On Wednesday, September 17, Dr. Michael Smith, Director of the Department of Defense’s Critical Reagents Program (CRP) was the first speaker in the GMU Biodefense Program’s Biodefense Policy Seminars for Fall 2014. Dr. Smith’s spoke on the “Ebola Virus Epidemic 2014: Where the Rubber Met the Roadmap.”
Dr. Smith discussed the role of the Critical Reagents Program (CRP) in DoD’s biodefense program and its role in the West African Ebola outbreak. CRP is responsible for the characterization, production, and distribution of reagents and consumables employed on deployed diagnostic and detection platforms and those under development by other programs. The CRP provides standardized assays which can detect the presence of certain biological agents such as bacteria or viruses to the U.S. Government, companies with U.S. government contracts, and foreign governments. The CRP also maintains a large collection of microbial cultures, antibodies, and antigens for research and development purposes.
During the 2012 Ebola outbreak in Uganda and Democratic Republic of Congo, Dr. Smith and his team learned that the assay they had developed to test for the Ebola virus did not detect that specific strain of virus effectively. Learning this enabled the CRP to re-work their testing, which has been of great benefit during this 2014 outbreak. When Ebola virus emerged in Guinea—the first time the disease had appeared in West Africa—CRP was able to provide the new tests—free of charge—to neighboring Sierra Leone before the first case emerged in that country.
Given Sierra Leone’s almost complete lack of public health laboratory capacity, diagnosis and treatment had been based solely on clinical judgment. Since the initial stages of Ebola virus disease are similar to the early signs of other diseases such as malaria, basing diagnosis on clinical presentation is unreliable. The pre-positioning of advanced diagnostic systems in Sierra Leone enabled the country to identify patients much more quickly than during previous Ebola outbreaks.
While the use of the new assays has enabled real time confirmation of virus, Dr. Smith discussed other obstacles to getting the outbreak under control. The medical system in Sierra Leone relies on family members providing patients with food and supplies at hospitals that have no electricity or air conditioning. In situations like this, many patients may stay home rather than going to a clinic or isolation unit. Because of this, it is very possible that the numbers of infections and deaths could be significantly higher than estimated. According to reports cited by Dr. Smith, an estimated 1 in 3 individuals infected with Ebola are not seeking medical attention. In densely populated cities in West Africa, this provides an opportunity for the unchecked spread of the disease.
Despite these obstacles, however, the relationships that CRP has forged on the ground in Sierra Leone to improve laboratory capacity and the accuracy and timeliness of diagnostic tests has allowed CRP to expand its fight against Ebola. CRP has been granted access to clinical data and samples from patients who have survived the disease. CRP and its interagency partners hope that the blood and sera of those patients can be used to create new therapeutics or a vaccine for the Ebola virus.
The GMU Biodefense Policy Seminars are monthly talks that are free and open to the public and feature leading figures from the academic, security, industry and policy fields discussing critical issues in biodefense. For more information, please visit https://pandorareport.org/events/biodefense-policy-seminar-series/.