TIME Sierra Leone

Sierra Leone Releases Last Known Ebola Patient

Sierra Leone Ebola patient released
Alie Turay—AP Adama Sankoh, 40, center, who contracted Ebola after her son died from the disease late last month stands with health officials the moment after she was discharged from Mateneh Ebola treatment center on the outskirts of Freetown, Sierra Leone on Aug. 24, 2015.

Sierra Leone must go 42 days without another Ebola case in order to be declared free of Ebola virus

(MATENEH, Sierra Leone) — Health authorities in Sierra Leone released the country’s last known Ebola patient from a hospital on Monday, a milestone that allows the nation to begin a 42-day countdown to being declared free of the virus that has killed nearly 4,000 people here.

President Ernest Bai Koroma presented a certificate of discharge to Adama Sankoh, 40, who contracted Ebola after her son died from the disease late last month.

“The Ebola fight is not yet over — go and tell members of your community that,” the president said when presenting the certificate to the woman. “Go back to your community and continue to live life as you used to. ”

Sankoh, whose 23-year-old son contracted Ebola in the capital, Freetown, before traveling to his home village, thanked everyone who provided her care during her illness. She also vowed to be the last person infected in Sierra Leone with the virus.

“Although my child died of Ebola I am very happy that I have survived today,” she said upon leaving the Ebola treatment center in Mateneh village on the outskirts of Makeni, the president’s hometown.

If Sierra Leone is declared free of transmission of the Ebola virus it would leave just one country with the disease — Guinea — after an epidemic that has killed more than 11,200 people since late 2013.

But first Sierra Leone must go 42 days — equal to two incubation periods of 21 days — without another Ebola case in order for the World Health Organization to make such a declaration. It’s a benchmark that Liberia reached in May only to then experience a brief reappearance of cases.

___

Associated Press writer Krista Larson in Dakar, Senegal, contributed to this report.

TIME ebola

Sierra Leone Has First Week of No New Ebola Cases

Sierra Leone - Ebola Checkpoint
Zoom Dosso—AFP/Getty Images Sierra Leonean health officials checking for the ebola virus on passengers transiting at the border crossing with Liberia in Jendema on March 28, 2015 .

An entire village was put under quarantine

Sierra Leone has gone one full week without any new Ebola cases, a first since the start of the outbreak over a year ago.

On Monday, the World Health Organization (WHO) announced that the Ebola response has moved into “phase 3,” which means responders are working to ensure that the last known cases of Ebola in the country have not spread.

The WHO traced the final cases to a man who worked in Freetown, the capital, and then returned to his home village of Massessehbeh in a northern region in the country, called Tonkolili. The man died in a hospital while receiving malaria treatment, and a postmortem test confirmed he had Ebola. Responders put the entire village in quarantine for 21 days, bringing in water and food and providing information and support, while checking everyone daily for signs of Ebola.

Two family members of the man who died got Ebola and were treated. On Aug. 14, nearly 600 people in the village came out of quarantine and there was a celebration, the WHO said. The President of Sierra Leone, Ernest Bai Koroma, cut the quarantine tape.

Since the outbreak started, about 13,470 people in Sierra Leone have been infected with Ebola, and nearly 4,000 have died from the virus. The latest numbers available indicate that among the most affected countries of Sierra Leone, Liberia and Guinea, over 27,920 cases of Ebola have been reported and over 11,280 people have died from the disease since the start of the outbreak.

TIME ebola

Attention, World: The Ebola Fight Isn’t Over

Dr. Joanne Liu MSF
Natacha Buhler—MSF

Doctors Without Borders/Médecins Sans Frontières international president Dr. Joanne Liu reminds the world that the fight against Ebola is not over

The race to contain the largest Ebola epidemic in history has been a marathon, not a sprint. One year ago I arrived in West Africa and found the virus tearing through the region. It was destroying families and ripping apart the very fabric of society, while national authorities and a handful of aid organisations desperately struggled against this unrelenting, invisible foe.

Returning to Liberia, Guinea and Sierra Leone three months later, hundreds of people were still falling sick each week. It was impossible to identify how they had become infected, or to work out who they had been in contact with and might themselves have infected. But international support had finally begun rolling in, whilst preparations for starting clinical trials of experimental treatments and vaccines were underway.

Last week I returned to the region, and am relieved to see just how far we have come. Although we still have some way to go, today we collectively have the means to bring the epidemic to an end.

For months there have been 20-30 new cases of Ebola each week. Last week there were just three. New chains of infection are now more quickly and efficiently investigated and we can track the virus’ spread in communities. The national authorities are demonstrating strong leadership and maintaining the momentum to end the outbreak.

Although we all crave a sign that the end is in sight, the only reliable forecast in this epidemic has been its unpredictability. It has waxed and it has waned; often, just as it seems to have been extinguished in an area, one missed sick person or one unsafe burial has caused it to flare up again.

But in the most encouraging signal so far, the interim results of an Ebola vaccine trial in Guinea were published ten days ago– and were very promising. While the VSV vaccine alone will not bring the outbreak to an end, we hope it will be an additional tool to help finally stop the virus in its tracks.

Although we feel more hopeful than ever before, we are scared to let down our guard for even an instant. The goal is to get to zero patients for 42 days – twice the incubation period of the virus – after which a country or region can be declared Ebola-free.

To cross that finish line, perseverance – if not sheer stubbornness – is needed, continuing to thoroughly trace every person in contact with an Ebola patient, to identify and respond to new cases early, and to make sure that burials are carried out safely.

The ultimate key to success lies in gaining the trust and confidence of local people. Our health promotion team in Forécariah, Guinea, told me how, since Ebola flared up again this summer, they go from house to house every day to explain to each family how the virus is transmitted, what the symptoms are, what to do if someone falls sick and how to care for them safely.

The stories they hear from some villagers may sound surprising this far into the epidemic: scepticism that Ebola is real, rumours that the disease is spread by foreigners in spacesuits, or that it can be cured with traditional medicine. But taking the time to listen and respond on a personal level has been proven to work.

The truth is that the impact of Ebola will be far more long-lasting than we could have imagined. The health systems of Guinea, Liberia and Sierra Leone, already weak before the outbreak, lie in tatters. Hundreds of health workers are tragically dead. Meanwhile Ebola survivors need our continued support. Beating the virus has turned out to be their first hurdle, followed by medical complications we don’t yet fully understand, all while coping with stigma from their communities.

Four out of ten people in Sierra Leone know someone who has died, been quarantined or survived the virus. These nations are grieving, yet continue to show tremendous courage and determination.

Ebola may have faded from the headlines, but it hasn’t gone away. We don’t know how far away the finish line is, but we do know that to reach it, everyone involved in the response – both national and international – needs to channel all their energies into keeping up the momentum. And by accelerating use of the new vaccine in the affected countries, we can help break chains of transmission and protect frontline workers.

Our teams were there at the beginning. And like long-distance runners, we will stay to the end.

Dr. Joanne Liu, international president of Médecins Sans Frontières/Doctors Without Borders (MSF)

TIME ebola

Experimental Ebola Vaccine Could Stop Virus in West Africa

It has been called "a game-changer"

LONDON (AP) — An experimental Ebola vaccine tested on thousands of people in Guinea seems to work and might help shut down the waning epidemic in West Africa, according to interim results from a study published Friday.

There is currently no licensed treatment or vaccine for Ebola, which has so far killed more than 11,000 people in West Africa since the world’s biggest outbreak began in the forest region of Guinea last year. Cases have dropped dramatically in recent months in the other two hard-hit countries, Sierra Leone and Liberia.

“If proven effective, this is going to be a game-changer,” said Dr. Margaret Chan, Director-General of the World Health Organization, which sponsored the study. “It will change the management of the current outbreak and future outbreaks.”

Scientists have struggled for years to develop Ebola treatments and vaccines but have faced numerous hurdles, including the sporadic nature of outbreaks and funding shortages. Many past attempts have failed, including a recently abandoned drug being tested in West Africa by Tekmira Pharmaceuticals.

For the study, researchers gave one dose of the new vaccine to more than 4,000 health care workers and other people within 10 days of their close contact with a sick Ebola patient. Another group of 3,500 people got the shot more than 10 days after their exposure to the infectious virus. In the group that received the vaccine immediately, there were no Ebola cases versus 16 cases in people who got delayed vaccination.

The vaccine, developed by the Canadian government, has since been licensed to Merck & Co. but has not yet been approved by regulators. The study results were published online Friday in the journal Lancet.

At the moment, officials think the vaccine would only be used once an outbreak starts, to protect those at high-risk; there are no plans to introduce mass vaccination campaigns like those for measles or polio or to create huge stockpiles of the shots.

Merck, based in Kenilworth, New Jersey, noted its vaccine is in what is normally the final round of human testing in Sierra Leone, and in mid-stage testing in Liberia.

Merck will manufacture the vaccine if it’s approved for use outside patient studies. In late-morning trading in the U.S., Merck shares were up 62 cents, or 1.1 percent, at $59.13.

Last December, Gavi, the vaccine alliance, said it would spend up to $300 million buying approved Ebola vaccines. The private-public partnership, which often buys immunizations for poor countries, said Friday that it “stands ready to support the implementation of a WHO-recommended Ebola vaccine.”

An expert group monitoring the study’s data and safety recommended the trial be stopped on July 26 so that everyone exposed to Ebola in Guinea could be immunized.

The vaccine uses an Ebola protein to prompt the body’s immune system to attack the virus.

“It looks to be about as safe as a flu vaccine,” said Ben Neuman, a virologist at the University of Reading who was not part of the trial. Researchers are still assessing possible side effects; the most serious seemed to be fever and the stress experienced by patients who believe such symptoms were due to Ebola.

“This (vaccine) could be the key that we’ve been missing to end the outbreak,” Neuman said. “I don’t see any reason on humanitarian grounds why it should not be used immediately.” He said further tests would be necessary to see if the vaccine might also protect pregnant women, children and adolescents; those trials are already under way. It’s also uncertain how long protection might last.

WHO vaccines expert Marie-Paule Kieny said having an effective vaccine might avert future disasters but added it would still take months to get the shot approved by regulators.

“Using a tool like this vaccine, we would be able to stop the epidemic from going really wild and spreading further,” she told reporters, noting that stamping out future outbreaks still depends on early detection. WHO first identified Ebola in Guinea last March but did not declare the epidemic to be a global emergency until August, when the virus had killed nearly 1,000 people.

Other Ebola vaccines are being studied elsewhere but the declining caseload is complicating efforts to finish the trials.

___

AP Business Writer Linda A. Johnson in Trenton, N.J., contributed to this report.

TIME Infectious Disease

‘We Are Not Prepared For Another Epidemic’: World Bank Survey

LIBERIA-HEATH-EBOLA
Getty Images A woman, suspected of carrying ebola, looks on while under quarantine in the red zone of the Elwa clinic, an ebola treatment center in Monrovia on July 20, 2015. AFP PHOTO / ZOOM DOSSO (Photo credit should read ZOOM DOSSO/AFP/Getty Images)

A new World Bank poll reveals many countries are fearful of epidemics like Ebola and do not think the world is prepared to handle them

Correction appended, July 23

Many people living in developed countries do not think the world is prepared to appropriately respond to another infectious disease epidemic like the ongoing Ebola outbreak, a new World Bank survey shows.

The new data comes from a World Bank Foundation survey released Thursday morning. Researchers polled 4,000 people in the general public living in the regions as well as what the organization classified as opinion elites (defined as people with a university diploma who closely follow global news) and discovered that people around the world are highly concerned about global disease outbreaks, are not convinced the global community is well equipped to handle such outbreaks, and are in support of more funding for protections.

When asked to rank which global issues are most concerning, the people polled collectively ranked global health and epidemics third, after climate change and terrorism. Concern over epidemics was higher than that for global poverty and human rights abuses. When asked specifically about which global health problems concerned people most, global infectious diseases beat out other issues including HIV/AIDS, obesity and hunger.

Not only is concern over epidemics high, but twice as many people think there will be another epidemic like Ebola than people who do not. In addition, a high proportion of the people surveyed expect there could be an epidemic in their own country. That’s especially interesting, the researchers pointed out in a press conference, given that most of the countries had very few people with Ebola if any at all.

People living in the United States, France and the United Kingdom were especially unconvinced that the world is prepared to handle another outbreak. The Ebola outbreak has infected over 27,700 people and killed over 11,260. It’s been widely acknowledged that the world did not react fast enough, and a recent report cited major cultural problems at the World Health Organization (WHO) that interfered with the agency’s leadership during the outbreak and contributed to its failures to adequately respond.

The poll highlights the fact that members of the general public recognize the risk epidemics pose and support investment to prevent them. Nearly 60% of those surveyed said they support funding and policy changes in developing countries that will help protect their own country from risk, and about 70% say strengthening the health systems in developing countries will save money.

Pledges from countries to aid in the Ebola outbreak as well as vows from global agencies to reform their processes to better respond in the future have been made throughout the last year. Whether these translate to real changes and increased capacities to prevent and respond to the next outbreak remains to be seen, but it’s clear from the new poll that it’s what the people want.

Correction: The original version of this story misstated group that conducted the poll. It’s the World Bank Group.

TIME ebola

Ebola Doctor Recounts His Battle with the Virus in New Book

WaterBrook Press

Dr. Kent Brantly and his wife Amber detail the physician's work on Ebola—and his survival of it

A year after Dr. Kent Brantly captivated the world as the first American with Ebola to be treated in the United States, the medical missionary and his wife Amber have penned a new book, Called for Life: How Loving Our Neighbor Led Us Into the Heart of the Ebola Epidemic, which chronicles their experiences as two medical missionaries unexpectedly propelled into a devastating outbreak.

Among the most captivating—and disturbing sections—are the Brantlys’ retelling of when Ebola first crept into West Africa, and Kent’s detailed description of what it felt like when the virus invaded his body. “I also developed a petechial rash: small red spots from my chest out to my arms,” Kent writes, clinically describing the progression of symptoms. “Their appearance meant blood vessels had broken in those areas. Over the next couple of days, the rash would progress until the spots coalesced into generalized, large red erythematous rash from head to toe.”

Though the year of Ebola epidemic news coverage has increased public understanding of the virus, Kent’s narrative reiterates how devastating and serious an Ebola diagnosis was, and still remains. He vividly describes moments of panic when during which he wrapped himself around the ankles of victims’ family member, begging them not to take the contagious bodies of their loved ones home.

While the Brantly family—among a handful of other patients—put a face to the outbreak, the couple dedicate a large portion of the book to describe Ebola’s unseen victims. There was Harris the plumber, who tried to help a woman get her Ebola-infected husband to a hospital, only to catch and die from the disease himself. There was Lusu, a mother who watched both her daughters die before she succumbed herself. The Brantlys also recount some of the factors that contributed to the epidemic’s spread, like the dearth of latex gloves in hospitals. Despite the fact that Liberia is one of the largest producers of raw latex, most of it is exported.

The Brantlys’ story is also emotional, tacking between Kent and Amber’s recollections of the same events: Kent, in Liberia, unsure he can breathe much longer, while a heartbroken Amber prays in the United States that her husband makes it through the night. Those who followed the Brantly family’s story in real-time will remember how often Kent thanked God for his life during his discharge press conference from Emory University Hospital. The book is written in a similar vein, with plenty of references to Bible versus and prayer. Brantly addresses potential critics head-on, writing that he’s never used his medical position to evangelize, and he explains his own occasional struggles to reconcile God with science:

“I know that some consider it controversial for me to claim that God saved my life when I had received an experimental drug and some of the greatest medical care available in the world. I can see how these two realities appear to contradict each other. I also feel the dissonance with claiming God saved my life while thousands of others died. These issues are not clear-cut for me. I wrestle with these tensions… Some may call it a grand coincidence, and I couldn’t argue against them. But when I see the unlikely and highly improbable events that occurred—not only during my illness, but also for decades preceding the Ebola epidemic in West Africa—I see the hand of God at work, and I give him the credit.”

The Brantly family recently returned to Liberia to visit the country they previously called home. In May Liberia was declared Ebola-free, but by July 1 officials announced the country has new cases of the disease. So far, Ebola has infected over 27,690 people in Liberia, Sierra Leone, and Guinea, killing over 11,260.

TIME Innovation

How Student Loans Make College More Expensive

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

These are today's best ideas

1. Cheap student loans are helping colleges boost tuition costs. Find out how.

By Bob Sullivan in Money

2. Americans are living longer. That’s not a good thing.

By Michael Grunwald in Politico

3. Subject to whim and shrouded in mystery, America’s prison parole system must be reformed.

By Beth Schwartzapfel in the Marshall Project

4. This needle-free Ebola vaccine could change everything.

By Anna Almendrala in the Huffington Post

5. Food powder from expired produce could feed the world’s hungry.

By Kathleen Wong in Mashable

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME ebola

Ebola Kills Woman in Liberia

The country had been disease-free for nearly two months

A Liberian woman has died from Ebola, igniting fears of a comeback of the virus that ravaged the region from December 2013 through early this year.

The newest cases are centered around Montserrado County, home to the country’s capital Monrovia, and neighboring Margibi County, where the disease was first reported to have emerged last month, according to Reuters. There have now been six confirmed cases of the virus in the area.

The woman died only a few hours after being admitted to the hospital.

Liberia had been celebrating nearly two months of being Ebola-free prior to the latest reemergence of the virus. Health experts believe the virus was dormant during that time, but could have been transmitted sexually by an Ebola survivor.

The first death of the most recent outbreak occurred earlier in July when a teenage boy died from the virus.

TIME global health

Here’s How Much More Money Is Needed to Improve Global Health

Outbreaks like Ebola highlight the gaps in the way money is raised and used for protecting people’s health, a new study finds

In a report published in the journal Lancet, researchers point out large gaps in the money raised and dispatched for public health purposes and the medical needs of countries, particularly in the developing world, to keep their populations healthy.

Despite recurrent outbreaks of pandemic infections such as SARS and, most recently, Ebola, donors have committed less than a third of the estimated $3.4 billion that is needed to maintain a strong pandemic preparedness system, according to the World Bank. Overall, donor countries have spent only half of the $6 billion that the World Health Organization says is needed to maintain global public health.

What’s lacking, the study authors say, is a more focused system for investing in global health that emphasizes programs designed to achieve certain public health functions, such as vaccinating a particular population or corralling antibiotic resistance or the spread of multi-drug resistant tuberculosis. It’s an approach championed by philanthropic organizations such as the Bill & Melinda Gates Foundation, the organization that funded the study. Part of the funding conditions of its programs include specifying outcomes and a timeframe for achieving them.

“For example, countries like China and India would substantially benefit from market shaping to lower drug prices and increased international efforts to control multi-drug resistant tuberculosis,” Dr. Marco Schaferhoff, association director of SEEK Development in Germany and one of the co-authors of the report, said in a statement. “At the same time…donor countries should also ensure that vulnerable and marginalized populations in middle-income countries, such as ethnic minorities who suffer discrimination, refugees, and people who inject drugs, receive sufficient support.”

TIME ebola

What It’s Like To Fight Ebola When the World Stops Listening

My first deployment into the Ebola outbreak was in September, when I was sent to Liberia. After three months there I was eventually stationed in Guinea, another Ebola-affected region where I am currently serving as an emergency response coordinator.

Over the last year, the Ebola outbreak has infected more than 27,500 people in Liberia, Guinea and Sierra Leone and killed more than 11,200 of those people. It’s still ongoing. When I first joined the response, the situation was very serious. Cases were increasing exponentially, and Médecins Sans Frontières/Doctors Without Borders (MSF) was putting out calls for help and for more actors to get involved. The calls were largely ignored and unfulfilled until later.

Today in Guinea there are many people and organizations involved, but there is virtually no external interest. Despite the fact that we are still seeing cases of Ebola every week—something that would have been considered a disaster just two years ago—the outbreak has stopped dominating the public conversation and news cycle.

Have we noticed the world has stopped paying attention? Yes, we have. Are we surprised by it? No, we’re not. It’s the news cycle, and we know that. Many of my colleagues have a healthy dose of cynicism that goes along with idealism. We wouldn’t pursue this job if we didn’t, because you don’t last long if you let yourself be disappointed. People lose interest. It happened with Haiti, it happened with Nepal, it happens every single time. In some ways, it reinforces our conviction that this is the right place for us to be.

We still have about twelve to eighteen cases of Ebola per week in Guinea, and a third of the cases we saw last week were not on a contact list—meaning they were surprises. When there are unexpected cases, it’s dreadful from a public health point of view. The current situation is better than it has been, but it’s not as good as it should be. In an absolutely perfect and best-case scenario, we could see an end for Ebola in Guinea by October. But that’s an optimistic estimate.

We are aware everyone is tired. The national authorities are tired— they have been working on this non-stop and they just want the outbreak to end. The people of Guinea are tired of the uncertainty and fear. This is an observant Muslim country, and people are very affected by the fact that they can’t go on pilgrimage to Mecca until the epidemic is over. The public is tired of hearing about Ebola. MSF has been working on this for more than a year. We are tired.

But the outbreak is not over yet. And while the lack of attention is normal, it’s not very helpful. The problems that contributed to the scale of this outbreak still exist in many places. People need to realize that the World Health Organization (WHO) is only as good as its member states. If people want to help, they should insist that their country respects its commitments to donations and spending. They should realize that these problems do not exist in isolation and that to some extent they affect everybody.

We understand that people cannot believe that the Ebola outbreak is not over. Neither can we. But we can’t stop paying attention.

Anna Halford is the Ebola Emergency Coordinator in Guinea for Médecins Sans Frontières/Doctors Without Borders (MSF).

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