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  • The Bill & Melinda Gates Foundation to Fund Disease Surveillance Network in Africa and Asia to Prevent Childhood Mortality and Help Prepare for the Next Epidemic

    http://www.prnewswire.com/news-relea...300078689.html

    SEATTLE, May 6, 2015 /PRNewswire-USNewswire/ -- At its Global Partners Forum, the Bill & Melinda Gates Foundation will announce the Child Health and Mortality Prevention Surveillance Network (CHAMPS), a network of disease surveillance sites in developing countries. These sites will help gather better data, faster, about how, where and why children are getting sick and dying. This data will help the global health community get the right interventions to the right children in the right place to save lives. The network will also be invaluable in providing capacity and training in the event of an epidemic, such as Ebola or SARS. The Gates Foundation plans an initial commitment of up to $75 million on the effort.

    "The world needs better, more timely public health data not only to prepare for the next epidemic, but to save children's lives now," said Bill Gates, co-chair of the Bill & Melinda Gates Foundation. "Over the past 15 years, deaths of children in developing countries have been dramatically reduced, but to continue that trend for the next 15 years, we need more definitive data about where and why children are dying. This will also better position us to respond to other diseases that may turn into an epidemic."

    This network of disease surveillance sites in areas with high childhood mortality rates in Sub Saharan Africa and South Asia will offer a long-term approach to information management, laboratory infrastructure and workforce capacity – vital resources in geographies lacking sufficient public health infrastructure. This network could be repurposed quickly in the event of an epidemic, as in Nigeria where the national polio program's Emergency Operations Center was mobilized to fight Ebola.
    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 in West Africa

      http://www.cdc.gov/vhf/ebola/outbrea...4-west-africa/

      On May 9, the Ebola virus outbreak in Liberia was declared over after 42 days had elapsed since the burial of the last confirmed case in the country. The country has now entered a three-month period of heightened vigilance. WHO will maintain an enhanced presence in the country until the end of 2015, with a particular focus on areas that border Guinea and Sierra Leone.
      Jo Bowyer
      Chartered Physiotherapist Registered Osteopath.
      "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

      Comment


      • One-Step Reverse-Transcription FRET-PCR for Differential Detection of Five Ebolavirus Species

        http://journals.plos.org/plosone/art...l.pone.0126281

        Ebola Virus Disease (EVD), previously known as Ebola hemorrhagic fever, is an emerging infectious disease caused by a deadly virus of the family Filoviridae, genus Ebolavirus [1, 2]. Of the five identified Ebolavirus species, four of them (Zaire ebolavirus, Sudan ebolavirus, Taï Forest ebolavirus and Bundibugyo ebolavirus) are known to cause disease in humans, whereas the fifth (Reston ebolavirus) causes disease in non-human primates and swine only [3–6]. Since human infections were first reported in 1976 on the Ebola River in Democratic Republic of the Congo [7], outbreaks of EVD have occurred into twelve countries (South Sudan, Democratic Republic of Congo, Côte d’Ivoire, Gabon, Uganda, Republic of Congo, Guinea, Philippines, Nigeria, Senegal, Liberia, Mali). There have also been imported cases in Sierra Leone, Spain, and the United States of America [8–10, 3, 11, 12]. By January 25, 2015, a total of 22, 092 cases of Ebola infections have been confirmed, of which 8, 810 cases of EVD have been fatal [12].
        A generic PCR that can detect and differentiate all Ebolavirus species is needed as increased international movement of people increases the potential of transmission for multiple Ebolavirus species with varying pathogenicity [11, 17, 25–28]. Here we report a highly-sensitive one-step reverse-transcription FRET-PCR capable of rapidly identifying and differentiating all five Ebolavirus species.
        Jo Bowyer
        Chartered Physiotherapist Registered Osteopath.
        "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

        Comment


        • Hurrah!

          :clap1::clap1::clap1:

          http://www.theguardian.com/world/201...sful-in-guinea

          Hurrah for science!

          Hurrah for Norway!

          :clap2::clap2::clap2:
          Peering over the shoulders of giants.

          Know pain. Know gain.

          Comment


          • Social Vulnerability and Ebola Virus Disease in Rural Liberia

            http://journals.plos.org/plosone/art...l.pone.0137208

            Abstract

            The Ebola virus disease (EVD) epidemic that has stricken thousands of people in the three West African countries of Liberia, Sierra Leone, and Guinea highlights the lack of adaptive capacity in post-conflict countries. The scarcity of health services in particular renders these populations vulnerable to multiple interacting stressors including food insecurity, climate change, and the cascading effects of disease epidemics such as EVD. However, the spatial distribution of vulnerable rural populations and the individual stressors contributing to their vulnerability are unknown. We developed a Social Vulnerability Classification using census indicators and mapped it at the district scale for Liberia. According to the Classification, we estimate that districts having the highest social vulnerability lie in the north and west of Liberia in Lofa, Bong, Grand Cape Mount, and Bomi Counties. Three of these counties together with the capital Monrovia and surrounding Montserrado and Margibi counties experienced the highest levels of EVD infections in Liberia. Vulnerability has multiple dimensions and a classification developed from multiple variables provides a more holistic view of vulnerability than single indicators such as food insecurity or scarcity of health care facilities. Few rural Liberians are food secure and many cannot reach a medical clinic in <80 minutes. Our results illustrate how census and household survey data, when displayed spatially at a sub-county level, may help highlight the location of the most vulnerable households and populations. Our results can be used to identify vulnerability hotspots where development strategies and allocation of resources to address the underlying causes of vulnerability in Liberia may be warranted. We demonstrate how social vulnerability index approaches can be applied in the context of disease outbreaks, and our methods are relevant elsewhere.
            Jo Bowyer
            Chartered Physiotherapist Registered Osteopath.
            "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

            Comment


            • Long-term sequelae after Ebola virus disease in Bundibugyo, Uganda: a retrospective cohort study

              http://www.thelancet.com/journals/la...152-0/fulltext

              Summary
              Background
              The limited data available for long-term Ebola virus disease health outcomes suggest that sequelae persist for longer than 1 year after infection. The magnitude of the present outbreak in west Africa necessitates a more complete understanding of the health effects and future medical needs of these patients.

              Methods
              We invited adult survivors of the 2007 Bundibugyo Ebola virus outbreak in Uganda and their contacts to take part in an observational study roughly 29 months after the outbreak. We collected information about health status, functional limitations, and demographics. We collected blood samples for clinical chemistry, haematology, and filovirus antibodies using ELISA. Analyses were restricted to probable and confirmed survivors and their seronegative contacts.

              Findings
              We recruited 70 survivors of the 2007 Bundibugyo Ebola virus and 223 contacts. We did analyses for 49 probable and confirmed survivors and 157 seronegative contacts. Survivors of the Bundibugyo Ebola virus were at significantly increased risk of ocular deficits (retro-orbital pain [RR 4·3, 95% CI 1·9–9·6; p<0·0001], blurred vision [1·9, 1·1–3·2; p=0·018]), hearing loss (2·3, 1·2–4·5; p=0·010), difficulty swallowing (2·1, 1·1–3·9; p=0·017), difficulty sleeping (1·9, 1·3–2·8; p=0·001), arthralgias (2·0, 1·1–3·6; p=0·020), and various constitutional symptoms controlling for age and sex. Chronic health problems (prevalence ratio [PR] 2·1, 95% CI 1·2–3·6; p=0·008) and limitations due to memory loss or confusion (PR 5·8, 1·5–22·4; p=0·010) were also reported more frequently by survivors of Bundibugyo Ebola virus.

              Interpretation
              Long-term sequelae persist for more than 2 years after Ebola virus disease. Definition of health consequences related to Ebola virus disease could improve patient care for survivors and contribute to understanding of disease pathogenesis.
              I am prompted to post this 2007 paper after seeing footage on the BBC news this morning of British aid workers meeting their former patients. One of the Brits has long term sequelae.

              http://www.bbc.co.uk/news/uk-34399019
              Jo Bowyer
              Chartered Physiotherapist Registered Osteopath.
              "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

              Comment


              • David Beckham, Boris Johnson and Cheryl Fernandez-Versini amongst the stars honouring Ebola aid workers at Pride of Britain Awards

                http://www.standard.co.uk/showbiz/da...-a2957496.html

                The special recognition award for the British Ebola aid effort recognises that the dedication and care of British support workers helped to contain the outbreak and reduce the number of deaths.

                It notes that doctors, nurses and support staff willingly went to the worst-affected areas to set up treatment centres even though they risked catching Ebola as they lived and worked alongside victims.

                British nurses Will Pooley, 30, of Suffolk, and Pauline Cafferkey, 37, of Glasgow, and British Army medic Corporal Anna Cross, 25, of Cambridge, have all recovered after being treated for the contagious disease.
                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 re-admitted to the Royal Free

                  http://www.bbc.co.uk/news/uk-scotland-34483584

                  NHS Greater Glasgow and Clyde confirmed that the virus is present in Pauline Cafferkey but said it was left over from the original infection.
                  NHS Greater Glasgow and Clyde said she had been admitted to the Queen Elizabeth University Hospital in Glasgow on Tuesday after feeling unwell and was treated in the infectious diseases unit.
                  She was transferred from Glasgow to the Royal Free Hospital in the early hours of the morning due to an unusual late complication in her illness.
                  Ms Cafferkey spoke to BBC News about the difficulties she had encountered in her recovery.
                  She had experienced thyroid problems and her hair had fallen out.
                  Some survivors of the virus have had eye and joint problems, as well as ongoing fatigue.
                  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 nurse Pauline Cafferkey 'in serious condition'

                    http://www.bbc.co.uk/news/uk-scotland-34483584

                    Dr Ben Neuman, a virologist from the University of Reading, told BBC Radio's Good Morning Scotland programme that the outlook for Ms Cafferkey was good and it was unlikely the virus remained infectious.
                    He said: "Once the virus is removed from the blood once, it tends to retreat into the hard-to-access components of the body. It'll hide in places like the back of your eye or breast milk."
                    He said the effects of the virus on the body could last for up to two years, although it was difficult to know how long it could actually persist.
                    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: 58 close contacts of Ebola nurse being monitored

                      http://www.theguardian.com/world/201...eing-monitored

                      Health officials have imposed twice-daily temperature checks and travel restrictions on 58 people who had close contact with Pauline Cafferkey, the Scottish nurse who was diagnosed with Ebola in December and fell ill again last week with complications related to the disease.

                      Of the 58, 40 were confirmed as having had direct contact with the nurse’s bodily fluids and were offered an Ebola vaccine in line with criteria set out by an expert advisory group that includes Health Protection Scotland, Public Health England and the Scottish government. Of those 40, 25 have accepted the vaccine and a further 15 have either declined it or were unable to receive it due to existing medical conditions.
                      All 58 people will continue to be closely monitored for 21 days since their last contact with Cafferkey. The healthcare workers involved have been asked not to have any direct patient contact during this period.
                      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 nurse Pauline Cafferkey's rapid decline after being 'cured' leaves experts staggered

                        http://www.independent.co.uk/news/uk...-a6694201.html

                        A British nurse who was apparently cured of Ebola earlier this year is now in a critical condition, doctors have said, with experts expressing astonishment at the deterioration of her condition.
                        Medics working in West Africa during the current outbreak – by far the worst ever recorded – say they have seen many rashes, infections and eye problems in people suffering from so-called “post-Ebola syndrome”.

                        The exact nature of Ms Cafferkey’s illness is not known, but experts have expressed shock at the severity of her condition.

                        Jonathan Ball, professor of molecular virology at the University of Nottingham, said the news was “frankly staggering.”

                        “I am not aware from the scientific literature of a case where Ebola has been associated with what we can only assume as life threatening complications after someone has initially recovered, and certainly not so many months after,” he said.
                        In a statement on 14 October, the Royal Free said it was “sad to announce that Pauline Cafferkey’s condition has deteriorated and she is now critically ill.”
                        Jo Bowyer
                        Chartered Physiotherapist Registered Osteopath.
                        "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                        Comment


                        • How Pauline Cafferkey's Ebola relapse tears up everything doctors thought they knew

                          http://www.theguardian.com/world/201...ught-they-knew

                          When Cafferkey fell ill last week, it did not look like Ebola. “We’ve been reassured and there’s absolutely no reason to doubt it – that she wasn’t presenting with symptoms that would pose a risk to other people,” said Ball. “She wasn’t presenting with classic Ebola symptoms.”

                          NHS Scotland is taking every precaution by identifying 65 people who had physical contact recently with Cafferkey, including healthcare staff when she reported feeling ill, monitoring them for 21 days and and offering them a vaccination, as is the protocol for Ebola. Cafferkey’s illness is caused by the virus and therefore there is a theoretical risk that the virus could have been transferred to somebody else. But she was not vomiting or bleeding. “The risk to the public remains extremely low,” said NHS Scotland.

                          Both Cafferkey, 39, and Crozier, 44, had initially been very ill with Ebola, suffering from a higher viral load than other colleagues. That could play a part in the lingering of the virus. Nevertheless, doctors will now be on the alert for signs of long-term health problems in any of the western survivors. Unfortunately, the decimated health systems of west Africa are in no position to spot the danger signs among their many thousands of survivors.
                          Persistence of Ebola Virus in Ocular Fluid during Convalescence
                          Jay B. Varkey, M.D., Jessica G. Shantha, M.D., Ian Crozier, M.D., Colleen S. Kraft, M.D., G. Marshall Lyon, M.D., Aneesh K. Mehta, M.D., Gokul Kumar, M.D., Justine R. Smith, M.B., B.S., Ph.D., Markus H. Kainulainen, Ph.D., Shannon Whitmer, Ph.D., Ute Ströher, Ph.D., Timothy M. Uyeki, M.D., M.P.H., M.P.P., Bruce S. Ribner, M.D., M.P.H., and Steven Yeh, M.D.
                          N Engl J Med 2015; 372:2423-2427June 18, 2015DOI: 10.1056/NEJMoa1500306


                          Among the survivors of Ebola virus disease (EVD), complications that include uveitis can develop during convalescence, although the incidence and pathogenesis of EVD-associated uveitis are unknown. We describe a patient who recovered from EVD and was subsequently found to have severe unilateral uveitis during convalescence. Viable Zaire ebolavirus (EBOV) was detected in aqueous humor 14 weeks after the onset of EVD and 9 weeks after the clearance of viremia.
                          My bold
                          Jo Bowyer
                          Chartered Physiotherapist Registered Osteopath.
                          "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                          Comment


                          • Royal Free hospital in London says Briton’s condition has improved from ‘critically ill’ to ‘serious but stable’

                            http://www.theguardian.com/world/201...ves-royal-free
                            Jo Bowyer
                            Chartered Physiotherapist Registered Osteopath.
                            "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                            Comment


                            • Doctors say British nurse has long recovery ahead of her after suffering meningitis brought on by lingering Ebola infection

                              http://www.theguardian.com/world/201...-free-hospital

                              Pauline Cafferkey, the British nurse who contracted Ebola nine months ago in west Africa, came close to death from meningitis caused by the lingering virus, doctors have revealed.

                              Her condition has significantly improved and she is now well enough to chat to medics, use her iPad and sit up in bed. Doctors expect her to make a slow but full recovery.

                              Dr Mike Jacobs, an infectious diseases consultant at the Royal Free hospital in London, said Cafferkey had not become reinfected with the virus since her recovery in January but it had persisted in the brain, and this had led to viral meningitis.

                              “The virus re-emerged around the brain and around the spinal column to cause meningitis,” Jacobs said. “She developed some serious neurological complications.”

                              Asked how ill Cafferkey had become, Jacobs said: “It is really important to understand the word critical. It means someone is at imminent risk of dying. We were all extremely concerned about Pauline’s condition a week ago.”

                              He added: “We’re very hopeful that Pauline will slowly make a full recovery, that’s very much in our sights. Over time we anticipate that the virus will be completely eradicated. She has a long road to full recovery.”
                              Yay for the team at the Royal Free (which includes 2 physios).
                              Last edited by Jo Bowyer; 22-10-2015, 04:33 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


                              • The doctor leading the London hospital team treating Ebola nurse Pauline Cafferkey has revealed he made a transatlantic dash back to Britain as soon as he learned of her relapse.

                                http://www.standard.co.uk/news/uk/do...-a3096666.html

                                At the time Dr Jacobs, an infectious diseases consultant given a national role preparing the NHS for future outbreaks of deadly viruses, was making a speech on Ebola to a doctors’ conference.

                                He immediately abandoned the planned five-day trip and was back at the Royal Free only hours after Ms Cafferkey, 39, was re-admitted to its high-level isolation unit on October 8.

                                The Scottish nurse, who contracted Ebola while on volunteer work with Save The Children in Sierra Leone last December, is said to be “much better” after being declared critically ill and at imminent risk of death last week.
                                However, she has avoided Irn Bru, the Scottish fizzy drink she credited with aiding her first recovery in January.

                                One hospital source said: “She has gone right off it.”
                                Dr Jacobs said: “The crucial treatment she is receiving is the exceptional nursing care here at the Royal Free Hospital.

                                "That is the thing which really makes the difference.”
                                I wonder how prevalent exceptional nursing care is nowadays. In recent years I have seen proceedures rather than care from senior nursing staff. I once worked with an outstanding nursing sister on medical wards, who had been given medals in several of the countries in which she worked. A few days off her retirement I asked her what she thought was her greatest achievement and she told me quite seriously that it had taken years to perfect the art of giving a bedpan in such a way that the patient was physically as comfortable as possible, entirely unembarrassed, able to empty the bladder and bowel effectively and was properly cleaned up afterwards. Much of this involved timing of medications as well as knowing the patient.
                                Last edited by Jo Bowyer; 23-10-2015, 09:38 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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