Germany’s Angela Merkel has sharply criticized Donald Trump’s decision to retract his endorsement of the G7 communique. Events in Canada had only strengthened her commitment to a stronger, more unified EU, she said.
All posts by nedhamson
Ebola virus disease and the vaccine….
As the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) looks to be under control, how much the vaccine has helped remains an unanswered question. But will it be answered with hardly any new cases being confirmed? Let’s have a closer look at the timing of things.
Vaccine versus care, tracing and supportive treatments
The finals days of the EVD epidemic in West Africa which spanned from 2013 to 2016. https://virologydownunder.blogspot.com/2014/07/ebola-virus-disease-evd-2014-west.html-evd-2014-west.html
Don’t get me wrong – having this vaccine is a fabulous and beneficial addition to the struggle to contain EVD outbreaks. What happened from 2013 to 2016 in Guinea, Sierra Leone and Liberia [5] should never happen again.
But a question surrounding the use of the vaccine is whether it actually prevented cases of EVD this time around, or were the central pillars of containment sufficient?[8,11] These pillars were recently described by Médecins Sans Frontières [1] as…
- Early care and isolation of people who present with symptoms
- Tracing and follow-up of patient contacts
- Informing people about the disease, how to prevent it and where to seek help
- Supporting existing healthcare structures
- Temporarily adapting cultural behaviour to make funerals safe
- Outreach activities (pro-active case finding)
#UPDATE: These are the ‘six pillars’ of intervention to contain an Ebola outbreak:
1.Early care and isolation of people who present with symptoms
2.Tracing and following up patient contacts
3.Informing people about the disease, how to prevent it and where to seek pic.twitter.com/G0dDckY3pa— MSF West Africa (@MSF_WestAfrica) June 8, 2018
These responses were certainly rolled out more quickly in the current outbreak.
What does the timing look like?
I’ve added to my latest graph of totals (cases, suspected cases, probable cases, confirmed cases and fatal cases). Two new vertical dashed lines indicate when vaccination with the recombinant vesicular stomatitis virus carrying an Ebola virus glycoprotein gene (rVSV-ZEBOV) EVD vaccine began in the Mbandaka region (which sits in the Wangata health zone) and in the Iboko and Bikoro health zones. These lines help tell us some things:
- There were 7 confirmed cases of EVD after the Mbandaka vaccinations began and before the Bikoro/Iboko campaign commenced; all within 3-days (23rd to 24th May) after the first shots
- There were 3 confirmed cases of EVD after the Bikoro/Iboko vaccinations began; 2 within 2 days (29th and 30th May), and 1 at 9 days later (6th June)
What does the literature say about how quickly the vaccine protects?
In the discussion of a study of the effectiveness of ring vaccination in Guinea, the authors noted that the time to induce protective immunity using this same vaccine, “might happen quickly, within a few days or a week.” If so, the vaccine may indeed have been responsible for the slowing and stopping of confirmed cases days after it was deployed.[2,12] We know for certain that a good immune response is usually in place 28 days after vaccination.[2,12]
The DRC outbreak has been much smaller than that in West Africa. The rVSV-ZEBOV vaccine remains unlicensed requiring individual consent for each dose. Use of the vaccine in the DRC has been accompanied by ethical approval and oversight from the DRC Ministry of Health and has also been part of studies to better understand its effectiveness. Because it is unlicensed, widespread use of the vaccine has not been on the agenda and so numbers of vaccinated people are also fairly small.
Previous studies in macaques found that, if given within a short time after infection, the rVSV-ZEBOV vaccine could provide a prophylactic effect.[3,4] One of these studies suggested that protection may result from an initial non-specific innate immune response that matures into a more specific response,[3] while the other pointed to natural killer cells and non-neutralizing antibody as essential factors with day 6 after infection being a critical time point in macaque studies.[4]
If we look more closely at each of the health zones, we can see some other interesting things.
The vertical dashed lines show when vaccine rollout began in the health zones. From these graphs, we can see some really interesting differences.
One difference is unrelated to vaccination. There is a very different proportion of fatal cases (PFC) in Iboko (currently at 20%) compared to Bikoro (72%) and Wangata (74%; but low case numbers). Is this low value in the Iboko health zone due to lost fatal cases, cases that could not be tested or to better care? We saw better survival rates in West African treatment units like that in the Hastings Police Training School near Freetown, Sierra Leone where more aggressive support (including intravenous fluids, antibiotics and antimalarials) was provided (h/t @AhmedTejanSie).[13]
In Bikoro, there were no confirmed cases for days before vaccination began, and there have been none since. That means we can’t tell if there was a protective effect. But we will still be able to follow the vaccinated people and determine whether a protective immune response resulted.
In Iboko there were confirmed EVD cases before and a few after. It will be interesting to learn whether those post-vaccination cases were among vaccinated people or in different transmission chains or among known contacts who just hadn’t been vaccinated yet.
In Wangata, like Bikoro, there were no confirmed EVD cases in the days leading up to the vaccination campaign, and none added since. Iboko, which also has had the highest caseload of this outbreak, may be our only hope of answer the question of vaccine effectiveness.
The outbreak slows before treatments get trialled
Graphing the day-by-day doses of vaccine given in the 3 affected DRC health zones. Data from DRC MOH[9].Click on image to enlarge.
Teasing out the role of the vaccine in the DRC-2018 outbreak will be a challenge and with the way things look, the need for another vaccine [6] or perhaps even for treatments,[7] is fading quickly. At least, unless there are plans by the Chinese to vaccinate their citizens ahead of the next outbreak.
Another marker of outbreak control is that vaccine administrations have slowed. Today’s data from the DRC MOH included the lowest number of vaccinations (81;[10]) since the roll-out began (averaging around 165 per day). With just over 2,100 vaccinations provided so far, it’s unlikely all of the first batch of 7,500 doses will be needed. And the second batch certainly won’t be unless things take a dramatic turn for the worse.
The decreasing need for preventative and therapeutic drugs is a good thing for the people of the DRC since it means the outbreak is probably controlled. On the other hand, it means we won’t learn more about what could be useful in treating EVD cases before the next outbreak.
Perhaps some of these treatments will prove useful in clearing our persistent Ebola virus infections. That would certainly be a good thing. If not, then we’ll just go through this whole process again next time; hopefully, more quickly. But at least we’ll have more ducks in a row because we will have learned and planned ahead for all of the necessary steps.
Won’t we?
References…
- Democratic Republic of Congo: Fighting Ebola on the ground, a race against time
http://www.msf.org/en/article/democratic-republic-congo-fighting-ebola-ground-race-against-time - Efficacy and effectiveness of an rVSV-vectored vaccine expressing Ebola surface glycoprotein: interim results from the Guinea ring vaccination cluster-randomised trial
https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(15)61117-5.pdf?code=lancet-site. - Efficacy of Vesicular Stomatitis Virus–Ebola Virus Postexposure Treatment in Rhesus Macaques Infected With Ebola Virus Makona
https://academic.oup.com/jid/article-lookup/doi/10.1093/infdis/jiw218 - Effective Post-Exposure Treatment of Ebola Infection
http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.0030002 - post-Ebola syndrome or just chronic Ebola virus disease…?
https://virologydownunder.blogspot.com/2015/08/post-ebola-syndrome-or-just-chronic.html - China may compete with the West for limited opportunities to test Ebola vaccine
https://www.statnews.com/2018/06/08/china-may-compete-with-west-to-test-ebola-vaccine/ - Ebola treatments approved for compassionate use in current outbreak
http://www.afro.who.int/news/ebola-treatments-approved-compassionate-use-current-outbreak - Excitement over use of Ebola vaccine in outbreak tempered by real-world challenges
https://www.statnews.com/2018/05/23/ebola-vaccine-drc-real-world-challenges/ - https://us13.campaign-archive.com/home/?u=89e5755d2cca4840b1af93176&id=aedd23c530
- https://us13.campaign-archive.com/?u=89e5755d2cca4840b1af93176&id=8564b3ef86
- Vaccines Alone Won’t Beat Ebola
https://www.theatlantic.com/health/archive/2018/05/vaccines-alone-wont-beat-ebola/561128/ - Efficacy and effectiveness of an rVSV-vectored vaccine in preventing Ebola virus disease: final results from the Guinea ring vaccination, open-label, cluster-randomised trial (Ebola Ça Sufft!)
https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)32621-6.pdf - Ebola in Freetown Area, Sierra Leone — A Case Study of 581 Patients
https://www.nejm.org/doi/full/10.1056/NEJMc1413685
The post Ebola virus disease and the vaccine…. appeared first on Virology Down Under.
Journalist Mohammed al-Baba shot by IDF while covering Gaza protests – IFEX
Mohammed al-Baba, a photographer for Agence France-Presse, was hit by a live round fired by the Israel Defense Forces while covering a protest east of the northern Gazan city of Jabalia.
Source: Journalist Mohammed al-Baba shot by IDF while covering Gaza protests – IFEX
How the IDF is tarnishing the name of the medic it killed in Gaza
The IDF Spokesperson’s Unit published a video it claims shows Razan al-Najjar throwing a tear gas canister into an open field and professing to be a ‘human shield’ — as if that justifies her killing.
By Yael Marom
The photo of Razan that circulated on social media.
“Razan al-Najjar is no angel of mercy,” tweeted IDF Arabic Spokesman Avichay Adraee on Thursday. Attached to Adraee’s defamatory tweet was an edited video in which a young woman dressed in a white coat and a headscarf, a mask covering her face, throws a tear gas canister during a protest in Gaza. According to the IDF Spokesperson’s Unit, the film proves that al-Najjar, in life, was far from the image that has spread on social media after her death.
Since last Friday, when al-Najjar, a Palestinian medic, was killed, the IDF has been dealing with a public relations crisis. The army first announced that her death would be investigated, then declared that the investigation showed she was not shot by a soldier but “wounded by shrapnel,” and then declared that at the very least she wasn’t intentionally and directly targeted.
#رزان_النجار لم تكن #ملاك_الرحمة كما تحاول دعاية #حماس تسويقها فاعترافها بأنها شكلت درعًا بشريًا للمشاغبين المحرضين يثبت كيف تستسغل حماس جميع فئات المجتمع الغزاوي لصالح أهدافها وأهداف #إيران. فهل المسعفون في العالم يلقون قنابل ويشاركون في أعمال شغب ويسمون أنفسهم دروعًا بشرية؟ pic.twitter.com/kJ89kf9PN2
— افيخاي ادرعي (@AvichayAdraee) June 7, 2018
The IDF’s chief provocateur in Arabic has now taken the effort to justify al-Najjar’s death to the next level.
The 20-second propaganda video opens with a picture of al-Najjar with angel wings. Then the picture shakes, threatening music plays in the background, and a short clip of a young woman, her head and face covered, plays. The woman is handed a tear gas canister that is spouting gas, and she throws it a few meters. The video then sharply cuts to another time and place — to a clip from an interview with al-Najjar where she explains why she chose to participate in the Great Return March, seemingly saying that she is a human shield.
There is no evidence that the young woman who throws the tear gas canister is in fact al-Najjar. The IDF Spokesperson has not even made the effort to note the date or place the clip was filmed. And even if it is al-Najjar in the video, it is clear that she throws the tear gas canister only a few meters into an empty field — there are no soldiers in the area, and the Gaza-Israel separation barrier is not even visible in the clip. One can reasonably assume that the tear gas canister she throws was fired into Gaza by Israeli soldiers or by an IDF drone. The tear gas canister is spouting gas as she throws it — any reasonable person would try to do the same to avoid suffocating.
In his tweet, Adraee claims that al-Najjar admitted to serving as a “human shield for the inciting disrupters,” proving that “Hamas exploits all of Gazan society for its aims and the aims of Iran.” Adraee asks, “Do other paramedics in the world throw bombs, participate in riots, and call themselves human shields?” In the second half of the edited video, al-Najjar does appear to say the words “human shield,” after which the video cuts sharply. In the original video, however, which is cut out from the version distributed by the IDF, there is second half to al-Najjar’s sentence: “to defend the wounded on the front lines.” Perhaps not the wisest choice of words in the world, but far from the incriminating evidence that Adraee claimed the video showed.
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The IDF Spokesperson published an edited video, comprised of clips that have no discernable connection to each other or to the specific day al-Najjar was killed, in order to justify the killing of the young paramedic, to prove that she was not simply an innocent nurse, and to present her as a terrorist or a potential terrorist.
The video is meant to tell us: it was okay to kill her, she was an Arab. And Israel’s mainstream media outlets, to prove their patriotism and boost their ratings, completely bought the IDF’s spin. They published the clip without question or clarification or warnings that it was not in any way verified, or nothing that it in no way justifies her killing. A broadcaster on one of Israel’s most-watched channels even said, without any proof of this in the video, that al-Najjar threw the tear gas canister “during a violent protest.”
“The IDF’s digital platforms are operational tools in the operational arm of the IDF,” Brig.-Gen. Ronen Manelis told a room full of Israel journalists several months ago. Manelis said openly that the IDF uses its digital platforms “to create deterrence and to blacken (tarnish) the enemy — either explaining that our enemy is really bad and to tarnish his name to say don’t join them, or to deter them.” The provocations of Avichay Adraee are simply part of the IDF’s operational strategy.
At least in Israel, the IDF Spokesperson’s current operation seems to be succeeding, with the generous help of mainstream journalists.
Yael Marom is Just Vision’s public engagement manager in Israel and a co-editor of Local Call, where a version of this article was originally published in Hebrew.
What would you do if soldiers dragged your son out of bed in the middle of the night? | +972 Magazine
The soldiers pass through the house. In one of the rooms a terrified woman holds a small child, telling the soldiers that she is alone with the children. “Everything is okay,” the soldiers tell her. What is so okay about their forced presence in the middle of the night? After that, the soldiers tell the adults to bring the children to them. Young children are woken up in order to stand before the soldiers. The soldiers make another round inside the house, another round of talks with the adults, and the soldiers continue on their way. What was the purpose of the raid? What were they looking for? Who were they looking for? Did the soldiers themselves even know? Was the systematic fear the raid instilled itself the purpose of the raid?
Poet Galal El-Behairy’s ‘Letter from Tora Prison’
Freedom!
Ahead of the expected verdict for imprisoned Egyptian poet Galal El-Behairy, ArabLit — like PEN centers around the world — is sharing a work El-Behairy wrote in prison:
El-Behairy was arrested more than three months ago, on March 3, 2018, on charges related to his most recent book of poems, خير نسوان الأرض, The Finest Women on Earth (2018) and lyrics he wrote for Ramy Essam’s song “Balaha.” A campaign against him called him a spy, and called for his citizenship to be revoked.
In a statement, El-Behairy responded to the charges against his poems.
El-Behairy was held for a week without family or friends knowing his whereabouts before he appeared on March 10, reportedly showing signs of torture. While Egyptian prosecution did order a medical examination, according to PEN, the results have neither been made public nor shared with El-Behairy’s lawyer.
El-Behairy’s first court appearance was May 6, and he faced charges of being a member of a terrorist group, spreading false news, abuse of social-media networks, blasphemy, contempt of religion, and insulting the military. The verdict was initially to be handed down May 9. It was postponed to May 16, and is now expected June 27.
English PEN has urged “the Egyptian authorities to release him and the many other writers and activists unlawfully detained in Egypt immediately and unconditionally.” PEN International has also written an open letter to the Egyptian government, signed by PEN directors around the world.
To draw international attention to the case, several PEN centers, as well as Artists at Risk an ArabLit, are publishing a new poem El-Behairy wrote in detention. The translator wishes to remain unnamed, due to potential repercussions against himself and his family.
A Letter from Tora Prison
By Galal El-Behairy
From the Tora Prison in Cairo
May 2018
You, something
in the heart, unspoken,
something
in the throat, the last wish
of a man on the gallows
when the hour of hanging comes,
the great need
for oblivion; you, prison
and death, free of charge;
you, the truest meaning of man,
the word “no”—
I kiss your hand
and, preparing for the trial,
put on a suit and pray
for your Eid to come.
I’m the one
who escaped from the Mamluks,
I’m the child
whose father’s name is Zahran,
and I swim in your name, addiction.
I’m the companion of outlawed poets.
O my oblivion, I’m the clay
that precedes the law of concrete.
In the heart of this night
I own nothing
but my smile.
I take my country in my arms
and talk to her
about all the prisoners’ lives… out there
beyond the prison’s borders,
beyond the jailer’s grasp,
and about man’s need… for his fellow man,
about a dream
that was licit
and possible,
about a burden
that could be borne
if everyone took part in it.
I laugh at a song
they call “criminal,”
which provoked them
to erect a hundred barricades.
On our account, they block out the sun
and the thoughts in the head.
They want to hide the past
behind locks and bolts,
preventing him from whispering
about how things once were.
They want to hide him
by appointing guards—
weak-minded foreigners
estranged from the people.
But what wonder is this?
His fate is written
in all the prison cells.
His cell has neither bricks
nor steel,
and he was not defeated
within it.
Outside… a squadron of slaves.
Inside… a crucified messiah.
The thorns above his brow
are witnesses: You betrayed his revolution
with your own hands.
With shame in your eyes, you
are the Judases of the past,
whatever your religion, whatever
miniscule vision you have.
We’ve come back
and we see you.
You who imprisoned
the light, that naked groaning.
The light doesn’t care
how tall the fence is;
it’s not hemmed in
by steel bars
or officers’ uniforms.
It cannot be forgotten.
You can take a public square away from us,
but there are thousands and thousands of others,
and I’ll be there, waiting for you.
Our land will not betray us.
With each olive branch
we’re weaving your shrouds.
And the young man you killed
has come back, awake now
and angry.
He’s got a bone to pick
with his killer.
He’s got a bone to pick
with the one who betrayed him,
the one who, on that night of hope,
acquiesced, fell silent, and slept.
His wound has healed; he’s come back,
a knight
without a bridle;
he’s setting up the trial
while an imam prays among us
and illumines the one who was blind;
he’s rolling up his sleeves, preparing
for a fight;
he was killed—yes, it’s true—and yet
he has his role in this epic;
he stands there now
and holds his ground.
We’ve returned
to call on God
and proclaim it: “We’ve come back,
come back
hand in hand.”
Again we proclaim it: “We’ve come back,
and we vow
to spread the light,
the new dawn,
the keen-sighted conscience.”
We’ve come back, and we can smell
the fear in in your veins;
and our cheers tonight
are the sweetest of all:
“We are not afraid.
We are not afraid.”
We saw a country
rise from sleep
to trample a pharaoh
and cleanse the age
of the cane and cudgel.
We saw a country sing:
those were no slave songs,
no harbingers of doom, rather
songs fitting
for a new kind of steel.
We saw it.
We saw a country
where no one is oppressed.
Suggested actions:
Readers can add their support to the petition for Galal’s release.
Opinion | ‘Tell Them I Was Not Afraid’
Reports: Trump to skip G7 meeting on climate
When you can’t take the heat, you get out of the kitchen!

U.S. President Donald Trump will leave the G7 summit early — missing the meeting on climate change.
Fiction: A Persian Turned Parisian Insists: I’m Not an Immigrant, I’m an Exile
The narrator of Negar Djavadi’s novel, “Disoriental,” banished from her Iranian homeland, builds a life in France by recalling her family’s stories.
Russian VPN Filter Malware Much Worse Than Previously Believed
News: Late last month, the FBI stated it had taken aim at a botnet of 500,000 largely residential broadband routers that had been infected by the
Source: Russian VPN Filter Malware Much Worse Than Previously Believed




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