Global leaders warn against Ebola complacency

United Nations (UN) Secretary-General Ban Ki-moon today urged countries to continue their support for West Africa's Ebola outbreak countries, adding that although the virus is still outpacing response activities, continued scale-up could bring the disease under control by the middle of 2015.

Ban made the comments at a media briefing after a UN chief executives meeting with the World Bank to assess the status of the global response.

Leaders urge countries to continue response surge

He said the situation in Mali—where recent cases have surfaced—is deeply concerning and that he instructed Anthony Banbury, head of the UN Mission for Ebola Emergency Response (UNMEER) to establish a support mission in Mali and that World Health Organization (WHO) Secretary-General Margaret Chan, MD, MPH, will travel to Mali today to meet with government officials and assess the situation.

For the three main outbreak countries, it's not too soon to start working on recovery, especially in the healthcare, education, and food security sectors, Ban said. "I'm asking the international community to continue its support. The international response is still outpaced by the virus."

Chan told reporters that there are early signals of hope that the disease is slowing in some countries, but new areas are reporting new cases, and the emergence of a new Ebola cluster is concerning. "Complacency will be our enemy, and we need to continue to do more to get to zero."

She said UN partners, the US Centers for Disease Control and Prevention (CDC), and Doctors without Borders (MSF) are all scaling up their actions in Mali in a "no regret policy."

"We must smother this little fire before it gets out of control," Chan said.

World Bank President Jim Yong Kim said in a statement that this is a pivotal moment in the Ebola epidemic, with clear evidence of progress, especially in Liberia, and signs that the international response is making a difference. "But there's also evidence that is very worrisome, such as the increase in infections in Sierra Leone and the spreading of the outbreak to Mali."

Kim also warned governments not to become complacent.  "We know this deadly virus has a history of resurgence, so we all must remain vigilant even where things look promising."

Case number update

It its latest case report today, the WHO said that, as of Nov 18, the global number of Ebola cases has risen to 15,351, including 5,459 deaths. The numbers reflect an increase of 206 illnesses and 39 fatalities since the WHO's last update 2 days ago.

The WHO said transmission is intense in Guinea, Liberia, and Sierra Leone, and that Mali's total remains at 6, and all of the people infected by Ebola in that country died from their infections.

Of the new cases reported today, more than half were in Sierra Leone, which reported 117 more infections and 17 additional deaths since the WHO's last report. Guinea's case total rose by 76, with 22 more fatalities reported. Meanwhile, Liberia reported 13 more cases, while its number of deaths fell by 1 since earlier this week.

Mali Ebola response

MSF said yesterday that it has beefed up its team in Mali and has expanded its activities there in the wake of the Nov 11 detection of an Ebola case in Bamako, the country's capital.  It warned that swift, coordinated actions are needed, especially in the first few days following a newly detected case.

It said one patient who was being treated in its case management center died yesterday and that a patient with a suspected infection is being treated there. MSF said it is running the center with CNAM, Mali's national disease center.

MSF didn't say which patient died. However, Mali's state television announced today that a doctor who treated the patient that sparked a clinic cluster, a sick Imam from Guinea, died of Ebola virus disease (EVD), Reuters reported today.

The group also said in a statement today that it is evacuating a Spanish member of its staff from Bamako who suffered a needlestick injury during the care of a confirmed Ebola patient. It said the woman is not showing any disease symptoms and has not tested positive for Ebola, but is being taken to a treatment center in Madrid as a precautionary measure.

In another health worker development, a Cuban doctor infected with Ebola while working in Sierra Leone has arrived in Geneva for treatment, the Associated Press (AP) reported today. Quoting a Geneva medical official, it said the man wearing a protective suit was able to walk off the plane before boarding an ambulance.

Other developments

  • Iowa-based NewLink Genetics may team up with pharmaceutical giant Merck in the hopes of expediting production and distribution of its Canadian-developed Ebola vaccine, VSV-EBOV, Postmedia News reported today. NewLink staff met with Merck representatives and the Public Health Agency of Canada in Ottawa last week, and the company may announce an agreement in the "not-too-distant future," the story said. Scientists who developed the vaccine have expressed frustration over perceived delays in testing and manufacturing, with some critics suggesting Canada withdraw from its agreement with NewLink to work with a larger company.

  • The WHO yesterday reported on research priorities laid out in a Nov 13-14 meeting of its Ebola Science Committee, chaired by Peter Piot, MD, PhD, of the London School of Hygiene and Tropical Medicine. Priority topics included disease pathogenesis, correlates of immunity, viral dynamics, clinical course and interventions, epidemiology and population health, capacity building, lab testing, and behavioral science.

  • Yesterday marked 42 days since the last Ebola outbreak case-patient in the Democratic Republic of the Congo (DRC) tested negative twice, signaling an end to the outbreak there, the WHO said today in a statement. The outbreak, in Jeera County in Equateur province involved 66 cases of EVD, including 8 among healthcare workers. The WHO first reported it on Aug 27. The agency commended the country for its leadership and effective response. It was the DRC's seventh outbreak since the virus was first identified there in 1976.

Editorial director Jim Wappes contributed to this report.

See also:

Nov 21 World Bank statement

Nov 21 WHO situation update

Nov 20 MSF statement

Nov 21 Reuters story

Nov 21 MSF statement

Nov 21 AP story

Nov 21 Postmedia News story

Nov 20 WHO summary of research priorities

Nov 21 WHO statement on DRC

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