=381

Convalescent blood and plasma therapies

Potential vaccines, medicines and other health technologies

Medicines, medical devices and protective equipment

Ethics working group on Ebola

 

Source
http://www.who.int/medicines/emp_ebola_section/en/
]]> http://www.ebolaweb.org/?feed=rss2&p=381 0 Social Pathways for Ebola Virus Disease in Rural Sierra Leone, and some Implications for Containment http://www.ebolaweb.org/?p=374 http://www.ebolaweb.org/?p=374#comments Mon, 17 Nov 2014 16:40:28 +0000 http://www.ebolaweb.org/?p=374 Published by PLOS Neglected Tropical Diseases, October 31, 2014

 

Abstract

The current outbreak of Ebola Virus Disease in Upper West Africa is the largest ever recorded.  Molecular evidence suggests spread has been almost exclusively through human-to-human contact.  Social factors are thus clearly important to understand the epidemic and ways in which it might be stopped, but these factors have so far been little analyzed.  The present paper focuses on Sierra Leone, and provides data on the least understood part of the epidemic – the largely undocumented spread of Ebola in rural areas.  Various forms of social networking in rural communities and their relevance for understanding pathways of transmission are described.  Particular attention is paid to the relationship between marriage, funerals and land tenure.  Funerals are known to be a high-risk factor for infection.  It is suggested that more than a shift in awareness of risks will be needed to change local patterns of behavior, especially in regard to funerals, since these are central to the consolidation of community ties.  A concluding discussion relates the information presented to plans for halting the disease.  Local consultation and access are seen as major challenges to be addressed.

 

Reference

Alexander, K. A., C. E. Sanderson, M. Marathe, B. L. Lewis, C. M. Rivers, J. Shaman, J. M. Drake, et al. “What Factors Might Have Led to the Emergence of Ebola in West Africa?,” 2014. http://blogs.plos.org/speakingofmedicine/files/2014/11/Alexander-et-al.pdf.

Read the full article
http://blogs.plos.org/speakingofmedicine/2014/10/31/social-pathways-ebola-virus-disease-rural-sierra-leone-implications-containment/

PDF file
http://blogs.plos.org/speakingofmedicine/files/2014/11/Alexander-et-al.pdf

 

 

 

]]> http://www.ebolaweb.org/?feed=rss2&p=374 0 What Factors Might Have Led to the Emergence of Ebola in West Africa? http://www.ebolaweb.org/?p=369 http://www.ebolaweb.org/?p=369#comments Mon, 17 Nov 2014 16:31:48 +0000 http://www.ebolaweb.org/?p=369 By PLOS Neglected Tropical Diseases, November 11, 2014

 

Abstract
An Ebola outbreak of unprecedented scope emerged in West Africa in December 2013 and presently continues unabated in the countries of Guinea, Sierra Leone, and Liberia. Ebola is not new to Africa and outbreaks have been confirmed as far back as 1976. The current West African Ebola outbreak is the largest ever recorded and differs dramatically from prior outbreaks in its duration, number of people affected, and geographic extent. The emergence of this deadly disease in West Africa invites many questions, foremost among these: Why now and why in West Africa? Here, we review the sociological, ecological, and environmental drivers that might have influenced the emergence of Ebola in this region of Africa and its spread throughout the region. Containment of the West African Ebola outbreak is the most pressing, immediate need. A comprehensive assessment of the drivers of Ebola emergence and sustained human-to-human transmission is also needed in order to prepare other countries for importation or emergence of this disease.  Such assessment includes identification of country-level protocols and interagency policies for outbreak detection and rapid response, increased understanding of cultural and traditional risk factors within and between nations, delivery of culturally embedded public health education, and regional coordination and collaboration, particularly with governments and health ministries throughout Africa. Public health education is also urgently needed in countries outside of Africa in order to ensure that risk is properly understood and public concerns do not escalate unnecessarily. To prevent future outbreaks, coordinated, multiscale, early warning systems should be developed that make full use of these integrated assessments, partner with local communities in high-risk areas, and provide clearly defined response recommendations specific to the needs of each community.

 

Reference
Alexander, K. A., C. E. Sanderson, M. Marathe, B. L. Lewis, C. M. Rivers, J. Shaman, J. M. Drake, et al. “What Factors Might Have Led to the Emergence of Ebola in West Africa?,” 2014. http://blogs.plos.org/speakingofmedicine/files/2014/11/Alexander-et-al.pdf.

Read the full article

http://blogs.plos.org/speakingofmedicine/2014/11/11/factors-might-led-emergence-ebola-west-africa/

PDF file
http://blogs.plos.org/speakingofmedicine/files/2014/11/Alexanderetal.pdf
]]> http://www.ebolaweb.org/?feed=rss2&p=369 0 Tracking Ebola with CrisisNET and the Ushahidi Platform http://www.ebolaweb.org/?p=363 http://www.ebolaweb.org/?p=363#comments Mon, 17 Nov 2014 14:27:46 +0000 http://www.ebolaweb.org/?p=363

The Ebola epidemic has finally captured international attention. Coverage of Ebola was minimal when the disease was confined to West Africa, but a small number of recent cases in the US and Europe have sparked frantic, hysterical reporting from western media outlets and subsequent public panic. In light of this, it’s important to keep the threat in perspective. For example, the above chart shows the number of confirmed and suspected cases in every country touched by the virus.

This World Health Organization data, provided by the Humanitarian Data Exchange and visualized using analysis tools we’re developing at CrisisNET, confirms statements by the Centers for Disease Control reassuring people in the US and Europe that their chances of contracting Ebola are vanishingly small (in fact, to date all known cases outside of West Africa have been health workers directly involved in treating Ebola patients).
 

Read the full article
http://reliefweb.int/report/liberia/tracking-ebola-crisisnet-and-ushahidi-platform
PDF Presentation
http://reliefweb.int/sites/reliefweb.int/files/resources/Tracking%20Ebola%20with%20CrisisNET%20and%20the%20Ushahidi%20Platform%20-%20Ushahidi%20-%20Ushahidi.pdf

 

Website
http://crisis.net/
]]> http://www.ebolaweb.org/?feed=rss2&p=363 0 Communicating Uncertainty – Ebola, Public Health, and the Scientific Process http://www.ebolaweb.org/?p=350 http://www.ebolaweb.org/?p=350#comments Mon, 17 Nov 2014 13:59:08 +0000 http://www.ebolaweb.org/?p=350

The levees of the Red River in Grand Forks, North Dakota, are built to withstand 51-ft water levels. In 1997, the National Weather Service predicted a flood, but despite a 35% margin of error for previous estimates, it emphasized that the river would crest at 49 ft at most. When the waters rose to 54 ft, wreaking havoc on the area, local inhabitants were shocked and angry. Why had forecasters projected such confidence in their prediction? According to Nate Silver, who describes the incident in The Signal and the Noise, “The forecasters later told researchers that they were afraid the public might lose confidence in the forecast if they had conveyed any uncertainty in the outlook.”

 

Reference

Rosenbaum, Lisa. “Communicating Uncertainty — Ebola, Public Health, and the Scientific Process.” New England Journal of Medicine, November 13, 2014. doi:10.1056/NEJMp1413816.

 

Full article: http://www.nejm.org/doi/full/10.1056/NEJMp1413816#t=article
Source
http://eboladigest.blogspot.fr/2014/11/ebola-digest-fri-111414.html
http://www.ncbi.nlm.nih.gov/pubmed/25394322?dopt=Abstract
]]> http://www.ebolaweb.org/?feed=rss2&p=350 0 Ebola, epidemics, and ethics – what we have learned http://www.ebolaweb.org/?p=345 http://www.ebolaweb.org/?p=345#comments Wed, 12 Nov 2014 17:43:55 +0000 http://www.ebolaweb.org/?p=345

When considering the allocation of scarce resources, the most pressing question is: who should be treated?

Abstract
The current Ebola epidemic has presented challenges both medical and ethical. Although we have known epidemics of untreatable diseases in the past, this particular one may be unique in the intensity and rapidity of its spread, as well as ethical challenges that it has created, exacerbated by its geographic location. We will look at the infectious agent and the epidemic it is causing, in order to understand the ethical problems that have arisen.

 

Reference

Donovan: Ebola, epidemics, and ethics – what we have learned. Philosophy, Ethics, and Humanities in Medicine 2014 9:15. Doi:10.1186/1747-5341-9-15

 

Read the full open access editorial
]]> http://www.ebolaweb.org/?feed=rss2&p=345 0 Ebola virus disease outbreak: incorporating ethical analysis into the health system response http://www.ebolaweb.org/?p=342 http://www.ebolaweb.org/?p=342#comments Wed, 12 Nov 2014 17:33:06 +0000 http://www.ebolaweb.org/?p=342 by Abha Saxena, in the Indian Journal of Medical Ethics

The current outbreak of Ebola in western Africa has been unprecedented for various reasons, mostly because of its magnitude, its expansion across the borders of several countries of the region, and its propagation in capital cities. The outbreak initially involved no more than a few hundred people mainly in the rural parts of Africa, but by mid-September it had affected more than 5800 persons and caused more than 2500 deaths in four countries (mainly in urban locations). It is still not showing any signs of decreasing in intensity. This epidemic has brought to the fore many issues which have implications that go beyond just Ebola and western Africa. For example, it has highlighted the ever-widening social and economic inequalities within and between countries; the globalisation and interconnectedness of our world today; and the dire economic consequences of epidemics – this outbreak of Ebola has had the power to close down ports and airports, as well as seal borders. The outbreak has also brought to the fore a number of ethical issues, some of which have been raised during earlier epidemics, and some of which are novel.

 

Reference

Abha Saxena, “Ebola virus disease outbreak: incorporating ethical analysis into the health system response”. Indian Journal of Medical Ethics, Vol 11, No 4 (2014). http://www.ijme.in/~ijmein/index.php/ijme/article/view/2130/4592

]]> http://www.ebolaweb.org/?feed=rss2&p=342 0 A comprehensive database of the geographic spread of past human Ebola outbreaks http://www.ebolaweb.org/?p=339 http://www.ebolaweb.org/?p=339#comments Wed, 12 Nov 2014 17:22:17 +0000 http://www.ebolaweb.org/?p=339 Published on Scientific Data,

Abstract

Ebola is a zoonotic filovirus that has the potential to cause outbreaks of variable magnitude in human populations. This database collates our existing knowledge of all known human outbreaks of Ebola for the first time by extracting details of their suspected zoonotic origin and subsequent human-to-human spread from a range of published and non-published sources. In total, 22 unique Ebola outbreaks were identified, composed of 117 unique geographic transmission clusters. Details of the index case and geographic spread of secondary and imported cases were recorded as well as summaries of patient numbers and case fatality rates. A brief text summary describing suspected routes and means of spread for each outbreak was also included. While we cannot yet include the ongoing Guinea and DRC outbreaks until they are over, these data and compiled maps can be used to gain an improved understanding of the initial spread of past Ebola outbreaks and help evaluate surveillance and control guidelines for limiting the spread of future epidemics.

Ebola is a zoonotic filovirus that has the potential to cause outbreaks of variable magnitude in human populations. This database collates our existing knowledge of all known human outbreaks of Ebola for the first time by extracting details of their suspected zoonotic origin and subsequent human-to-human spread from a range of published and non-published sources. In total, 22 unique Ebola outbreaks were identified, composed of 117 unique geographic transmission clusters. Details of the index case and geographic spread of secondary and imported cases were recorded as well as summaries of patient numbers and case fatality rates. A brief text summary describing suspected routes and means of spread for each outbreak was also included. While we cannot yet include the ongoing Guinea and DRC outbreaks until they are over, these data and compiled maps can be used to gain an improved understanding of the initial spread of past Ebola outbreaks and help evaluate surveillance and control guidelines for limiting the spread of future epidemics.

 

Reference

Mylne, Adrian, Oliver J. Brady, Zhi Huang, David M. Pigott, Nick Golding, Moritz U.G. Kraemer, and Simon I. Hay. “A Comprehensive Database of the Geographic Spread of Past Human Ebola Outbreaks.” Scientific Data 1 (October 23, 2014). http://dx.doi.org/10.1038/sdata.2014.42.

Read the full open access article
http://www.nature.com/articles/sdata201442
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