Ebola virus disease in West Africa--the first 9 months of the epidemic and forward projections.

BACKGROUND: On March 23, 2014, the World Health Organization (WHO) was notified of an outbreak of Ebola virus disease (EVD) in Guinea. On August 8, the WHO declared the epidemic to be a "public health emergency of international concern." METHODS: By September 14, 2014, a total of 4507 probable and confirmed cases, including 2296 deaths from EVD (Zaire species) had been reported from five countries in West Africa--Guinea, Liberia, Nigeria, Senegal, and Sierra Leone. We analyzed a detailed subset of data on 3343 confirmed and 667 probable Ebola cases collected in Guinea, Liberia, Nigeria, and Sierra Leone as of September 14. RESULTS: The majority of patients are 15 to 44 years of age (49.9% male), and we estimate that the case fatality rate is 70.8% (95% confidence interval [CI], 69 to 73) among persons with known clinical outcome of infection. The course of infection, including signs and symptoms, incubation period (11.4 days), and serial interval (15.3 days), is similar to that reported in previous outbreaks of EVD. On the basis of the initial periods of exponential growth, the estimated basic reproduction numbers (R0 ) are 1.71 (95% CI, 1.44 to 2.01) for Guinea, 1.83 (95% CI, 1.72 to 1.94) for Liberia, and 2.02 (95% CI, 1.79 to 2.26) for Sierra Leone. The estimated current reproduction numbers (R) are 1.81 (95% CI, 1.60 to 2.03) for Guinea, 1.51 (95% CI, 1.41 to 1.60) for Liberia, and 1.38 (95% CI, 1.27 to 1.51) for Sierra Leone; the corresponding doubling times are 15.7 days (95% CI, 12.9 to 20.3) for Guinea, 23.6 days (95% CI, 20.2 to 28.2) for Liberia, and 30.2 days (95% CI, 23.6 to 42.3) for Sierra Leone. Assuming no change in the control measures for this epidemic, by November 2, 2014, the cumulative reported numbers of confirmed and probable cases are predicted to be 5740 in Guinea, 9890 in Liberia, and 5000 in Sierra Leone, exceeding 20,000 in total. CONCLUSIONS: These data indicate that without drastic improvements in control measures, the numbers of cases of and deaths from EVD are expected to continue increasing from hundreds to thousands per week in the coming months.

Evaluation of urban measles mass campaigns for children aged 9-59 months in Mali.

There are an estimated 234,000 cases of measles and 13,851 measles-related deaths per year in Mali. In 1998 and 1999, 548,309 children aged 9-59 months were vaccinated against measles during mass campaigns in urban centers across Mali. After the first campaign, measles incidence decreased by 95% in districts encompassing vaccinated urban centers and by 41% in nonvaccinated districts. There was no shift in the proportion of cases by age group in vaccinated centers. Measles in vaccinated districts after the campaign was likely related to persistent transmission in age groups not targeted for vaccination and among children living in nonvaccinated districts. The second campaign (1999) did not change the incidence of measles in vaccinated compared with nonvaccinated centers. Urban mass measles vaccination probably did not affect overall measles transmission in Mali. Mass vaccination of all children in Mali, targeting a larger age group, will be necessary to reach measles control objectives.

Deformidades del tercio medio de la cara: presentación de un caso / Deformities of mid-third of the face: report of a case

Se analiza un caso que presenta una deformidad postraumática del tercio medio, edente total superior y parcial inferior. Se describe el plan de tratamiento adoptado, los pasos de la intervención quirúrgica y su rehabilitación protésica. Se estudia en general las deformidades del tercio medio, planificación del tratamiento, la importancia del equipo multidisciplinario, los princípios rectores que se deben tener en cuenta en las osteotomías del tercio medio de la cara

La mentonoplastia como tratamiento coadyuvante del prognatismo mandibular / Mentoplasty as auxiliary treatment of mandibular prognathism

Se plantea que el prognatismo mandibular ha recibido desde principios de siglo la atención de cirujanos y ortodoncistas, existiendo numerosas técnicas para su tratamiento; sin embargo, en ocasiones esta corrección trae como consecuencia un mentón pobre y excesivamente largo. Se indica que el mentón y el surco mentolabial son esenciales para la estética facial, el cual constituye la línea básica o fundamental para la armonía entre la barbilla, los labios y la nariz. Se informa la existencia de varias técnicas quirúrgicas para la correción del mentón en distintas direcciones y se hace una descripción de las mismas, ilustrándose con dos pacientes tratados con técnicas de mentonoplastia