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Lessons From Africa's Hard-Won Victory Over Ebola

BLOOMBERG  Commentary      by Charles Kenney                                              Feb. 3, 2015
...Without good surveillance, disease threats can fester undetected until they are considerably harder to contain. At the moment, countries simply declare they have the capacity to meet global standards and the WHO takes their word for it. There should be a system of independent review, backed up with international assistance and support to ensure that all countries really do have the capacity to track infectious disease outbreaks and control their spread across borders.

....the global health research system is primarily driven by market pressures. The cost of bringing a drug through the regulatory processes to market averages around $1 billion. That's a big reason why pharmaceutical companies would rather spend money on treatments for the diseases of the rich than for conditions that largely affect people in countries like Liberia...

There are two approaches to deal with that problem: lower the cost of drug development and increase the market for the products that emerge. ...

To increase demand, governments can club together to create an "advanced market commitment": If a drug developer produces a vaccine or therapy that meets certain standards, donors precommit to buy it in bulk....

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'Good virus' believed to help increase survival chances in Ebola and HIV infections

INTERNATIONAL BUSINESS NEWS by Jayalaksmi K      Feb. 2, 2015

A common virus that infects billions at some point of their lives is believed to deliver some protection against other deadlier viruses like HIV and Ebola.

David O'Connor, a pathology professor at the University of Wisconsin in Madison, found the genetic fingerprints of the virus GBV-C in the records of 13 samples of blood plasma from Ebola patients.

While six of the 13 people who were co-infected with Ebola and GBV-C died, seven survived.

Combined with earlier studies that have hinted persistent infection with the virus slowed disease progression in some HIV patients, researchers think the virus could be beneficial.

"We're very cautious about over-interpreting these results," O'Connor told NPR. He is now waiting to get a bigger sample, to see if there really is a strong connection between GBV-C infection and survival.
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In pursuit of next-generation Ebola stockpile vaccines

REUTERS   by Kate Kell and Ben Herschler                                                                        Feb. 1. 2015
LONDON --As West Africa's devastating Ebola outbreak begins to dwindle, scientists are looking beyond the endgame at the kind of next-generation vaccines needed for a vital stockpile to hit another epidemic hard and fast.

 

Research assistant Georgina Bowyer works on a vaccine for Ebola at The Jenner Institute in Oxford, southern England January 16, 2015. Credit: Reuters/Eddie Keogh

Determined not to lose scientific momentum that could make the world's first effective Ebola interventions a reality, researchers say the shots, as well as being proven to work, must be cheap, easy to handle in Africa and able to hit multiple virus strains.

That may mean shifting focus from the stripped-down, fast-tracked vaccine development ideas that have dominated the past six months, but it mustn't mean the field gets bogged down in complexities.

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There's an Ebola Vaccine in Africa. Now What?

A scanning electron micrograph of the Ebola virus. The first large-scale trials of an Ebola vaccine are underway in Africa.(NIAID / Flickr)

Unprecedented: In four months, the Ebola vaccine has gone from concept to field trial. Success is not assured.

 THE NATIONAL JOURNAL  by Brian Resnick                      Jan. 28, 2015

Detailed description of the problems issues and procedures for fieldingand testing Ebola vaccines in West Africa.

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..."Without the (Ebola) virus circulating, there's no way to prove the vaccine is effective. At current infection rates, trial researchers would need to see 100 cases of Ebola over a four-month period to achieve statistical significance. That time frame may stretch, or fall apart altogether.

"It's a real dilemma," says Margaret Harris, an MD and spokeswoman for the World Health Organization. "It's extremely good news that the cases are coming down, but it does mean we may not have clear phase III data."

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An experimental Ebola vaccine looks promising in a human trial

Vaccine  was made by introducing an Ebola gene in a chimpanzee cold virus

THE VERGE    by Arielle Duhaime-Ross                                                             Jan. 28, 2015

An Ebola vaccine produced using a chimpanzee common cold virus appears to be safe to use on humans, according to a study published today in the New England Journal of Medicine. Three different doses of vaccine were tested on healthy humans in the UK, and it was well-tolerated; it triggered high levels of antibody formation without also triggering serious side effects. But until the vaccine is tested in an area where an Ebola risk actually exists, it’s efficacy against the disease will remain a mystery.

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http://www.theverge.com/2015/1/28/7930947/ebola-vaccine-human-trials-results

A Monovalent Chimpanzee Adenovirus Ebola Vaccine — Preliminary Report

 New England Journal of Medicine

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Ebola mutations could make some drugs ineffective

BALTIMORE SUN     by Scott Dance                                                   Jan. 20, 2015

In the year since Ebola began spreading across West Africa, the virus has mutated in more than 600 ways that change it slightly from versions studied in labs and used to develop treatments, according to researchers at Fort Detrick. And 10 of the mutations could make some drugs used to treat the virus ineffective, they wrote in research published Tuesday.

The "genomic drift," as the scientists called it, could make agents similar to the experimental drug ZMapp unable to bind to the virus anymore.

While the changes affect only a tiny fraction of Ebola's genome, they offer new lessons about the virus that might not have been learned because of the wide scope of the outbreak, larger than all others combined
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http://www.baltimoresun.com/health/bs-hs-ebola-mutation-20150120-story.html

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Common Generic Drug May Cure Ebola

PHARMACY TIMES   by Monica V. Mahoney, Pharms D, -BCPS-AQ ID                                            Jan. 15, 2015
Monica V. Mahoney, PharmD, BCPS-AQ ID
Monica V. Mahoney, PharmD, BCPS-AQ ID
Monica V. Mahoney, PharmD, BCPS-AQ ID
Several antibody-mediated, antiviral-focused, and vaccine-derived approaches are currently being investigated, but a major setback to many of these modalities is the time it takes to produce the interventions.
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Fast track development of Ebola Vaccines

Principles and target product criteria

THE CENTER FOR INFECTIOUS DESEASE AND POLICY                                              Jan 12, 2015

The unprecedented morbidity and mortality from the 2013- 2015 Ebola virus disease (EVD) epidemic in West Africa has challenged every aspect of our global ability to effectively detect, respond to, and control such a rapidly emerging infectious disease crisis.

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Magic Blood? Emory's Ebola Plasma Bank

NBC NEWS   by Maggie Fox                                                                      Jan. 14, 2015
Cup by cup, Emory University is collecting bags of liquid gold from the small club of American Ebola survivors.

They're collecting the plasma as part of an experiment to see if transfusing blood from people who have lived through the horrific infection can save the newly ill. Many of the survivors have been given this so-called convalescent plasma, but no one knows if it's actually helping.

"The protocol allows us to collect and transfuse convalescent plasma from U.S. Ebola survivors," says Dr. Anne Winkler, the Emory pathologist overseeing the study. "This is a completely voluntary process."

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Probe of Ebola burial practices pinpoints risks, triggers changes

CENTER FOR DISEASE POLICY AND RESEARCH by Lisa Schnirring                                   Jan. 13, 2015

An early September assessment of burial practices in some of Sierra Leone's Ebola hot spots revealed a host of problems that were probably helping fuel ongoing virus transmission in the country, experts from the US Centers for Disease Control and Prevention (CDC) and Sierra Leone's health ministry reported today.

The team conducted its first assessment in three high-risk areas, focusing on burial practices, cemetery management, and adherence to recommended practices. Then they looked at the issues again the following month on a broader scale ahead of the Sierra Leone government's national rollout of standard procedures for safe and dignified burials. They published their findings in Morbidity and Mortality Weekly Report (MMWR).

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http://www.cidrap.umn.edu/news-perspective/2015/01/probe-ebola-burial-practices-pinpoints-risks-triggers-changes

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