Ebola Symptoms Research Articles

Generation of efficacy data on 60y and older population using SARS-CoV-2 Vaccines

Immunisation Schedule. Influenza A (H5N1) update: "Bird flu spillover to mammals needs to be monitored closely, risk to humans currently low but we must prepare". (WHO). Respiratory Syncytial Virus (RSV) Bivalent Subgroups A and B Vaccine for Infants and Adults (due 2023). False Listing of RB51 as Approved Medicine for Brucellosis or Malta Fever. Streptococcus pneumoniae PCV20. R21/Matrix-M™ Malaria (Plasmodium falciparum) vaccine 77% efficacy (due 2023). Bivalent SARS-Cov-2. [I am very thankful to receive links, additions and corrections to update, and to remove any obsolete material herein if spotted. Anti-Covid-19, anti-MMR, anti-Gardasil, anti-poliovirus anti-vaxxer depopulating messages are both unwelcome and repulsive to me.] BREAKING NEWS: Vaccine Catastrophe - Veterinary Vaccine (Live-Attenuated Brucella abortus strain RB51) has incorrectly been indicated as an 'approved' prophylactic therapy for human vaccination against Brucellosis or Malta Fever (also variously known as ‘Mediterranean Fever’ and ‘Undulant Fever’). This error is totally inexcusable as this strain is extremely harmful when given to humans. Immunisation Schedule for Zaire Ebola virus for work where large bull (bovine) and buffalo herds are present (put together for the rescue and care insurers). Zaire Ebola contamination management in large herds of aforesaid large ruminants proves problematic with the biohazard suit that protect from the disease vectors as the animals respond aggressively to the human protective gear leading to panicking animals attacks, attempts of human butchery and animal rummage where people and properties can suddenly become threatened, as a health protection gives rise to animal threat by the rummaging animals trampling and horn attacking people in biohazard gear. The ring fencing experimental Zaire Ebola vaccines were not available at the time of this original plan instigated where the China-based organisation prepared an emergency quantitative easing (QE) cash programme, ‘helicopter drops of money’ as a mitigation strategy to persuade the food producers and food vendors to continue serving the general public against an infection risk during a major ebola epidemic - to prevent food industry's distribution and production collapses as the personnel might otherwise decide to stop working and to stay home so as to avoid infecting themselves by the dangerous pathogen (in this case a Zaire Ebola Virus). The above can lead to severe food shortages and ultimately potential starvation occurrence unless that epidemic had not subsided soon enough to prevent this secondary consequence from emerging. Because of similarity of early Zaire Ebola symptoms to other infectious illnesses at the early stages, the work undertaken in remote areas, the lead time in medical evacuations in case of illnesses, and the immense cost of privately-funded flying hospital dispatch to carry out a rescue operation, an exhaustive mutual exclusion prophylactic scheme was initiated to minimise unnecessary calls for such a flying hospital facility (remote medical service) from overseas. Reported BEXSERO to GlaxoSmithKline on an unlisted side effect of stealthy temperature rise (see 19/03/2020 version, page 7) to +42.3C / +108.1F with weakening of normal body temperature control like sweating and relative lack of sense of highly elevated body temperature able to cause heat stroke and other related damage to body. The immunisation schedule incorporates emergency authorisation Covid-19 immunisations and coronavirus vaccines that shortly complete their approval. Some of the Covid-19 immunisations likely vanish from marketplace as soon as the pandemic is over whereas some other vaccine designs may seek themselves second life as generic coronavirus immunisations. (The research field of coronaviruses is rapidly changing with these overlooked viruses also causing many common colds is brought into spotlight.) Almost all Covid-19 products have not been tested for concomitant use with many other immunisation products and therefore a reasonable space should be allowed between immunisations to avoid adverse effect risks. Because of this one ought to consider whether at current pandemic situation some immunisation products of lesser importance should be taken and whether it is better to defer them until situation clears (considering the ongoing infections with Covid-19 variants and especially in some remote regions where sequencing of the variants is very sparse as the protection to Covid-19 is very important). Because of above reason, this schedule is not currently geared for rapid deployment in tropics as too many uncertainties lie within which good protection against Covid-19 must prevail. Section on Covid-19 products is continually expiring due to evolving situation. Updates on Streptococcus pneumoniae PCV20. The latest version of the document supersedes all earlier versions that ought to be discarded and not used.

New Generation Vaccine Strategies against COVID-19

Immunisation Schedule. Influenza A (H5N1) update: "Bird flu spillover to mammals needs to be monitored closely, risk to humans currently low but we must prepare". (WHO). Respiratory Syncytial Virus (RSV) Bivalent Subgroups A and B Vaccine for Infants and Adults (due 2023). False Listing of RB51 as Approved Medicine for Brucellosis or Malta Fever. Streptococcus pneumoniae PCV20. R21/Matrix-M™ Malaria (Plasmodium falciparum) vaccine 77% efficacy (due 2023). Bivalent SARS-Cov-2. [I am very thankful to receive links, additions and corrections to update, and to remove any obsolete material herein if spotted. Anti-Covid-19, anti-MMR, anti-Gardasil, anti-poliovirus anti-vaxxer depopulating messages are both unwelcome and repulsive to me.] BREAKING NEWS: Vaccine Catastrophe - Veterinary Vaccine (Live-Attenuated Brucella abortus strain RB51) has incorrectly been indicated as an 'approved' prophylactic therapy for human vaccination against Brucellosis or Malta Fever (also variously known as ‘Mediterranean Fever’ and ‘Undulant Fever’). This error is totally inexcusable as this strain is extremely harmful when given to humans. Immunisation Schedule for Zaire Ebola virus for work where large bull (bovine) and buffalo herds are present (put together for the rescue and care insurers). Zaire Ebola contamination management in large herds of aforesaid large ruminants proves problematic with the biohazard suit that protect from the disease vectors as the animals respond aggressively to the human protective gear leading to panicking animals attacks, attempts of human butchery and animal rummage where people and properties can suddenly become threatened, as a health protection gives rise to animal threat by the rummaging animals trampling and horn attacking people in biohazard gear. The ring fencing experimental Zaire Ebola vaccines were not available at the time of this original plan instigated where the China-based organisation prepared an emergency quantitative easing (QE) cash programme, ‘helicopter drops of money’ as a mitigation strategy to persuade the food producers and food vendors to continue serving the general public against an infection risk during a major ebola epidemic - to prevent food industry's distribution and production collapses as the personnel might otherwise decide to stop working and to stay home so as to avoid infecting themselves by the dangerous pathogen (in this case a Zaire Ebola Virus). The above can lead to severe food shortages and ultimately potential starvation occurrence unless that epidemic had not subsided soon enough to prevent this secondary consequence from emerging. Because of similarity of early Zaire Ebola symptoms to other infectious illnesses at the early stages, the work undertaken in remote areas, the lead time in medical evacuations in case of illnesses, and the immense cost of privately-funded flying hospital dispatch to carry out a rescue operation, an exhaustive mutual exclusion prophylactic scheme was initiated to minimise unnecessary calls for such a flying hospital facility (remote medical service) from overseas. Reported BEXSERO to GlaxoSmithKline on an unlisted side effect of stealthy temperature rise (see 19/03/2020 version, page 7) to +42.3C / +108.1F with weakening of normal body temperature control like sweating and relative lack of sense of highly elevated body temperature able to cause heat stroke and other related damage to body. The immunisation schedule incorporates emergency authorisation Covid-19 immunisations and coronavirus vaccines that shortly complete their approval. Some of the Covid-19 immunisations likely vanish from marketplace as soon as the pandemic is over whereas some other vaccine designs may seek themselves second life as generic coronavirus immunisations. (The research field of coronaviruses is rapidly changing with these overlooked viruses also causing many common colds is brought into spotlight.) Almost all Covid-19 products have not been tested for concomitant use with many other immunisation products and therefore a reasonable space should be allowed between immunisations to avoid adverse effect risks. Because of this one ought to consider whether at current pandemic situation some immunisation products of lesser importance should be taken and whether it is better to defer them until situation clears (considering the ongoing infections with Covid-19 variants and especially in some remote regions where sequencing of the variants is very sparse as the protection to Covid-19 is very important). Because of above reason, this schedule is not currently geared for rapid deployment in tropics as too many uncertainties lie within which good protection against Covid-19 must prevail. Section on Covid-19 products is continually expiring due to evolving situation. Updates on Streptococcus pneumoniae PCV20. The latest version of the document supersedes all earlier versions that ought to be discarded and not used.

Building Resilient Health Systems: Experimental Evidence from Sierra Leone and The 2014 Ebola Outbreak*

Abstract Skepticism about the quality of health systems and their consequent underuse are thought to contribute to high rates of mortality in the developing world. The perceived quality of health services may be especially critical during epidemics, when people choose whether to cooperate with response efforts and frontline health workers. Can improving the perceived quality of health care promote community health and ultimately help to contain epidemics? We leverage a field experiment in Sierra Leone to answer this question in the context of the 2014 West African Ebola crisis. Two years before the outbreak, we randomly assigned two interventions to government-run health clinics—one focused on community monitoring, and the other conferred nonfinancial awards to clinic staff. Prior to the Ebola crisis, both interventions increased clinic utilization and patient satisfaction. Community monitoring additionally improved child health, leading to 38% fewer deaths of children under age five. Later, during the crisis, the interventions also increased reporting of Ebola cases by 62%, and community monitoring significantly reduced Ebola-related deaths. Evidence on mechanisms suggests that both interventions improved the perceived quality of health care, encouraging patients to report Ebola symptoms and receive medical care. Improvements in health outcomes under community monitoring suggest that these changes partly reflect a rise in the underlying quality of administered care. Overall, our results indicate that promoting accountability not only has the power to improve health systems during normal times, but can also make them more resilient to emergent crises.

Preparedness is essential for malaria-endemic regions during the COVID-19 pandemic

Preparedness is essential for malaria-endemic regions during the COVID-19 pandemic

Building Resilient Health Systems: Experimental Evidence from Sierra Leone and the 2014 Ebola Outbreak

Developing countries are characterized by high rates of mortality and morbidity. A potential contributing factor is the low utilization of health systems, stemming from the low perceived quality of care delivered by health personnel. This factor may be especially critical during crises, when individuals choose whether to cooperate with response efforts and frontline health personnel. We experimentally examine efforts aimed at improving health worker performance in the context of the 2014–15 West African Ebola crisis. Roughly two years before the outbreak in Sierra Leone, we randomly assigned two accountability interventions to government-run health clinics — one focused on community monitoring and the other gave status awards to clinic staff. We find that over the medium run, prior to the Ebola crisis, both interventions led to improvements in utilization of clinics and patient satisfaction with the health system. In addition, child health outcomes improved substantially in the catchment areas of community monitoring clinics. During the crisis, the interventions also led to higher reported Ebola cases, as well as lower mortality from Ebola — particularly in areas with community monitoring clinics. We explore three potential mechanisms: the interventions (1) increased the likelihood that patients reported Ebola symptoms and sought care; (2) unintentionally increased Ebola incidence; or (3) improved surveillance efforts. We find evidence consistent with the first: by building trust and confidence in health workers, and improving the perceived quality of care provided by clinics prior to the outbreak, the interventions encouraged patients to report and receive treatment. Our results suggest that accountability interventions not only have the power to improve health systems during normal times, but can additionally make health systems resilient to crises that may emerge over the longer run.

Building Resilient Health Systems: Experimental Evidence from Sierra Leone and the 2014 Ebola Outbreak

Underuse of health systems and a lack of confidence in their quality contribute to high rates of mortality in the developing world. How individuals perceive health systems may be especially critical during epidemics, when they choose whether to cooperate with response efforts and frontline health workers. Can improving the perceived quality of healthcare promote community health and ultimately, help to contain epidemics? We leverage a field experiment to answer this question in the context of Sierra Leone and the 2014 West Africa Ebola crisis. Two years before the outbreak, we randomly assigned two accountability interventions to government-run health clinics – one focused on community monitoring and the other conferred non-financial awards to clinic staff. These interventions delivered immediate benefits under conditions. Even prior to the Ebola crisis, both interventions increased clinic utilization and satisfaction with healthcare, and community monitoring additionally improved child health, leading to 38 percent fewer deaths of children under five. Later, during the crisis, the interventions also increased reporting of Ebola cases by 62 percent, and significantly reduced Ebola-related deaths. Evidence on mechanisms suggests that the interventions improved confidence in the health system, encouraging patients to report Ebola symptoms and receive medical care. These results indicate that promoting accountability not only has the power to improve health systems during normal times, but can also make them more resilient to crises that emerge over the longer run. Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

US FDA allows sales of rapid Ebola test

The US Food and Drug Administration has given the green light to OraSure Technologies to sell a rapid diagnostic for Ebola in the US. The OraQuick Ebola Rapid Antigen Test detects the VP40 antigen produced in response to Ebola viruses. It can be used to test blood from people with symptoms of Ebola and oral fluid from people suspected of having died from the virus. The test, which can take up to 30 min, is the first rapid diagnostic for Ebola authorized by the FDA for marketing in the US. The World Health Organization (WHO) concluded in 2016 that the test is acceptable for use in emergencies to aid in diagnosing Ebola as the cause of death and to test people with symptoms of the virus to help prevent transmission. Both the WHO and the FDA note that results from the quick test should be confirmed with an approved nucleic

The Check and Report Ebola (CARE+) Program to Monitor Travelers for Ebola After Arrival to the United States, 2014-2016.

The 2014-2016 Ebola epidemic in West Africa influenced how public health officials considered migration and emerging infectious diseases. Responding to the public's concerns, the US government introduced enhanced entry screening and post-arrival monitoring by public health authorities to reduce the risk of importation and domestic transmission of Ebola while continuing to allow travel from West Africa. This case study describes a new initiative, the Check and Report Ebola (CARE+) program that engaged travelers arriving to the United States from countries with Ebola outbreaks. The Centers for Disease Control and Prevention employed CARE ambassadors, who quickly communicated with incoming travelers and gave them practical resources to boost their participation in monitoring for Ebola. The program aimed to increase travelers' knowledge of Ebola symptoms and how to seek medical care safely, increase travelers' awareness of monitoring requirements, reduce barriers to monitoring, and increase trust in the US public health system. This program could be adapted for use in future outbreaks that involve the potential importation of disease and require the education and active engagement of travelers to participate in post-arrival monitoring.

Care of Pregnant Women: Experience from a Maternity-Specific Ebola Isolation Unit in Sierra Leone.

The Ebola virus disease epidemic was devastating to the West African region, particularly for pregnant women. Prior to the epidemic, maternal mortality in this region was among the highest in the world. Throughout the region, screening of patients with Ebola was difficult, as the symptoms of malaria or typhoid mimicked Ebola, but even more difficult for pregnant women, because of the large overlap between Ebola symptoms and pregnancy-related complications. In November 2014, the world's first maternity-specific isolation and screening system, to our knowledge, was created at the Princess Christian Maternity Hospital in Freetown to meet the emergent needs of the population of pregnant women during the epidemic. Starting in December 2014 through June 2016, in collaboration with hospital leadership and the Ministry of Health and Sanitation, Partners In Health supported Princess Christian Maternity Hospital in creating a safer health care environment with the shared goal of improving safety and health outcomes and of addressing the unique needs of pregnant women, by focusing on improving 4 key areas: 1) screening, 2) isolation, 3) laboratory diagnostics, and 4) clinical service delivery in isolation, including human resource management and training. The screening guidelines were adapted to include maternal health care considerations, a new screening area was constructed, the laboratory result turnaround time was reduced, and the isolation unit was improved to enhance safety and care delivery. Human resources were supported with additional staff hired and trainings on infection prevention and control, overall resulting in better preparing Princess Christian Maternity Hospital to provide care for pregnant women during outbreaks. The authors' experience at Princess Christian Maternity Hospital provides a model of screening, isolation, and care specifically for maternity patients, and directly addresses infection risk and mortality. The recommendations we provide can be used in future outbreaks.

Clinical Surveillance and Evaluation of Suspected Ebola Cases in a Vaccine Trial During an Ebola Epidemic: The Sierra Leone Trial to Introduce a Vaccine Against Ebola.

ClinicalTrials.gov [NCT02378753] and Pan African Clinical Trials Registry [PACTR201502001037220].

Household Transmission of Ebola Virus: Risks and Preventive Factors, Freetown, Sierra Leone, 2015.

Knowing risk factors for household transmission of Ebola virus is important to guide preventive measures during Ebola outbreaks. We enrolled all confirmed persons with Ebola who were the first case in a household, December 2014-April 2015, in Freetown, Sierra Leone, and their household contacts. Cases and contacts were interviewed, contacts followed prospectively through the 21-day incubation period, and secondary cases confirmed by laboratory testing. We enrolled 150 index Ebola cases and 838 contacts; 83 (9.9%) contacts developed Ebola during 21-day follow-up. In multivariable analysis, risk factors for transmission included index case death in the household, Ebola symptoms but no reported fever, age <20 years, more days with wet symptoms; and providing care to the index case (P < .01 for each). Protective factors included avoiding the index case after illness onset and a piped household drinking water source (P < .01 for each). To reduce Ebola transmission, communities should rapidly identify and follow-up all household contacts; isolate those with Ebola symptoms, including those without reported fever; and consider closer monitoring of contacts who provided care to cases. Households could consider efforts to minimize risk by designating one care provider for ill persons with all others avoiding the suspected case.

Knowledge and Attitude of Women Attending Polyclinic-Reproductive and Child Health (RCH) on Ebola Prevention

The prevention and control of infectious diseases has been given all rooms in the medical field. In the last decades, the battle to fight against infectious diseases has gained an upper hand, however with the outbreak of Ebola in the early 2014, the fear and terror won the heart of everyone including the health care providers. There is a need for the health care systems to adjust to the prevention and control of this infection. In the control of spreading and transmission of this dreadful disease, emergency teams have been established in almost every hospital and health centers across the country, The Gambia. Part of the measures that are to be taken in controlling the transmission of Ebola is to create awareness among the people in the communities.In a bid to measure the level of awareness and the attitudes by the people, although there has been no Ebola suspected or confirmed case in Gambia, the need to measure how prepared her people is a right function. Women attending the polyclinic were taken on one on one interview with 132 participants whose responses were analyzed and evaluated. This study focuses on the measurement of the degree of awareness, the type of reactions that women who attend polyclinic manifested on Ebola prevention approaches. The level of awareness of Ebola outbreak and the attitudes of women attending polyclinic is not very impressive. While 48% of the respondents are aware of Ebola, 64% could accurately identify the signs and symptoms of Ebola, Almost everyone were first informed about the outbreak on the national TV. The level of understanding as to prevention and control of spreading is far below average and 76% of the respondents would welcome a family member or friend who would have been recovered from Ebola Viral Infection.

College students’ knowledge, attitudes and adherence to public service announcements on Ebola in Nigeria: Suggestions for improving future Ebola prevention education programmes

Introduction: Apprehension over a possible recurrence of Ebola remains pervasive among college students in Nigeria. Prevention education continues to be carried out through public service announcements (PSAs) on radio, television and in the social media. However, little is known about college students’ knowledge, attitudes and adherence to PSAs on Ebola virus. The purpose of this study was to investigate college students’ knowledge and attitude about Ebola and factors that predict adherence to Ebola education information mediated through PSAs. Methods: A total of 211 copies of structured questionnaire were administered to a multi-stage sample drawn from a medium-sized private university in Nigeria. Results: The majority of the participants responded correctly to the questions related to Ebola virus transmission. Nearly 86% of students agreed that Ebola can be contracted through the body secretions of a sick person, 83% students identified the basic symptoms of Ebola as fatigue and vomiting, while 82% agreed that regular washing of hands and use of hand sanitisers can prevent transmission of Ebola. Knowledge and attitudes emerged as significant predictors of students’ adherence to PSA advice on Ebola disease ( p &lt; .05). Discussion: Misconceptions about the causes and transmission of Ebola abound in spite of the high awareness about the virus, suggesting that the Ebola PSAs may not have succeeded in dispelling some strongly held beliefs about Ebola virus disease. The findings suggest that a considerable percentage of college students no longer follow the advice contained in Ebola-related PSAs. It may be that the declaration that Nigeria is Ebola free by World Health Organization (WHO) has given rise to a lax attitude towards the disease. Conclusion: In spite of their shortcomings, PSAs remains an important vehicle for conveying Ebola prevention education to college students.

"Ebola &amp;Ccedil;a Suffit!" is not enough to Prove Efficacy of an Ebola Vaccine

A recently published Ebola vaccine trial claimed an almost perfect result with no cases of Ebola after the vaccine had time to take effect - a vaccine efficacy of 100%. This article is a detailed review of the information published about the trial and, particularly, this claim. The trial design was sub-optimal because randomization was only partial (and one treatment arm was unrandomized), it was unblinded and did not use a placebo. Less information on the comparison arm that substituted for a placebo was provided, such as adverse events, compared to the active treatment arms. There was little baseline information on the trial participants, which is particularly important to ensure equivalence of the arms of a trial that was not fully randomized. In particular, Ebola tests were not performed at baseline, so the possibility of false positive test results or pre-existing asymptomatic cases exists. Ebola symptoms and adverse reactions following vaccination seen during the trial were very similar, allowing diagnostic bias. The exclusion of Ebola cases among the vaccinated during the 10 days after randomization is an arbitrary decision for an infection with an incubation period of 2 to 21 days and not a substitute for comparing vaccine to placebo. Considering the entire 31-day reporting period, two subgroups of unvaccinated participants had significantly fewer cases of Ebola than the two vaccinated groups. The problems with this trial are so grave that it cannot be taken as even weak evidence that the vaccine trialed is effective at preventing Ebola Virus Disease (EVD).

The impact of active surveillance and health education on an Ebola virus disease cluster - Kono District, Sierra Leone, 2014-2015.

BackgroundDuring December 2014–February 2015, an Ebola outbreak in a village in Kono district, Sierra Leone, began following unsafe funeral practices after the death of a person later confirmed to be infected with Ebola virus. In response, disease surveillance officers and community health workers, in collaboration with local leadership and international partners, conducted 1 day of active surveillance and health education for all households in the village followed by ongoing outreach. This study investigated the impact of these interventions on the outbreak.MethodsFifty confirmed Ebola cases were identified in the village between December 1, 2014 and February 28, 2015. Data from case investigations, treatment facility and laboratory records were analyzed to characterize the outbreak. The reproduction number (R) was estimated by fitting to the observed distribution of secondary cases. The impact of the active surveillance and health education was evaluated by comparing two outcomes before and after the day of the interventions: 1) the number of days from symptom onset to case-patient isolation or death and 2) a reported epidemiologic link to a prior Ebola case.ResultsThe case fatality ratio among the 50 confirmed Ebola cases was 64.0 %. Twenty-three cases occurred among females (46.0 %); the mean age was 39 years (median: 37 years; range: 5 months to 75 years). Forty-three (87.8 %) cases were linked to the index case; 30 (61.2 %) were either at the funeral of Patient 1 or had contact with him while he was ill. R was 0.93 (95 % CI: 0.15–2.3); excluding the funeral, R was 0.29 (95 % CI: 0.11–0.53). The mean number of days in the community after onset of Ebola symptoms decreased from 4.0 days (median: 3 days; 95 % CI: 3.2–4.7) before the interventions to 2.9 days (median: 2 days; 95 % CI: 1.6–4.3) afterward. An epidemiologic link was reported in 47.6 % of case investigations prior to and 100 % after the interventions.ConclusionsInitial case investigation and contact tracing were hindered by delayed reporting and under-reporting of symptomatic individuals from the community. Active surveillance and health education contributed to quicker identification of suspected cases, interrupting further transmission.

Ebola – A Dentist’s Concern?

Ebola virus disease is a rare, deadly disease prevalent in West Africa. The recent outbreak has been the deadliest so far and cases have been reported far and wide also. The Ebola virus is spread through direct contact with blood and body fluids of an infected person, or with contaminated objects. Chief symptoms include fever, severe headache, weakness, muscle pain, diarrhea, vomiting and unexplained hemorrhages. The case-fatality rate of the current outbreak is approximately 71%. Recovery from Ebola depends on the patient’s immune response. No specific vaccination or treatment is available and only symptomatic treatment can be given but a range of blood, immunological and drug therapies are under development. Supportive care-rehydration and treatment of specific symptoms, improves survival. Even though it is highly unlikely that someone with Ebola symptoms will seek dental care, dentists should take a proper medical and travel history and follow standard precautions with effective barrier techniques when giving palliative care for serious oral conditions. Dentists should delay routine dental care wherever possible. It is important to educate and update health care workers including dentists about the various aspects of Ebola and drastic improvements in control measures be done to contain the disease.

Empathy for Pauline Cafferkey.

I feel sorry for Pauline Cafferkey who is under investigation by the NMC for allegedly failing to disclose symptoms of ebola.

Ebola Virus Infection: Overview and Update on Prevention and Treatment.

In 2014 and 2015, the largest Ebola virus disease (EVD) outbreak in history affected large populations across West Africa. The goal of this report is to provide an update on the epidemic and review current progress in the development, evaluation and deployment of prevention and treatment strategies for EVD. Relevant information was identified through a comprehensive literature search using Medline, PubMed and CINAHL Complete and using the search terms Ebola, Ebola virus disease, Ebola hemorrhagic fever, West Africa outbreak, Ebola transmission, Ebola symptoms and signs, Ebola diagnosis, Ebola treatment, vaccines for Ebola and clinical trials on Ebola. Through 22 July 2015, a total of 27,741 EVD cases and 11,284 deaths were reported from all affected countries. Several therapeutic agents and novel vaccines for EVD have been developed and are now undergoing evaluation. Concurrent with active case investigation, contact tracing, surveillance and supportive care to patients and communities, there has been rapid progress in the development of new therapies and vaccines against EVD. Continued focus on strengthening clinical and public health infrastructure will have direct benefits in controlling the spread of EVD and will provide a strong foundation for deployment of new drugs and vaccines to affected countries when they become available. The unprecedented West Africa Ebola outbreak, response measures, and ensuing drug and vaccine development suggest that new tools for Ebola control may be available in the near future.Electronic supplementary materialThe online version of this article (doi:10.1007/s40121-015-0079-5) contains supplementary material, which is available to authorized users.

Fearing or fearsome Ebola communication? Keeping the public in the dark about possible post-21-day symptoms and infectiousness could backfire

US quarantine announcements do not include information that there is a moderate likelihood that Ebola-exposed people might exhibit symptoms, signalling infectiousness, beyond 21 days. As a result it is possible that if and when there is media coverage in the US of a delayed-symptom case, it might create citizen distrust in public health authorities and information and cause citizens to overestimate the risk of Ebola infection. In this article we report a research study which examined whether openness about post-21-day symptoms would attenuate negative reactions. We ran two experiments with online opportunity (Amazon mTurk) samples of Americans in late October-early November 2014, between the two deaths from Ebola in the US. In these experiments we assessed the reactions of respondents who saw quantitative estimates of post-21-day-symptom likelihood (n = 1413), or were informed about post-21-day symptoms with a rationale for the 21-day period after all saw a mock news story about a US case of 30th-day symptoms (n = 425). We found in both experiments that perceived risk increased and trust declined when people learned of post-21-day symptoms, and disbelief increased that 21 days without symptoms means no Ebola infection. In Study 2, informed persons and controls changed perceived risk and trust relative to baseline; test-group participants distrusted local medical personnel less and wanted shorter quarantines compared to controls who did not receive the information. Our findings suggest that informing Americans about the small likelihood of post-21-days Ebola symptoms would not increase perceived risk and distrust, and might diminish negative reactions to the media reporting a case who developed symptoms of Ebola after 21 days. Thus, public health officials wanting appropriate public responses to potential or actual epidemics may benefit from early communication of unpleasant infectious-disease facts before events reveal them, and signal officials’ lack of preparedness for public reactions.

Ebola virus disease.

Ebola is an unfamiliar disease with a high mortality rate. Until recently, it occurred only in rural tropical regions and most health care providers had only read about it in epidemiology classes. With globalization, international travel, and foreign medical missions, it is possible that a patient with Ebola exposure and/or symptoms may present in any emergency department. All health care providers must be familiar with identifying the signs and symptoms of Ebola and capable of initiating an appropriate response. This article presents an overview of Ebola virus disease for health care providers, covering pathophysiology, identification, treatment, and general considerations for hospitals and providers to consider when developing policies and procedures.