YouTube as a Source of Information on Ebola Virus Disease

Analyzing The Ebola ViruAnalyzing The Impact That The Ebola Virus Disease Has on Children

Ebola virus disease (EVD) is a complex zoonosis that is highly virulent in humans. The largest recorded outbreak of EVD is ongoing in West Africa, outside of its previously reported and predicted niche. We assembled location data on all recorded zoonotic transmission to humans and Ebola virus infection in bats and primates (1976–2014). Using species distribution models, these occurrence data were paired with environmental covariates to predict a zoonotic transmission niche covering 22 countries across Central and West Africa. Vegetation, elevation, temperature, evapotranspiration, and suspected reservoir bat distributions define this relationship. At-risk areas are inhabited by 22 million people; however, the rarity of human outbreaks emphasises the very low probability of transmission to humans. Increasing population sizes and international connectivity by air since the first detection of EVD in 1976 suggest that the dynamics of human-to-human secondary transmission in contemporary outbreaks will be very different to those of the past.DOI: http://dx.doi.org/10.7554/eLife.04395.001

he World Health Organization (WHO) was first notified of a rapidly evolving outbreak of Ebola virus disease (EVD) in Guinea on 23 March 2014.On 8 August 2014, the WHO declared the Ebola epidemic a "public health emergency of international concern".A two-year-old child who died (6 August 2013) in southern Guinea was identified as 'patient zero' of the current Ebola outbreak, which is still raging.As of 21 November 2014, there have been 15,351 reported Ebola cases in eight countries since the outbreak began, with 5,459 reported deaths.The countries affected include Guinea, Liberia, Sierra Leone, Nigeria, Senegal, Mali, Spain, and the US.Transmission remains intense in Guinea, Liberia, and Sierra Leone. 1 Although the overall situation in the affected countries remains critical, there are signs that the disease outbreak is potentially being controlled.The current EVD outbreak in West Africa is caused by the genus Ebolavirus which belongs to the family Filoviridae.This is an enveloped, negativesense single-stranded RNA virus.Ebolavirus was first described in 1976 in Zaire (now called the Democratic Republic of the Congo) near the Ebola river, hence the name. 2 There are five identified Ebola virus species, four of which are known to cause disease in human.The virus causing the current outbreak in West Africa Ebola belongs to the Zaire species.Ebola can cause disease in humans and non-human primates (monkeys, gorillas, and chimpanzees).The natural reservoir host of the Ebola virus remains unknown.However, it is believed that the virus is animal-borne and that fruit

Ebola virus: a new concern, its virological characteristics, diagnosis, present condition, and treatment during the ongoing SARS-CoV-2 omicron variant - correspondence.

ABSTRACTBackground: Internet-videos, though popular sources of public health information, are often unverified and anecdotal. We critically evaluated YouTube videos about Zika virus available during the recent Zika pandemic.Methods: Hundred-and-one videos were retrieved from YouTube (search term: zika virus). Based upon content, they were classified as: informative, misleading or personal experience videos. Quality and reliability of these videos were evaluated using standardized tools. The viewer interaction metrics (e.g. no. of views, shares, etc.), video characteristics (video length, etc.) and the sources of upload were also assessed; and their relationship with the type, quality and reliability of the videos analyzed.Results: Overall, 70.3% videos were informative, while 23.8% and 5.9% videos were misleading and related to personal experiences, respectively. Although with shorter lengths (P < 0.01) and superior quality (P < 0.01), yet informative videos were viewed (P = 0.054), liked (P < 0.01) and shared (P < 0.05) less often than their misleading counterparts. Videos from independent users were more likely to be misleading (adjusted OR = 6.48, 95% CI: 1.69 – 24.83), of poorer (P < 0.05) quality and reliability than government/news agency videos.Conclusion: A considerable chunk of the videos were misleading. They were more popular (than informative videos) and could potentially spread misinformation. Videos from trustworthy sources like university/health organizations were scarce. Curation/authentication of health information in online video platforms (like YouTube) is necessary. We discuss means to harness them as useful source of information and highlight measures to curb dissemination of misinformation during public health emergencies.

Are adaptive randomised trials or non-randomised studies the best way to address the Ebola outbreak in west Africa?

The current Ebola virus disease (EVD) outbreak in West Africa—the worst since Ebola virus was identified in 1976—provides a stark reminder of the human consequences of EVD. There are great challenges, ethical dilemmas and uncertainty in providing safe obstetric interventions to Ebola virus-infected women in a humanitarian emergency setting. Although applying the precautionary principle is eminently sensible, especially when protecting healthcare staff, the limited evidence underpinning discussions regarding management of pregnant women with EVD should be acknowledged, with very few studies to date reporting on maternal and fetal outcomes. Much of our understanding of EVD comes from previous outbreaks in resource-limited settings in Africa, a very different healthcare context to the UK. Women in these settings are at high-risk for exposure to Ebola virus (because of their predominant caregiver role, both in domestic and healthcare settings), rather than women being more susceptible to Ebola virus. Ebola virus is transmitted from person to person through close and direct physical contact with body fluids from a symptomatic individual. In the early symptomatic phase, the virus is present in blood but thought to be at very low levels in other body fluids. Infectiousness increases with illness severity, and, in the late phase, all body fluids should be considered infectious, with blood, faeces and vomit being most infectious. Skin is almost certainly highly contaminated in late-stage disease, as maintaining good hygiene with diarrhoea, vomiting, incontinence and bleeding is near impossible (Public Health England; Ebola in pregnancy. 2014, https://www.gov.uk/government/publications/information-for-healthcare-workers-ebola-in-pregnancy). Bausch et al. isolated Ebola virus from breast milk in one lactating woman, in both the acute and convalescent phases of illness (after demonstrated viral clearance from blood), suggesting that the mammary glands may be an immunologically protected site with delayed viral clearance (Bausch et al. J Infect Dis 2007;196:S142–7). However, it is unknown if Ebola virus is transmitted routinely from mothers to infants through breastfeeding (Jamieson et al. Obstet Gynecol 2014;124:1005–10). It is likely that fetal infection occurs through the placenta. In the current outbreak in Guinea, Baggi et al. found a high Ebola virus load in the amniotic fluid of two pregnant women, and in one this was after viral clearance from blood in the convalescent phase. Placental samples in both were also positive for Ebola virus (Baggi et al. Euro Surv 2014;19(49)). In most previous EVD outbreaks, pregnancy-related information was not collected systematically or routinely reported. Data on pregnancy outcomes in the current Ebola outbreak are also relatively scarce, with some reports from Guinea (Baggi et al.; Baize et al. N Engl J Med 2014;371:1418–25), Sierra Leone (Schieffelin et al. N Engl J Med 2014;371:2092–100) and Liberia (Chertow et al. N Engl J Med 2014;371:2054–7). Only the report by Baggi et al. from Guinea specifically focuses on pregnancy outcomes, describing induced deliveries after intrauterine death in two 7-month gestation Ebola virus-infected pregnant women who were in the convalescent phase of illness; both women survived. In the other reports (Baize et al.; Chertow et al.; Schieffelin et al.), pregnancy-related outcomes are described among other clinical outcomes in Ebola virus-infected patients. Limited evidence suggests that pregnant women are at increased risk of spontaneous abortion (Baize et al.; Bull WHO 1978;56:271–93; Bwaka et al. J Infect Dis 1999;179:S1–7; Chertow et al.; Mupapa et al. J Infect Dis. 1999;179:S11–12; Schieffelin et al.), pregnancy-related haemorrhage (Mupapa et al.; Schieffelin et al.), stillbirth (Baggi et al.; Mupapa et al.) and death (Bull WHO; Mupapa et al.) when infected. However, although evidence to date suggests that maternal mortality is high among Ebola virus-infected pregnant women, there are also reports of maternal survival after fetal loss (Bull WHO; Baggi et al.; Baize et al.; Bwaka et al.; Mupapa et al.). High neonatal mortality rates have also been reported. Live infants born to Ebola virus-infected mothers have invariably died (Bull WHO; Mupapa et al.), but some have died in the late neonatal phase, and whether these deaths represented actual cases of EVD or resulted from the many other causes of high infant mortality has not always been known (Bull WHO). As we learn more about Ebola virus transmission and the clinical course of illness and recovery, we must continually revisit our approach to its control and treatment, based on best-quality evidence. Meeting maternal health needs in West Africa while better understanding and managing the risk to healthcare workers in the ongoing Ebola outbreak is the real challenge. AK has previously worked as a clinician with Médecins Sans Frontières in Liberia (2005/06) and currently works for Public Health England.

Business scholars have long emphasized the need for a continuous flow of strategic, tactical and operational information in order for decision makers to make informed organizational choices. However, much of the practical and theoretical work on ‘organizational learning’ and ‘environmental scanning’ has been aspatial and focused on the large corporation. Researchers of small business dynamics and entrepreneurship have measured firms’ use of information sources, but this work also remains largely aspatial. Geographers have only begun to scratch the surface of the relationships between forms of industrial spatial organization and the use of specific information sources at a firm level. Coupling these various perspectives, I investigate the use and qualitative assessment of information sources by establishments in a highly localized industry (carpets in northern Georgia) and make some comparisons with several other industries in other regions (plastics and textile producers). Analysis is based upon responses to a mail survey soliciting information from (mainly small) firms regarding their use of 15 common sources of market and technical information. I contextualize the use of information sources in the carpet industry by reviewing important industry trends and circumstances as well as the industry’s spatial organization. The results indicate that firms in the carpet industry, perhaps the most agglomerated industry in the United States, report relatively low overall use and availability of common sources of information compared with firms in other industries and regions. Organizational attributes, such as size and affiliation, may have stronger relationships to the sources of information that firms typically use than local context.

The handling, capturing, butchering, and transportation of wildmeat can increase the risk of zoonoses, including the Ebola virus disease (EVD). Guinea, West Africa, experienced a catastrophic outbreak of EVD between 2013 and 2016. This study aimed to understand local people’s sources of information concerning EVD, their perceptions of potential wildlife carriers of EVD and their meat and fish consumption behavior during this period. A semi-structured questionnaire was administered to 332 participants in two urban centers (N = 209) and three villages (N = 123) between January 3 and March 30, 2015 in the prefecture of Lola in southeastern Guinea. Chi-square analyses revealed that, in rural areas, awareness missions represented the main source of information about EVD (94.3%), whereas in urban settings such missions (36.1%), as well as newspapers (31.6%) and radio (32.3%) were equally mentioned. Bats (30.1% and 79.4%), chimpanzees (16.3% and 48.8%) and monkeys (13.0% and 53.1%) were the most commonly cited potential agents of EVD in both rural and urban areas respectively, while the warthog (2.3% rural and 6.5% urban), crested porcupine (1.7% rural and 10.7% urban), duiker (1.19% rural and 2.6% urban) and the greater cane rat (1.1% rural and 9.5% urban) were also cited but to a lesser extent. However, 66.7% of rural respondents compared to only 17.2% in the urban area did not consider any of these species as potential carriers of the Ebola virus. Nonetheless, a fifth of our respondents reported not consuming any of these species altogether during the EVD outbreak. Among all seven faunal groups mentioned, a significant reduction in reported consumption during the Ebola outbreak was only noted for bats (before: 78.3% and during: 31.9%) and chimpanzees (before: 31.6% and during: 13.5%). Automatic Chi-Square Interaction Detection (CHAID) analysis revealed that the belief that bats or chimpanzees were associated with EVD or not had a significant effect respectively on their non-consumption or continued consumption. However, only 3.9% of respondents reported shifting to alternative protein sources such as domestic meat or fish specifically to avoid EVD. Only 10.8% reported consuming more domestic meat during the EVD outbreak compared with before; affordability and availability were the main reported reasons for why people did not consume more domestic meat and why two thirds reported consuming more fish. While increased domestic meat consumption was linked to the belief that duikers, the most commonly consumed wildmeat before the epidemic, were associated with EVD, increased fish consumption was not predicted by any EVD related factors. Our study revealed deep-rooted false beliefs among rural respondents and constraints when it comes to access to alternative protein sources such as domestic meat. Our findings emphasize the urgent need for greater consideration of the relationship between socio-economic context, food security, and public health.

Ebola virus is among the most deadly pathogens, with case fatality rates of up to 90%.1 Ebola virus is categorized as a tier 1 pathogen by the US government because of its potential for deliberate misuse with significant potential for mass casualties. The current outbreak of Ebola virus in West Africawithmore than23 000casesand9000deaths2alsodemonstrates the long-underestimated public health threat that Ebola virus poses as a natural human pathogen. There are no licensed vaccines or postexposure treatments for combating Ebola virus. However, substantial progress has beenmade in developing vaccines and antivirals that can protect laboratory animals against lethal disease.1,3 Advancing these interventions for human use is a matter of utmost urgency. In this issue of JAMA, Lai et al4 report the use of a firstgeneration recombinantvesicular stomatitisvirus–basedEbola vaccine (VSVΔG-ZEBOV)5 to treat aphysicianwhoexperienced aneedlestick in anEbola treatment unit in Sierra Leoneduring the current Ebola virus outbreak. A single dose of the VSVΔGZEBOVvaccinewasadministeredapproximately43hoursafter thepotential exposure. Thepatient experienceda transient febrile syndrome after vaccination. Importantly, no evidence of Ebolavirusinfectionwasdetected,andthevaccineelicitedstrong innateandEbolavirus–specificadaptiveimmuneresponses.Most significantly, thevaccine,whichexpresses thesurfaceglycoproteinofEbolavirus,wasable to inducean IgGantibodyresponse against theEbola virus glycoprotein at a level that has been associatedwith protection of nonhuman primates.5 It is difficult to draw any definitive conclusions from a single case report. The inability todetect evidenceofEbola virus infectionmost likely is because therewasnot anactual exposure; however, it cannot be completely ruled out that the intervention was effective in controlling Ebola virus replication. Even though this patient experienced some adverse events after vaccination, the patient reported having traveler’s diarrhea prior to receiving the VSVΔG-ZEBOV vaccine; therefore, it is also not possible to draw any strong conclusions regarding any adverse events from this case in regard to the safety of the vaccine. This is the second time that the VSVΔG-ZEBOV vaccine has been used to treat a potential exposure to Ebola virus. The initial use occurred in 2009 for a laboratory worker in Germany6 and also involved a needlestick injury. The results of that incident were nearly identical; however, the severity of adverse events following vaccinationwas lessnotable in theGermancase comparedwith the patient in the case report by Lai et al.4 The2 incidents involving theuseof theVSVΔG-ZEBOVvaccine for the treatment of high-risk Ebola virus exposures further reinforce the need for public health approaches that prevent and control outbreaks. Efforts to develop effective vaccines and treatments against Ebola virus began soon after its discovery in 1976. However, advances were slow until the decadeof the 2000swhenat least 10different preventive vaccines were developed that conferred complete protection in the criterion standardnonhumanprimatemodels.1 Postexposure treatments and therapies that canprotect nonhumanprimates against Ebola virus have been much more difficult to develop. Similar to the rabies vaccine, the VSVΔG-ZEBOV vaccine can be used both as a conventional preventive vaccine and as a postexposure treatment. When used as a treatment, the VSVΔG-ZEBOV vaccine protected 50% of nonhuman primates against lethal Ebolavirus (Zaire species) infectionwhen given shortly after exposure.7 Only 2 potential therapies, ZMapp8 and TKM-Ebola,9 have been shown to completely protect 100% of nonhuman primates from a lethal Ebola virus (Zaire species) infection when administered after exposure. Both drugs have been administered under compassionate use during the current outbreak to treat a number of patients repatriated to Europe and the United States. Even though these patients have had very high survival rates, the role of ZMapp and TKM-Ebola in the outcome is unknown because in many cases they received multiple types of experimental therapies, including convalescent serum, and also likely benefited from the advanced supportive medical care in specialized facilities. Other treatments such as brincidofovir and favipiravir also have been used to treat patients infected with Ebola virus during the current outbreak; however, their benefit is even more difficult to measure because neither treatment has been associated with strong protection of nonhuman primates against Ebola virus. An important point noted in the report by Lai et al4 is that the patient declined other experimental drugs in lieu of the VSVΔG-ZEBOV vaccine. This also raises issues regarding patient consent and theuseof experimental therapies. This is an important consideration because ultimately the patient or a representative of the patient makes the decision and should be informed of all options, available data, and risks. It is unknownwhat other drugswere offered to the patient in the report byLai et al.4 Shortagesof ZMappduring the currentEbola virus outbreak have been reported, and it is clear that even though promising antivirals have been developed, they have Related article page 1249 Opinion

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The article describes some results of the research project «The mass consciousness in the zone of military conflict in the Donbass» and an attempt was made to identify patterns of using information sources for the population of the free part of the Luhanska oblast. The survey is based on data from a panel survey conducted in January-December 2017. It was found that the main sources of new information are TV, Internet and the closest social environment (friends, acquaintances, relatives, colleagues). The last two groups have a network character and often disseminate unofficial information. It was also found that the main sources of important information are Internet, TV and the closest social environment. There are statistically significant differences in the use of different sources of information depending on gender, type of settlement, age and education level. Also, a factor analysis of the use of new information sources was made, in the course of which four factors are distinguished: 1 – Internet, information received during stay in educational institutions, information from friends and acquaintances, relatives; 2 – traditional media (newspapers, radio, television); 3 – from colleagues and managers; 4 – from advertisement, from random people, from magazines. Also, factor analysis of the sources of important information was conducted. It was established what the new information of non-private nature was perceived by respondents during the day: in the first place – «political life in Ukraine», in the second place – «prices and tariffs», in the third place – «the war on the Donbass». This is the evidence that the war becomes part of everyday life and there is reduction of people’s attention to it. The differences were found in the receipt of such information depending on gender and age. Also, estimates of the emotional impact of daily new information are given. Basic practices of using the Internet and watching TV are defined. The rating of TV channels in the north of Luhanska Oblast is given in the article – Ukrainian nationwide channels prevail. It was found that both Ukrainian and Russian media’s level of distrust far exceeds the level of trust, but the level of trust to Ukrainian media is still higher. In the use of information sources there is a steady increase of the role of network sources of information (electronic social networks, networks of communication with relatives, acquaintances, friends, colleagues).

WHO meeting chooses untried interventions to defeat Ebola