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Ebola Lying in Wait

NEW YORK TIMES by Pam Belluck and William J. Broad     April 20, 2015

A growing body of scientific clues — some ambiguous, others substantive — suggests that the Ebola virus may have lurked in the West African rain forest for years, perhaps decades, before igniting the deadly epidemic that swept the region in the past year, taking more than 10,000 lives.

Around 2004 at a government hospital in Kenema, Sierra Leone, a team of American scientists and West African medical personnel found what appeared to be Ebola antibodies in nearly 9 percent of blood samples. Credit Carl De Souza/Agence France-Presse — Getty Images

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Evaluating Clinical Trial Designs for Investigational Treatments of Ebola Virus Disease

PLOS MEDICINE   by Ben Cooper and others                                                             April 14, 2015
Experimental treatments for Ebola virus disease might reduce EVD mortality. There is uncertainty about the ability of different clinical trial designs to identify effective treatments, and about the feasibility of implementing individually randomised controlled trials during an Ebola epidemic

A treatment evaluation programme for use in EVD was devised using a multi-stage approach (MSA) with two or three stages, including both non-randomised and randomised elements. The probabilities of rightly or wrongly recommending the experimental treatment, the required sample size, and the consequences for epidemic outcomes over 100 d under two epidemic scenarios were compared for the MSA, a sequential randomised controlled trial (SRCT) with up to 20 interim analyses, and, as a reference case, a conventional randomised controlled trial (RCT) without interim analyses.

Read complete study.

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001815

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Ebola Analysis Finds Virus Hasn't Become Deadlier, Yet

ICT  INFECTION CONTROL TODAY                                                                  April 14, 2015
(Scroll down for full study)
Research from the University of Manchester using cutting-edge computer analysis reveals that despite mutating, Ebola hasn’t evolved to become deadlier since the first outbreak 40 years ago. The surprising results demonstrate that while a high number of genetic changes have been recorded in the virus, it hasn’t changed at a functional level to become more or less virulent.

The findings, published in the journal Virology, demonstrate that the much higher death toll during the current outbreak, with the figure at nearly 10,500, isn’t due to mutations/evolution making the virus more deadly or more virulent.

As professor Simon Lovell from the Faculty of Life Sciences explains.... What we found was that whilst Ebola is mutating, it isn’t evolving to the point of adapting to become more or less virulent. The function of the virus has remained the same over the past four decades which really surprised us. Unfortunately this does mean the Ebola virus that has now emerged on several occasions since the 1970s will very probably do so again.”

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Yes, We Were Warned About Ebola

NEW YORK TIMES OP-ED  By BERNICE DAHN, VERA MUSSAH and CAMERON NUTT   April 7, 2015               
MONROVIA, Liberia — The conventional wisdom among public health authorities is that the Ebola virus, which killed at least 10,000 people in Liberia, Sierra Leone and Guinea, was a new phenomenon, not seen in West Africa before 2013. (The one exception was an anomalous case in Ivory Coast in 1994, when a Swiss primatologist was infected after performing an autopsy on a chimpanzee.)

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Merck, NewLink Ebola vaccine appears safe, effective in new studies

REUTERS by Sharon Bagley                                                                      April 1, 2015

Early-stage trials of an experimental Ebola vaccine, two in the United States and four in Africa and Europe, have found that it appears to be safe and triggered robust production of Ebola-fighting antibodies, scientists reported on Wednesday.

Since trials cannot ethically expose volunteers to Ebola, the production of antibodies is a proxy for whether vaccines could prevent or even treat the disease.

The trials all tested a vaccine called VSV-ZEBOV, which was developed at the Public Health Agency of Canada and licensed to NewLink Genetics Corp and then to Merck & Co Inc. It consists of a cattle virus called rVSV that has been engineered to carry Ebola genes, which produce proteins meant to trigger production of anti-Ebola antibodies.

According to separate teams of scientists, that is what happened, two papers in the New England Journal of Medicine reported.

Read complete story.
http://www.reuters.com/article/2015/04/01/us-health-ebola-vaccine-idUSKBN0MS5DN20150401

Read NEW ENGLAND JOURNAL OF MEDICINE  papers

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BioCryst gets HHS contract for Ebola drug development

CENTER FOR INFECTIOUS DISEASE RESEARCH AND POLICY by Lisa Schnerring               March 31, 2015

The US Department of Health and Human Services (HHS) announced today that it has awarded BioCryst Pharmaceuticals a $12 million grant to continue development of BCX4430, a small-molecule drug designed to treat Ebola and other filovirus infections, and to prepare for large-scale manufacturing of the agent.

Studies in nonhuman primates suggest that the drug is effective against Ebola and Marburg viruses and could be useful as a broad-spectrum antiviral, the HHS said in a statement. BCX4430 is currently in phase 1 human trials, and if results show safety, it could be one of the treatments to be tested for efficacy in clinical trials.

BCX4430 is the first small-molecule Ebola treatment that BARDA has supported. Other Ebola products in development that have received BARDA funding include the monoclonal antibody cocktail ZMapp and three vaccines.
Read complete story.
http://www.cidrap.umn.edu/news-perspective/2015/03/biocryst-gets-hhs-contract-ebola-drug-development

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Ebola rapid diagnostic kit developed by UK scientists in Sierra Leone

Doctors says the kit, if approved by health authorities, could transform the admissions process with its capacity to deliver results within 20 minutes

THE GUARDIAN    by Lisa O'Carroll                              March 29, 2015

A rapid Ebola diagnostic kit similar to a pregnancy kit has been developed by British military scientists and NHS medics in Sierra Leone.

Health care workers prepare to entering a high risk zone at an Ebola virus clinic in Sierra Leone, where the diagnostic kit has been undergoing tests. Photograph: Michael Duff/AP

It can be administered at the bedside and return its first results within 20 minutes, slashing dramatically the normal 24-hour turnaround for lab results.

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The tail of the epidemic and the challenge of tracing the very last Ebola case

EUROSURVEILLANCE  by  K. Kaasik-Aaslav and  D. Coulombier                                   March 26, 2015

Upon entering what seems to be the tail of the epidemic and, as in any such moment, the ‘Ebola endgame’ strategy requires adaptation to the heterogeneity of the epidemiological situation. The tools for EVD control need to be fine-tuned and the commitment from the teams supporting local authorities in affected countries needs to be sustained.

While the pressure on clinical and laboratory expertise gradually decreases, the demand shifts towards field epidemiologists to assist local public health experts and support community workers to engage in active surveillance and to monitor remaining transmission chains in affected communities.

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Laboratory support during and after the Ebola virus endgame: towards a sustained laboratory infrastructure

EUROSURVEILLANCE by I. Goodfellow, C. Reusken, and M. Koopmans  

  March 26, 2015                                                              

The Ebola virus epidemic in West Africa is on the brink of entering a second phase in which the (inter)national efforts to slow down virus transmission will be engaged to end the epidemic. The response community must consider the longevity of their current laboratory support, as it is essential that diagnostic capacity in the affected countries be supported beyond the end of the epidemic.

The emergency laboratory response should be used to support building structural diagnostic and outbreak surveillance capacity.

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Ebola pioneer, stem cell researcher honoured with Canada Gairdner Awards

CANADIAN PRESS                                                                                March 25, 2015
One of the co-discoverers of the Ebola virus and a leading Canadian stem cell researcher are among this year's winners of the prestigious Canada Gairdner Awards.

Dr. Peter Piot is the recipient of the Canada Gairdner Global Health Award, recognizing his work on the discovery of the Ebola virus in 1976 and his leadership in the global response to the HIV-AIDS epidemic.

Dr. Janet Rossant, chief of research at Toronto's Hospital for Sick Children, is the recipient of the 2015 Canada Gairdner Wightman Award, which honours a Canadian who has demonstrated outstanding leadership in medicine and medical science.

Five international scientists are also being honoured with Canada Gairdner Awards, two each from the United States and Japan and one from Switzerland....

Dr. Peter Piot won the 2015 Canada Gairdner Global Health Award in recognition of his work on the discovery of the Ebola virus in 1976 and his leadership in the global response to the HIV-AIDS epidemic. (David Azia/Associated Press)

Red complete story.

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