Ebola 2/4

[Buster's Uncle]

Only 40 percent of Ebola funds reached target countries - study
Reuters
By Kate Kelland  5 hours ago



Healthcare workers prepare to disinfect an ambulance transporting a newly admitted Ebola patient at the entrance to the Save the Children Kerry Town Ebola treatment centre outside Freetown, Sierra Leone, December 22, 2014. REUTERS/Baz Ratner



LONDON (Reuters) - Almost $2.9 billion was pledged by the end of 2014 in donations to fight West Africa's Ebola epidemic, yet only around 40 percent had actually reached affected countries, researchers said on Tuesday.

A study by the U.N. Office for the Coordination of Humanitarian Affairs that tracked international donations showed barely $1.09 billion had reached the worst affected countries by the end of last year, they said.

"These delays ... may have contributed to spread of the virus and could have increased the financial needs," said Karen Grepin, a global health policy expert at New York University who led the study and published it in the BMJ British medical journal.

The West Africa Ebola epidemic, the worst in history, has killed more than 8,800 people since it began more than a year ago, decimating already weak health systems in Guinea, Liberia and Sierra Leone. Its spread now appears to be slowing, especially in Liberia which now has just five cases.

Grepin analysed the level and speed of pledges made to fight Ebola and how they aligned with estimates of funds required to control the epidemic.

She found not only that more than half of funds pledged by international donors had not reached the target countries, but also that global agencies had failed to reliably estimate the amount of money needed.

While Guinea first informed the World Health Organization of a "rapidly evolving outbreak" of Ebola on March 23, 2014, the first major international appeal was not until August, when some $71 million was asked for.

By mid-September 2014, around six months after the epidemic started, the United Nations estimated $1 billion would be needed, only to raise that in November to an estimate of $1.5 billion.

"Clearly, international leaders have found it challenging to estimate the financial requirements to tackle this rapidly spreading outbreak," Grepin said in a commentary about her findings. "The problem has not been the generosity of donors but that the resources have not been deployed rapidly enough."

U.N. Ebola chief David Nabarro said last month a further $4 billion -- equivalent to all aid committed so far -- was needed by relief agencies and authorities in the worst affected countries to end the epidemic, with U.N. agencies alone needing $1 billion of that to fund their part in the fight.


http://news.yahoo.com/only-40-percent-ebola-funds-reached-target-countries-070359979.html

[Buster's Uncle]

Blood from Ebola survivors could help spur new disease treatments
Reuters
By Julie Steenhuysen  6 hours ago



CHICAGO (Reuters) - After successfully treating four Ebola patients last year, Emory University in Atlanta is now leading a government-funded project that will use blood from survivors of the deadly virus to test a novel way of treating infectious disease.

Traditional vaccines boost the immune system’s response to infections. The new project will inject people with genetic material, such as DNA or RNA, in hopes of spurring a person’s own cells to make specific antibodies capable of fighting Ebola or other pathogens.

"The person's body is the factory," said Dr. James Crowe of Vanderbilt University, one of the collaborators on the project. "It's a cool idea."

Experts say the method, if proven to be safe and effective, would be faster and cheaper than conventional drug production and could potentially be used to treat illnesses such as seasonal flu or malaria.

Antibodies are typically grown in large vats of mammal cells or in some cases, tobacco plants, such as Mapp Biopharmaceutical's experimental Ebola treatment ZMapp.

The Defense Advanced Research Projects Agency (DARPA), the Pentagon's elite research arm, has awarded Emory up to $10.8 million over three years to direct the project.

It will include research teams at the U.S. Centers for Disease Control and Prevention, the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), and several academic research labs including the University of Wisconsin-Madison, Rockefeller University, Vanderbilt and Scripps Research Institute.

Getting access to blood samples from survivors of the current Ebola outbreak in West Africa has been challenging, but Emory has a distinct advantage in having treated a small number of patients on U.S. soil.

All four of its former patients agreed to take part in the program, said Rafi Ahmed, director of the Emory Vaccine Center, who is leading the effort.

Ahmed and colleagues intend to isolate antibodies made by these patients in response to the Ebola virus, and through a series of experiments in animals, identify the most effective ones for fighting off an Ebola infection.

The approach is unrelated to an experimental treatment provided to several Ebola patients in the United States, which involved transfusions of blood plasma from Ebola survivors.

Researchers will take two approaches. In one, they will produce large quantities of Ebola-fighting antibodies that could be infused into patients intravenously, a conventional approach known as passive immunization.

Protection using this method has a short half life of about two to three weeks, and the antibodies require refrigeration, which is not always available in countries fighting an infectious disease outbreak.

That is why the team is also testing the new method for making protective drugs based on DNA or RNA, rather than the older vaccine technology using killed or weakened viruses to stimulate an immune response, a process that can take several months to manufacture.

"In this method, we are trying to go in as silently as possible," bypassing the immune response, which may not always work, and directly providing the recipe for a highly effective antibody, said Col. Daniel Wattendorf, program director at DARPA who came up with the new strategy.

Wattendorf said the effort is based on prior, early stage research with drugmakers Novartis and Sanofi looking at whether they could make vaccines out of ribonucleic acid, or RNA.

"What was particularly intriguing about RNA was that it has no chance of integrating into the human genome," he said. The effect was temporary.

Initially, the technology was being developed in hopes of protecting soldiers from seasonal flu or germs that cause diarrhea on the battlefield, but the Ebola outbreak presented an opportunity to accelerate the research.

To succeed, researchers will need to identify an effective delivery system to carry the genetic instructions into the body and learn how to quickly identify the most protective antibodies. The goal is to get the process down to 90 days for most diseases, Wattendorf said.

The group is in the process of characterizing several Ebola antibody candidates to find which are the most potent, Ahmed said. At that point, the researchers and DARPA will seek out drug company partners.

Testing in people could begin within two years, with the goal of having a better weapon for the next Ebola outbreak.

(Reporting by Julie Steenhuysen; Editing by Michele Gershberg and Sue Horton)


http://news.yahoo.com/blood-ebola-survivors-could-help-spur-disease-treatments-060804064--finance.html

[Buster's Uncle]

Low infection rate halts Ebola treatment trials in Liberia
AFP  5 hours ago



A doctor holds a seringe containing the Ebola vaccine ChAd3 during trials on November 4, 2014 (AFP Photo/Richard Juilliart)



London (AFP) - Britain's Wellcome Trust said that clinical trials it was funding for a new Ebola treatment in Liberia were halted on Tuesday due to a fall in new cases.

"The current position is that there is no realistic prospect of the trial enrolling sufficient patients to be able to reach a conclusion about the efficacy of the drug," the Wellcome Trust, Britain's biggest scientific research charity, said in a statement.

"Therefore the trial has been terminated," it added.

The Wellcome Trust said the decision was taken on Tuesday after the pharmaceutical company Chimerix, which manufactures the brincidofovir treatment, said it was withdrawing from the trial on Friday.

The first large-scale trials of two Ebola vaccines -- GlaxoSmithKline's Chad3-EBO-Z and rVSV-ZEBOV, manufactured by Merck and Newlink -- began in Liberia on Monday.

Tuesday's decision was taken by the Trial Steering Committee, which includes scientists from Liberia, the University of Oxford and Medecins Sans Frontieres.

"We're delighted that infections are falling, but fewer patients makes it more difficult to carry out the robust scientific studies needed," Peter Horby from the University of Oxford, who was leading the trial, said in a statement.

Jeremy Farrar, director of the Wellcome Trust, which is funding a multi-million pound therapeutics platform for experimental Ebola treatments, said it was "disappointing" that the trial could not continue.

"It is essential that other studies of potential treatments and vaccines continue and hopefully will still be able to deliver meaningful results for this and the inevitable future epidemics of Ebola," he said.

Stephen Kennedy, a study investigator from the Pacific Institute for Research and Evaluation in Liberia added: "The scientific community will move on without any clear evidence regarding the role of brincidofovir in the management of Ebola."

Weekly Ebola infections in west Africa have dropped to below 100 for the first time in more than six months, the WHO said last week, raising hopes the worst-ever outbreak of the virus is coming to an end.

The World Health Organisation said it had now shifted its efforts in Guinea, Liberia and Sierra Leone -- the countries worst-hit by the epidemic -- from slowing the spread to stamping it out completely.


http://news.yahoo.com/low-infection-rate-halts-ebola-vaccine-trials-liberia-191202020.html

[Buster's Uncle]

Ebola-hit Sierra Leone's schools to reopen on March 30
AFP  1 hour ago


Classrooms have been empty since the government announced a state of emergency in July in response to an outbreak which has killed almost 9,000 people in the region, more than 3,000 of them in Sierra Leone.

President Ernest Bai Koroma's office said he had granted permission for work to start on "water and sanitation issues, Ebola screenings and psychosocial support", ahead of the reopening.

"Thermometers will be made available to all schools to deal with any sudden attack before referral to a holding centre," education minister Minkailu Bah was quoted as saying.

"Isolation centres will be set up in each school and all primary school pupils will be dewormed."

The announcement clarifies a commitment made by the government in January to have all schools open by the end of March.

Sierra Leone is one of three west African countries hit by the deadliest Ebola outbreak on record, together with Guinea and Liberia.

The rate of new infections has slowed significantly in recent weeks, paving the way for a gradual return to normal.

More than a third of Sierra Leone's population of six million are aged between three and 17, although in reality the secondary school attendance rate is less than 40 percent for both boys and girls.

There was a mixed reaction to Sierra Leone's announcement in the capital Freetown, where private radio station African Young Voices was deluged with critical calls.

"The decision will be a recipe for danger and it would have been better for the authorities to wait a few more months before making the reopening," one caller said.

But another listener welcomed "a thoughtful decision for all" that would halt a rise in teenage pregnancy seen since schools closed and show the war against Ebola was being won.

UNICEF spokesman Christophe Boulierac told reporters in Geneva on Tuesday around 500,000 children -- around a quarter of the total roll -- had returned to school in Guinea since classrooms reopened on January 19.

Liberia announced last week that its schools would reopen on February 16, two weeks later than the date originally envisaged.

In a second announcement on Wednesday, Sierra Leone said it was delaying a population census originally planned for April until December because of the crisis.


http://news.yahoo.com/ebola-hit-sierra-leones-schools-reopen-march-30-003906317.html

[Buster's Uncle]

MSF says lack of public health messages on Ebola "big mistake": TRFN
Reuters
By Misha Hussain  2 hours ago



Volunteers for Medecins Sans Frontieres (MSF), or Doctors Without Borders, receive training on how to handle personal protective equipment during courses in Brussels October 15, 2014. REUTERS/Francois Lenoir



CONAKRY (Thomson Reuters Foundation) - Medecins Sans Frontieres (MSF) made the "big mistake" of focusing too much on treatment early on in the Ebola epidemic rather than speaking to people about tackling the disease, a senior member of the medical charity said.

MSF's response to the worst ever outbreak of Ebola, which has killed more than 8,800 people mainly in West Africa, has been praised by the World Health Organization and governments.

With 20 years of experience of treating Ebola, MSF deployed hundreds to the Ebola "hot zones" and was quick to isolate patients and trace their contacts.

However, Claudia Evers, MSF's Ebola emergency coordinator in Guinea, said: "MSF made a big mistake. We advocated for an increase in beds for too long, and everyone listened to MSF."

"Instead of asking for more beds we should have asked for more sensitisation activities," Evers told the Thomson Reuters Foundation in an interview.

The latest outbreak of Ebola, a haemorrhagic fever that kills roughly two-thirds of the people it infects, began in the forests of southern Guinea and was first identified in March 2014.

Mistrust of the government and health workers, partly due to lack of communication with ordinary Guineans, has prompted communities to hide infected people and bury bodies secretly, sparking fears the outbreak may flare up again, as it did twice in 2014.

A total of 42 new cases were recorded last week as well as three burials, according to government figures. In Guinea, there were just over 150 confimed cases of Ebola in January compared with around 500 confirmed cases in December.

Sakoba Keita, head of the national Ebola response, said Ebola transmission was still active in 14 of the country's 34 prefectures in the last week.

He said there were 11 new confirmed cases in Lola prefecture on the border with Ivory Coast and two new cases in northern Tougue, which had never before reported a case.

"Before we can get to 'zero Ebola', we have to get to zero resistance," Keita told donors and aid workers at a coordination meeting on Monday, referring to the government's 60-day Ebola eradication plan, which started at the beginning of the year.

MSF's Evers said the next stage of the Ebola response required a new approach if the disease was to be brought under control, centred on the promotion of good hygiene practices.

"Isolate your sick and bring them in for treatment," she said. "In the first nine months, if people had been given (these) proper messages, all this could have been prevented."


http://news.yahoo.com/msf-says-lack-public-health-messages-ebola-big-152814136.html

[Buster's Uncle]

Ebola virus sent out of high-security lab was likely dead: CDC
Reuters
By Julie Steenhuysen  2 hours ago



A transmission electron micrograph shows Ebola virus particles. REUTERS/U.S. Army Medical Research Institute of Infectious Diseases



CHICAGO (Reuters) - An internal investigation of an Ebola incident at a U.S. Centers for Disease Control and Prevention laboratory in December found that samples sent to a lower-security lab were "unlikely" to have contained live virus and posed no threat to staff, the CDC said on Wednesday.

The close call followed mishaps involving anthrax and a deadly strain of bird flu, raising questions about how the agency handles the world's deadliest pathogens.

CDC Director Dr. Tom Frieden said the agency had made "real progress" to improve safety, "but we have more to do."

The report found that on Dec. 22, a scientist working with Ebola, which in 2014 caused the worst recorded outbreak in West Africa, inadvertently transferred a small amount of virus from a high-biosecurity lab to a lower-biosecurity one not authorized to handle live Ebola.

A chief cause of the breach, the investigation concluded, was the "lack of a written study plan," a document that outlines specific steps to be followed in an experiment. The report also noted a failure to design the study to minimize the possibility of human error.

"That concerned me," said Scott Becker of the‎ Association of Public Health Laboratories. "I thought that was one of the issues they uncovered after the first lab incident."

According to the report, the scientist placed Ebola into two sets of tubes, one to inactivate it and another to merely isolate it. The tubes were identical except for a blue cap and label on one. But the caps had been removed, leaving no visual cue as to which was which, and the wrong tubes were sent to the lower-biosecurity lab down the hall.

CDC scientist Michael Shaw said most labs have adopted a material transfer certification, in which two scientists have to certify that pathogens were inactivated before they leave the lab. But the Ebola lab, which has been swamped by the West African outbreak, had not adopted it for internal transfers.

"It was a mistake. They were mortified when they discovered it had happened," Shaw said.

The report also took CDC to task for "lack of project oversight," noting the deadly-pathogens lab lacks a full-time manager.

The CDC said it is looking into changes to prevent further incidents, such as using colored liquids and different-sized containers to differentiate live from killed pathogens.

CDC last month said it installed surveillance cameras to ensure procedures are performed correctly.

(Reporting by Julie Steenhuysen; Additional reporting by Sharon Begley; Editing by Steve Orlofsky)


http://news.yahoo.com/ebola-virus-sent-high-security-lab-likely-dead-204100451.html

[Buster's Uncle]

Free from Ebola, survivors complain of new syndrome
Reuters
By Emma Farge and James Harding Giahyue  10 hours ago



Ebola survivor Romeo Doe poses for a picture at a clinic in Monrovia, February 1, 2015. REUTERS/James Giahyue



DAKAR/MONROVIA (Reuters) - Romeo Doe, a 29-year-old tailor who survived Ebola in Liberia, is struggling to cope with the impact of a disease that killed seven members of his family and now threatens his livelihood.

Since he was released from an Ebola center in the capital Monrovia in November, pressure is rising in his eyes and affecting his vision - a complaint some doctors say is common among survivors of the West African outbreak.

There are a growing number of survivors of the disease in the region, between 5,000 and 10,000 according to the United Nations, and some complain of side effects months after their recovery - a condition some doctors are calling "post-Ebola Syndrome" (PES).

"Since I was discharged I have felt this pain in my eyes," said Doe. "They, as you can see, are red; they are hurting me. I want the government to help me get back on my feet."

Ebola, which has killed almost 9,000 people across Guinea, Liberia and Sierra Leone, initially causes fever and vomiting, then attacks the immune system and vital organs, often causing internal and external bleeding.

About 60 percent of Ebola patients have died in the current outbreak, typically from shock or organ failure.

Some of those who have survived the disease report a mixture of symptoms after their recovery, including vision problems, joint pain, hair and memory loss and anxiety attacks.

Margaret Nanyonga, a doctor who treated Ebola patients in the town of Kenema in Sierra Leone, said she had seen survivors go blind. Overall about half of those she saw recover reported declining health, she said.

Doctors say it is not yet clear how long the symptoms last. There is also no scientific literature or medical consensus on any new syndrome among West African survivors or how many people might be affected.

Dan Kelly, founder of the non-profit organization Wellbody Alliance and a doctor specializing in infectious diseases, says the situation can be complicated by poor medical records making it hard to separate any new symptoms from pre-existing conditions. Ebola, like many severe infections, may also weaken survivors and make other illnesses more likely.

Kelly said some Ebola after-effects appear linked to the infection itself, with some patients developing symptoms similar to so-called autoimmune disorders - where the immune system is over stimulated and begins to attack the body's own tissues. Other patients develop symptoms similar to uveitis, he said, an eye inflammation causing blindness.

"With post-Ebola syndrome there is an autoimmune response: it's revved up, and we don't really know why," he told Reuters by telephone from Sierra Leone where he is helping with the Ebola response.


NEGLECT

When Korlia Bonarwolo left an Ebola treatment center in Monrovia last year, his blood was free of the virus but he had caught two other life-threatening diseases: malaria and pneumonia.

The 26-year old doctor's assistant blames his health problems on poor care, rather than complications related to Ebola infection.

At the John F. Kennedy medical center in Monrovia, draughts from the open-air corridors left him exposed, he says, while frightened nurses threw him juice boxes which he was often too weak to retrieve.

Back home, medical colleagues shunned him and he had to insert his own intravenous drip. Six months afterwards he has fully recovered but, as president of a survivors' association, wants to ensure others get better support and health information.

"The questions survivors are asking about where they are going to be health-wise in the future deserve answers," Bonarwolo said at a survivors' meeting organized by the United Nations.

The outbreak is now ebbing, and the health ministry says there are fewer than 10 cases in the country, but even survivors with no worrying symptoms say it is hard to get back to normal life with so many unanswered questions about Ebola's impact.

One of the ongoing concerns relates to sexual health. Some female Ebola survivors say they have stopped menstruating. The virus can also remain in semen for months.

The links between Ebola and mental health disorders is also little understood. A friend of Bonarwolo's survived Ebola only to develop a mental illness afterwards.


RESEARCH WINDOW

Ben Neumann, a virologist at Britain's Reading University who studies Ebola and other viruses and their effects, notes that Lassa virus, which comes from West Africa and causes a similar disease to Ebola, has also been reported as having longer-term health effects.

"(Lassa) survivors often report signs of nerve damage such as loss of hearing," he told Reuters, adding that it would be "surprising that something as damaging as Ebola did not have lasting effects".

The current lack of knowledge about post-Ebola health effects is probably "due to Ebola being a rare virus that left few survivors before this outbreak", he said.

Some after-effects of Ebola have been reported in previous outbreaks since the disease was first detected in 1976, but past epidemics were smaller and often more deadly, meaning there were fewer survivors to generate interest to warrant research.

So this outbreak creates a unique opportunity to learn more.

Kelly agrees, and wants swift follow-up.

"We are at risk of missing the window," he said. "We need to start catching survivors as they leave treatment centers."

(Additional reporting by Kate Kelland in London; Editing by Pravin Char)


 http://news.yahoo.com/free-ebola-survivors-complain-syndrome-163616656.html