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This manual addresses the design and construction of healthcare facilities supporting the response to Ebola and Marburg (E&M) disease outbreaks, particularly in treatment centres (TCs). It provides technical guidance, minimum requirements, practical tools and layout examples, and references for planning, designing, building, and operating healthcare facilities (TCs and others) to respond to E&M disease outbreaks in low– and middle-income contexts and resource-limited settings. The manual complements other World Health Organization (WHO) literature and contributes to the standardization of facility design and operation for safe and humane care and treatment of patients.
The most recent Ebola epidemic that began in late 2013 alerted the entire world to the gaps in infectious disease emergency preparedness and response. The regional outbreak that progressed to a significant public health emergency of international concern (PHEIC) in a matter of months killed 11,310 and infected more than 28,616. While this outbreak bears some unique distinctions to past outbreaks, many characteristics remain the same and contributed to tragic loss of human life and unnecessary expenditure of capital: insufficient knowledge of the disease, its reservoirs, and its transmission; delayed prevention efforts and treatment; poor control of the disease in hospital settings; and inadequate community and international responses. Recognizing the opportunity to learn from the countless lessons of this epidemic, the National Academies of Sciences, Engineering, and Medicine convened a workshop in March 2015 to discuss the challenges to successful outbreak responses at the scientific, clinical, and global health levels. Workshop participants explored the epidemic from multiple perspectives, identified important questions about Ebola that remained unanswered, and sought to apply this understanding to the broad challenges posed by Ebola and other emerging pathogens, to prevent the international community from being taken by surprise once again in the face of these threats. This publication summarizes the presentations and discussions from the workshop.
Divided into three sections along the lines of bacteriology, parasitology and virology, this book comprehensively provides a systematic, cross disciplinary approach to the science and control of all zoonoses, written by international specialists in human and veterinary medicine.
First published in March 2014 under the title "Clinical management of patients with viral haemorrhagic fever: a pocket guide for front-line health workers: interim emergency guidance for West Africa".
The Ebola and Marburg viruses are a pair of filoviruses that are among the most lethal hemorrhagic viruses on the planet. The authors present a review of past and current research into these pathogens, including 12 papers addressing the structure of the viral proteins; genomic replication; molecular mechanisms of entry; pathogenesis in nonhuman primates, guinea pigs, and mice; virus modulation of innate immunity; and cellular and molecular mechanisms of Ebola pathogenicity and related approaches to vaccine development.
Imagine a killer with the infectiousness of the common cold and power of the Black Death. Imagine something so deadly that it wipes out 90% of those it touches. Imagine an organism against which there is no defence. But you don't need to imagine. Such a killer exists: it is a virus and its name is Ebola. The Hot Zone tells what happens when the unthinkable becomes reality: when a deadly virus, from the rain forests of Africa, crosses continents and infects a monkey house ten miles from the White House. Ebola is that reality. It has the power to decimate the world's population. Try not to panic. It will be back. There is nothing you can do...
This is the first comprehensive review of the world literature on filovirus research and provides the most extensive bibliography of the subject yet published. There is special emphasis on foreign literature that has never been summarized. Every aspect of filovirus research, including their history, epidemiology, clinical picture, pathology, molecular biology, and political aspects are reviewed in detail.
Since the 2014 Ebola outbreak many public- and private-sector leaders have seen a need for improved management of global public health emergencies. The effects of the Ebola epidemic go well beyond the three hardest-hit countries and beyond the health sector. Education, child protection, commerce, transportation, and human rights have all suffered. The consequences and lethality of Ebola have increased interest in coordinated global response to infectious threats, many of which could disrupt global health and commerce far more than the recent outbreak. In order to explore the potential for improving international management and response to outbreaks the National Academy of Medicine agreed to manage an international, independent, evidence-based, authoritative, multistakeholder expert commission. As part of this effort, the Institute of Medicine convened four workshops in summer of 2015 to inform the commission report. The presentations and discussions from the Workshop on Research and Development of Medical Products are summarized in this report.
Recent disease events such as SARS, H1N1 and avian influenza, and haemorrhagic fevers have focussed policy and public concern as never before on epidemics and so-called 'emerging infectious diseases'. Understanding and responding to these often unpredictable events have become major challenges for local, national and international bodies. All too often, responses can become restricted by implicit assumptions about who or what is to blame that may not capture the dynamics and uncertainties at play in the multi-scale interactions of people, animals and microbes. As a result, policies intended to forestall epidemics may fail, and may even further threaten health, livelihoods and human rights. The book takes a unique approach by focusing on how different policy-makers, scientists, and local populations construct alternative narratives-accounts of the causes and appropriate responses to outbreaks- about epidemics at the global, national and local level. The contrast between emergency-oriented, top-down responses to what are perceived as potentially global outbreaks and longer-term approaches to diseases, such as AIDS, which may now be considered endemic, is highlighted. Case studies-on avian influenza, SARS, obesity, H1N1 influenza, HIV/AIDS, tuberculosis, and haemorrhagic fevers-cover a broad historical, geographical and biological range. As this book explores, it is often the most vulnerable members of a population-the poor, the social excluded and the already ill-who are likely to suffer most from epidemic diseases. At the same time, they may be less likely to benefit from responses that may be designed from a global perspective that neglects social, ecological and political conditions on the ground. This book aims to bring the focus back to these marginal populations to reveal the often unintended consequences of current policy responses to epidemics. Important implications emerge - for how epidemics are thought about and represented; for how surveillance and response is designed; and for whose knowledge and perspectives should be included. Published in association with the Economic and Social Research Council (ESRC)
During July 10-13, 2011, 68 participants from 32 countries gathered in Istanbul, Turkey for a workshop organized by the United States National Research Council on Anticipating Biosecurity Challenges of the Global Expansion of High-containment Biological Laboratories. The United States Department of State's Biosecurity Engagement Program sponsored the workshop, which was held in partnership with the Turkish Academy of Sciences. The international workshop examined biosafety and biosecurity issues related to the design, construction, maintenance, and operation of high-containment biological laboratories- equivalent to United States Centers for Disease Control and Prevention biological safety level 3 or 4 labs. Although these laboratories are needed to characterize highly dangerous human and animal pathogens, assist in disease surveillance, and produce vaccines, they are complex systems with inherent risks. Biosecurity Challenges of the Global Expansion of High-Containment Biological Laboratories summarizes the workshop discussion, which included the following topics: Technological options to meet diagnostic, research, and other goals; Laboratory construction and commissioning; Operational maintenance to provide sustainable capabilities, safety, and security; and Measures for encouraging a culture of responsible conduct. Workshop attendees described the history and current challenges they face in their individual laboratories. Speakers recounted steps they were taking to improve safety and security, from running training programs to implementing a variety of personnel reliability measures. Many also spoke about physical security, access controls, and monitoring pathogen inventories. Workshop participants also identified tensions in the field and suggested possible areas for action.