More Than Eyes Can See: A nine month journey through the AIDS pandemic
But right now, this crippling and potentially fatal disease is nearing eradication. In , there were only 29 cases globally. If eradication happens, polio will join smallpox as the only other human disease to become extinct. Great Healer, we pray for children, families, and communities affected by polio — especially in Africa and the Eastern Mediterranean, where polio still persists. Bless the work of doctors and organizations who are working hard to eradicate this disease.
By the time the world realized the extent of the AIDS crisis in sub-Saharan Africa in the late s, nearly an entire generation had succumbed to the disease in some nations. In Malawi, orphaned children were living alone or with overburdened caregivers. Lucia, then 9, and her brother were abandoned by their mother after their father died, likely of AIDS. A kind neighbor, a farmer named Vincent, took the children in. Now, HIV testing and anti-retroviral treatment — bolstered by a lack of stigma — allow adults to live normally with HIV. Communities in sub-Saharan Africa continue to confront the pandemic head-on.
AIDS messaging is everywhere, including on the wall of this school in Zambia. Here, clean water is more of a concern to these students than HIV — they know full well how the virus is transmitted. AIDS-related deaths have fallen by more than 51 percent since the peak in when 1. The U. Almighty Deliverer, You are our strong refuge. Reach out with Your unconditional love to be a refuge and source of hope for HIV-positive men, women, and children around the world.
World Vision is the largest nongovernmental provider of clean water in the developing world, reaching one new person with clean water every 10 seconds and three more schools every day with clean water. We are increasing our impact and scope to reach everyone, everywhere we work by The sixth of 17 Sustainable Development Goals created by the U. This past year, a community in Honduras , with the help of World Vision, finished building a near-marathon-length pipeline to bring clean water to their community. World Vision U.
President Emeritus Rich Stearns personally committed to help bring clean water to Rwand a, which will likely be the first country in the developing world to solve its water crisis. Faithful God, help World Vision to bring clean water to those who desperately need it, and work in hearts to reveal the living water we can receive from You.
Two years ago, we walked the Global 6K for Water with 5-year-old Cheru Lotuliapus , whose daily life in Kenya was consumed with finding water. The effects of this life meant Cheru and so many other girls and women in sub-Saharan Africa were not able to live up to their potential. So a standpipe will bring fresh water to Cheru and her family, only steps from where her mother cooks, washes clothes, and prepares tea.
Loving Father, we give thanks for water engineers who work tirelessly around the world to bring girls like Cheru clean water and a new lease on life. We ask for Your blessings on children, mothers, fathers, and communities who are thirsty. Purify, protect, and multiply their water sources. Strengthen their resolve so they may fully enjoy the benefits of clean water — essentials like education, gardens of fresh produce, and good health.
More Than Eyes Can See A nine month journey through the AIDS pandemic - video dailymotion
Together, we are supporting the efforts of those seeking to prevent violence, protect childhood, and help make societies safe for children. By , we hope to end abuse, exploitation, trafficking, and all forms of violence and torture against children. Loving God, reach out Your helping, healing, and loving hands to keep children safe from harm.
Bless this work to protect Your children. Members of this World Vision program also support one another in leading their families with empathy and encouragement, convincing other community members not to marry off their teenage daughters. Wonderful Counselor, show Your compassion to the multitudes of girls and women who endure the damaging physical and relational effects of child marriage. AIDS is associated with very high profile funds and personalities. In spite of this, there seems to be no control on the spread of the virus. Endorsement by well known personalities gives visibility and acceptance to any product social and commercial , and is a time tested approach in the field of advertising.
Prevention of AIDS is related to behavioural change in individuals who are expected to adopt safer sexual practices. This is an extremely difficult action response that the AIDS campaign expects from the target audience. This process is time consuming, however, we have to work more intensively. Given a limited budget available with NACO, all personalities roped in so far have offered their services for free. Media events that are appropriately located and strategised, are necessary to give visibility to the programme and also enthuse participation from target groups like the youth.
AIDS awareness campaign is concentrated mostly in urban areas whereas the rural belts are left untouched. The IEC campaign uses a number of media vehicles to spread the messages in the rural belt also. The bulk of the money is spent on Doordarshan and radio which is accessible by both urban and rural population. As recent surveys have shown, the reach of television has far outstripped the reach of even radio and other media. Apart from the mass media, interpersonnel communication methods are used, which cover urban slums and rural areas.
Proposals are invited through newspaper advertisements, which are screened by a Technical Advisory Committee which has members from the NGO community. Blacklisted NGOs are kept out and only those with proven track records are considered. Apart from verification of documents submitted, every NGO is physically verified for nature of work and presence in the target community. The number of NGOs is adequate but what about quality of work?
Minimum quality standards are set and necessary capacity building done to ensure compliance. Apart from an internal process of evaluation within the NGO, timely reports are received from them in desired formats. The NGOs have to provide audited statement of accounts for previous money received to ensure receipt of future installments. Every third year the NGO performance is evaluated by an external agency. It is a fact that certain groups of people, known to practice high risk behaviour are more likely to carry the virus than others.
These groups do not need half baked interventions where one just tells them about behaviour change.
BCC is important but that should be accompanied by services like STD treatment, condom provision, creation of enabling environment etc. It is felt that once these groups are approached in the right spirit, they are more likely to come out of their shell and join the mainstream and thereby be less stigmatised.
Many NGOs are harassed for their activities. What does NACO do about it? NGOs are normally harassed by police personnel. This is true mostly in states where adequate efforts to sensitise the law and order machinery are not being made. Although NACO has equivocally condemned all such instances of excesses by certain authorities, it is not in a position to become a supercop.
NACO on its part has worked out elaborate plans for a sustained advocacy initiative with police personnel at all levels. The NGO movement is operating at different levels in different states. States like Bihar, Uttar Pradesh, Jharkhand etc. The task is challenging and complex. The process is ongoing. Capacity building of NGOs is one activity that is to be done vigorously.
The state governments are also expected to provide an environment that builds trust between the government and the civil society and ensures long term partnerships. What is ICTC? As the HIV problem intensifies, the issues of care and support for affected individuals, and prevention of HIV transmission to those who are not affected, become even more critical.
It provides people with an opportunity to learn and accept their HIV sero status in a confidential and enabling environment and to cope with the stress arising out of HIV infection. The potential benefits of ICT are:. What is the setup at ICTC? One of the basic elements involved is a confidential discussion between the client and the trained counsellor and the focus is on emotional and social issues related to possible or actual HIV infection.
In order to ensure that the result of the HIV test is given on same day to the individual after post-test counselling, Rapid HIV Test Kits have been supplied to these centres or the client is asked to meet the same counsellor for post test counselling on appointed date. Orientation training is also conducted for these functionaries.
What has been done to make ICTCs user-friendly? In order to make the services more user-friendly following efforts are being made:. Is there a National Blood Policy? Yes, a National Blood Policy has been formulated and is now being implemented with the mission to ensure easily accessible and adequate supply of safe and quality blood collected from voluntary non-remunerated regular blood donors. What are the infections for which blood is tested? Every unit of blood is tested for all these infections. No charges for blood as such can be levied by any blood bank. However, the blood that is collected from a donor at no cost, needs to be processed to make it free of infection, to ensure that it has certain minimum quality standards.
Besides all these, establishment costs for the blood bank like infrastructure maintenance, salaries etc. Blood banks attempt to recover these costs as service charge from the consumer. Is there some uniform service charge fixed for a blood unit? There are some guidelines developed by the National Blood Transfusion Council and circulated by NACO, on the amount of service charge that can be charged by blood banks functioning in any sector in the country. These guidelines specify that no blood bank will charge more than Rs. However, since these are mere guidelines and have no legal.
The prime objective was to phase out professional donors and focus on voluntary donations. How far has this policy been successful and how much voluntary blood is collected in the country? A number of steps were taken by NBTC to keep a strict check on exploitation of the blood users by commercial and private blood banks. Extensive awareness programmes for donor motivation through Information, Education, Motivation, Recruitment and Retention of voluntary donors was launched.
Each state is given an annual target for collection of blood through voluntary sources and this is regularly reviewed by NACO. Is the blood issued by blood banks safe? Facilities have been provided by NACO to all the government and charitable blood banks like Red Cross to carry out these tests. Can one acquire HIV infection if one donates blood?
No, this is not possible as all materials used for collection of blood are sterile and disposable. Donating blood is a noble gesture. People who are healthy should come forward for donating blood voluntarily. Who can donate blood? Only a healthy person between the age group of 18 — 60 years, weighing 45 kg or more with haemoglobin content of Is there any inspection of blood banks? The blood banks can only function if they are licensed by the Drug Inspectors of the Food and Drug Administration of the respective states.
Every blood bank has to prominently display its license for anyone to check. Care and Support Q. Do AIDS cases require a separate ward? AIDS patients are to be treated at par with the general patients and there should be no discrimination. If testing has to be done in the hospital, is the consent of the patient required? Whenever HIV test is done, the consent has to be taken.
In case of unconscious patients, the consent of the relatives has to be taken. What is the importance of ICTC in care and support? Whenever a person feels, he can walk to an ICTC and get himself tested. Is the government considering to provide anti retroviral therapy for AIDS cases? Government as yet is not considering provision of anti retroviral therapy because of its cost. Antenatal therapy is not a cure but can only prolong the life of the patient and the drugs have to be continued for lifetime.
Integration into primary healthcare is a priority because it is necessary for ensuring sustainability. In the area of STD prevention and control, a syndromic approach to STD diagnosis is most suitable in the developing world as it does not require laboratory tests, and treatment can be given at the first contact with health services. WHO strongly advocates that all primary healthcare workers be trained in the syndromic approach to STD management.
An Action Plan for tackling this dual epidemic has been drawn up at the Centre between both the programmes which is initially focussed on the six high prevalence states and is under implementation at the moment by both the National Programmes. Hence treatment of both diseases should be under the supervision of an experienced physician, the dosages should be closely monitored and adjusted as needed.
If possible, treatment of TB should be completed before starting anti retroviral. Precise data about the prevalence of STIs in India is not available. Health seeking behaviour of those suffering from STDs is directly related to the stigma attached to the disease, because of which individuals with STI desire anonymity. As a result, they seek alternate source of medical aid including self-medication and only a small proportion report to public sector medical set-up. Because of this attitude and behaviour of those suffering from STIs, they continue to transmit infection to their multiple sex partners.
This is the main obstacle in converting infectious pool into non- infectious. The STI drugs are provided free of cost by the Government of India and adequate confidentiality is ensured for those attending these clinics. Such clinics are managed by experts trained to treat STIs. Another major activity of STD Control Programme is Targeted Intervention under which, special facilities are made available easily to commercial sex workers, truckers, migrant workers and other marginalised segments of society.
Partner notification, condom promotion and imparting IEC activities through peer-educators are the interventions organised as a part of the programme. STI management through syndromic approach has been now practiced by trained medical officers at peripheral, middle and even at tertiary levels of healthcare where adequate lab facilities are not available. What is FHAC? The campaign is carried out for a period of 15 days once a year.
The objectives of the campaign are:. Yes, every STD causes some damage to the genital skin and mucous layer, which facilitates the entry of HIV into the body. The most dangerous are:. Why is early treatment of STD important? High rates of STD caused by unprotected sexual activity enhance the transmission risk in the general population.
Early treatment of STD reduces the risk of spread to other sexual partners and also reduces the risk of contracting HIV from infected partners. Besides, early treatment of STD also prevents infertility and ectopic pregnancies. Messages will be consistent with the related programme of RCH. Every effort should be made to promote exclusive breast feeding for upto four months in the case of HIV positive mothers followed by weaning, and complete stoppage of breast feeding at six months in order to restrict transmission through breast feeding.
However, such mothers will be informed about the risk of transmission of HIV through breast milk and its consequences, and would be helped for making informed choice regarding infant feeding. Antiretroviral Therapy Q. Is the Government of India planning to introduce anti retroviral therapy free of cost in government hospitals? Who will be eligible for the supply of drugs? The Working Group has completed its deliberations. If government does proceed to introduce anti retroviral through the public health system, these will be delivered free of cost to the end consumer in government hospitals.
Condom Promotion Q. The government policy has been that condoms are an effective, protective measure to prevent the spread of HIV.
The government believes that it is necessary to be focused in the promotion of condoms since a large number of infections occur through unsafe sex. For the high risk groups, targeted social marketing and free distribution of condoms is being promoted through NGOs. How safe are condoms in preventing HIV? Consistent and correct use of Latex condoms are fully effective in preventing the spread of HIV through the sexual route. Therefore, the immune system is less able to prevent the growth and spread of the TB bacilli.
As a result, disseminated and extra-pulmonary TB disease is more commonly seen in the later stages. Thiacetazone causes severe cutaneous reactions that may be fatal and hence should be avoided.
1. Extreme poverty is giving up ground.
Patients who complete treatment show the same clinical, radiographic and microbiological response to short-course treatment irrespective of whether they are HIV positive or negative. Self-administration of treatment is associated with higher case fatality rates. You would need to login or signup to start a Discussion. Severe Symptoms: Headaches Blurred and distorted vision Cough and shortness of breath Persistent white spots or unusual lesions on your tongue or in your mouth Soaking night sweats Shaking chills or fever higher than F 38 C for several weeks Chronic diarrhea Persistent, unexplained fatigue Weight loss Skin rashes References: www.
Sharing infected needles : HIV can be transmitted through needles and syringes contaminated with infected blood. Sexual Contact : The most frequent mode of transmission of HIV is through sexual contact with an infected person. From mother to child : A pregnant woman infected with HIV virus can transmit the virus to her fetus through their shared blood circulation, or an infected nursing mother can transmit it to her baby through her breast milk. Accompanied by counseling for those who test positive. Conducted with the informed consent of the person being tested. These tests include: Window period : There is a period of time between HIV infection and the appearance of anti-HIV antibodies that can be measured which is called "window period".
Reverse transcriptase RT inhibitors - It interferes with a critical step during the HIV life cycle and keep the virus from making copies of itself. Protease inhibitors - It interferes with a protein that HIV uses to make infectious viral particles. Fusion inhibitors - It blocks the virus from entering the body's cells. Integrase inhibitors - It blocks an enzyme HIV needs to make copies of itself.
Multidrug combinations - It combines two or more different types of drugs into one. These medicines help people with HIV, but they are not perfect. People with HIV infection still have the virus in their bodies. They can still spread HIV to others through unprotected sex and needle sharing, even when they are taking their medicines. HIV prevention practices may be done by individuals to protect their own health: Spreading awareness among masses.
Safe injections: Using auto disposal syringes helps to prevent HIV infections.
Male circumcision: It is the surgical removal of the foreskin prepuce from the human penis. Safe blood transfusion procured only from authorized and accredited blood banks. Its priorities and thrust areas are drawn up accordingly and include the following: Considering that more than 99 percent of the population in the country is free from infection, NACP-III places the highest priority on preventive efforts while, at the same time, seeks to integrate prevention with care, support and treatment.
Sub-populations that have the highest risk of exposure to HIV will receive the highest priority in the intervention programmes. These would include sex workers, men-who-have-sex-with-men and injecting drug users. Second high priority in the intervention programmes is accorded to long-distance truckers, prisoners, migrants including refugees and street children. In the general population those who have the greater need for accessing prevention services, such as treatment of STIs, voluntary counselling and testing and condoms, will be next in the line of priority.
NACP-III ensures that all persons who need treatment would have access to prophylaxis and management of opportunistic infections. Children who are infected are assured access to paediatric ART. This will be done through the sectors and agencies involved in child protection and welfare. In mitigating the impact of HIV, support is also drawn from welfare agencies providing nutritional support, opportunities for income generation and other welfare services. NACP-III also plans to invest in community care centres to provide psycho-social support, outreach services, referrals and palliative care.
Socio-economic determinants that make a person vulnerable also increase the risk of exposure to HIV. Component 1 includes the following two subcomponents: 1. IEC will remain an important component of all prevention efforts and will include: Behavior change communication strategies for HRGs, vulnerable groups and hard to reach populations Increasing awareness among general population, particularly women and youth.
Services for Prevention The HIV epidemic in India is concentrated among high risk groups sex workers, men-having-sex-with-men, injecting drug users and clients of sex workers , though there is evidence of the infection spreading to the general population. Other additional body fluids that may transmit the virus that healthcare workers may come into contact with are: Cerebrospinal fluid surrounding the brain and the spinal cord Synovial fluid surrounding bone joints Amniotic fluid surrounding a foetus.
To find out if you are at risk for HIV, ask yourself the following questions: Have you had unprotected vaginal, oral or anal sex e. Have you shared needles to inject street drugs or steroids or to pierce your skin? Have you had a sexually transmitted infection STI or unwanted pregnancy? Have you had a blood transfusion or received blood products before April, ? The following may be warning signs of infection with HIV: Rapid weight loss Dry cough Recurring fever or profuse night sweats Profound and unexplained fatigue Swollen lymph glands in the armpits, groin, or neck Diarrhoea that lasts for more than a week White spots or unusual blemishes on the tongue, in the mouth, or in the throat Pneumonia Red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids Memory loss, depression and other neurological disorders.
Infected blood can be introduced into drug solutions by: Using blood-contaminated syringes to prepare drugs Reusing water Reusing bottle caps, spoons or other containers "spoons" and "cookers" Used to dissolve drugs in water and to heat drug solutions Reusing small pieces of cotton or cigarette filters "cottons" used to filter out particles that could block the needle.
Testing for Pregnant Women Q. NGOs Q. In order to make the services more user-friendly following efforts are being made: ICTCs are located in easily accessible areas mostly in OPDs. Informed consent in local language is taken before HIV testing. Clients are informed about the nature and consequences of HIV test before their consent is taken. It is emphasised that testing should not be forced but left at the will of the client.
Here it is emphasised that counsellors should not be rotated from centre to centre and from one day to another since the rapport between the counsellor and client is very essential. Adequate supply of condoms is made available in these counselling centres. Individuals attending the ICTC are also made aware about the outlets from which they can get condoms under various schemes. Counsellors are provided adequate training and ongoing support and supervision to ensure that they give good quality counselling and avoid burnout.
Linkages with NGOs for social support, follow-up counselling and care for those tested sero positive are emphasised. Innovative ways of scaling up ICT services and making them more accessible and available is the endeavour. Blood Safety Q. The most frequently reported symptoms were lethargy or fatigue, joint pain, and hair loss. Although most symptoms resolved or improved over time, only one survivor reported complete resolution of all symptoms. A study published in May discussed the case of Ian Crozier, a Zimbabwe-born physician and American citizen who became infected with Ebola while he was working at an Ebola treatment center in Sierra Leone.
However, after discharge Crozier began to experience symptoms including low back pain, bilateral enthesitis of the Achilles tendon , paresthesias involving his lower legs, and eye pain, which was diagnosed as uveitis. His eye condition worsened and a specimen of aqueous humor obtained from his eye tested positive for Ebola. The authors of the study concluded that "further studies to investigate the mechanisms responsible for the ocular persistence of Ebola and the possible presence of the virus in other immune-privileged sites e.
Another study, which was released in August looked at the health difficulties reported by survivors. Calling the set of symptoms "post-Ebolavirus disease syndrome", the research found symptoms that included "chronic joint and muscle pain, fatigue, anorexia, hearing loss, blurred vision, headache, sleep disturbances, low mood and short-term memory problems", and suggested the "implementation of specialized health services to treat and follow-up survivors".
In June , it was reported that local authorities did not have the resources to contain the disease, with health centres closing and hospitals becoming overwhelmed. I urge the international community to provide this support on the most urgent basis possible. In late August, MSF called the situation "chaotic" and the medical response "inadequate. Speaking from a remote region, an MSF worker said that a shortage of protective equipment was making the medical management of the disease difficult and that they had limited capacity to safely bury bodies.
By September, treatment for Ebola patients had become unavailable in some areas. Speaking on 12 September, WHO Director-General, Margaret Chan, said: "In the three hardest hit countries, Guinea, Liberia and Sierra Leone, the number of new cases is moving far faster than the capacity to manage them in the Ebola-specific treatment centers. Today, there is not one single bed available for the treatment of an Ebola patient in the entire country of Liberia.
In early December, the WHO reported that at a national level there were enough beds in treatment facilities to treat and isolate all reported Ebola cases, although their uneven distribution was resulting in serious shortfalls in some areas. Similarly, all affected countries had sufficient and widespread capacity to bury reported deaths; however, because not all deaths were reported, it was possible that the reverse could have been the case in some areas.
A number of Ebola Treatment Centres were set up in the area, supported by international aid organisations and staffed by a combination of local and international staff. Each treatment centre is divided into a number of distinct and rigorously separate areas. For patients, there is a triage area, and low- and high-risk care wards.
For staff, there are areas for preparation and decontamination. An important part of each centre is an arrangement for safe burial or cremation of bodies, required to prevent further infection. It is one of the most modern medical centers in Guinea. The center has a maternity unit for pregnant women with the virus. Although the WHO does not advise caring for Ebola patients at home, in some cases it became a necessity when no hospital treatment beds were available. For those being treated at home, the WHO advised informing the local public health authority and acquiring appropriate training and equipment.
The kits included protective clothing, hydration items, medicines, and disinfectant, among other items. The Ebola epidemic caused an increasing demand for protective clothing. A full set of protective clothing includes a suit, goggles, a mask, socks and boots, and an apron. Boots and aprons can be disinfected and reused, but everything else must be destroyed after use. Health workers change garments frequently, discarding gear that has barely been used.
This not only takes a great deal of time but also exposes them to the virus because, for those wearing protective clothing, one of the most dangerous moments for contracting Ebola is while suits are being removed. Staff who have returned from deployments to Western Africa say the clothing is so heavy that it can be worn for only about 40 minutes at a stretch. A physician working in Sierra Leone has said: "After about 30 or 40 minutes, your goggles have fogged up; your socks are completely drenched in sweat. You're just walking in water in your boots. And at that point, you have to exit for your own safety Here it takes 20—25 minutes to take off a protective suit and must be done with two trained supervisors who watch every step in a military manner to ensure no mistakes are made, because a slip up can easily occur and of course can be fatal.
USAID published an open competitive bidding for proposals that address the challenge of developing " The prototype has a small, battery-powered cooling pack on the worker's belt. The WHO recommends the use of 2 pairs of gloves, with the outer pair worn over the gown. Using 2 pairs may reduce the risk of sharp injuries; however, there is no evidence that using more than the recommended will give additional protection. WHO also recommends the use of a coverall, which is generally appraised in terms of its resistance to non-enveloped DNA virus.
When a gown or coverall is worn, it should continue beyond the shoe covers. Additionally, a designated doffing assistant was recommended to help in this process. The order in which boot covers are removed, by these guidelines, indicates their removal after the coverall or gown.
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Finally, a trained observer is to read to the healthcare worker each step in donning and doffing, but must not physically assist therein. In some places affected by the outbreak, care may have been provided in clinics with limited resources, and workers could be in these areas for several hours with a number of Ebola infected patients.
Among the fatalities was Samuel Brisbane, a former adviser to the Liberian Ministry of Health and Social Welfare, described as "one of Liberia's most high-profile doctors". Fonnie was also a co-author of a study that analyzed the genetics of the Ebola virus; five others contracted Ebola and died while working on the same study. Basing their choice on "the person or persons who most affected the news and our lives, for good or ill, and embodied what was important about the year", the editors of Time magazine in December named the Ebola health workers as Person of the Year.
Editor Nancy Gibbs said: "The rest of the world can sleep at night because a group of men and women are willing to stand and fight. For tireless acts of courage and mercy, for buying the world time to boost its defenses, for risking, for persisting, for sacrificing and saving, the Ebola fighters are Time's Person of the Year. The CDC further indicated that healthcare workers in Guinea were less likely to report contact with an infected individual than non-healthcare workers.
There is as yet no known confirmed medication or treatment for Ebola virus disease. The director of the US National Institute of Allergy and Infectious Diseases has stated that the scientific community is still in the early stages of understanding how infection with the Ebola virus can be treated and prevented. The effectiveness of potential treatments for any disease is usually assessed in a randomized controlled trial , which compares the outcome of those who received treatment to those who received a placebo i.
However, randomized controlled trials are considered unethical when a disease is frequently fatal, as is the case with Ebola. In December , a study was released that found that the viral load found in a patient's blood in the week after the onset of symptoms is a strong indication of the patient's likelihood to die or survive the disease.
The researchers suggested that this information could help to assess the efficacy of proposed treatments more accurately in non-randomized clinical trials. Ebola control is hindered by the fact that current diagnostic tests require specialised equipment and highly trained personnel. Since there are few suitable testing centres in Western Africa, this delays diagnosis. This new device allows for the use of portable instruments that can provide immediate diagnosis.
Several Ebola vaccine candidates had been developed in the decade prior to and had been shown to protect nonhuman primates against infection, but none had yet been approved for clinical use in humans. Additionally, there were two phase III studies being conducted with two different vaccines. In July , researchers announced that a vaccine trial in Guinea had been completed that appeared to give protection from the virus.
The vaccine, rVSV-ZEBOV ,  had shown high efficacy in individuals, but more conclusive evidence was needed regarding its capacity to protect populations through "herd immunity". The vaccine trial employed "ring vaccination", a technique that was also used in the s to eradicate smallpox , in which health workers control an outbreak by vaccinating all suspected infected individuals within the surrounding area.
In addition to showing high efficacy among those vaccinated, the trial also showed that unvaccinated people were indirectly protected from Ebola virus through the ring vaccination approach, termed "herd immunity". The vaccine has not yet had regulatory approval, but it is considered to be so effective that , doses have already been stockpiled. Researchers have found the results "quite encouraging [but] there is still a lot more work to be done on vaccines for Ebola.
From the beginning of the outbreak, there existed considerable difficulty in getting reliable estimates—both of the number of people affected and of its geographical extent. With the use of heat maps , it was determined that the outbreak did not uniformly unfold over the affected community areas. Growth in the regions of Guinea, Liberia and Sierra Leone was very different over time, indicating that monitoring the outbreak at district level was important.
Visual inspection of incidence curves alone could not render the needed results or data; growth rates with a two-dimensional heat map were used. Finally, the study showed that accurate predictions of growth were improbable, coupled with knowledge about the disease that was not fully adequate at the time as there were now cases of sexual transmission. Calculating the case fatality rate CFR accurately is difficult in an ongoing epidemic due to differences in testing policies, the inclusion of probable and suspected cases, and the inclusion of new cases that have not run their course.
Mortality is measured by number of deaths in a population per the proportion of the population per unit of time. The basic reproduction number , R 0 , is a statistical measure of the average number of people expected to be infected by one person who has a disease. If the rate is less than 1, the infection dies out; if it is greater than 1, the infection continues to spread—with exponential growth in the number of cases. On 28 August , the WHO released its first estimate of the possible total cases from the outbreak as part of its roadmap for stopping the transmission of the virus.
It stated that "this Roadmap assumes that in many areas of intense transmission the actual number of cases may be two- to fourfold higher than that currently reported. It acknowledges that the aggregate case load of Ebola could exceed 20, over the course of this emergency. The Roadmap assumes that a rapid escalation of the complementary strategies in intense transmission, resource-constrained areas will allow the comprehensive application of more standard containment strategies within three months.
When the WHO released these estimates, a number of epidemiologists presented data to show that the WHO projection of a total of 20, cases was likely an underestimate. On 23 September , the WHO revised their previous projection, stating that they expected the number of Ebola cases in Western Africa to be in excess of 20, by 2 November In a report released on 23 September , the CDC analysed the impact of under-reporting, which required correction of case numbers by a factor of up to 2.
With this correction factor, approximately 21, total cases were estimated for the end of September in Liberia and Sierra Leone alone. The same report predicted that total cases, including unreported cases, could reach 1. A study published in December found that transmission of the Ebola virus occurs principally within families, in hospitals and at funerals. The data, gathered during three weeks of contact tracing in August, showed that the third person in any transmission chain often knew both the first and second person.
The study concluded that the epidemic would not be as difficult to control as feared, if rapid, vigorous contact tracing and quarantines were employed. Projections of future cases should also reflect the possibility that deforestation might have a hand in terms of the more recent Ebola outbreaks. It has been suggested that due to the clearing of forest for commercial use, various types of bats namely fruit bats may be taken out of their natural habitat and therefore into closer and potential contact with civilization.
In addition to the loss of life, the outbreak had a number of significant economic impacts. In March , the United Nations Development Group reported that due to a decrease in trade, closing of borders, flight cancellations, and drop in foreign investment and tourism activity fueled by stigma, the epidemic resulted in vast economic consequences both in the affected areas and throughout Africa. This indicated a decline in the Liberian national economy during the outbreak, as well as an indication that the county of Montserrado was hardest hit economically. The capital city Monrovia suffered construction and restaurant unemployment the most, while outside the capital, the food and beverage sectors suffered economically.
A recuperation in the economy, at the end of the outbreak, was expected to be more rapid in some sectors than in others. Also, if the massive decline in economic activity persisted, the authors suggested a focus on economic recovery in addition to support for the healthcare system.
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Another study showed that the economic effect of the Ebola outbreak would be felt for years due to preexisting social vulnerability. The economic effects were being felt nationwide in Liberia, such as the termination of expansions in the mining business. In spite of the end of civil violence since and inflows from international donors, the reconstruction of Liberia had been very slow and non-productive—water delivery systems, sanitation facilities and centralized electricity were practically non-existent, even in Monrovia.
Even before the outbreak, medical facilities did not have potable water, lighting or refrigeration. The authors indicated that lack of food and other economic effects would probably continue in the rural population long after the Ebola outbreak had ended. Speaking at the World Bank and the International Monetary Fund IMF , Liberian president Ellen Johnson Sirleaf said the amount was needed because "[o]ur health systems collapsed, investors left our countries, revenues declined and spending increased. The IMF has been criticised for its lack of assistance in the efforts to combat the epidemic.
In December , a Cambridge University study linked IMF policies with the financial difficulties that prevented a strong Ebola response in the three most heavily affected countries,  and they were urged by both the UN and NGOs who had worked in the affected countries to grant debt relief rather than low-interest loans. According to one advocacy group, " It expected the most severe losses in the three affected countries, with a wider impact across the broader Western African region.
In July , the WHO convened an emergency meeting of health ministers from eleven countries and announced collaboration on a strategy to co-ordinate technical support to combat the epidemic. In August they published a roadmap to guide and coordinate the international response to the outbreak, aiming to stop ongoing Ebola transmission worldwide within 6—9 months, and formally designated the outbreak as a Public Health Emergency of International Concern. In September , the United Nations Security Council declared the Ebola virus outbreak in Western Africa "a threat to international peace and security" and unanimously adopted a resolution urging UN member states to provide more resources to fight the outbreak.
In May , Dr Margaret Chan indicated, "demands on WHO were more than ten times greater than ever experienced in the almost year history of this Organization"   and on 23 March, she stated that "the world remains woefully ill-prepared to respond to outbreaks that are both severe and sustained. There was significant criticism of the WHO from some aid agencies because its response was perceived as slow and insufficient, especially during the early stages of the outbreak. The leaders pledged to assist in carrying out WHO regulations.
Critics criticized the G7 leaders, saying they were not committed enough in the fight against the possibility of future pandemics. In a panel of experts looked at the ways of preventing small outbreaks from becoming large epidemics. Their recommendations were published in the November issue of The Lancet. According to the panel, the epidemic had exposed problems in the national and international institutions responsible for protecting the public from the human consequences of infectious disease outbreaks such as the Ebola epidemic. The panel was highly critical of the WHO's management of the Ebola crisis noting that it took them months to respond and when they did they were slow to act, poorly co-ordinated and inadequately informed.
The report pointed out that the committee responsible for checking the WHO's actions during the outbreak i. The WHO may also have hesitated because it was criticised for creating panic by declaring a public health emergency during the relatively mild H1N1 pandemic. This, the report states, showed the risks in having such consequential decision-making power in one individual—a risk made worse when there was no mechanism of responsibility for such leadership failure.
The panel outlined 10 recommendations for the prevention and handling of future infectious disease outbreaks. Included in the recommendations of the changes needed to fight future outbreaks is the creation of a U. Security Council health committee to expedite political attention to health issues and the establishment of a global fund to finance and accelerate the development of outbreak-relevant drugs and treatment. The report also noted that competent governance of the global system demanded political leadership and a WHO that is more focused and appropriately financed and whose integrity is restored through the application of adequate reforms and leadership.
The WHO has stated that the reported numbers "vastly underestimate the magnitude of the outbreak", estimating there may be three times as many cases as officially reported. A single source may report statistics for multiple "as of" dates.
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From Wikipedia, the free encyclopedia. The — outbreak which caused widespread loss of life and socioeconomic disruption in the region. This article is about the Ebola virus epidemic in Africa in — See also: Ebola virus epidemic in West Africa timeline. Widespread outbreak.
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Limited outbreak. Isolated cases. Medically evacuated cases. Further information: Ebola virus epidemic in Guinea. Further information: Ebola virus epidemic in Sierra Leone. Further information: Ebola virus epidemic in Liberia. Further information: Ebola virus disease in Nigeria. Further information: Ebola virus disease in Mali. Further information: Ebola virus disease in the United Kingdom. Further information: Ebola virus disease cases in Spain. Further information: Ebola virus cases in the United States.
Further information: Democratic Republic of the Congo Ebola virus outbreak. Main article: Prevention of viral hemorrhagic fever. See also: Cultural effects of the Ebola crisis. See also: Ebola virus disease treatment research and Ebola vaccine. See also: Post-Ebola virus syndrome. Play media. Further information: Ebola virus disease treatment research. Further information: Ebola vaccine. Further information: Responses to the Ebola virus epidemic in West Africa. Main article: West African Ebola virus epidemic timeline of reported cases and deaths.
Viruses portal. United Kingdom case dated 29 December.
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