Research

THE NEW ENGLAND JOURNAL OF MEDICINE                                                                                 Dec. 3, 2014
By Edward Cox, M.D., M.P.H., Luciana Borio, M.D., and Robert Temple, M.D.

...Studying investigational therapies for EVD presents scientific, practical, and ethical challenges. Not surprisingly, there has been substantial debate about the best and most appropriate study approaches.2,3 It is generally agreed that a trial with a concurrent control group, in which patients are randomly assigned to receive the test drug plus the best available supportive care (BASC) or to BASC alone, would be the most efficient and reliable way to evaluate the safety and effectiveness of candidate products.

 Some people in the health care community, however, have argued against such trials, urging instead use of a historical control — that is, making investigational drugs as widely available as their supply allows and then comparing mortality rates among treated patients with rates that would have been expected absent the drugs, on the basis of past experience with EVD.

ASSOCIATED PRESS                                                                                                        Dec. 2, 2014 

BETHESDA, Maryland  — Declaring the "fight is nowhere close to being over," President Barack Obama on Tuesday heralded strides in the effort to confront Ebola in West Africa and in protecting the U.S. against the spread of the deadly virus. He said squelching the disease remains an urgent priority even if the American public's attention has shifted elsewhere.

"We cannot let down our guard, even for minute," Obama said. "We can't just fight this epidemic, we have to extinguish it."

Obama spoke after touring the National Institutes of Health in Washington's Maryland suburbs where he witnessed advances in Ebola-fighting research. He highlighted the NIH's progress in developing an Ebola vaccine, calling the initial results "exciting" while cautioning that there are "no guarantees" about the vaccine's ultimate success.

NIH researchers last week reported that the first safety study of a vaccine candidate found no serious side effects, and that it triggered signs of immune protection in 20 volunteers. U.S. health officials are planning much larger studies in West Africa to try to determine if the shots really work...

CNN -- By Laura Smith-Spark                              Nov. 27, 2014

The first human trial of an experimental Ebola vaccine has produced promising results, U.S. scientists said, raising hopes that protection from the deadly disease may be on the horizon.

All 20 healthy adults who received the vaccine in a trial run by researchers from the National Institutes of Health in Maryland produced an immune response and developed anti-Ebola antibodies, the NIH said Wednesday.

None suffered serious side effects, although two people developed a brief fever within a day of vaccination.

The vaccine is being developed by the NIH's National Institute of Allergy and Infectious Diseases and British pharmaceutical giant GlaxoSmithKline. The process has been fast-tracked in light of the current catastrophic Ebola outbreak in West Africa, which has claimed more than 5,000 lives.

http://www.cnn.com/2014/11/27/health/ebola-outbreak/

PLOS CURRENT OUTBREAKS                                                                              Nov. 21, 2014
By David Fisman and Ashleigh Tuite, Dalla Lana School of Public Health, University of Toronto

As removal of population-level susceptibility through vaccination could be a highly impactful control measure for this epidemic, we sought to estimate the number of vaccine doses and timing of vaccine administration required to reduce the epidemic size. Our base model was fit using the IDEA approach, a single equation model that has been successful to date in describing Ebola growth. We projected the future course of the Ebola epidemic using this model. Vaccination was assumed to reduce the effective reproductive number. We evaluated the potential impact of vaccination on epidemic trajectory under different assumptions around timing of vaccine availability.