The Ebola Vaccine and the Ethics of Drug Trials

By Greg Mercer

The World Health Organization recently announced that a trial of the VSV-EBOV Ebola virus vaccine in Guinea has been “highly effective,” and that randomization in the trial would be stopped to allow for expansion of the range of subjects and protection of more people against the virus.  The trial began in March, and until recently, randomized subjects so that some received the vaccine immediately, while others received it later, after the virus’ gestation period.

A paper published in The Lancet details the study, and finds that the vaccine is highly effective and likely safe to use in the affected population.  The “recombinant, replication-competent vesicular stomatitis virus-based” vaccine is administered in a single dose via the deltoid muscle.  4,123 people received the vaccination immediately, while 3,528 people received the delayed vaccination (more on the study methodology in a moment). The researchers found that no subjects developed a case of Ebola after receiving the immediate or delayed vaccination, meaning that the vaccine proved 100% effective (with p=0.0036 at 95% CI).  These findings are excellent news for researchers, government officials, and those in the affected counties, and are fascinating from a scientific standpoint.

At The New Republic, Timothy Lahey, of Dartmouth, argues that these results, while promising, aren’t necessarily confirmed.  He notes that the lack of a placebo (because of the study’s particular methodology) makes it difficult to determine effectiveness, the vaccine could have failed to protect subjects from infection in a way that the study didn’t detect, and that a statistical aberration could mean that while the vaccine is not actually 100 % effective.  Regardless of whether these potential pitfalls affected the study or not, Lahey raises an important issue in drug testing for a disease like Ebola.  He is concerned that a lower standard for vaccines could mean that lower-income countries might not receive drugs of the same quality as rich countries, and points to past failed vaccines to illustrate the fallacy of believing that all vaccines work as intended.

The ethical dilemmas of drug testing have been front and center in the Ebola crisis.  Back in November, 2014, Nature reported on public health officials weighing the question of whether to use control groups when testing treatments for a disease with 70% mortality.  At the time, some advocated for applying experimental treatments (like the ZMapp antiviral cocktail, which had been used in patients but whose effectiveness was not entirely determined) to all patients, while others argued that these treatments might not be more effective than standard care, and that randomized trials guard against harmful side effects and provide a clearer picture of a drug’s effectiveness.

The VSV-EBOV vaccine was tested in the “ring” method that was previously used in the eradication of Smallpox.  This method eschews the double-blind placebo treatments commonly associated with drug trials.  Instead, this method creates a “ring” around new cases.  Contacts and contacts of contacts were identified by Guinea’s tracking system, and eligible adults were entered into randomization blocks, and received either the immediate or delayed vaccination.  This way, all of the subjects received the treatment, but in varying circumstances to establish effectiveness.  The full study is available via The Lancet.

Ethical drug testing is a crucial consideration, and has an imperfect past.  The National Institutes of Health’s own ethics guide cites a study that led to the United States’ ethics rules: a study that withheld syphilis treatment from 400 African-American men.  And for many, there’s good reason to be concerned about the actions of international organizations and multinational corporations.  In 1996, Pfizer conducted a study of an experimental drug on children with meningitis in Nigeria. While Pfizer maintained that the study was philanthropic, allegations arose from Nigerians and international organizations that children and parents were not informed that they were part of a study, and that Pfizer withheld treatment without consent or administered dangerous drugs.  The incident spawned a series of lawsuits and a panel of Nigerian medial experts condemned Pfizer’s actions in 2006, as reported by The Washington Post.

Epidemics and drug testing present a multitude of practical and ethical concerns, but careful consideration of the issues and sound methodology can, as they did in Guinea, produce exciting scientific and humanitarian results.

Image Credit: Psychonaught

Pandora Report 7.26.15

Mason students are working through their summer courses and I’m happy to say mine is OVER! Let the summer begin (two months late)! This week we’ve got great news about Polio in Nigeria and a somber anniversary in Japan. We’ve also got other stories you may have missed.

Enjoy the rest of your weekend and have a great week!

A-Bomb Victims Remembered in Potsdam, Where Truman Ordered Nuclear Strikes

Coming up on the 70th anniversary of the atomic bombs being dropped on Hiroshima and Nagasaki, German and Japanese citizens in the city of Potsdam held a remembrance ceremony for both the victims that died in the blast and the future. Japan has become, according to the former President of the International Court of Justice, the world’s conscience against nuclear weapons and power. Why? Japan is “the only country in the world to have been the victim of both military and civilian nuclear energy, having experienced the crazy danger of the atom, both in its military applications, destruction of life and its beneficial civilian use, which has now turned into a nightmare with the serious incidents of Fukushima.”

Japan Times—“The Potsdam Conference was held between July 17 and Aug. 2 in 1945. The United States dropped an atomic bomb on Hiroshima on Aug. 6 and another bomb on Nagasaki three days later. On Aug. 15 that year, Emperor Hirohito announced to the nation that Japan had accepted the Potsdam Declaration, in which the United States, Britain and China demanded the nation’s unconditional surrender.”

Nigeria Beats Polio

Very, very, very exciting news: Nigeria has not had a case of polio in a year. A year! This makes Nigeria polio free and the last country in Africa to eliminate the disease. The achievement was possible with contributions from the Nigerian government (where elimination of the disease was a point of “national pride”), UNICEF, the WHO, the CDC, the Bill and Melinda Gates Foundation, Rotary International, and other organizations. With Nigeria’s accomplishment, there are only two other countries in the world where polio still exists—Afghanistan and Pakistan.

Voice of America—“Carol Pandek heads Rotary International’s polio program. She told VOA via Skype that a year being polio-free is a milestone for Nigeria, but noted that it is not over. “Now they need to continue to do high quality immunization campaigns for the next several years,” she said, as well as have a strong surveillance system so, should there be any new cases, they can be identified as soon as possible.”

Stories You May Have Missed

 

Image Credit: Fg2

Pandora Report 05.17.15

Yowza! That’s another semester in the books for the GMU Biodefense students. Please excuse the sparse activity on the blog, but with the semester over, things should be getting back to normal.

This weekend we have a updates on Ebola and the bird flu outbreak in the U.S., plus other stories you may have missed.

Have a great week, (enjoy the Mad Men finale!) and see you back here next weekend!

Ebola is (still) living in an American doctor’s eye

As an update, Liberia has (finally) been declared Ebola free, the number of cases in Guinea continue to rise due to transmissions at funerals, and those in Sierra Leone are dying less from Ebola than from other diseases due to the collapse of the healthcare system. It’s been over a year and we are still learning things about Ebola and its persistence on hospital surfaces, sexual fluids, and now, according to a study in the New England Journal of Medicine, the eye. WHO volunteer Ian Crozier was diagnosed in Sierra Leone and transported to Emory University where he was treated. Months later he returned to the hospital with symptoms like blurred vision and acute pain in his left eye. The cause? Ebola.

The Washington Post—“Ebola may have found refuge in patients’ eyes because, researchers said, the eye is walled off from the immune system. As the New York Times put it: “The barriers are not fully understood, but they include tightly packed cells in minute blood vessels that keep out certain cells and molecules, along with unique biological properties that inhibit the immune system.” This phenomenon is called “immune privilege” — and it means the eye can harbor viruses.”

America’s $45 Billion Poultry Industry Has a (Really) Bad Case of Bird Flu

The title says it all, frankly. Since early December 2014 three strains of highly pathogenic avian influenza have been circulating in North America. A state of emergency has been declared in Iowa (one of the hardest hit states) and over 21 million birds have been killed to contain and prevent the spread of the virus. Beyond the culling of birds, the outbreak is having an affect on business—China, South Korea, and Mexico have banned imports of U.S. poultry (to protect their own industries.)

The Motley Fool—“Falling exports could hurt farmers, but it could also help to offset domestic price increases from less supply. Although, with tens of millions of bird deaths and no end in sight to the pandemic, domestic food prices could be the largest casualty in the end.”

Stories You May Have Missed

 

Image Credit: 8thstar

Pandora Report 4.19.15

Sunday has to be the biggest brunch day of the week, so it is only fitting that our lead story looks at the many (delicious and nutritious) uses of maple syrup. We also look at Dengue fever in Brazil, missteps in the U.S. fight against Ebola, and other stories you may have missed.

Once you’re updated, get out there and enjoy the rest of your weekend and the beautiful weather! Have a great week!

Syrup Extract Found to Make Antibiotics More Effective Against Bacteria

It seems like we look at growing antibiotic resistance every week here at Pandora Report. This week, researchers at McGill University in Montreal reported that a “concentrated extract of maple syrup makes disease-causing bacteria more susceptible to antibiotics.” This finding suggests that combining the extract with antibiotics could increase their effectiveness and lead to lower antibiotic usage overall. Honestly, is there anything maple syrup can’t make better?!

Infection Control Today—“‘We would have to do in vivo tests, and eventually clinical trials, before we can say what the effect would be in humans,” [Professor Nathalie] Tufenkji says. “But the findings suggest a potentially simple and effective approach for reducing antibiotic usage. I could see maple syrup extract being incorporated eventually, for example, into the capsules of antibiotics.’”

Brazilian Teams on Alert because of Dengue Fever Outbreak

Brazilian soccer teams are on high alert because of a dengue fever outbreak that has already affected some of the country’s top teams. This week three players were diagnosed with the mosquito borne disease, which normally takes about two weeks to recover from. Players have been forced to use insect repellent during games and practices and health officials have been asked to check fields and training centers for mosquito breeding sites.

USA Today—“Cases of dengue fever have increased significantly across Brazil this year, with most of them reported in Sao Paulo state. Brazil’s health ministry said there have been more than 460,000 cases of the disease in the country in 2015, which accounts for almost 5,000 cases a day. More than 130 people have died so far this year, the ministry said.”

Empty Ebola Clinics in Liberia Are Seen as A Misstep in U.S. Relief Effort

After spending hundreds of millions of dollars and deploying 3,000 U.S. troops to build Ebola treatment centers (E.T.C.) in Liberia, the facilities have largely sat empty. Only 28 Ebola patients have been treated at the 11 E.T.C.s built by the U.S. military. Nine of the centers never had a single Ebola patient. Looking back, the emphasis on building E.T.C.s had far less of an impact than the “inexpensive, nimble measures taken by residents to halt the outbreak.”

The New York Times—“Had the Americans and other donors been more flexible, critics and some officials contend, the money could have been put toward rebuilding Liberia’s shattered health care system—or backing the efforts of local communities—instead of focusing on treatment centers that would scarcely be used.”

Stories You May Have Missed

 

Image Credit: Dvortygirl

Pandora Report 2.15.15

It’s the last holiday weekend before the summer and its too cold to go outside! Don’t worry, we’ve got some good reading while you’re staying warm inside: antibiotic resistance, U.S. Troops leaving West Africa, a new vaccine for polio and LOTS of stories you may have missed.

Enjoy your Monday holiday and have a safe and healthy week!

Rivers Can Be a Source of Antibiotic Resistance

As the U.S. Government increases its funding to fight growing antibiotic resistance, a study coming out of the University of Warwick’s School for Life Sciences and the University of Exeter Medical School points to rivers and streams as a major source of antibiotic resistance in the environment. The study of the Thames River found that greater numbers of resistant bacteria existed close to some wastewater treatment plants and that these plants are likely “to be responsible for at least half of the increase observed.”

R&D Magazine—“The team also found that several other factors affected the prevalence of antibiotic resistance, such as changes in rainfall and land cover. For example, heavy rainfall at a point surrounded by grassland raised resistance levels; whereas a heavy rainfall at a point surrounded by woodland reduced the levels seen.”

U.S. Bringing Home Almost All Troops Sent to Africa in Ebola Crisis

The U.S. military is bringing home nearly all troops that were sent to West Africa 10 months ago in order to fight the Ebola outbreak. This withdrawal comes at a time where 700 homes in Sierra Leone were put under quarantine after a new case was diagnosed in Freetown. Quarantine seems like a smart move, since researchers have now confirmed that the virus can remain contagious on a dead body for up to a week. Despite troops leaving, testing has begun in Liberia for two potential vaccine candidates.

CNN—“[Pentagon press secretary Rear Adm. John] Kirby said about 100 military service members will remain in West Africa to support the 10,000 civilian responders who remain. These service members will “build on a strong military partnership with the Armed Forces of Liberia to enhance their Ebola response efforts and provide disaster response training to the government of Liberia,” he said.”

Synthetic Vaccine Sought to Finally Eradicate Polio

While, after six months of no new cases, Africa is close to wiping out wild polio, a team of international scientists are working to create a wholly artificial vaccine to combat the disease. The Bill and Melinda Gates Foundation and the World Health Organization are providing a $647,000 grant to create an entirely synthetic approach that will address shortcomings in the existing vaccine. This new vaccine would be entirely virus free.

BBC—“…the existing oral vaccine uses a weakened version of the virus as its stimulus to provoke a response and protection in the patient. And in just a few particular individuals, this can set up an infection in the gut that then enables a reactivated virus to pass out of the body and spread to other, unvaccinated people.

But if the virus particle has no genetic machinery this transmission route is closed, and the World Health Organization and the Gates Foundation is to fund the scientists to engineer just such particle for use as a replacement vaccine.”

Stories You May Have Missed

  

Image Credit: Wikimedia Commons

Pandora Report 2.1.15

No themed coverage this week, sadly. However, we’ve got stories covering the Federal fight against antibiotic resistance, ISIS airstrikes, and super mosquitoes in Florida. All this in addition to stories you may have missed.

Have a fun Super Bowl Sunday (go team!) and a safe and healthy week!

Obama Asking Congress to Nearly Double Funding to Fight Antibiotic Resistance to $1.2 Billion

One of The White House’s goals for 2015 was to combat growing antibiotic resistance through research into new antibiotics and efforts to prevent the over prescription of these vital drugs. President Obama is requesting that Congress add additional funding to this fight, bringing the total to $1.2 billion. The funding will be a start, but there are many other things that can happen in order to fight this extremely important problem.

U.S. News & World Report—“The Centers for Disease Control and Prevention says more than 23,000 Americans die every year from infections that can withstand some of the best antibiotics. The World Health Organization said last year that bacteria resistant to antibiotics have spread to every part of the world and might lead to a future where minor infections could kill.”

Air Strike Kills IS ‘Chemical Weapons Expert’

News came Saturday morning that U.S. airstrikes in Iraq last week killed a mid-level Islamic State militant who specialized in chemical weapons. Killed on January 24, Abu Malik had worked at Saddam Hussein’s Muthana chemical weapons production facility before joining Al-Qaeda in Iraq in 2005.

Radio Free Europe/Radio Liberty—“Officials say his death could “temporarily degrade” the group’s ability to produce and use chemical weapons. Coalition air strikes have pounded the Mosul area over the past week [and] The U.S.-led coalition has carried out more than 2,000 air raids against IS militants in Syria and Iraq since August 8.”

Millions of Genetically Modified Mosquitoes Could Fight Disease in Florida

On January 11, we had a small note about the possibility of genetically modified mosquitos controlling diseases like chikungunya and dengue, but this week coverage on this issue absolutely exploded! British biotech firm Oxitec plans to release millions of genetically modified mosquitos in Florida to control the existing population and help control the spread of these diseases. The A. Aegypti species of mosquito is extremely prevalent in Florida and recently has become resistant to most chemical pesticides. Residents, of course, are up in arms over the potential release of this “mutant mosquito”.

The Weather Channel—“Technology similar to this is already in use in Florida and other states, Entomology Today points out. Sterile Insect Technique (SIT) employs a similar technique, sterilizing insects so that when they mate, no offspring are produced. “Florida spends roughly $6 million a year using SIT to prevent Mediterranean fruit fly infestations, while California spends about $17 million a year,” Entomology Today wrote.”

Stories You May Have Missed

Image Credit: Wikimedia Commons

Pandora Report 1.18.15

For those who’ve been reading for awhile, you’ve probably surmised that one of my personal health interests is seasonal and pandemic flu. There were plenty of stories about that this week, so that’s what we’ll focus on. We’ll also look at Ebola and other stories you may have missed. My apologies for posting delays this week, I’m dealing with some rotator cuff and carpal tunnel issues in my right arm, and let me tell you, it is HARD to type with your dominant arm in a sling!

Enjoy your holiday Monday (if you have one) and have a safe and healthy week!

Texas Health Experts Say Universal Flu Vaccine Could be a Reality

The CDC has said that this year’s seasonal flu vaccine was only 23% effective due to unanticipated antigenic drift—meaning the predicted strains in the vaccine didn’t match the dominant strains of the virus that are currently circulating. In order to combat this in the future, scientists at Mount Sinai health system in New York are in the process of testing a universal flu vaccine which will go into clinical trials this year.

KLTV.com—“‘There is work going on to see if, perhaps a different kind of vaccine could be developed maybe against a different part of the flu virus, one that is not so subject to this antigenic drift or to change as readily from one year to the next,” [Dr. Levin of UT Health Northeast] says.”

Scientists Find Brain Protein Aids Influenza Recovery

Scientists at Washington State University in Spokane have found a brain protein that boosts the healing power of sleep and speeds recovery from the flu in mice. Professor James M. Kruger said this discovery could lead to alternative treatments for flu and other infectious diseases by stimulating production of the brain protein called AcPb. This discovery comes at a time where avian influenza is prevalent in Taiwan, Japan, Nigeria, China, Egypt, Canada, the U.S. and Mexico.

Washington State University—“Krueger showed this recovery involves AcPb and an immune system signaling chemical called interleukin-1. AcPb links up with interleukin-1 to help regulate sleep in healthy animals. It also prompts infected animals to spend more time sleeping during an illness.

In the study, mice who lacked the gene for AcPb slept less after being infected with influenza virus. They also became chilled, grew sluggish, lost their normal circadian rhythms and ultimately died in higher numbers than the mice who slept longer.”

This Week in Ebola

As GMU students return to classes, so do students in Ebola affected Guinea. Schools in Guinea will re-open Monday, and schools in Liberia are set to re-open “next month.” No date has been set for schools in Sierra Leone. Despite this, the President of Sierra Leone has declared that there will be zero new confirmed Ebola cases by the end of March the country will be Ebola-free, by WHO standards, by May. These announcements come at a time when Dr. Thomas Frieden, Director of the CDC, has said he was “very confident we can get to zero cases in this epidemic if we continue the way we’re going and nothing unexpected happens” and the outbreak appears to be slowing down. Last week brought record low numbers—for Guinea, the lowest total since mid-August; for Liberia, the lowest total since the first week of June; for Sierra Leone the second week of declines and the lowest level since the end of August. However, there are still “at least 50 micro-outbreaks” underway throughout West Africa.

Pauline Cafferkey, the Scottish nurse infected with Ebola, is “showing signs of improvement” and an American soldier who was found dead in Texas after his deployment in West Africa reportedly showed no signs of Ebola leaving officials to remark that there was “no evidence of a public health threat.”

A seemingly large amount of good news this week left space for new ruminations on Ebola and outbreaks in general. Wired  had an interesting piece on Nanobiophysics and how it could stop future global pandemics while The Chicago Tribune looked at bats and their likely role in Ebola outbreaks and CNBC looked at the price of protection from global pandemics—would you believe $343.7 billion?

Stories You May Have Missed

 

Image Credit: NBC News

Pandora Report 1.11.15

Dirt is all around, I mean, truly, all around. We wash it off our produce, get it smashed into the soles of our shoes, and vacuum it out of our homes. But is dirt really that bad? The stories this week look at dirt as a source of antibiotics and a disposal method for chemical weapons. We also look at Ebola and other stories you may have missed.

Have a fabulous week!

DARPA Wants to Turn Chemical Weapons Into Dirt

DARPA has a new idea for eliminating chemical weapons—breaking them into safe compounds like oxides and earth metal salts, in other words, soil. Considering the drawbacks for current disposal methods, the agency’s Agnostic Compact Demilitarization of Chemical Weapons program has put out a call for proposals for a weapons-to-dirt plan.

Popular Mechanics—“The defense research agency is looking for a transportable system that can fit in a 40-foot-long shipping container and process at least 55 gallons of chemical weapons and precursor material every hour for a 48-hour period. Processing will be conducted near the chemical weapons storage site, use local materials (such as dirt of plant matter), and produce no hazardous waste.”

New Class of Antibiotic Found in Dirt Could Prove Resistant to Resistance

A study published this week in Nature looks at a new antibiotic, called Teixobactin, which could keep working for “longer than any other” before bacteria could develop resistance. It is still at least four years away from availability and can only treat gram-positive bacteria like staph, strep, and TB. And where was this new antimicrobial found? Dirt from a grassy field in Maine.

The Washington Post—“Most microbiologists only ever work with around 1 percent of microbes—the ones that will grow politely in the lab. But the rest refuse to grow on traditional growth media, like petri dishes. But there are potential antibiotics all over the world being created by plants, fungi, and microorganisms. Lewis and his colleagues sandwiched soil between two semi-permeable membranes, effectively tricking soil microbes into growing in a “natural” environment that was actually a lab culture.

Among the 10,000 organisms and 25 antibiotics they grew in this new type of culturing method is Teixobactin. It successfully obliterated MRSA and drug-resistant TB in cell cultures and in mice, and did so without any signs that the bacteria might become resistant to it.”

This Week in Ebola

Ebola has reached beyond health. Since the outbreak began, in Sierra Leone a combination of curfew, a ban on public gatherings, plummeting GDP, and inflation have fueled economic freefall. And remember when Texas nurse Amber Joy Vinson got on a plane to Ohio to shop for bridesmaid gowns for her own wedding? Well the store, announced it will be going out of business due to flagging sales and stigma of being the “Ebola” bridal store.  The pharmaceutical industry is chugging along in creation of and testing of possible vaccines for the Ebola virus; all of this comes at a time where the number of deaths is over 8,200 and the number of cases stands at over 20,000. The Economist has an amazing series of charts, maps, and graphs that look at the scope of the outbreak.

Meanwhile, the British nurse diagnosed with Ebola is in critical, but stable, condition, and an American health care worker was transported to the Nebraska Medical Center’s specialized biocontainment unit for observation. Travelers from Mali will no longer face enhanced screening when they arrive in the U.S., as the last case in Mali was December 5 and there are no active cases in the country.

Lastly, there were two interesting first-person stories from those who have returned from West Africa. First, an NPR correspondent in Washington DC writes about the terrifying moment when he woke up with a fever within 21 days of his return from Liberia. Then, an Australian MSF nurse wrote about the “sheer brutality” of the Ebola virus he experienced while in Liberia.

Stories You May Have Missed

 

Image Credit: United Nations University

Pandora Report 1.4.15

Happy 2015! I hope all of you enjoyed a safe, happy, and healthy holiday season. As we get back into things, this week we will look at Seasonal Flu, 1980s Chemical Weapons, and, of course, Ebola. Please also enjoy a wrap up of other stories from the last two weeks in the Stories You May Have Missed section.

Have a fabulous week!

This Season’s Flu Activity Has Reached the Epidemic Threshold, the CDC Says

On the heels of the announcement that this year’s flu vaccine is not as effective as hoped, the Centers for Disease Control and Prevention has announced that they are seeing elevated activity in all their influenza surveillance systems and that this year’s seasonal flu has reached epidemic levels. The Virginia Department of Health has called the flu “widespread” in our state. The CDC urges it is still too early to determine if this season will be worse than others but preliminary data seems to reflect that it may be.

The Washington Post—“The influenza season reaches an epidemic level when the proportion of deaths attributed to pneumonia and influenza reaches a certain threshold: 6.8 percent. According to the CDC’s latest available information on the flu season, the percentage is currently at the threshold.”

Secret Papers: UK Studied Chemical Weapons Buildup in the 1980s

Newly released, formerly secret, documents show that in the early 1980s former Prime Minister Margaret Thatcher’s government considered rebuilding Britain’s chemical weapons arsenal in the face of a perceived looming threat of the Soviet Union. Thatcher’s defense chiefs were worried that the country would have only nuclear weapons in order to respond to a possible Soviet chemical attack.

ABC News—“In the papers, Thatcher states that it might be considered “negligent” of the government not to develop a credible response to a Soviet chemical attack short of using nuclear weaponry. She also suggests urging the Americans to modernize their chemical arsenal.

The lack of a chemical capacity was called a “major gap” in NATO’s military capacity by Defense Secretary Michael Heseltine in a secret 1984 document. He said the threat of a nuclear response lacked credibility.”

This Week in Ebola

While we were celebrating and enjoying the holidays, Ebola, of course, didn’t take a break. In the spirit of the season the UK’s Queen praised the selflessness of those fighting the ongoing epidemic in West Africa. And while Christmas gatherings were cancelled in Sierra Leone and Guinea, those in Liberia made sure their Christmas spirit was on full display. As 2014 came to an end, there were many looks back at the year in Ebola and the possible source of the start of the outbreak. The first case of Ebola was diagnosed in Britain by a nurse who contracted the disease in West Africa and there were reports of a possible lab error exposure to the virus at the CDC.

There are some reasons for optimism as 2015 begins, including survival rates increasing for cases in Sierra Leone and promising news on the vaccine front. Vaccines tested in Uganda against Ebola and the related filovirus Marburg have proven to be safe and effective in generating an immune response to the deadly viruses  and the U.S. Department of Health and Human Services has awarded contracts worth $43 million to develop two possible Ebola vaccines more quickly. According to the UN’s Anthony Banbury, 2015 should see the number of Ebola cases brought to zero by the end of the year and Al Jazeera America argues that this year should be focused on immunization and investment in West African health systems.

The last two Ebola updates are entirely unrelated and include the unverified possibility that ISIS militants have contracted Ebola and interesting coverage by NPR of how Ebola has affected love and sex.

Stories You May Have Missed

 

Image Credit: The Washington Post

Pandora Report 12.21.14

The winter holidays are here and with them comes the final 2014 news roundup. This week we look at superspreaders, dengue fever, and, of course, Ebola.

There will be no roundup next week as I will be spending time with family and friends. I hope all of you have the opportunity to do the same and are surrounded by those you love during this time of year. It has been a privilege and a pleasure serving as the Managing Editor of the Pandora Report since March. I hope you have enjoyed reading it as much as I’ve enjoyed writing it.

I hope to see you right back here again in 2015!

The 20% Who Spread Most Disease

How did Typhoid Mary spread the disease to dozens of people but never get sick herself?

Researchers at Stanford University are looking into the science behind “superspreaders”—the idea that some people spread more disease than others. Recent experiments have suggested that the body’s immune response might play a role in helping to spread pathogens to others, however, it isn’t clear if the immune system of the superspreader or their behavior plays a bigger role in the passage of disease.

The Wall Street Journal—“‘It’s telling us that these superspreaders…are tolerant of high levels of the pathogen and any little disturbance and added inflammation that this antibiotic treatment did to them,” said Dr. Monack. “I wouldn’t say they have stronger immune systems. I would say it’s in a state that protected them from this added disturbance in the gut.’”

Dengue Fever Vaccine on the Cards After Novel Antibody Discovery

Over the past 50 years cases of dengue fever have soared—nearly 100 million per year. Normally the infection causes a fever which lasts about a week, but some develop hemorrhagic fever which kills about 22,000 a year. Gavin Screaton at the Imperial College in London warns “it’s likely that without a vaccine this disease is not going to be controlled.” That’s why a discovery of a new antibody brings hope that vaccine development may be closer than we thought.

The Guardian—“The researchers spotted the new group of antibodies while they were studying blood drawn from patients who picked up dengue infections in south-east Asia.

They found that about a third of the immune reaction launched by each patient came from a new class of antibodies. Instead of latching on to a single protein on the virus surface – as usually happens – the new group of antibodies latches on to a molecular bridge that joins two virus proteins together.”

This Week in Ebola

It’s been a hard year in West Africa with the worst Ebola outbreak in history still ongoing. In Sierra Leone, the country with the most cases, treatment centers are overflowing with patients. The President has announced that Christmas has been cancelled as news came that the most senior doctor—Victor Willoughby—died. Dr. Willoughby was the 11th of Sierra Leone’s 120 doctors to die from the virus. For the lucky ones who survive, they must cope with after effects including blindness and joint pain. And don’t forget the stigma—a heart breaking article in the New York Times describes the plight of Ebola orphans who aren’t taken in for fear that they are ticking disease time bombs. Cuban doctors are some of the most active on the front lines, but news this week came that the U.S. embargo has delayed payment of those doctors. There are glimmers of hope though, as the U.N. Economic Commission for Africa urged debt cancellation for Ebola affected West African countries and experimental serum therapy treatment made from the blood of recovered patients arrived in Liberia.

Stateside, a child flying though O’Hare Airport in Chicago was quarantined when a high fever was discovered after screening. Johns Hopkins University was chosen as one of the winners in a global competition to create an improved protection suit for those fighting Ebola on the front lines. Lastly, an American doctor—Richard Sacra—who was infected with Ebola in Liberia and returned to the U.S. for treatment, has said that he will return to Liberia in January to continue fighting the outbreak.

Stories You May Have Missed

 

Image Credit: Free Images