Ebola vaccine, projections, quarantines, impact — a year after a public health emergency was recognized, we’re reading about results

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NewWWRThis week sees the end of a year since the World Health Organization Emergency Committee on the 2014 Ebola outbreak in west Africa met for the first time, and declared the epidemic to be a “public health emergency of international concern.” As of that week last August, the spread of the largest ever recorded outbreak of the virus had been reported for more than eight months, had moved to the capital cities of three resource-poor and fragile countries, had also landed in Lagos, Nigeria  — Africa’s most populous city — the month before, had been confirmed to have killed 932 people, and had sickened in excess of a thousand more.

We’re reading about some of the responses that followed the WHO’s recognition of the crisis, and the difference some have made.

Vaccine candidate shows 100 percent efficacy – By the end of the month that WHO recognized the Ebola crisis as an emergency, lagging efforts to find a vaccine offering protection against the virus had been reinvigorated. An article in The Lancet, summarized here, reports the result of an interim analysis of vaccine trial in Guinea among 7,651 contacts, or contacts of contacts of Ebola-infected people between April 1 and July 20 this year. Allowing for incubation, researchers looked at outcomes from 10 days on after a vaccine candidate was administered immediately to more than half of the contacts, and delayed three weeks for the others. None of those who received the candidate immediately became sick with Ebola in that time, while 16 of those whose vaccination was delayed did, which adds up to 100 percent efficacy, and evidence that the vaccination could work on a larger scale researchers said. The trial, called “Ebola ça suffit,” (for Ebola, that is enough) is continuing, as are other studies to find vaccines for the virus.

CDC’s overblown estimate of Ebola outbreak . . . – If the world continued to neglect the Ebola outbreak as it had until August, a math-based projection put together last August and released by the U.S. Centers for Disease Control and Prevention a month later said, it could see more than a million cases of the disease by the start of 2015. National, international and public health leaders and agencies had recognized and launched more appropriate responses by then, so those numbers, though widely reported at the time, were not to be. Instead, the agency’s other prediction, which was that cases would drop as steeply as they had risen in the face of a strong response, was realized. This Associated Press story about Marvin Meltzer, the man who did the math, notes that an overestimate of the numbers of unreported cases helped swell the dire projection. But it also notes that the big number got attention than a more current and conservative estimate would have, and certainly more than the reports describing deaths and suffering had.

Quarantines, caution, and realities – As healthy volunteers who had cared for Ebola patients in west Africa returned to Charlotte, North Carolina last August, public health officials, knowing little about the course of the disease or its transmission decided to order them quarantined. This article tells how one of them, a physician who continues to work in Liberia, objected, calling the move both unnecessary and unjust. The article notes that a federal review has now backed that physician on that first quarantine and ones that followed in other cities.

WHO Ebola Situation Report – This World Health Organization report from the last week of July tells of the lowest confirmed total of Ebola cases in more than a year — four in Guinea, three in Sierra Leone, and once again, none in Liberia, where of six cases confirmed since the end of June two patients have died and the others have been discharged from treatment. One of the current seven patients, in the two countries that have yet to see a lasting decline, however, is a health worker in Guinea, where health workers have continued to be infected in five of the last six weeks. More than 2000 contacts were being monitored at the time this report was released.

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