Ebola: UN emergency response mission winds down as WHO announces possible ‘game changer’ vaccine

UN News Centre: Having achieved its “core objective” of scaling up global action to tackle the Ebola outbreak in West Africa, the United Nations Mission for Ebola Emergency Response will officially wind down today, transferring its role to the World Health Organization (WHO), which just announced that an experimental vaccine being tested in Guinea appears to be highly effective and could be a “game changer.”

In WHO’s announcement and in results it published today in the medical journal, The Lancet, the UN health agency said the results from an interim analysis of trials in Guinea show that the VSV-EBOV vaccine is highly effective against Ebola, which has killed more than 11,000 people in Liberia, Sierra Leone, as well as Guinea, in an epidemic that has proved devastating for the region.

The agency said that while the vaccine up to now shows 100 per cent efficacy in individuals, “more conclusive evidence is needed on its capacity to protect populations.”

The Guinea vaccination trial began in affected communities on 23 March 2015 to evaluate the efficacy, effectiveness and safety of a single dose of the vaccine VSV-EBOV by using a so-called ring vaccination strategy, the agency said. “To date, over 4,000 close contacts of almost 100 Ebola patients, including family members, neighbours, and co-workers, have voluntarily participated in the trial,” it said.

Describing the initial results as “promising” and “exciting,” WHO Executive Director said Dr. Margaret Chan told reporters: “I would like to say that if proven effective, this is going to be a game-changer. It will change the management of the current Ebola outbreak and future outbreaks.”...

A 26-year-old man, the third participant enrolled in VRC 207, receives a dose of the investigational NIAID/GSK Ebola vaccine at the NIH Clinical Center in Bethesda, Md. Credit: NIAID

Coal giant exploited Ebola crisis for corporate gain, say health experts

Suzanne Goldenberg in the Guardian (UK): Public health experts involved in the response to the Ebola crisis have condemned what they described as a ludicrous, insulting and opportunistic attempt to exploit the disease for corporate gain by the world’s largest privately-held coal company.

As part of a PR offensive to rebrand coal as a “21st-century fuel” that can help solve global poverty, it has emerged that at the height of Ebola’s impact in Africa, Peabody Energy promoted its product as an answer to Africa’s devastating public health crisis.

Greg Boyce, the chief executive of Peabody, a US-based multinational with mining interests around the world, included a slide on Ebola and energy in a presentation to a coal industry conference in September last year. The slide suggested that more energy would have spurred the distribution of a hypothetical Ebola vaccine – citing as supporting evidence a University of Pennsylvania infectious disease expert.

The World Health Organisation believes nearly 27,000 people contracted Ebola in an outbreak of the virus in West Africa last year, and more th
an 11,000 died – although the international agency believes that is probably an underestimate.

Public health experts who were involved in fighting the spread of Ebola were outraged at Peabody’s suggestion that expanding energy access with coal generation could have hindered the spread of Ebola and helped with the distribution of a vaccine – especially as there is no approved vaccine against the disease....

Coal stockpile at the Peabody Coal's Kayenta mine, Peabody Coal photo, Wikimedia Commons, under the Creative Commons Attribution 3.0 Unported license

Liberia's long road to recovery from ebola

IRIN: Liberia has lifted nationwide curfews and reopened its land borders with key trading partners Sierra Leone and Guinea, but a full recovery from the economic impact of the Ebola outbreak will take time, experts say.

“The reopening of the border is going to have an impact immediately, both in terms of livelihoods and the availability of food, as well as informal trade,” said Errol Graham, the World Bank’s country economist for Liberia, who spoke to IRIN from Virginia. “But there is going to be a lot of asymmetry between the [speed of] recovery and the crisis. The crisis was an immediate thing because of fear and aversion. The recovery is going to take a little longer.”

Within hours of the reopening of the border, people and merchandise began to flow from one side to the other. Local markets, once again stocked with fresh produce, meat and home goods, buzzed with activity, for the first time in more than six months.

In the interior of Liberia, Graham said, “We are also seeing, with the abatement of the crisis, people starting to go back to work and we expect to see more of that over time. And as foreigners who were involved in concessions in the natural resource sector come back, we expect to see more improvements in the employment situation.”...

The city of Kakata in Liberia, shot by Thadk, Wikimedia Commons, under the Creative Commons Attribution-Share Alike 3.0 Unported license 

Ebola - is culture the real killer?

An opinion piece by Obinna Anyadike, Editor-at-Large, in IRIN: “African culture” – cute if you’re a tourist, catastrophic when you want to put a lid on Ebola, or so some international health experts and media coverage of the outbreak would have us believe.

Why do people persist with risky funeral rites, eat Ebola-harbouring bushmeat, and occasionally attack the very health workers sent to help, the news reports leave us wondering. What is the value of “traditional beliefs” when they are harmful: why can’t people just act more rationally?

The simple answer is; ask the communities. The growing number of researchers that do, find that people are acting as responsibly as they can in desperate circumstances. The lack of a properly functioning Ebola response and weak healthcare services has forced communities into rough and ready self-reliance. Faced with hotlines going unanswered, overcrowded Ebola Treatment Units (ETU), militarized quarantine areas, communities are actually looking for more information, not less.

“Communities will do the best they can given the resources they have, even if ‘un-cultural’, in moments of crisis in order to fight for a future,” a recent study exploring community responses in urban Liberia found. It noted community leaders want training so they can provide safe burials; young men are rallying to guard their neighborhoods against perceived threats; and some people, ill-advisedly, have improvised protection suits out of raincoats and plastic bags to nurse the sick....

Hospital in Kenema, Sierra Leone, where blood samples are tested for ebola, shot by Leasmhar, Wikimedia Commons, under the Creative Commons Attribution-Share Alike 3.0 Unported license

After ebola, what next for West Africa’s health systems

IRIN: As rates of Ebola infection fall in Guinea, Liberia and Sierra Leone, planning has begun on how to rebuild public health systems and learn lessons from the outbreak. Nobody is declaring victory yet. But in Sierra Leone, the worst-affected country, there were 117 new confirmed cases reported in the week to 18 January, the latest statistics available, compared with 184 the previous week and 248 the week before that. Guinea halved its cases in the week to 18 January – down to 20 – and Liberia held steady at eight.

The epidemic is not over until there are zero cases over two incubation periods – the equivalent of 42 days. “It’s like being only a little bit pregnant – there’s no such thing as a little Ebola. We have to get to zero, there can be no reservoirs of Ebola,”  Margaret Harris, spokesperson of the World Health Organization (WHO), told IRIN.

But after 21,724 cases and 8,641 deaths in nine countries since the epidemic began in Guinea last year, there is some light. And health workers are already starting to look at what’s next. “Right now important meetings are going on in each country to work out what needs to be done to rebuild - in some significant respects to build health systems almost anew - and to build back better,” said Harris.

A European Union donor conference isdue at the beginning of March in Brussels. “What we want to see as a country is a resilient health system that can withstand shocks,” Liberia’s Assistant Health Minister Tolbert Nyenswah told IRIN. “Our plan [to be presented in Brussels] will be finalized by the end of February. It will be well costed with tangible goals.”

Ebola tested the public health systems in the three West African countries to near destruction – most places in the world would have also struggled. But where the three failed was at the basic “nitty-gritty” level of “standard surveillance, testing and monitoring, the containment of cases, the bread and butter of public health”, said Adia Benton, a social anthropologist at Brown University in Rhode Island....

Ebola training in Guinea, shot by CDC Global CDC Global, Wikimedia Commons via Flickr, under the Creative Commons Attribution 2.0 Generic License

Ebola vaccine will soon be tested in West Africa

Richard Harris at NPR's "Goats and Soda" blog: Ebola vaccine developers are on track to start testing their products in West Africa in about a month, the World Health Organization said at a press conference today. And it's a race against the clock — testing will become more challenging if the number of new Ebola cases continues to drop.

Two vaccines have already passed the preliminary safety trials — one from GlaxoSmithKline and a second being developed by Merck and a small biotech company called NewLink Genetics. The
next step is to find out whether either or both will actually protect people from this deadly disease.

Testing has been a delicate subject, because the most effective tests involve a comparison group that will not receive an actual vaccine – at least not right away. Some people object to tests like this because they feel they are being exploited as experimental subjects.

But vaccine organizers hope they've found a way to involve West African citizens without alienating them. Liberia, Sierra Leona and Guinea each have different testing strategies, Dr. Marie-Paule Kieny, Assistant Director-General at the WHO, said at a news conference Friday.

Liberia's current plan is to test both vaccines in a head-to-head trial, and have a third group that will receive a placebo shot. Each of the three groups will include 9,000 volunteers. That test could start as early as the end of January, Dr. Kieny says....

Universal health coverage - ebola reveals the gaps

IRIN: West Africa's Ebola epidemic has cruelly exposed the weaknesses of health systems in the countries where it struck. It was understandable that they were not prepared for Ebola, which has never been reported in the region before, but the director of the World Health Organization (WHO), Margaret Chan, says what they lacked was a robust public health infrastructure to deal with the unexpected.

“This requires good background data on the usual,” she says, “so that the unusual stands out. [It means] making good quality care accessible and affordable to everyone, and not just to wealthy people living in urban areas; having enough facilities available in the right places with enough well trained staff and uninterrupted supplies of essential medicines; diagnostic capacity that returns rapid and reliable results; and information systems that pinpoint gaps and direct strategies and resources towards unmet needs.”

Chan was speaking on what had been designated as the first Universal Health Coverage Day (on 12 December), setting out an ambitious check-list for health systems which can cope with whatever is thrown at them. This is clearly a challenge in any developing country, but much more of a challenge in fragile states like those currently affected by Ebola.

Nick Hooton is a research, policy and practice adviser with the ReBuild Consortium which works on how to strengthen health systems in post-conflict states. He told IRIN that although research still had to be done, the post-conflict environment was almost certainly a reason why the disease spread so fast. “Undoubtedly the systems are very poor,” he says, “and the staffing levels are very low, but there are also subtler factors at work, issues about trust and things like that. This is a disease which has been well controlled in other places, and yet got massively out of control. If you look at the DRC [Democratic republic of Congo] and northern Uganda, there is no great supply of health professionals there either. So we are talking about things like a breakdown in the links between the communities and the public services which take a long time to build up again.”...

Ebola virions, from Charting the Path of the Deadly Ebola Virus in Central Africa. PLoS Biol 3/11/2005: e403 doi:10.1371/journal.pbio.0030403 (apparently via Ayacop), Wikimedia Commons, nder the Creative Commons Attribution 2.5 Generic license

Sierra Leone’s worrying ebola trend

IRIN: In the week ending 30 November, Sierra Leone reported 537 confirmed Ebola cases, 152 more than the previous week and over four times the combined number of cases in Guinea and Liberia during the same period, according to World Health Organization’s (WHO) latest updates.

For more than a month, the outbreak has been slowing in Liberia, which reported 43 cases from 24-28 November. In Guinea, where the virus was first reported in March, there has been a slight increase in cases since October. Seventy-seven cases were reported in the last week of November, says WHO.

Health authorities in Sierra Leone say the continued denial of the existence of Ebola and unsafe burials are driving up infections. Seventy percent of infections are due to unsafe burials of Ebola victims, Brima Kargbo, chief medical officer at the Ministry of Health and Sanitation, told reporters on 3 December.

“The issue of denial is still [widespread] in our communities despite the fact that there is increased awareness and sensitization. People continue to hide the sick; people continue to wash bodies,” Kargbo said.

“What we have done is continue to engage the community leaders - for them to fully understand the risk factors of Ebola and for them to see the need to be involved in the fight [against Ebola] by reporting early when their loved ones are sick; at the same time for people not to bury without the support of the medical teams.”...

Bringing ebola tests up to speed

IRIN: Ebola in West Africa is believed to have erupted almost a year ago in southern Guinea, but was confirmed by the French Pasteur Institute only in March 2014, by which time it had killed 60 people and was suspected to have crossed the border into Liberia and Sierra Leone.

While it now takes just a few hours to diagnose Ebola, the rate and scale of the outbreak (in which more than 14,000 cases have been reported so far in West Africa, Europe and the US) still outpace the hours-long tests, necessitating even quicker diagnoses.

Currently in West Africa, samples have to be transported to a laboratory where the commonly used test takes 4-6 hours between set-up and results. Poor roads, and lack of electricity and properly functioning health systems are some of the obstacles to timely diagnoses.

“Getting specimens to the lab can take days and getting the result to clinicians and patients can also take several days. So the time between taking samples and receiving the result can be as long as four days,” Margaret Harris, a spokesperson with the World Health Organization (WHO), told IRIN.

WHO on 18 November called for rapid diagnostic kits to overcome the complex and lengthy lab tests. Safe and easy-to-use kits would help quickly isolate Ebola patients from others who present with similar early symptoms but have other ailments....

Questions over Mali's ebola response

IRIN: The failure of a top Malian hospital to detect probable cases of Ebola has raised questions about whether the country's health system is sufficiently prepared to tackle the disease.

"We have several confirmed cases," Samba Sow, head of the Mali's National Centre for Disease Control (CNAM), told IRIN. "Our goal is to prevent the virus from spreading." But the government only released an Ebola emergency plan on 30 October, a week after the first Ebola case.

In Kayes, where a two-year-old girl tested positive for Ebola on 23 October, the hospital was caught off-guard. Only two of its 160 workers had received training on how to detect and treat Ebola patients and how to protect themselves while doing so, said hospital director Toumani Konaré. "The staff had the right protective gear, but they didn't know how to use it," he told IRIN.

Before the current outbreak in Mali, the World Health Organization (WHO) had categorized the country as at-risk, due to its long border and strong economic ties with Guinea, where the epidemic began. It was targeted as a country to receive technical assistance, including training on infection prevention, epidemiological surveillance and contact tracing.

Sow said preparations started in April. However, those preparations were focused mostly on the 805km border that Mali shares with Guinea. The government started to send a few health workers to check travellers for fever and other signs of the virus among the chaos of trucks, buses, bush taxis and motorbikes at border checkpoints.

The Ministry of Health says the Kouremalé border checkpoint, where an imam who died of Ebola in Mali on 27 October had entered from Guinea, checks more than 1,000 people and 150 vehicles per day....

Ebola a stark reminder of link between health of humans, animals, environment

Emily Caldwell at the Ohio State University News Room: For many, global public health seems like an abstract and distant problem – until the Ebola virus is diagnosed among people in our midst. Though no one would call the Ebola pandemic a good thing, it has presented an opportunity for scientists to alert the public about the dire need to halt the spread of infectious diseases, especially in developing and densely populated areas of the world.

“What often seems like an abstract notion becomes very concrete when a deadly virus previously contained in Western Africa infects people on American soil,” said Wondwossen Gebreyes, professor of veterinary preventive medicine at The Ohio State University. “It does create a certain sense of urgency and awareness that this world is much smaller than we think.”

Gebreyes is the lead author of an article published in the Nov. 13, 2014, issue of PLOS Neglected Tropical Diseases that makes the case for accelerating efforts to put “One Health” into action. One Health refers to a strategy to more fully understand and address the links between animal health, human health and the environment.

The paper emphasizes the danger of zoonotic infections – those transmitted from animals to humans – and the staggering damage they do, especially in developing nations that lack a variety of resources. These diseases don’t just kill people, but they cause tremendous economic harm in a variety of ways: killing livestock, reducing the ranks of qualified health and education providers, creating political unrest and stopping development in its tracks.

There is an urgent need for progress. Approximately 75 percent of emerging infectious diseases are those transmitted from animals to humans, and the world is on pace to experience at least one deadly disease outbreak each year.

...“To attain a true One Health approach, we need broad recognition of the interconnectivity among the health of humans, domestic or wild animals and the environment, which are all closely linked by the pathogens that they share,” he said....

Dengue's spread flies under the radar amid ebola scare

AFP: One of the most familiar sounds in Malaysia's capital is the approaching drone of a fumigation fogger spewing thick white plumes of insecticide, part of so-far futile efforts to arrest a spiralling dengue fever outbreak.

Malaysia is among several countries across Asia and Latin America grappling with a mosquito-borne virus that is proving tough to eradicate as it infects millions.

While the Ebola threat has captured headlines, the World Health Organization (WHO) warns that dengue -- while far less lethal -- has become one of the fastest-growing global health threats, contracted by 50-100 million people each year.

"The increase in dengue incidence and severity of the outbreaks is a global phenomenon, with a 30-fold increase over the past five decades," said Ahmed Jamsheed Mohamed, a doctor in the WHO's Southeast Asia office, adding that eradication is "not seen as feasible in the near future".

...While Ebola has killed nearly 5,000 people this year, mainly in west Africa, with an estimated 13,000 infections, dengue kills up to 20,000 annually, and 40 percent of the world's population live in dengue-risk areas....

Mosquito larvae, photo data unavailable 

Aid agencies adapt to Ebola challenge

IRIN: From using Bitcoins to fundraise, to adopting new strategies to prevent malaria victims appearing to be Ebola cases, to working with new partners - aid agencies in West Africa are learning to adapt fast. "The response to every humanitarian crisis has to be context specific," said Nigel Clarke, the director of programme development and quality for Save the Children's operations in Liberia. "That's the key standard that humanitarian agencies utilize in all crises. But this Ebola crisis is unprecedented because of all the associated risks of cross infection."

Humanitarian workers, for example, would normally want to bring people together during times of crises, to do things such as spread key messages, distribute food and other supplies, and sit down with communities in groups to discuss needs, Clarke said.  "But a lot of those things are not possible in this context and so we are having to sort of adapt as we go."

In order to help get the outbreak under control, they have now branched out and partnered with the governments of Sierra Leone, Cuba and the UK, as well as other health agencies and workers, to establish and run a treatment centre in Freetown's Kerry Town.  The new, 100-bed Ebola Treatment Unit is the first time that Save the Children has ever worked on a global health emergency in this capacity.

"We're all in a place now where we never thought we would be," said Rob MacGillivray, Save the Children's country manager in Sierra Leone. "In the past, we never considered direct case management, but eventually the outbreak overtook us and now we've had to fight this battle in a way we've never fought a humanitarian battle in the past."....

An ebola virus particle, shot by NIAID, Wikimedia Commons via Flickr, under the Creative Commons 2.0 license

Overcoming Ebola stigma takes time

IRIN: Ebola survivors in Liberia and Sierra Leone are facing mixed reactions as they return home after contracting the deadly virus. While some have been welcomed back into their communities, most are facing discrimination and stigmatization, or have even been shunned.

"I returned back to the community very happy," said Ibrahim Thomas, who lives in Freetown. "I didn't have any problems with the community or anybody. The worshippers at my mosque used to pray for me [when I was sick], so when I came back, they were so happy to see me alive and well."  Thomas, who lost his wife and two of his children to Ebola, said many of his neighbours have been sympathizing with him and doing what they can to help.

But not all survivors are so lucky. "I was devastated when I returned to my community," said 27-year-old Alhaji Bangura, who lost both parents, his wife and two children to Ebola in Sierra Leone. "I was very lucky to survive. but now some people are still afraid of me, even to come very close to me. I had so many friends before but now most of them have distanced themselves from me."  Bangura said most people will only talk to him outside their home and often refuse to give him any food or drink....

Scanning electron micrograph of Ebola virus budding from the surface of a Vero cell (African green monkey kidney epithelial cell line). Credit: NIAID, Wikimedia Commons via Flickr, under the Creative Commons Attribution 2.0 Generic license

Ebola workers urge safety, solidarity

IRIN: Hanna Majanen summed it up best: "It is the things you do automatically that are difficult. People will touch their face, rub their eyes and bite their fingernails. These are the things you forget.”

As medical focal point for Médecins Sans Frontières (MSF) in Liberia, Majanen is well-versed in the rules and recommendations laid down by the organization for its frontline workers treating Ebola patients.

MSF, along with organizations like the World Health Organization (WHO) and the US Centers for Disease Control and Prevention (CDC), has urged health workers to get as close as they can to a "zero risk" working environment. That means not only following strict procedures on wearing personal protection equipment (PPE) and ensuring maximum standards of hygiene in every aspect of work, but ensuring psychological back-up for those treating Ebola patients, and limiting rotations.

The US-based NGO International Medical Corps (IMC), expanding its Ebola activities in Liberia, provides a five-day pre-deployment training programme for recruits with a strong focus on PPE, emphasizing that IMC prides itself on taking care of the "wellness, safety and security of all individuals".

 Health workers have always been among the fatalities in Ebola outbreaks, notably in Sudan and the then Zaire where the virus first came to light in 1976. But the West Africa epidemic highlighted their extreme vulnerability. According to WHO, in its Ebola Response Roadmap Situation Report for 8 October, some 401 health workers had contracted Ebola, with 232 confirmed or suspected deaths…

A new Ebola isolation war in Lagos, shot by Bryan Christensen, Wikimedia Commons via Flickr, under the Creative Commons Attribution 2.0 Generic license.

Ebola hits West Africa food security

IRIN: West Africa's Ebola outbreak, which has been disrupting agricultural and market activities, threatens to erode food security and negatively affect the livelihoods of millions of already vulnerable people in Guinea, Liberia and Sierra Leone unless more is done to meet their immediate food and nutritional needs, say aid agencies.

They say they are still calculating the number of food insecure households, but alre
ady the results of initial rapid assessments are worrying.

The World Food Programme (WFP) found that more than 80 percent of people surveyed via mobile phone in the eastern part of Sierra Leone say they have been eating less expensive food since the outbreak began. Three-quarters of respondents have begun to reduce the number of daily meals and portion sizes.

...A rapid assessment survey last month in Sierra Leone by the Food and Agriculture Organization (FAO) found that 47 percent of farmers have had their work "considerably disrupted" by the Ebola outbreak.

"Here, we have the largest cocoa farms," said Sidikie Kabba, a farmer from eastern Sierra Leone. "Now it's quarantined because of Ebola, so people aren't travelling. Before, I was harvesting my produce - up to 50 bags - but now even 10 bags is difficult. So I'm losing money," he said...

A chart of Ebola deaths to October 1, created by Malanoqa, Wikimedia Commons, under the Creative Commons 4.0 International license

The link between environmental degradation and Ebola

Peter Stoett and Catherine Machalaba in the Toronto Star:  The Ebola epidemic besieging West Africa is perhaps the starkest warning yet that as we tear down forests, we open ourselves up to new strains of virulent disease. Among the key lessons from the current outbreak is that human-created pressures such as intensified food production, rapid trade and travel, and climate change, are putting future generations at risk of further Ebola-like catastrophes.

Through some mix of travel control, medical advances, and humanitarian assistance, we can hopefully stop the current outbreak’s carnage. But what can we do to prevent future outbreaks of so-called exotic diseases?

Delegates at the recent UN conference on biodiversity in South Korea expressed particular concern that the long-term alteration of habitats (by, for example, logging, farming, mining) and speeding climate change will increase the chances of the spread of exotic diseases. They compellingly made the case that Guinea, Liberia, and Sierra Leone are all known for their high deforestation rates; and each has been affected by periods of civil strife that exacerbated population displacement and relocation.

It would be premature to conclude that deforestation or other causes of ecosystem change were the factors behind this outbreak, but they remain part of the equation for Ebola, other emerging illnesses and even established diseases like malaria.

Unsustainable policies designed to increase agricultural output for export, illegal logging, the mercurial rise of the palm oil industry and the hunt for oil and gold within tropical and boreal forests — all of these place humans in greater contact with wild species, in some cases for the first time, enabling more efficient transmission of diseases both known and unknown.

Indeed, scientists started linking infectious diseases with environmental alteration decades ago. Today, climate change complicates the issue: most predictions (many of them already realized) suggest the changing climate will allow for the spread of invasive species, degrade ecosystems’ resiliency and ultimately broaden the reach of some diseases....

CDC Disease detective Kari Yacisin (left) conducts contact tracing for Ebola in West Africa with a local health official. CDC photo via Wikimedia Commons, under the Creative Commons 2.0 license

West Africa gears up to contain Ebola spread

IRIN: As the Ebola caseload rises to over 5,350, aid agencies and governments in countries not yet affected by the deadly virus are gearing up for its potential spread across new borders by pre-positioning supplies, training health workers, identifying isolation centres, and disseminating prevention campaign messages, among other activities.

Countries that share a land border with the affected countries, including Côte d'Ivoire, Guinea Bissau, and Mali, are considered to be most at risk.

"It is vitally important that, countries - especially surrounding countries that don't have Ebola cases as of yet - are prepared for a worst case scenario," said Pieter Desloovere, a spokesperson for the World Health Organization (WHO).

In August, WHO issued an Ebola Response Roadmap to help countries across the region limit the spread of the virus. One of its three objectives is to strengthen the ability of all countries to detect and deal with any potential cases.

"The reason that Ebola started in Guinea and has since spread to Liberia and other countries is that no one was paying attention," said Grev Hunt, the UN Children's Fund's (UNICEF's) sub-regional coordinator for the Ebola outbreak. "We were caught unaware. But now, we are paying very close attention to what is going on and making sure the same thing won't happen again."....

Ebola cases in Guinea in 2014. Graph created by StefanPohl, public domain

Ebola outbreak: 'Thousands of orphans shunned'

BBC News: At least 3,700 children in Guinea, Liberia and Sierra Leone who have lost one or both parents to Ebola this year face being shunned, the UN children's organisation has said. Carers were urgently needed for these orphans, Unicef said.

A basic human reaction like comforting a sick child has been turned "into a potential death sentence", it added. The World Health Organization (WHO) says more than 3,000 people have died of Ebola in West Africa. It is the world's most deadly outbreak of the virus.

The figure on the number of Ebola orphans follows a two-week assessment mission by Unicef to the three countries worst-affected by the outbreak. An earlier version of this story said that 4,900 children had lost parents but the correct figure is 3,700. It found that children as young as three or four years old were being orphaned by the disease.

Children were discovered alone in the hospitals where their parents had died, or back in their communities where, if they were lucky, they were being fed by neighbours - but all other contact with them was being avoided....

Sierra Leone quarantines one million ahead of UN Ebola talks

Terra Daily via AFP: Sierra Leone began a quarantine of more than one million people Thursday in the largest open-ended lockdown in the Ebola outbreak, as world leaders met to discuss the crisis at the United Nations. The northern districts of Port Loko and Bombali have been closed off indefinitely along with the southern district of Moyamba -- effectively sealing in around 1.2 million people.

With the eastern districts of Kenema and Kailahun already under quarantine, more than a third of the population of six million -- in five of the nation's 14 districts -- now finds itself unable to move freely.

The president said 12 of the county's 149 tribal chiefdoms -- much smaller administrative areas than districts -- were also to be placed in quarantine, although the total population in these areas was not immediately clear.

"The isolation of districts and chiefdoms will definitely pose great difficulty but the lives of everyone and the survival of our country takes precedence over these difficulties," President Ernest Bai Koroma told the nation in a televised address late Wednesday....