STOPPING EBOLA: NSF FUNDS RESEARCH ON STOPPING EBOLA

FROM:  NATIONAL SCIENCE FOUNDATION 

Halting the spread of Ebola: Nigeria a model for quick action, scientists find

Rapid control measures critical to stopping the virus in its tracks

Ebola. The word brings fear of an unseen and potentially lethal enemy. But there are ways to stop its spread, say infectious disease scientists.

Quick intervention is needed, according to the researchers, who recently published their findings in the journal Eurosurveillance.

Analyzing Ebola cases in Nigeria, a country with success in containing the disease, the scientists estimated the rate of fatality, transmission progression, proportion of health care workers infected, and the effect of control interventions on the size of the epidemic.

Rapid response needed

"Rapid control is necessary, as is demonstrated by the Nigerian success story," says Arizona State University (ASU) scientist Gerardo Chowell, senior author of the paper.

"This is critically important for countries in the West Africa region that are not yet affected by the Ebola epidemic, as well as for countries in other regions of the world that risk importation of the disease."

The research is funded by the U.S. National Science Foundation (NSF)-National Institutes of Health (NIH)-Department of Agriculture (USDA) Ecology and Evolution of Infectious Diseases (EEID) Program.

"Controlling a deadly disease like Ebola requires understanding how it's likely to spread, and knowing the ways of managing that spread that are most likely to be effective," says Sam Scheiner, NSF EEID program director.

"Being able to respond quickly needs a foundation of knowledge acquired over many years. The work of these scientists is testimony to long-term funding by the EEID program."

Control measures in Nigeria

The largest Ebola outbreak to date is ongoing in West Africa, with more than 8,000 reported cases and 4,000 deaths. However, just 20 Ebola cases have been reported in Nigeria, with no new cases since early September.

All the cases in Nigeria stem from a single traveler returning from Liberia in July.

The study used epidemic modeling and computer simulations to project the size of the outbreak in Nigeria if control interventions had been implemented during various time periods after the initial case, and estimated how many cases had been prevented by the actual early interventions.

"This timely work demonstrates how computational simulations, informed by data from health care officials and the complex social web of contacts and activities, can be used to develop both preparedness plans and response scenarios," says Sylvia Spengler, program director in NSF's Directorate for Computer and Information Science and Engineering, which also supported the research.

Control measures implemented in Nigeria included holding all people showing Ebola symptoms in an isolation ward if they had had contact with the initial case. If Ebola was confirmed through testing, people diagnosed with the disease were moved to a treatment center.

Asymptomatic individuals were separated from those showing symptoms; those who tested negative without symptoms were discharged.

Those who tested negative but showed symptoms--fever, vomiting, sore throat and diarrhea--were observed and discharged after 21 days if they were then free of symptoms, while being kept apart from people who had tested positive.

Brief window of opportunity

Ebola transmission is dramatically influenced by how rapidly control measures are put into place.

"Actions taken by health authorities to contain the spread of disease sometimes can, perversely, spread it," says NSF-funded scientist Charles Perrings, also of ASU.

"In the Nigeria case, people who tested negative but had some of the symptoms were not put alongside others who tested positive," says Perrings. "So they had no incentive to flee, and their isolation did nothing to increase infection rates. Elsewhere in the region isolation policies have had a different effect."

The researchers found that the projected effect of control interventions in Nigeria ranged from 15-106 cases when interventions are put in place on day 3; 20-178 cases when implemented on day 10; 23-282 cases on day 20; 60-666 cases on day 30; 39-1,599 cases on day 40; and 93-2,771 on day 50.

The person who was initially infected generated 12 secondary cases in the first generation of the disease; five secondary cases were generated from those 12 in the second generation; and two secondary cases in the third generation.

That leads to a rough estimate of the reproduction number according to disease generation declining from 12 during the first generation, to approximately 0.4 during the second and third disease generations.

A reproductive number above 1.0 indicates that the disease has the potential to spread.

Recent estimates of the reproduction number for the ongoing Ebola epidemic in Sierra Leone and Liberia range between 1.5 and 2 (two new cases for each single case), indicating that the outbreak has yet to be brought under control.

The effectiveness of the Nigerian response, scientists say, is illustrated by a dramatic decrease in the number of secondary cases over time.

The success story for Nigeria, they maintain, sets a hopeful example for other countries, including the United States.

Co-authors of the Eurosurveillance paper are Gerardo Chowell, Arizona State University; Folorunso Oludayo Fasina, University of Pretoria, South Africa; Aminu Shittu, Usmanu Danfodiyo University, Nigeria; David Lazarus, National Veterinary Research Institute, Plateau State, Nigeria; Oyewale Tomori, Nigerian Academy of Science, University of Lagos, Lagos, Nigeria; Lone Simonsen, George Washington University, Washington, D. C.; and Cecile Viboud, National Institutes of Health, Bethesda, Md.

-- Cheryl Dybas, NSF (
-- Julie Newberg, ASU
Related Programs
Ecology and Evolution of Infectious Disease

PRESIDENT OBAMA'S REMARKS ON EBOLA

FROM:  THE WHITE HOUSE 

September 25, 2014

Remarks by President Obama at U.N. Meeting on Ebola

United Nations Building

New York City, New York

11:15 A.M. EDT

PRESIDENT OBAMA:  Mr. Secretary-General, thank you for bringing us together today to address an urgent threat to the people of West Africa, but also a potential threat to the world.  Dr. Chan, heads of state and government, especially our African partners, ladies and gentlemen:  As we gather here today, the people of Liberia and Sierra Leone and Guinea are in crisis.  As Secretary-General Ban and Dr. Chan have already indicated, the Ebola virus is spreading at alarming speed.  Thousands of men, women and children have died.  Thousands more are infected.  If unchecked, this epidemic could kill hundreds of thousands of people in the coming months.  Hundreds of thousands.

Ebola is a horrific disease.  It’s wiping out entire families.  It has turned simple acts of love and comfort and kindness -- like holding a sick friend’s hand, or embracing a dying child -- into potentially fatal acts.  If ever there were a public health emergency deserving an urgent, strong and coordinated international response, this is it.

But this is also more than a health crisis.  This is a growing threat to regional and global security.  In Liberia, in Guinea, in Sierra Leone, public health systems have collapsed.  Economic growth is slowing dramatically.  If this epidemic is not stopped, this disease could cause a humanitarian catastrophe across the region.  And in an era where regional crises can quickly become global threats, stopping Ebola is in the interest of all of us.

The courageous men and women fighting on the front lines of this disease have told us what they need.  They need more beds, they need more supplies, they need more health workers, and they need all of this as fast as possible.  Right now, patients are being left to die in the streets because there’s nowhere to put them and there’s nobody to help them.  One health worker in Sierra Leone compared fighting this outbreak to “fighting a forest fire with spray bottles.”  But with our help, they can put out the blaze.

Last week, I visited the Centers for Disease Control and Prevention, which is mounting the largest international response in its history.  I said that the world could count on America to lead, and that we will provide the capabilities that only we have, and mobilize the world the way we have done in the past in crises of similar magnitude.  And I announced that, in addition to the civilian response, the United States would establish a military command in Liberia to support civilian efforts across the region.

Today, that command is up and it is running.  Our commander is on the ground in Monrovia, and our teams are working as fast as they can to move in personnel, equipment and supplies.  We’re working with Senegal to stand up an air bridge to get health workers and medical supplies into West Africa faster.  We’re setting up a field hospital, which will be staffed by personnel from the U.S. Public Health Service, and a training facility, where we’re getting ready to train thousands of health workers from around the world.  We’re distributing supplies and information kits to hundreds of thousands of families so they can better protect themselves.  And together with our partners, we’ll quickly build new treatment units across Liberia, Guinea and Sierra Leone, where thousands will be able to receive care.

Meanwhile, in just the past week, more countries and organizations have stepped up their efforts -- and so has the United Nations.  Mr. Secretary-General, the new UN Mission for Ebola Emergency Response that you announced last week will bring all of the U.N.’s resources to bear in fighting the epidemic.  We thank you for your leadership.

So this is all progress, and it is encouraging.  But I want us to be clear:  We are not moving fast enough.  We are not doing enough.  Right now, everybody has the best of intentions, but people are not putting in the kinds of resources that are necessary to put a stop to this epidemic.  There is still a significant gap between where we are and where we need to be.  We know from experience that the response to an outbreak of this magnitude has to be fast and it has to be sustained.  It’s a marathon, but you have to run it like a sprint.  And that’s only possible if everybody chips in, if every nation and every organization takes this seriously.  Everybody here has to do more.

International organizations have to move faster, and cut through red tape and mobilize partners on the ground as only they can.  More nations need to contribute critical assets and capabilities -- whether it is air transport, or medical evacuation, or health care workers, or equipment, or treatment.  More foundations can tap into the networks of support that they have, to raise funds and awareness.  More businesses, especially those who already have a presence in the region, can quickly provide their own expertise and resources, from access to critical supply chains to telecommunications.  And more citizens -- of all nations -- can educate themselves on this crisis, contribute to relief efforts, and call on their leaders to act.  So everybody can do something.  That’s why we’re here today.

And even as we meet the urgent threat of Ebola, it’s clear that our nations have to do more to prevent, detect and respond to future biological threats -- before they erupt into full-blown crises.  Tomorrow, in Washington, I’ll host 44 nations to advance our Global Health Security Agenda, and we are interested in working with any country that shares this commitment.

Just to emphasize this issue of speed again.  When I was down at the CDC -- and perhaps this has already been discussed, but I want to emphasize this -- the outbreak is such where at this point more people will die.  But the slope of the curve, how fast we can arrest the spread of this disease, how quickly we can contain it is within our control.  And if we move fast, even if imperfectly, then that could mean the difference between 10,000, 20,000, 30,000 deaths versus hundreds of thousands or even a million deaths.  So this is not one where there should be a lot of wrangling and people waiting to see who else is doing what.  Everybody has got to move fast in order for us to make a difference.  And if we do, we'll save hundreds of thousands of lives.

Stopping Ebola is a priority for the United States.  I've said that this is as important a national security priority for my team as anything else that's out there.  We'll do our part.  We will continue to lead, but this has to be a priority for everybody else.  We cannot do this alone.  We don't have the capacity to do all of this by ourselves.  We don't have enough health workers by ourselves.  We can build the infrastructure and the architecture to get help in, but we're going to need others to contribute.

To my fellow leaders from Liberia, Sierra Leone and Guinea, to the people of West Africa, to the heroic health workers who are on the ground as we speak, in some cases, putting themselves at risk -- I want you to know that you are not alone.  We’re working urgently to get you the help you need.  And we will not stop, we will not relent until we halt this epidemic once and for all.

So I want to thank all of you for the efforts that are made. But I hope that I'm properly communicating a sense of urgency here.  Do not stand by, thinking that somehow, because of what we've done, that it's taken care of.  It's not.  And if we don't take care of this now we are going to see fallout effects and secondary effects from this that will have ramifications for a long time, above and beyond the lives that will have been lost.

I urge all of you, particularly those who have direct access to your heads of state, to make sure that they are making this a top priority in the next several weeks and months.

Thank you very much.  (Applause.)

END
11:25 A.M. EDT