Category Archives: pandemic

WHO | WHO Ebola news

Elsewhere, the outbreak is expected to continue for some time. WHO’s operational response plan extends over the next several months. Staff at the outbreak sites see evidence that the numbers of reported cases and deaths vastly underestimate the magnitude of the outbreak.

via WHO | WHO Ebola news.

No further explanation or quantification of what “vastly underestimate the magnitude of the outbreak” means. Two, three, ten times the number of cases and death have not been reported? Don’t know but expect they will quickly try to get a better handle on it.

VDU’s blog: Ebola virus may be spread by droplets, but not by an airborne route: what that means

Included in guidelines issued by the WHO (7) and CDC (5) is the need for droplet precautions (Figure). This is very important for healthcare workers, family and other caregivers who stay close and are frequently exposed for lengthy periods of time with severely ill, highly virulent cases of EVD. These cases may actively propel infectious droplets containing vomit and blood across the short distances separating them from caregivers. But this is a form of direct transmission, and is not airborne transmission.

Messaging the masses.

Leaving aside other issues around acquiring a rare disease like Ebola when outside of the current outbreak region, the case definitions and risk assessments have raised confusion. There are questions around how otherwise apparently well-protected healthcare workers in West Africa are acquiring an EBOV. For a virus described as spreading only through direct contact, recommendations for the use of masks, implying airborne spread to many, fuel such questions.  In fact, face protection is recommended to prevent infectious droplets landing on vulnerable membranes (mouth and eyes).

It’s important to pass a message that is correct, but also to ensure distrust does not result from a public reading apparently contradictory literature. Such distrust and real concern have been rampant among a hyperactive social media. Simple, clear phrases like “ebolaviruses cannot be caught from around a corner”, may help uncomplicate the communication lines. And it works on Twitter.

via VDU’s blog: Ebola virus may be spread by droplets, but not by an airborne route: what that means.

Ebola kills 56 in two days, says WHO | News , World | THE DAILY STAR

The Ebola virus killed 56 people in just two days, bringing the global death toll to 1,069, the World Health Organization said Wednesday.

The death toll, which passed the 1,000-mark at the weekend, soared higher between August 10 and 11.

The number of confirmed infections jumped by 128 over the two days, bringing the total number of cases to 1,975 people, the UN’s health agency said.

New cases and deaths had been registered in all four west African countries so far hit by the worst Ebola epidemic seen since the deadly virus was discovered four decades ago.

Liberia saw 71 new cases and 32 new deaths, while Sierra Leone recorded 53 new cases and 19 more deaths, according to fresh WHO data.

Guinea, where the outbreak began at the beginning of the year, counted four new cases and four new deaths.

Nigeria, meanwhile, counted one more death, bringing the total there to three, but WHO lowered the total number of suspected, probable and confirmed cases in the country to 12 from 13.

via Ebola kills 56 in two days, says WHO | News , World | THE DAILY STAR.

Avian Flu Diary: PNAS: Receptor Usage & Cell Entry Of Bat Coronaviruses

Bats, increasingly, are being viewed as substantial reservoirs for dangerous viruses. While long known to vector rabies, in the 1990s outbreaks of Hendra in Australia and Nipah in Malaysia and parts of Asia were eventually traced to bats, and while conclusive evidence is still lacking, the Ebola virus (and its cousin Marburg) are all believed to have bat origins

 

Bats are abundant (roughly 1/4th of all mammal species), mobile and wide ranging, and have adapted over millions of years to carry a variety of highly pathogenic viruses without ill effect.

via Avian Flu Diary: PNAS: Receptor Usage & Cell Entry Of Bat Coronaviruses.

Team finds potential MERS transmission mechanism between bats and humans

“Overall, our findings suggest that MERS virus has successfully adapted to human cells for efficient infections, and HKU4 virus can potentially infect human cells,” said Li. “MERS and MERS-related bat viruses present a constant and long-term threat to human health. So far little is known about these bat viruses that are evolutionary ancestors to human viruses. We need to look at bat viruses carefully, learn how they infect cells and jump species, and then develop strategies to block their transmission to humans.”

via Team finds potential MERS transmission mechanism between bats and humans.

Top ten most dangerous viruses in the world | Sci-Tech | DW.DE | 12.08.2014

1. The most dangerous virus is the Marburg virus. It is named after a small and idyllic town on the river Lahn – but that has nothing to do with the disease itself. The Marburg virus is a hemorrhagic fever virus. As with Ebola, the Marburg virus causes convulsions and bleeding of mucous membranes, skin and organs. It has a fatality rate of 90 percent.

via Top ten most dangerous viruses in the world | Sci-Tech | DW.DE | 12.08.2014.

WHO | Ethical considerations for use of unregistered interventions for Ebola viral disease (EVD)

{Nothing in the guidelines says patients/victims/stricken people must give informed consent to use of experimental drugs on them, or informed consent of their family – lots to be sure that medical community and drug firms get information. I smell a rat here and it seems that WHO has caved to both governments and companies. Governments have to appear to be doing something or look bad. Drug firms want to look compassionate, get a get out of jail free card for doing good deeds while still charging billions for drugs that in many cases were financed with public funds for initial research. Me cynical – well yes, Wellcome Foundation made billions from Burroughs Wellcome first HIV/AIDS drug before they made it a bit more affordable. No more drugs available now but everyone looks good and has permission to experiment on West Africans.}

Ethical criteria must guide the provision of such interventions. These include transparency about all aspects of care, informed consent, freedom of choice, confidentiality, respect for the person, preservation of dignity and involvement of the community.

In order to understand the safety and efficacy of these interventions, the group advised that, if and when they are used to treat patients, there is a moral obligation to collect and share all data generated, including from treatments provided for ‘compassionate use’ (access to an unapproved drug outside of a clinical trial).

The group explored how the use of these interventions can be evaluated scientifically to ensure timely and accurate information about the safety and efficacy of these investigational interventions. There was unanimous agreement that there is a moral duty to also evaluate these interventions (for treatment or prevention) in the best possible clinical trials under the circumstances in order to definitively prove their safety and efficacy or provide evidence to stop their utilization. Ongoing evaluation should guide future interventions.

In addition to this advice, the panel identified areas that need more detailed analysis and discussion, such as:

ethical ways to gather data while striving to provide optimal care under the prevailing circumstances;

ethical criteria to prioritize the use of unregistered experimental therapies and vaccines;

ethical criteria for achieving fair distribution in communities and among countries, in the face of a growing number of possible new interventions, none of which is likely to meet demand in the short term.

via WHO | Ethical considerations for use of unregistered interventions for Ebola viral disease (EVD).

WHO | WHO Statement on the Meeting of the International Health Regulations Emergency Committee Regarding the 2014 Ebola Outbreak in West Africa

< Me: The nut of the problem is still that in responding to pressure from many governments is that no one wants to close borders to trade and travel because of economic worries and that health is still not number one! >

But read the whole announcement – don’t rely on what others, say they said.

 

There should be no general ban on international travel or trade; restrictions outlined in these recommendations regarding the travel of EVD cases and contacts should be implemented.

States should provide travelers to Ebola affected and at-risk areas with relevant information on risks, measures to minimize those risks, and advice for managing a potential exposure.

States should be prepared to detect, investigate, and manage Ebola cases; this should include assured access to a qualified diagnostic laboratory for EVD and, where appropriate, the capacity to manage travelers originating from known Ebola-infected areas who arrive at international airports or major land crossing points with unexplained febrile illness.

The general public should be provided with accurate and relevant information on the Ebola outbreak and measures to reduce the risk of exposure.

States should be prepared to facilitate the evacuation and repatriation of nationals (e.g. health workers) who have been exposed to Ebola.

via WHO | WHO Statement on the Meeting of the International Health Regulations Emergency Committee Regarding the 2014 Ebola Outbreak in West Africa.

Avian Flu Diary: The New Normal: The Age Of Emerging Disease Threats

Over the past three decades, dozens of new – mostly zoonotic – diseases have been identified.   Some of these new, or re-emerging disease threats, include:

 

HIV

SARS

The re-emergence and spread of H5N1 bird flu in 2003

An H1N1 `Swine Flu’  pandemic in 2009

Swine Variant Influenza viruses (H1N1v, H1N2v, H3N2v)

MERS-CoV and other `bat borne’ viruses like Nipah and Hendra

H7N9, H10N8, H5N2 and other emerging avian flu viruses

Lyme Disease, CCHF, Heartland Virus, SFTS, and other tickborne diseases

The global spread of MRSA, along with the recent arrival of of NDM-1 and other Carbapenemases that threaten the viability of our antibiotic arsenal.

An explosion and spread of mosquito-borne diseases like  dengue, chikungunya & malaria

Even old scourges, once thought on the way out, are showing new signs of life . . . like Pertussis, measles, and polio.

Perhaps most troubling of all has been the emergence of increasingly drug resistant strains of tuberculosis.

And the one that has everyone’s attention right now;  Ebola.

via Avian Flu Diary: The New Normal: The Age Of Emerging Disease Threats.