TIME ebola

WHO Chief Unveils Reforms After Ebola Response Criticized

WHO Director-General Margaret Chan addresses the media during a special meeting on Ebola at the WHO headquarters in Geneva
World Health Organization (WHO) Director-General Margaret Chan addresses the media during a special meeting on Ebola at the WHO headquarters in Geneva on Jan. 25, 2015. Pierre Albouy—Reuters

"The Ebola outbreak revealed some inadequacies and shortcomings"

The head of the UN’s global health agency has laid out a set of reforms to better and more quickly fight disease outbreaks, in a frank acknowledgement that the organization struggled to confront the scale of the 2014 Ebola outbreak that killed more than 8,600 people.

“This was West Africa’s first experience with the virus, and it delivered some horrific shocks and surprises,” said World Health Organization (WHO) director General Margaret Chan in a speech on Sunday. “The world, including WHO, was too slow to see what was unfolding before us.”

The needed changes, she said, include country-specific emergency workforces trained with “military precision”; a strengthened team of epidemiologists for detecting disease and a network of other providers to allow responders to reach “surge capacity.”

“The Ebola outbreak revealed some inadequacies and shortcomings in this organization’s administrative, managerial, and technical infrastructures,” she said, calling for a “dedicated contingency fund to support rapid responses to outbreaks and emergencies.”

The remarks came as the WHO’s executive board prepared to meet in Geneva to discuss reform proposals that many in the international community consider to be overdue. The response to Ebola by the UN’s health agency was seen by many as slow and ineffectual.

Indeed, Sunday’s speech did not mark the first time Chan acknowledged her organization’s shortcomings. In October, she told TIME that “the scale of the response did not match the scale of the outbreak.”

TIME ebola

Mali Is Now Ebola-Free

Mali Ebola Spared No More
A health worker sprays disinfectants near a mosque, after the body of a man suspected of dying from the Ebola virus was washed inside before being buried in Bamako, Mali Baba Ahmed—AP

The country has gone 42 days without reporting a new case

Mali is officially Ebola-free after going 42 days without reporting a new case, according to the World Health Organization.

The country’s Health Minister Ousmane Kone made an announcement during a national broadcast on Sunday night.

During his speech, Kone heaped praise on the country’s health workers and Malian authorities for “weeks of intense work” that led to the result, according to Agence France-Presse.

Mali recorded its first Ebola case in October after a 2-year-old contracted the deadly virus. Following the incident, the country launched a massive eradication campaign.

In total, the disease only infected eight people in the country, but six of them were killed by it, according to statistics compiled by the WHO.

More than 8,400 people have succumbed to the deadly virus in West Africa.

TIME ebola

FDA Approves Roche’s Ebola Test

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Getty Images

A fast-acting Ebola test gets a green light for emergency use

The U.S. Food and Drug Administration (FDA) has approved pharmaceutical company Roche’s fast-acting Ebola test for emergency use.

It can take almost a full day to get results from Ebola tests on the market, but Roche’s new LightMix Ebola Zaire rRT-PCR Test provides results in just over three hours. Reuters reports that the test had been used temporarily by some labs in the U.S. and other countries to identify the strain of Ebola spreading in West Africa. The test is still not approved for general use.

Early diagnosis can lead to faster response and treatment. So far, 7,693 people have died of Ebola in West Africa and 19,695 have contracted the disease. The test is used on patients who begin to exhibit symptoms of the disease.

[Reuters]

TIME ebola

Expert: Ebola Outbreak Will Probably Last All of Next Year

Professor Peter Piot still says he is encouraged by the progress made in Sierra Leone, where he believes the epidemic will soon peak Baz Ratner—Reuters

Professor Peter Piot still says he is encouraged by the progress made in Sierra Leone

Correction appended: Dec. 24, 2014, 7:00 a.m. E.T.

The Ebola epidemic in West Africa is likely to continue through 2015, says Professor Peter Piot, director of the London School of Hygiene and Tropical Medicine.

“We need to be ready for a long effort, a sustained effort [for] probably the rest of 2015,” he told the BBC after returning from Sierra Leone.

Piot, who was one of the scientists who discovered Ebola in 1976, said he was impressed by the progress he had seen in the country, where mortality rates have fallen to as low as one in three.

“You don’t see any longer the scenes where people are dying in the streets,” he said.

But although the outbreak has peaked in Liberia and probably will do so in Sierra Leone too in the coming few weeks, the epidemic could have a “very long tail and a bumpy tail.”

“The Ebola epidemic is still very much there,” he said. “People are still dying, new cases are being detected.”

[BBC]

The previous version of this article identified Peter Piot as the director of the World Health Organization. He is the director of the London School of Hygiene and Tropical Medicine.

TIME ebola

There Are 53 Drugs That Could Treat Ebola

University of Utah Researchers Work Toward Cure For Ebola Strains
A container holds a Peptide that contains a potential new drug candidates for testing against a part of Ebola that is vulnerable to drugs, at the University of Utah on Oct. 14, 2014 in Salt Lake City. George Frey—Getty Images

New research raises prospect of treatments to be found in already available drugs

Scientists have identified 53 existing drugs that could be effective in fighting Ebola, according to newly published research.

There is currently no vaccine or drug available to treat the disease, which is one of the primary reasons the virus has been able to infect 18,603 people so far, and kill 6,915. A vaccine is undergoing clinical trials in humans, but a drug to treat people who already have the disease is critically needed. The experimental drug ZMapp has been used on a handful of Ebola patients, but resources of it are exhausted and it has not undergone adequate testing.

Running against the clock, some groups of scientists have decided that one of the most efficient ways to go about tackling the task of developing and distributing an Ebola drug is by screening drug compounds already available to see if any of those compounds could be used to create an effective drug.

MORE: Scientists Explore 10,000 Compounds for an Ebola Drug

In a new study published in the Nature Press journal Emerging Microbes and Infections, researchers at the Icahn School of Medicine at Mount Sinai and the National Institutes of Health (NIH) said they’ve identified 53 promising drug compounds. The team used high speed technology to scan through a library of 2,816 U.S. Food and Drug Administration-approved compounds already used for other ailments. Their method, which uses a virus-like particle that contained Ebola proteins, was calibrated to identify drugs that could prevent Ebola from infecting human cells by 50%.

Among these 53 promising compounds are ones used in cancer drugs, antihistamines, antibiotics, and antidepressants.

The compounds will be tested in animals to see what effects they have on Ebola, as well as their side effects. If a drug is proven both safe and effective, the government may use it in Ebola zones.

As TIME reported in October, scientists at Emory University Hospital are taking a similar approach to their library of 10,000 drug compounds. They think it’s possible Ebola could be treated similarly to the the treatments they’ve developed for viruses like HIV and Hepatitis C.

TIME ebola

U.N.: Ebola Outbreak Will Take Several More Months to Contain

Liberia Ebola Missed Goals
Health workers wearing Ebola protective gear spray the shrouded body of a suspected Ebola victim with disinfectant at an Ebola treatment center at Tubmanburg, on the outskirts of Monrovia, Liberia, on Nov. 28, 2014 Abbas Dulleh—AP

The U.N. goal of containing 100% of Ebola cases by Jan. 1 will not be met

The U.N.’s special envoy on Ebola said Thursday that it would be several months before the outbreak in West Africa is under control.

Dr. David Nabarro said international governments as well as local communities had taken a “massive shift” in responding to the crisis over the past four month, the Associated Press reports.

However, he noted that more needed to be done to contain the spread of the disease in western Sierra Leone and northern Mali.

“It’s going to take, I’m afraid, several more months before we can truly declare that the outbreak is coming under control,” Nabarro said.

The World Health Organization aimed to have 100% of cases isolated by Jan. 1, but acknowledges that previous targets have not been met.

[AP]

TIME ebola

How Effective Is Screening for Ebola at Airports?

New York's JFK Airport Begins Screening Passengers For Ebola Virus
A plane arrives at New York's John F. Kennedy Airport (JFK) airport on October 11, 2014 in New York City. Spencer Platt—Getty Images

Since August, 80,000 passengers have been screened for Ebola at various airports around the world. Here’s what health officials found

As the Ebola outbreak in West Africa escalated over the summer, the World Health Organization recommended airport screening as a way to contain spread of the disease. WHO advised that all people leaving the most severely affected countries—Guinea, Liberia and Sierra Leone—should have their temperatures taken and be asked about any Ebola-related symptoms they might have, including fever, headaches, vomiting and diarrhea.

Since the program began in August, more than 80,000 passengers have been screened as they left these countries, 12,000 of them headed for the U.S. Do the screenings work? In a report published in the MMWR, officials at the U.S. Centers for Disease Control reveal the latest information from the program.

Anyone with a fever or other symptoms—or who reported having a high risk of being exposed to Ebola, such as having contact with Ebola patients—was not allowed to fly. According to the CDC report, none of those who were denied boarding were diagnosed with Ebola. But two patients without symptoms when they left West Africa, Thomas Eric Duncan and Dr. Craig Spencer, eventually developed Ebola after arriving in the U.S.

The MMWR report also details the U.S.’s more stringent airport entry screening for all passengers arriving from the three affected countries. Beginning Oct. 11, all passengers coming to the U.S. from these countries were required to fly into one of five airports: John F. Kennedy International Airport in New York, Newark Liberty International Airport in New Jersey, Washington-Dulles International Airport, Chicago O’Hare International Airport or Hartsfield-Jackson Atlanta International Airport. They are also required to take their temperatures for 21 days, the incubation period for the Ebola virus, and report them to local health officials. The designated airports are equipped with trained public health personnel who meet passengers and provide them with a kit to help them record their temperatures, as well as educate them about who to call if they develop symptoms.

From Oct. 11 to Nov. 10, 1, 993 passengers were screened this way, and 4.3% were referred to the CDC for additional evaluation. Seven people had symptoms and were referred to proper medical personnel, but none developed Ebola. “Using these processes to educate each traveler and then link the traveler to public health authorities for the duration of the incubation period is of critical importance to facilitate rapid detection of illness and implementation of appropriate public health control measures,” the authors write.

But the most effective way to prevent the epidemic from spreading is to control it at its source. In a separate MMWR report, researchers at the CDC say that their first assessment of Ebola infection and control in Sierra Leone reveals many gaps. In a review of six of the 14 districts in Sierra Leone that are affected by Ebola, the CDC Ebola Response Team found that none had a dedicated infection control supervisor to oversee training and implementation of infection control procedures, such as wearing protective equipment and isolating patients. There were also no national, district or facility standards for infection control, and screening of patients for Ebola was inadequate. All districts also lacked sufficient personal protective equipment, the gear that is critical for protecting health care workers treating Ebola patients, and many did not have running water, enough chlorine bleach to sanitize contaminated objects, or incinerators for burning disposable medical waste.

“An increasingly coordinated and comprehensive [infection and prevention control] program with district and health facility level support is urgently needed to prevent Ebola in districts where the prevalence is low and to strengthen the existing…response in areas with high prevalence of Ebola,” the CDC officials write.

TIME ebola

Sierra Leone Has Overtaken Liberia in Ebola

A burial team extracts the body of Isatu Sesay, 16, an Ebola victim, from her home in Kissi Town, Sierra Leone.
A burial team extracts the body of Isatu Sesay, 16, an Ebola victim, from her home in Kissi Town, Sierra Leone, Nov. 22, 2014. Daniel Berehulak—The New York Times/Redux

It now has more cases than anywhere in the world

Sierra Leone has the highest number of Ebola cases of any country, according to the most recent World Health Organization statistics.

Sierra Leone has seen 7,780 cases of Ebola, more than the 7,719 cases in Liberia, WHO figures published on Monday show. Some 17,800 people have fallen ill with virus in those two countries and in Guinea, 6,187 of whom have died.

In the WHO’s latest situation report, published last week, the group said its goal of safely burying 70 % of Ebola victims and isolating 70 % of Ebola patients had been met in “most districts” of the three hardest-hit West African countries. The WHO cited Liberia as a bright point in the global effort to contain the disease, reporting that case incidence was “stable or declining” in the struggling nation, where 3,177 people have died from the disease.

Yet the WHO said that transmission of the virus was still “intense” in Sierra Leone, which at the beginning of the month reported more than 500 new cases over a period of just days.

TIME ebola

The First Attempt to Digitize Ebola Health Records

Ebola treatment in West Africa is going digital

Keeping detailed patient records during the Ebola outbreak can be a nightmare.

Currently, health care workers use very basic methods, ranging from scanning files to writing on white boards to calling results across rooms to simple memorization. But the International Rescue Committee (IRC), a crisis organization, is about to change that by bringing in electronic health records to its new Ebola treatment unit opening the week of Dec. 15 in Monrovia, Liberia.

“There’s a rule in medicine that if it’s not written down, you didn’t do it,” says Dr. Wilson Wang, a senior clinical advisor for IRC’s Ebola response. Wang says the new electronic health record system can be used for health care accountability and to record decisions made, as well as those decisions’ outcome. IRC’s new system can be accessed via waterproof Sony tablets that can be brought into high-risk zones. The devices will still destroyed when the unit is no longer needed, but the actual data will not be lost. The system was developed by IRC’s own technology team with the help of health software company Vecna.

Some of the patient data will be handed over to the Liberian Ministry of Health to aid in contact tracing, but IRC says other data that doesn’t identify patients will be shared publicly in some capacity. That data could consist of what specific Ebola treatments are being provided, how many patients are seen in the unit, what percentage of patients test positive or negative for the virus, how many people survived, and among those who didn’t, where did they go? In the future, this may aid in other outbreaks, and help scientists and researchers understand what went right and wrong in the current outbreak.

“We want to share [the system],” says Wang. “We plan to essentially give it away, but we want to demonstrate that it works.”

It will also enable physician support. Currently, doctors treating Ebola rely on their own experiences and what’s reported to be successful in the past to determine how to treat a person, but Wang says there’s not a single place doctors can go to get the most up to date data on what’s working in the current outbreak. The new system could make it easier for doctors to get directions on how much medication they should provide, for instance, or what to do when someone has a seizure. “When providers are under stress, and even when they’re not, they make mistakes. They’re human,” says Wang. It’s his hope that this technology could help doctors avoid some of those mistakes by giving them a resource to turn to.

IRC has been in West Africa for over two decades often helping hospitals with infrastructure. When the current outbreak is contained, IRC says it plans to find a way to use the system to help rebuild the currently devastated health system in Liberia—even if it’s just to aid in administrative tasks. “Hospitals need a system to manage this type of data and place orders [for resources and drugs],” says Wang. “[Right now] it’s sort of like coming up with a grocery list for a party when you don’t know what people are going to eat.”

In the meantime, IRC plans to roll out the system in its own unit in mid-December, and plans to continue to refine the platform as they go.

“We think this has the potential to really change not only how quality and safety is addressed in an Ebola situation, but it can also be adapted to any health care situation,” says Wang.

TIME ebola

Obama Renews Calls for a $6 Billion Ebola Fund

U.S. President Obama talks about Ebola at the National Institutes of Health in Bethesda
U.S. President Barack Obama talks about Ebola during his visit to the National Institutes of Health in Bethesda, Maryland on December 2, 2014. Larry Downing — Reuters

He wants Congress to approve the aid package before the holiday recess

U.S. President Barack Obama renewed calls Tuesday for Congress to approve more than $6 billion in emergency funding to help tackle the Ebola outbreak in West Africa.

The President issued the fresh plea during a visit to the U.S. National Institutes of Health in Maryland, where he praised researchers and scientists working on an experimental Ebola vaccine that has shown promising results during initial rounds of testing.

“If we want other countries to keep stepping up, we will have to continue to lead the way,” said Obama. “And that’s why I’m calling on Congress to approve our emergency funding request to fight this disease before they leave for the holidays.”

The President’s appeal comes as Doctors Without Borders sharply criticized the international community’s slow, uneven response to the Ebola outbreak.

Globally over 17,000 people have contracted the highly contagious virus, which has resulted in the deaths of more than 6,000.

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