Sierra Leone announces holiday ban, response surge

Sierra Leone's government announced a ban on Christmas and New Years' parties and other festivities to curb the spread of Ebola and said it will launch a month-long response surge to fight the virus, which is still fueling intense illness, especially in the western part of the country.

The holiday announcement comes amid still-rising cases in Sierra Leone and on the heels of a 2-week lockdown of Kono district, in the eastern part of the country, an area previously thought to be under control. Jarrah Kawusu-Konte, a spokesman for Sierra Leone's president, made the announcement about Christmas and New Years' on Dec 12, Reuters reported today.

He said the government is planning to keep people indoors during Christmas through Boxing Day (Dec 26) and the new year.

In its latest case number update today, the World Health Organization (WHO) said that, as of Dec 13, Sierra Leone has reported 8,273 Ebola infections, along with 2,033 deaths from the disease. As of last week, Sierra Leone has the most cases of the three hardest-hit countries, though Liberia—with 7,797 cases—hasn't reported its data since Dec 9.

The WHO put the overall global Ebola total at 18,464 illnesses and 6,841 deaths.

Surge target: getting the sick into treatment

Kawusu-Konte said government officials are eager to break the chain of transmission through parties and gatherings, but he did not say when the ban would take effect, according to the report.

Authorities are planning a 1-month surge, starting Dec 17, that will target areas in and around the capital city of Freetown, Reuters said. Palo Conteh, who heads the country's National Ebola Response Center, told Reuters that a main emphasis will be tracking down sick people and getting them in to Ebola treatment centers, more of which will open in the coming week.

A statement posted today on Sierra Leone's health ministry Web site said a new 100-bed Ebola treatment unit opened over the weekend in Port Loko district. The district's medical officer Adikali Kamara, MD, said in the statement that more than 900 confirmed Ebola cases have been confirmed in Port Loko, with 8 positive cases reported from Dec 12 to Dec 15.

"With these facilities, there is a ray of hope for Port Loko district and beyond," he said in the statement.

Meanwhile, the disease has sickened yet another doctor in Sierra Leone, the Associated Press (AP) reported today. Sierra Leone's chief medical officer Brima Kargo, MD, said yesterday that Victor Willoughby, MD, tested positive for the Ebola virus, which has now struck 12 of the country's doctors, killing 10 of them.

WHO experts discuss phase 2 vaccine trials, release psychological guide

A 2-day meeting began today to review an application for a phase 2 clinical trial of an Ebola vaccine developed by GSK and the National Institutes of Health (NIH). Called ChAd3, the vaccine uses a modified chimpanzee adenovirus. On Nov 26 researchers reported promising initial findings from the first human tests for the vaccine.

The WHO said in a statement that meeting participants include representatives from GSK and members of national ethics and regulatory authorities from Cameroon, Ghana, Guinea, Liberia, Mali, Nigeria, Senegal, and Sierra Leone. The agency added that technical support, if needed, will be available from regulatory groups in Canada, Europe, Switzerland, and the United States. The team will conduct a joint review of the phase 2 clinical trial application, with a decision about whether the trial will move forward expected to be announced on Dec 17.

The WHO said phase 1 trials for the ChAd3 vaccine are nearly completed in Mali, Switzerland, the United Kingdom, and the United States. It added that the group will hear the early results from the trials, but the main agenda item will be GSK's phase 2 protocol.

On another response front, the WHO said it and its partners have released a new resource for providing psychological first aid for Ebola outbreaks, as a resource for providing human, supportive, and practical help in a way that respects people's dignity, culture, and abilities.

The guide is a facilitator's manual that covers how to prepare an orientation, a full-day agenda that includes step-by-step descriptions for each module, handouts, and slides and instructions for group exercises and discussions. The WHO said the new guide is designed to be used alongside a psychological first aid guide for Ebola disease settings that it released in September.

Other developments

  • The US Agency for International Development (USAID) on Dec 12 announced nominees for its first awards under its Ebola Grand Challenge for Development. The theme of the first development challenge, launched in early October, is identifying ways to make personal protective equipment (PPE) more protective and comfortable for health workers battling Ebola in West Africa. USAID said in a statement that US government experts and their international partners heard pitches from the top innovators and narrowed the list to three in a rapid, rigorous review process. Projects that will receive support and testing include a Johns Hopkins and Jhpiego healthcare worker suit designed for quicker and safer doffing with an integrated cooling feature, an antiseptic from Aquarious GEP LLC and Innovative BioDefense that protects against pathogens for up to 6 hours when applied to the skin, and a spray-on barrier that kills and repels microbes. USAID said a separate partnership will rapidly evaluate several cooling solutions, including off-the-shelf cooling undergarments and a base layer cooling system from a sports-wear company designed to cool blood at pulse points.

  • Health authorities in Guinea-Bissau are isolating and testing a man from Guinea who has a suspected Ebola infection and entered the country a day after it reopened its borders, according to an update today from the United Nations Mission for Ebola Emergency Response (UNMEER).The man had a high fever and was placed under surveillance as he tried to pass through the Fulamori border crossing. He evaded security and boarded a bus for the eastern city of Gabu, where authorities apprehended him. Eight of his fellow passengers have been quarantined.

  • The WHO said the number of children who have been infected by Ebola in Guinea is 432, reflecting 20% of the confirmed cases. Of that number, 260 died and 134 survived their infections, UNMEER said today. It said 37 are still being cared for in Ebola treatment centers.

  • In its Dec 12 update, UNMEER said UN Secretary-General Ban Ki-moon has appointed Ismail Ould Cheikh Ahmed of Mauritania to succeed Anthony Banbury as the head of UNMEER. Banbury will return to New York in early January. Ahmed has 28 years of development and humanitarian assistance experience with the UN in Africa, the Middle East, and Eastern Europe, and is currently the deputy head of the UN Support Mission to Libya.

See also:

Dec 15 Reuters story

Dec `15 WHO case number update

Dec 15 Sierra Leone health ministry statement

Dec 15 AP story

Dec 15 WHO statement on joint review of phase 2 Ebola vaccine trials

Dec 15 WHO psychological first aid statement

Dec 12 USAID statement

Dec 15 UNMEER update

Dec 12 UNMEER update

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