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  • Ebola nurse Pauline Cafferkey 'has made full recovery'

    http://www.bbc.co.uk/news/uk-scotland-34791692

    Ms Cafferkey said she was "forever thankful for the amazing care" she had received at the Royal Free, which has a specialist isolation unit for treating highly infectious diseases. She added: "For a second time staff across many departments of the hospital have worked incredibly hard to help me recover and I will always be grateful to them and the NHS."I am looking forward to returning to Scotland and to seeing my family and friends again."
    Jo Bowyer
    Chartered Physiotherapist Registered Osteopath.
    "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

    Comment


    • Interesting that Australian Customs will remove the need for all passengers to fill in the form relevant to any travel to or within countries at risk of Ebola, by December this year.

      Comment


      • Transmission network of the 2014–2015 Ebola epidemic in Sierra Leone

        http://rsif.royalsocietypublishing.o...2/112/20150536

        Abstract

        Understanding the growth and spatial expansion of (re)emerging infectious disease outbreaks, such as Ebola and avian influenza, is critical for the effective planning of control measures; however, such efforts are often compromised by data insufficiencies and observational errors. Here, we develop a spatial–temporal inference methodology using a modified network model in conjunction with the ensemble adjustment Kalman filter, a Bayesian inference method equipped to handle observational errors. The combined method is capable of revealing the spatial–temporal progression of infectious disease, while requiring only limited, readily compiled data. We use this method to reconstruct the transmission network of the 2014–2015 Ebola epidemic in Sierra Leone and identify source and sink regions. Our inference suggests that, in Sierra Leone, transmission within the network introduced Ebola to neighbouring districts and initiated self-sustaining local epidemics; two of the more populous and connected districts, Kenema and Port Loko, facilitated two independent transmission pathways. Epidemic intensity differed by district, was highly correlated with population size (r = 0.76, p = 0.0015) and a critical window of opportunity for containing local Ebola epidemics at the source (ca one month) existed. This novel methodology can be used to help identify and contain the spatial expansion of future (re)emerging infectious disease outbreaks.
        Jo Bowyer
        Chartered Physiotherapist Registered Osteopath.
        "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

        Comment


        • Guinea's last known ebola patient recovers and leaves hospital

          http://www.telegraph.co.uk/news/worl...-hospital.html

          Guinea's last known Ebola patient, a 19-day-old baby boy, has recovered and been released from a treatment centre in the capital Conakry, a health official said on Monday.
          The baby's release means that Guinea, the last country still battling the virus, can begin its 42-day countdown to ending the outbreak. In a major breakthrough, neighbouring Sierra Leone was declared Ebola-free on Nov. 7.
          "The last confirmed case of Ebola has been released from a treatment centre," said Fode Tass Sylla, spokesman for Guinea's Ebola coordination unit. "We did two tests after his treatment and they came back negative."
          The baby was born in the Nongo Ebola treatment centre to an infected mother who did not survive.
          Sixty-eight people who had been in contact with the country's last cluster of patients and were deemed at risk of developing the haemorrhagic fever were released from quarantine on Saturday.

          The worst known Ebola epidemic in history began in Guinea's forest region nearly two years ago and has since killed around 11,300 people, predominantly in West Africa.
          Jo Bowyer
          Chartered Physiotherapist Registered Osteopath.
          "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

          Comment


          • Ebola crisis: Liberia boy dies after fresh cases

            http://www.bbc.co.uk/news/world-africa-34909949

            A 15-year-old boy has died of Ebola in Liberia less than three months after the country was declared free of the virus, officials have told the BBC.
            He tested positive last week and died late on Monday at a treatment centre near the capital, Monrovia, Francis Kateh, the chief medical officer, said.
            His father and brother are being treated for Ebola at the centre.
            Liberia has seen more than 10,000 Ebola cases and more than 4,000 deaths since the West Africa outbreak began in 2013.
            The World Health Organization (WHO) has twice declared Liberia to be Ebola-free, once in May and again in September.
            Jo Bowyer
            Chartered Physiotherapist Registered Osteopath.
            "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

            Comment


            • Nurse provides firsthand account of combating Ebola

              http://www.sciencedaily.com/releases...1125113215.htm

              International nurse volunteers responding to the Ebola outbreak in West African encountered death on nearly every shift and worked under conditions that challenged their ingenuity in providing even basic care. That is according to one nurse's account in American Journal of Nursing, published by Wolters Kluwer, which provides a rare glimpse of the realities clinicians and patients with Ebola faced inside one Ebola Treatment Unit (ETU).
              Jo Bowyer
              Chartered Physiotherapist Registered Osteopath.
              "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

              Comment


              • Ebola outbreak: Stigma and uncertainty stalk survivors

                http://www.bbc.co.uk/news/world-africa-34973741

                The Ebola outbreak in West Africa was the worst on record.
                In past outbreaks there had only been a few hundred deaths and a few hundred survivors. Now there are around 17,000 survivors and scientists are finding out new and unexpected things about the longer-term impact of the disease.
                Until this outbreak, it was thought Ebola could stay in semen for only three months after patients recovered. But research in Sierra Leone has now shown it can linger for at least nine months.
                Scientists are still trying to establish how long it can persist in the body, and, crucially, for how long it could be infectious.
                There's been one known case where a male survivor infected his partner and it was six months after he recovered.
                Jo Bowyer
                Chartered Physiotherapist Registered Osteopath.
                "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                Comment


                • Social Consequences of Ebola Containment Measures in Liberia

                  http://journals.plos.org/plosone/art...l.pone.0143036

                  Abstract

                  Introduction

                  In the Ebola Virus Disease (EVD) outbreak in Liberia, two major emergency disease-control measures were cremation of bodies and enforcement of quarantine for asymptomatic individuals suspected of being in contact with a positive case. Enforced by State-related actors, these were promoted as the only method to curtail transmissions as soon as possible. However, as with other harsh measures witnessed by Liberian citizens, in many cases those measures elicited uncontrolled negative reactions within the communities (stigma; fear) that produced, in some cases, the opposite effect of that intended.

                  Methodology

                  The research has been conducted in two phases, for a total of 8 weeks. Ethnography of local practices was carried out in 7 neighbourhoods in Monrovia and 5 villages in Grand Cape Mount County in Liberia. 45 Focus Group Discussions (432 participants) and 30 semi-structured interviews sustained the observing participation. Randomly selected people from different social layers were targeted. The principal investigator worked with the help of two local assistants. Perceptions and practices were both analysed.

                  Results

                  Participants stressed how cremation perpetuated the social breakdown that started with the isolation for the sickness. Socio-economical divides were created by inequitable management of the dead: those who could bribe the burial teams obtained a burial in a private cemetery or the use of Funeral Homes. Conversely, those in economic disadvantage were forced to send their dead for cremation. State-enforced quarantine, with a mandatory prohibition of movement, raised condemnation, strengthened stigmatization and created serious socio-economic distress. Food was distributed intermittently and some houses shared latrines with non-quarantined neighbours. Escapes were also recorded. Study participants narrated how they adopted local measures of containment, through local task forces and socially-rooted control of outsiders. They also stressed how information that was not spread built up rumours and suspicion.

                  Conclusions

                  Populations experiencing an epidemic feel a high degree of social insecurity, in addition to the health hazards. Vertical and coercive measures increase mistrust and fear, producing a counter-productive effect in the containment of the epidemic. On the other hand, local communities show a will to be engaged and a high degree of flexibility in participating to the epidemic response. Efforts in the direction of awareness and community involvement could prove to be better strategy to control the epidemic and root the response on social participation.
                  Jo Bowyer
                  Chartered Physiotherapist Registered Osteopath.
                  "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                  Comment


                  • What lessons have we learned from the 2014 ebola epidemic in West Africa?

                    http://www.sciencedaily.com/releases...0108083724.htm

                    Summary:
                    An academic has analysed what could have been done differently in the efforts to prevent the Ebola epidemic in 2014. In particular, the review focuses on the limits of patient location and travel mapping as a reason why it was difficult to contain Ebola from spreading. Because nobody anticipated such an expansive epidemic, regional disease protocols were not immediately implemented, he concludes.
                    Jo Bowyer
                    Chartered Physiotherapist Registered Osteopath.
                    "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                    Comment


                    • Bispecific Antibody Affords Complete Post-Exposure Protection of Mice from Both Ebola (Zaire) and Sudan Viruses

                      http://www.nature.com/articles/srep19193

                      Abstract
                      Filoviruses (Ebola and Marburg) cause severe hemorrhagic fever. There are five species of ebolavirus; among these, the Ebola (Zaire) and Sudan viruses (EBOV and SUDV, respectively) are highly pathogenic and have both caused recurring, large outbreaks. However, the EBOV and SUDV glycoprotein (GP) sequences are 45% divergent and thus antigenically distinct. Few antibodies with cross-neutralizing properties have been described to date. We used antibody engineering to develop novel bispecific antibodies (Bis-mAbs) that are cross-reactive toward base epitopes on GP from EBOV and SUDV. These Bis-mAbs exhibit potent neutralization against EBOV and SUDV GP pseudotyped viruses as well as authentic pathogens, and confer a high degree (in one case 100%) post-exposure protection of mice from both viruses. Our studies show that a single agent that targets the GP base epitopes is sufficient for protection in mice; such agents could be included in panfilovirus therapeutic antibody cocktails.
                      Jo Bowyer
                      Chartered Physiotherapist Registered Osteopath.
                      "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                      Comment


                      • Beyond Knowledge and Awareness: Addressing Misconceptions in Ghana’s Preparation towards an Outbreak of Ebola Virus Disease

                        http://journals.plos.org/plosone/art...l.pone.0149627

                        Abstract

                        Background

                        Ebola Virus Disease (EVD) is not new to the world. However, the West African EVD epidemic which started in 2014 evolved into the largest, most severe and most complex outbreak in the history of the disease. The three most-affected countries faced enormous challenges in stopping the transmission and providing care for all patients. Although Ghana had not recorded any confirmed Ebola case, social factors have been reported to hinder efforts to control the outbreak in the three most affected countries. This qualitative study was designed to explore community knowledge and attitudes about Ebola and its transmission.

                        Methods

                        This study was carried out in five of the ten regions in Ghana. Twenty-five focus group discussions (N = 235) and 40 in-depth interviews were conducted across the five regions with community members, stakeholders and opinion leaders. The interviews were recorded digitally and transcribed verbatim. Framework analysis was adopted in the analysis of the data using Nvivo 10.

                        Results

                        The results showed a high level of awareness and knowledge about Ebola. The study further showed that knowledge on how to identify suspected cases of Ebola was also high among respondents. However, there was a firm belief that Ebola was a spiritual condition and could also be transmitted through air, mosquito bites and houseflies. These misconceptions resulted in perceptions of stigma and discrimination towards people who may get Ebola or work with Ebola patients.

                        Conclusion

                        We conclude that although knowledge and awareness about Ebola is high among Ghanaians who participated in the study, there are still misconceptions about the disease. The study recommends that health education on Ebola disease should move beyond creating awareness to targeting the identified misconceptions to improve future containment efforts.
                        Jo Bowyer
                        Chartered Physiotherapist Registered Osteopath.
                        "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                        Comment


                        • Researchers discover new Ebola-fighting antibodies in blood of outbreak survivor

                          https://www.sciencedaily.com/release...0219141406.htm

                          The antibodies, isolated from the blood of a survivor of the 2014 Ebola outbreak and the largest panel reported to date, could guide the development of a vaccine or therapeutic against Ebola. The new study also revealed a previously unknown site of vulnerability in the structure of the deadly virus.

                          "Our Science paper describes the first in-depth view into the human antibody response to Ebola virus," said team leader Laura Walker, senior scientist at Adimab, LLC, and an alumna of TSRI's PhD program. "Within weeks of receiving a blood sample from a survivor of the 2014 Ebola outbreak, we were able to isolate and characterize over 300 monoclonal antibodies that reacted with the Ebola virus surface glycoprotein."
                          The researchers believe the techniques in this study could be used to find treatments for other emerging diseases, such as Zika virus.

                          Bornholdt thinks of the new study as a test case. In just over a year, the combination of Adimab and TSRI methods led to the discovery of promising antibodies--and future experiments should move even more quickly now that researchers have experience with these tools.

                          "With other outbreaks, we could take blood samples from the first wave of survivors and potentially produce a therapeutic rapidly," said Bornholdt. "That's the long-term goal."
                          Jo Bowyer
                          Chartered Physiotherapist Registered Osteopath.
                          "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                          Comment


                          • Ebola crisis provides framework for responding to outbreaks like Zika virus

                            https://www.sciencedaily.com/release...0218195932.htm

                            As world leaders grapple with containing the Zika virus, the Ebola epidemic in West Africa provides valuable lessons for how to respond to infectious disease epidemics, according to a policy report published by researchers at Princeton University and the Wellcome Trust.
                            The researchers' recommendations are as follows:

                            Strengthen local health care. During the Ebola epidemic, workers on the ground bore the brunt of the outbreak. More than 800 health care workers were infected, and 500 workers died. Therefore, strengthening and rebuilding these local health care infrastructures is the key to containing future outbreaks. This can be done by building trust within the health care system as well as political structures.

                            Improve international response. The first cases of Ebola were confirmed in March 2014, and yet, the WHO did not declare it a public health emergency until August 2014. The WHO must be able to respond more quickly and with greater impacts going forward. By setting up a dedicated Center for Health Emergency Preparedness and Response, this could be achieved. Likewise, research should be coordinated during the time between epidemics as well as during outbreaks.

                            Considering multiple perspectives. The Ebola crisis shows that social structures, living environments and human behavior all influence the course of an epidemic. Therefore, moving beyond disciplinary silos is essential. One example that illustrates this importance involves the development of safe, effective and deployable vaccines. A recent Ebola vaccine in Guinea has been successful, but it could have been deployed earlier. Developing an international cooperative to support the development and licensing of vaccines is an urgent priority.

                            Acting synergistically. History shows that the best results occur when international bodies work in collaboration with local governments and health systems with a shared agenda in mind. Providing basic health services at a community level is the key to establishing trust, improving surveillance and creating capacity to mount a rapid response.
                            Jo Bowyer
                            Chartered Physiotherapist Registered Osteopath.
                            "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                            Comment


                            • Pauline Cafferkey has been flown down to The Royal Free from Glasgow within the last few hours for her third admission to the specialist unit.

                              Timeline: Pauline Cafferkey's Ebola illness
                              30 December, 2014 - Ebola nurse Pauline Cafferkey transferred to London unit
                              31 December, 2014 - Experimental drug for Ebola patient Pauline Cafferkey
                              4 January, 2015 - UK Ebola nurse Pauline Cafferkey 'in critical condition'
                              12 January, 2015 - Ebola nurse no longer critically ill
                              24 January, 2015 - Ebola nurse: Pauline Cafferkey 'happy to be alive'
                              10 October, 2015 - Ebola nurse Pauline Cafferkey remains 'serious'
                              14 October, 2015 - Ebola nurse Pauline Cafferkey now 'critically ill'
                              21 October, 2015 - Ebola caused meningitis in nurse Pauline Cafferkey
                              12 November, 2015 - Ebola nurse Pauline Cafferkey 'has made full recovery'
                              23 February, 2016 - Ebola nurse Pauline Cafferkey flown to London hospital
                              There are other cases of remission and relapse in the countries where the disease spread, but these are less well documented.

                              Dr Derek Gatherer, lecturer in the Division of Biomedical and Life Sciences at Lancaster University, said it was "now becoming clear that Ebola is a far more complex disease than we previously imagined".
                              He said: "The meningitis that Ms Cafferkey suffered from at the end of last year is one of the most serious complications of all, as it can be life-threatening.
                              "The other main rare serious complication is inflammation of the eyes (conjunctivitis and/or uveitis) which can lead to blindness, especially if supportive treatments are unavailable."
                              Dr Gatherer said major post-recovery complications included "joint aches, headaches and general tiredness which can last for months".
                              Last edited by Jo Bowyer; 23-02-2016, 09:49 PM.
                              Jo Bowyer
                              Chartered Physiotherapist Registered Osteopath.
                              "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                              Comment


                              • Post-Ebola syndrome in Sierra Leone

                                https://www.sciencedaily.com/release...0225140036.htm

                                This week it was widely reported that a British Nurse, Pauline Cafferkey, who was thought to have made a full recovery from Ebola, has been taken to a hospital for a third time due to what health officials described as delayed complications from the virus -- raising further questions about the long-term impact of the disease on survivors. Cafferkey is one of thousands of survivors who have reported suffering from issues that appear to be related to late effects of the virus.

                                Symptoms persisting

                                To find out more about the symptoms that persist or develop after hospital discharge Dr Janet Scott and Dr Calum Semple from the University's Institute of Translational Medicine, and their colleagues at the 34th Regiment Military Hospital, Freetown, Sierra Leone examined and interviewed every survivor discharged from the Ebola Treatment Unit at that hospital.

                                During December 1, 2014-March 30, 2015, they treated 84 persons with Ebola, of whom 44 (52%) survived. Survivors were interviewed and examined at their first follow-up appointment three weeks after discharge, which followed two negative blood tests for Ebola.

                                Of the 44 people studied:

                                70% reported musculoskeletal pain
                                48% reported having headaches
                                14% reported having problems with their eyesight
                                Mounting evidence

                                Dr Janet Scott, said: "The phenomenon of 'Post-Ebola Syndrome' is still not very well understood. This is due in part to the fact that, in the past, the disease's high fatality rate has meant there haven't been many survivors. Due to the scale of the last outbreak we now have access to more survivors who can help us understand more about the damage that this virus causes and the long term problems it causes.

                                "There has been mounting evidence of both mental and physical health problems in Ebola survivors after the virus is cleared from the bloodstream. In some cases these health problems, such as damage to joints, brain and eyes, may be caused by Ebola virus persisting and causing damage in some of the compartments of the body that are less accessible to the immune system.

                                "Currently, there is a lot of anecdotal evidence of Post-Ebola Syndrome. The continued study of survivors is necessary if we are to learn more about how the Ebola virus works and how it affects them. The Ebola epidemic is waning, but the effects of the disease will remain."

                                Dr Semple, said "Ebola has revealed to the world the fragility of the health systems in West Africa. The impact of Ebola has been profound with 28639 cases and 11316 deaths. As interest in Ebola wanes, we must not overlook that most of the 17 thousand survivors in West Africa are experienced on-going health problems and that 12 thousand children have been orphaned. There has also been shocking secondary impact on other health and education services."



                                Ebola lingers in survivors' eyes

                                https://www.sciencedaily.com/release...0717091954.htm

                                About one in four Ebola survivors from Sierra Leone suffer from uveitis, or inflammation inside the eye, a condition that can result in vision loss or blindness. The eye now joins the testes as a location where live Ebola virus can be found up to one year post-infection.

                                A new study, titled "Retinal Pigment Epithelial (RPE) Cells are a Potential Reservoir for Ebola Virus in the Human Eye," and published in Translational Vision Science & Technology (TVST), describes how the cells responsible for isolating the eye from the immune system, known as immune privilege, may also prevent clearance of the virus from infected tissue.
                                Update 18/07/2017
                                Last edited by Jo Bowyer; 18-07-2017, 12:55 PM.
                                Jo Bowyer
                                Chartered Physiotherapist Registered Osteopath.
                                "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                                Comment

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