Ebola Outbreak Update and Information Resources

I started researching Ebola yesterday, when I realized I needed a refresher course to answer some of my own questions about the disease. For example:

Why are so many people getting Ebola so quickly? It’s spread by body fluids like HIV is, so why does it spread so much more quickly and effectively?

It turns out that many more body fluids are MUCH more infectious with Ebola than with HIV. Ebola can be spread (even through microscopic droplets) in saliva, blood, tears, vomit, feces, semen, vaginal secretions (there is some dispute among official sources as to whether sweat can spread the disease).

In this helpful taxonomy from the Journal of Infectious Diseases: Assessment of the Risk of Ebola Virus Transmission from Bodily Fluids and Fomites, the authors explain,

“We found EBOV to be shed in a wide variety of bodily fluids during the acute phase of illness, including saliva, breast milk, stool, and tears. In most cases, the infected bodily fluid was not visibly contaminated by blood. Of particular concern is the frequent presence of EBOV in saliva early during the course of disease, where it could be transmitted to others through intimate contact and from sharing food, especially given the custom, in many parts of Africa, of eating with the hands from a common plate.”

Unlike with HIV and many other bloodborne pathogens, casual contact such as sharing a meal with someone infected with Ebola is a seriously risky activity!

In addition, it can take up to 3 weeks for symptoms to appear! Even after symptoms begin, people can be ambulatory and highly infectious. Funeral rites for Ebola victims in West Africa also often bring families and communities into close (even direct) contact with deceased victims, whose bodies can still easily transmit the virus to others.

According to this World Health Organization report released yesterday (4/14/14), 168 cases of Ebola have been confirmed in West Africa, and 108 people have died from the disease.

As Sanjay Gupta explains in this video, a turning point in the outbreak’s trajectory  was when the virus spread into Guinea’s capitol, Conakry, from outlying, rural areas where the outbreak began. People had been fleeing outlying villages in an attempt to avoid the virus, and someone infected inadvertently brought Ebola with them on the journey to the densely-populated city of almost 2 million people. The outbreak has spread across national borders in West Africa to Liberia, and cases are being tested in Mali.

HealthMap is an excellent (if also slightly terrifying) way to keep up with the geographic reach/distribution of all verified disease outbreaks globally, including Ebola:


U of M-affiliated readers can access GIDEON, which provides the full history of Ebola outbreaks globally clinical and diagnostic information, pictures, and even allows you to compare the disease to any others you might be interested in. For example:

Gideon capture

For everyone living and traveling in West Africa right now, and for the brave, dedicated health workers on the front lines: stay safe!

Lives Change! — Hashtags of the Week (HOTW): (Week of April 14, 2014)

Hatcher Graduate Library

Libraries change lives. As medical librarians this concept is at the heart and soul of our daily lives. What we do either directly informs the patient or the care provider, and can change both individual lives as well as the standard of care across institutions and nations. We all have stories of this happening. Sometimes it is that the information actually changed the progression of a disease or healing from an injury, while sometimes it is simply the caring and sense of someone listening who cares and understands.

This year, for National Library Week (which, by the way, starts today), the theme is LIVES CHANGE! Barbara Stripling, the President of the American Library Association, has proposed the Declaration for the Right to Libraries. Getting people to sign the Declaration is only part of it. Another part of it is getting people to stop and think and talk about how libraries have changed their lives.

Was it the librarian who made a safe place for you when you were a child in an unhappy home?

Was it the librarian who got you permission to access secured information for a school project that ended up becoming your career?

Was it the librarian who quietly found just the right book to help you deal with something that was troubling you?

Was it the librarian who dug deep and found some less common treatment ideas when everything else had failed?

Was it the librarian who kept your health challenges private, but gave you a person to talk with when there seemed to be no one?

Was it the librarian who listened to every idea you had for your thesis, and then turned up surprising tidbits you didn’t know you wanted?

Was it the librarian who helped you find and connect with a person to prototype your invention to make a new career for yourself?

Was it the librarian who found the answer to that one question that your next big project hung on, making it possible to complete the planning on time and under budget?

The hashtags for the week are associated with this meme – Lives Change, and National Library Week. Now, go sign the Declaration, and then tell your librarian you did, and why.

“Lives Change” / “Libraries Change Lives” #LivesChange

National Library Week 2014 #NLW14

Celebrate National Library Week April 13-19!

A banner with information about supporting libraries during National Library Week, April 13-19th!

Please plan to attend the National Library Week Town Hall presentation with Barbara Stripling, President of the American Library Association on “The Declaration to the Right to Libraries!”

Monday, April 14th, 10:30 am - 12 noon.
University of Michigan, Harlan Hatcher Graduate Library, Gallery, Room 100

James Hilton will introduce President Stripling who will share her national and international perspectives on the greatest challenges and opportunities for libraries to be life-long learning institutions, community builders, publishing partners, collaborators, empowerment engines, maker spaces, and much more.
The town hall meeting format encourages questions from the audience. If you have questions to submit in advance, please contact: Karen Downing or Emily Hamstra.  Read more about Barbara Stripling’s work: http://my.ischool.syr.edu/Profiles/Preview/bstripli

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Reflections from Paul Rusesabagina 20 Years After the Rwandan Genocide

April 7, 1994 is the date recognized by the international community as the beginning of the Rwandan Genocide.

During his lecture on March 27th at the Rackham Auditorium, Paul Rusesabagina shared why the anniversary of the atrocities is for him, and many other Rwandans and Ugandans, October 1, 1990.  This is the date that exiled Tutsis returned to Rwanda and began killing Hutu civilians, leaving 1 million people in refugee camps.  In 1993, a Hutu president was elected in the neighboring country of Burundi but he was assassinated by Tutsi soldiers.  Following the assassination, a peace agreement was signed by the Hutu government and Tutsi rebels and 2500 UN soldiers were placed in the capital city Kigali. Mr. Rusesabagina said that people who thought the genocide came and disappeared at specific points are mislead and misinformed; there were signs that genocide was occurring and that is was going to continue prior to April 7, 1994.


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Preparedness — Hashtags of the Week (HOTW): (Week of April 7, 2014)

SL - Wolverine: UMMS Elective, Play2Train

It seems like now every week has so many incredible conversations going on that it is hard to choose a topic for these weekly posts. This week I was saved by the synchronicity of two separate tags with similar themes. The annual Preparedness Summit conference was going on (#PS14), and then the weekly medical librarians chat (#medlibs) also focused on disaster preparedness. So, there you go, that’s today’s topic!

The Preparedness Summit focused on the profession, trends, new research, etc. The medical librarians chat, to my surprise, focused less on libraries and more on practical personal sharing of what’s most important to remember for personal safety in various types of disaster scenarios. Both were useful and information. Here are highlights from both hashtags. There are even overlapping tweets, with both hashtags!

Beyond “Light it Up Blue” — Maybe “Light it up Gold”!

UN: World Autism Awareness Day

Today is World Autism Awareness Day, a permanent observance created by the United Nations. Monday, Anna Schnitzer and I attended a presentation on campus by Elizabeth J. “Ibby” Grace on the rhetoric of autism activism. You can find notes, pictures, and livetweets from the event in this Storify.

Autistic Activism in an Age of the Blues: https://storify.com/pfanderson/autistic-activism-in-an-age-of-the-blues/

In the event, part of what we learned was that the Light It Up Blue campaign for autism awareness, which presents itself upon first glance as if they are representing the UN in this, is actually a corporate project sponsored by the controversial organization Autism Speaks.

Autism Speaks: Light It Up Blue

Autism Speaks does fund a great deal of interesting research, so I’m not going to touch on why they are considered so controversial (at least not in this post!). It was interesting to learn more from Ibby Grace about other ways to celebrate World Autism Awareness Day and support autism acceptance and the ASD community. Here are some she mentioned. Tone it Down Taupe seemed to be her favorite, but since we are UM, I figured if we aren’t going blue, maybe gold is another good choice! There are also a few others that appeared while I was searching.

WAAD: Tone it down taupe

Tone It Down Taupe (for Autism Acceptance): http://toneitdowntaupe.tumblr.com/
TIDT on Facebook: https://www.facebook.com/pages/Tone-it-Down-Taupe/446945788708219

WAAD: Light it up Gold

Light it up Gold (from AU for Autistic Union): https://www.facebook.com/groups/Goldforautism/

WAAD: Light it up Red

Light It Up Red: http://autismthroughoureyes.org/LightItUpRed/
Facebook: https://www.facebook.com/events/664431953623778/

There are so MANY images of the ribbon with the puzzle or the rainbow puzzle ribbon, that I can’t possibly point to them all. Here is one from Wikipedia.

Autism Awareness Ribbon

Meanwhile, Ibby Grace had a great point about diversity and acceptance in considering the question of autism awareness and acceptance.


Reverse Innovation — Hashtags of the Week (HOTW): (Week of March 31, 2014)

Ethnic Box

Reverse innovation is a concept I’ve been tracking closely recently, and which is critical in global health. The idea, in health anyway, is that we have as much to learn from developing nations as they have to learn from us. I heard a story of a visiting faculty member here from Ghana who saved a baby’s life because he knew how to manually reposition babies in the womb during delivery when there isn’t enough time to get the machines that are sometimes used here for the same purpose. That’s just one small, local example. Last week’s Twitter chat on reverse innovation brought up several others. You can find the complete chat and cited articles in this Storify:

Do low-income countries hold the key to health innovation?: https://storify.com/pfanderson/do-low-income-countries-hold-the-key-to-health-inn

Here are a few selected tweets from the chat.

Tracking the Trends in Emerging Technologies

Emerging Technology Trends 2014

Trying to do strategic planning? Want to know what’s looming on the horizon? I’ve been working on a little meta-analysis of emerging technology reports and the trends they identify. The top reported technologies and trends were these.

5 of 10

3d printing
learning analytics

4 of 10

Additive manufacturing
Big data
Flipped classroom
Games & gamification
Social media
Virtual reality
Wearable technology

3 of 10

Artificial intelligence
Mobile learning
Personal agency (learners, patients)
Personal genomics
Social networks

The infographic at the top gives you the highlights, with more information available at the blogpost.

Tracking the Trends: Emerging Technologies 2014 http://etechlib.wordpress.com/2014/03/21/tracking-the-trends-emerging-technologies-2014/

The Future of Genomic Medicine #FOGM14 — Hashtags of the Week (HOTW): (Week of March 21, 2014)

Lantern Slides: Heritance of Clefting

The image above is from one of the earliest studies on the genetics of clefting done here at the University of Michigan School of Dentistry. Those were the days, weren’t they? You had to track signs and symptoms across generations, for decades, trying to deduce large scale patterns. Now we spit in a tube and mail it off.

Pic of the Day - PGen

The Future of Genomic Medicine was just happening. It was being actively tweeted by a number of leading figures in healthcare and science — Eric Topol, Carl Zimmer, Dr. Khoury from the CDC, Magdalene Skipper from Nature, and (uh) Al Gore, just for starters. It was so active that the original hashtag, #FOGM14, had to be dropped because of spammers, and they group switched to #FOGM2014. It was so active that even though it happened two weeks ago, the hashtags are still active on Twitter with people continuing the conversations around the conference. Here are just a highly selected few tweets with interesting thoughts, resources, and take-aways from this important conference.


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World Water Day 2014: U.N. Focuses Energy on Energy

Today is World Water Day 2014, and the United Nations has chosen to emphasize the link between water and energy. This was surprising to me, because looking at the Millennium Development Goals (developed in 2000), there were no goals specifically related to energy usage or even the mention of global warming. When I think about international development/global health and water, I first think of the prevention of communicable diseases (cholera, guinea worm, etc.) and access to clean drinking water, which are addressed as part of the MDG goals. The United Nation’s reminder is timely and important:


In the last year, I have gained a better understanding about the successes and the limitations of the Millennium Development Goals, and today’s celebration is a further revelation for me:energy and climate change were completely left out in 2000 as international development goals, even though they are absolutely determinants for the future of people’s health globally. I wonder if the SDGs will tackle the issues of energy, climate change and water?

For more (incredibly timely) information, please check out UNWater’s World Water Development Report, which was released YESTERDAY, 3/21/2014.