Jake Dunning

Personal account/views. Infectious diseases consultant & researcher. Emerging & high consequence infectious diseases. Humanist.

[Jake Dunning @OutbreakJake]

Cases of Ebola are thankfully rare in the UK, but healthcare services must be prepared to assess and care for patients in whom Ebola is a possibility. This message summarises what to do and how to prepare, ensuring safe care whilst minimising disruption. https://t.co/SZZWBGsHCx

[BBC News (World) @BBCWorld]

How health workers in DR Congo are treating Ebola and staying safe https://t.co/zVRG12sTDU

[Jake Dunning @OutbreakJake]

@FLAHAULT @DoGoodScience Also requires an honest discussion about reactogenicity, and although transient (resolving in 7 days in most following vaccination) pyrexial and flu-like symptoms are very common following Ervebo, often looking like early EVD symptoms; this also needs to be factored into planning

[Jake Dunning @OutbreakJake]

@FLAHAULT @DoGoodScience I would not assume to know what any other population would want. I know my own view as someone who could be offered it as part of my work. The proposal is well intentioned, but it is not without risk (some may say a significant risk). It needs careful, objective decision-making.

[Jake Dunning @OutbreakJake]

@FLAHAULT I think it may be very challenging to communicate the uncertainties regarding cross protection, and to explain that the protective effect is unknown, that one cannot let one's guard down following vaccination (but not necessarily impossible - need to speak to engagement experts).

[Jake Dunning @OutbreakJake]

@FLAHAULT It's a risk. Views on how 'promising' it is vary among experts. Even the authors of the pre-print use appropriately cautious language. Using Ervebo for BDBV outside a trial would be a gamble. I am not a vaccinologist, but I think the considered views of the WHO TAG are important.

[Jake Dunning @OutbreakJake]

@ShaunLintern @petra_khoury In the 2013-16 west Africa epidemic, in which I was once accused of organ-harvesting & genocide(!), there was also a smaller element of disinformation, alongside misinformation. It came from people living through the outbreak. Local authorities described them as 'mischief makers'

[UN News @UN_News_Centre]

Ebola is a terrible disease because you often catch it while caring for someone you love – a husband, a child, a mother.

Stopping transmission means helping communities recognize symptoms early, access testing quickly and get timely care.

[Ranu Dhillon @RanuDhillon]

@MackayIM This is interesting & gets at a real challenge of how to tell if things are working in real time

We proposed 2 metrics (% cases from known chains & symptom-to-isolation interval) that never caught on & don’t get reported like confirmed/suspect cases do

https://t.co/x4ZfOoFY5P

[Jake Dunning @OutbreakJake]

@RanuDhillon Yes, assuming no issues with testing, this is what I was hoping to see - resolution of the large number of suspected cases over the past week, so we have a better idea (albeit still not an accurate picture) of what we are dealing with, what the trajectory might be for this one.

[Jake Dunning @OutbreakJake]

Pleased to have contributed to this session. I talked about preparing to care for suspected & rare confirmed cases of Ebola in Europe, focussing on key principles & proportionate measures to manage any potential infection risk, without causing panic or disrupting other services.

[ESCMID @ESCMID]

🚨 Yesterday’s webinar by the Emerging Infections Subcommittee and the European HLIU Network on the developing Bundibugyo ebolavirus outbreak is now available on ESCMID Media.

Find the link on the subcommittee’s page under the ‘Webinars’ tab ⬇️
https://t.co/lCPwocysgw

[CIDRAP @CIDRAP]

Can mosquitoes learn to love DEET? 🦟

Research published yesterday suggests that mosquitoes may learn to associate the smell of DEET with dinner—and start gravitating toward it instead of away from it.

Read more: https://t.co/Hs7uJA2XBv

[Jake Dunning @OutbreakJake]

Failure to fund an effective, rapid response now risks the same higher-wealth countries & regions having to pay out a lot more later to manage this crisis, potentially including managing related risks closer to home. The burden should not fall on just a few countries & charities.

[Reuters @Reuters]

World Health Organization Director-General Tedros Adhanom Ghebreyesus arrived in Kinshasa on May 28 to coordinate the response to an Ebola outbreak in the Democratic Republic of Congo, urging more international funding after only about a third of the needed support was secured https://t.co/D49lM7UMTb

[Jake Dunning @OutbreakJake]

Sounds like a great initiative. Would be good to know what the risk assessment is for exposure to pathogens in the air, including Legionella risk from cooling towers etc. And also how risk (including particulate/chem exposure) from 'roof-top air' compares to that for air in ICU.

[BBC News (UK) @BBCNews]

'I forgot what it feels like to be outside' – First rooftop intensive care ward opens https://t.co/k3oo5aNap0

[Jake Dunning @OutbreakJake]

@bmj_latest @emahase_ A worrying outbreak, but we don't know what the true trajectory is & panicky speculation about growth rates is unhelpful. % positive rates have had low denominators, set against a huge testing backlog for suspected cases with currently unknown final statuses (+ve, -ve, probable).

[Waihiga Mwaura @WaihigaMwaura]

We spoke to WHO's Dr Marie Belizaire from Bunia, Ituri province, Eastern DRC who told us that out of 2500+ ebola suspected contacts that they needed to trace only 30% had been located because of insecurity in the region.
#FocusOnAfrica @BBCAfrica

[Jake Dunning @OutbreakJake]

Again, those calling for community masking, perhaps because they think all infectious diseases are the same, need a wake up call about how Ebola transmits and the challenges of preventing contact transmission in resource-limited settings where even hand-washing can be difficult.

[The Associated Press @AP]

There is one handwashing station and one infrared thermometer to fight the Ebola epidemic in this camp for 10,000 displaced people in Bunia, a city at the heart of the outbreak in eastern Congo. https://t.co/rGyx6F8yQ0

[Jake Dunning @OutbreakJake]

@KindrachukJason @MackayIM @NEWS Yes, great visualisation (and it looks accurate to me). Thanks for keeping it updated, Ian. May I use it (or a subsequent version) if I need to, for future talks on this outbreak? I would, of course, say and state that this is your great work, not mine.

[Jake Dunning @OutbreakJake]

Echoing comments made by the WHO DG and others, getting control of this outbreak requires an immediate ceasefire by warring parties in Eastern DRC. Without it, there is a much greater risk of the outbreak becoming even worse, with a greater threat to global health too. 4/4.

[Jake Dunning @OutbreakJake]

We've come a long way since we did the RAPIDE trials in 2014-15, not least down to tremendous efforts from @AmandaRojek @PeterHorby & all working on the PARTNERS trial platform sponsored by WHO, including clinician-scientists in countries affected by Ebola & Marburg 1/3

[Kai Kupferschmidt @kakape]

https://t.co/7Ge5a7v6Bb

[Jake Dunning @OutbreakJake]

Launching & running trials of treatments in west Africa in 2014 was tough enough, but the current BDBV Ebola outbreak in DRC brings additional challenges to outbreak response which also affect research response; the risks are not just Ebola exposure, but also armed conflict. 3/4