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NEJM Perspective Pieces Discuss Responses To West African Ebola Outbreak

The New England Journal of Medicine (NEJM) on Wednesday published several perspective pieces discussing the ongoing Ebola outbreak.

NEJM: The International Ebola Emergency
Sylvie Briand, director of the pandemic and epidemic diseases department (PED) at the WHO, and WHO colleagues

“…These observations [about the Ebola outbreak] point to immediate priorities for control: early diagnosis with patient isolation, contact tracing, strict adherence to biosafety guidelines in laboratories, barrier nursing procedures and use of personal protective equipment by all health care workers, disinfection of contaminated objects and areas, and safe burials. … These recommended control methods are, of course, more easily recited than implemented. … Above all, we are looking for a sustained decrease in incidence, from week to week and district by district, with no sign of further geographic spread. In the coming days and weeks, that will be our primary measure of success in preventing infections and saving lives” (8/20).

NEJM: Ebola Virus Disease in West Africa — No Early End to the Outbreak
Margaret Chan, WHO director general

“Many people have asked me why the outbreak of Ebola virus disease in West Africa is so large, so severe, and so difficult to contain. These questions can be answered with a single word: poverty. … Experience tells us that Ebola outbreaks can be contained, even without a vaccine or cure. Nonetheless, with the formidable combination of poverty, dysfunctional health systems, and fear at work, no one is talking about an early end to the outbreak. The international community will need to gear up for many more months of massive, coordinated, and targeted assistance. A humane world cannot let the people of West Africa suffer on such an extraordinary scale” (8/20).

NEJM: Ebola 2014 — New Challenges, New Global Response and Responsibility
Thomas Frieden, CDC director, and CDC colleagues

“…The Centers for Disease Control and Prevention (CDC) is working intensively with partners to help stop the outbreak at its source in Africa. … In addition to acting to stop this outbreak, we should put systems in place to prevent another one. Earlier this year, the United States joined partner governments, the World Health Organization, and other multilateral organizations and nongovernmental actors to launch the Global Health Security Agenda, which aims to better protect all people from health threats. … The Global Health Security Agenda aims to strengthen public health systems in countries that need it most in order to stop outbreaks before they become emergencies…” (8/20).

NEJM: Studying ‘Secret Serums’ — Toward Safe, Effective Ebola Treatments
Jesse Goodman of Georgetown University and the Veterans Affairs Medical Center

“…As we move forward, quickly but cautiously, in using and testing new therapies, we have already learned some lessons from this outbreak — regarding the need to build trust, the need to enhance public understanding of experimental treatments and their safe evaluation, and the critical nature of the capacity both for public health intervention and to ethically field clinical studies under challenging conditions. When it comes to infectious diseases, we are increasingly one world and dependent on each other for knowledge, safety, and security” (8/20).

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