Government researchers, in collaboration with British drugmaker GlaxoSmithKline, will begin human trials next week for an experimental Ebola vaccine in the hopes of rushing the drug as quickly as possible to health workers and others at risk in West Africa.
The early-stage human trial is set to begin next week at the National Institutes of Health Clinical Center in Bethesda and will test both the safety of the vaccine and its ability to generate an immune response in patients. The initial trial will include about 20 adults, and officials said they hope to have initial safety data by the end of the year — a scientific and ethical necessity before distributing any new drug widely.
“Safety is paramount; it’s absolutely paramount,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told reporters on a call Thursday. “The data [on the vaccine] in nonhuman primates is really quite impressive. But in science, you never know, and that’s why we do the trials.”
At the same time, the NIH and other groups, such as the British-based public health charity Wellcome Trust, are trying to line up similar human Ebola vaccine trials in the United Kingdom, Gambia and Mali beginning as early as next month.
Those trials could begin as soon as researchers receive ethical and regulatory approvals in each country. Fauci said that while it might be ideal to conduct trials in countries being hit hard by the current outbreak, such as Liberia or Sierra Leone, “the infrastructure in those places would not allow the kind of careful Phase I studies that you would like to do.”
The vaccine being tested at NIH next week is based on a chimpanzee cold virus called chimp adenovirus type 3. The virus is used as a carrier to deliver pieces of genetic material from two Ebola species: Sudan and Zaire, the type currently responsible for the devastating toll in West Africa.
The vaccine is designed to deliver one part of Ebola’s genetic material to human cells, eventually triggering an immune response in the patient. The vaccine, however, does not allow Ebola genes to replicate.
“It’s important to know that the Ebola genetic material contained in the investigational vaccine cannot cause a vaccinated individual to become infected,” Fauci said.
Officials said that if the trial proceeds as planned, the first wave of safety data could become available by year end. Should that prove promising, health workers on the front lines of the outbreak and others at risk of contracting the disease potentially could receive the drug sometime next year, though that timeline remains uncertain.
NIH’s trial comes amid a flurry of efforts to ramp up testing and production of various other treatments and vaccines developed in recent years, primarily by small biotech firms and governments such as the United States and Canada.
The urgency is understandable: The World Health Organization said Thursday that the worst Ebola outbreak in history is getting worse. The agency said the outbreak that has ravaged West Africa for most of this year ultimately could infect 20,000 people before it runs its course. So far, the virus has claimed 1,552 lives, and it shows little sign of slowing. More than 3,000 people officially have been infected in the current outbreak, but WHO officials believe that the real tally is likely much higher.
Fauci and other officials said Thursday that while the accelerated efforts to develop vaccines and treatments for Ebola could make a difference, the quickest way to slow the spread of the disease is to quarantine victims, trace and monitor their contacts and follow established sanitation and treatment practices.
“Now, and in the immediate future, the real solution, if there is one, is to implement the public health measures” that have been proven to stop previous outbreaks, Fauci said. “In West Africa, these must be the main focus.”
, NBC News
The Ebola virus outbreak that’s ravaging West Africa probably started with a single infected person, a new genetic analysis shows.
This West African variant can be traced genetically to a single introduction, perhaps a person infected by a bat, researchers report in the journal Science.
Their study paints a remarkably detailed picture of how the virus spread from Guinea to Sierra Leone and Liberia in an outbreak that’s taken the lives of more than 1,500 people — including five of the researchers who worked on the report.
One thing is clear — it is definitely being spread by people, not by animals repeatedly infecting people, the researchers say. “We can see it entering different villages,” said Pardis Sabeti, a senior associate member at the Broad Institute and an associate professor at Harvard University, who led the study. “All the sequences are very similar, suggesting it came from a common source.” In Sierra Leone, it started with a traditional healer, says virologist Robert Garry of Tulane University, one of the researchers on the report. The healer treated patients from across the border in Guinea, where an outbreak of Ebola had started in February. Her patients flocked to her funeral, and 14 became infected as they prepared and buried the healer’s body, Garry said. “One of those ladies turned out to be a 20-something woman who was pregnant,” Garry said. She lost the baby, but sought medical care at Kenema hospital in Sierra Leone, which almost certainly saved her life. Genetic sequences taken from this lucky woman confirm the story. The researchers managed to get blood samples from 12 people infected at the healer’s funeral. In total, they got samples from 78 people and checked the sequences against what was known about the spread of the virus. The World Health Organization predicted Thursday that the epidemic would spread to as many as 20,000 people before it’s stopped. It’s already infected 3,000 people and killed 1,500 of them — and that’s just the people that doctors know about. Many have vanished into the forests, mistrustful of the medical system or afraid to go to hospitals. More than 200 of the victims have been health care workers. “Five members of our team have lost their battle with Ebola,” Sabeti told NBC News. “It’s frightening.” U.S. officials announced they’ll start the first human trials of a new vaccine next week, the first in a series of small safety tests. Any results will come too late to help anyone in the current outbreak, which must be fought using the old-fashioned methods of quick diagnosis, quarantine and isolation, supportive medical care and proper disposal of bodies, health experts say. The genetic testing can bolster efforts to understand just how the virus is spreading so that health workers can get ahead of it. All viruses mutate, and scientists can use the mutations as a kind of clock to trace the evolution and movement of a virus. Right now, says Garry, the Ebola virus strain in West Africa appears to be mutating twice as fast as it did in the past when it lived in an animal “reservoir,” probably a bat. “It’s going to change,” Garry said. “A human being is not a bat. The longer this virus is allowed to propagate human to human, the more it is going to adapt.” The genetics show that this particular strain of Ebola separated from the strains known to pop up in Central Africa in around 2004. One cluster can be traced to an infected healthcare worker, who infected a truck driver. The sequences also show that infection control can work. The pregnant woman whose case was the first seen in Sierra Leone went to a hospital prepared to deal with a different virus, the one that causes Lassa fever, so staffers there wore protective gear and did not become infected. The pregnant woman also did not infect anyone else, Garry said. But people are the source of the outbreak, Sabeti stressed. “At least from the data that we see right now, it is not repeated transmission from animals,” Sabeti said. That makes her question warnings from the government in Sierra Leone that caution people to avoid eating “bush meat” — animals hunted in the forest — and fruits such as mangoes. “I don’t think it is the best messaging,” she said. “They’re most likely to get it from another human.” Sabeti’s team has immediately posted all its data publicly on the internet for other researchers to use and analyze. “We’ve got to crowdsource the epidemic,” she said. “This is a frightening situation and we need to work together.” It was collaboration and quick groundwork that made the study possible, added Augustine Goba, director of the Lassa Laboratory at the Kenema Government Hospital in Sierra Leone. “This was possible because of our long-standing work to diagnose and study another deadly disease, Lassa fever. We could thus identify cases and trace the Ebola virus spread as soon as it entered our country,” Goba said in a statement. Source
told NPR that the situation is “overwhelming.” “Unfortunately, we are definitely not at the peak. It’s going to get worse before it gets better,” he said. “The real question is how much worse will it get? How many more people will be infected and how much more risk to the world will there be?” Dr. Frieden claims there are far more cases than reported because there are not enough health workers to maintain new cases/records. The disease has killed over half of the known 2,600 cases including 120 health workers according to the World Health Organization (WHO). Earlier Wednesday, Dr. Sahr Rogers died in Sierra Leone, becoming the third top doctor to die from Ebola. The WHO evacuated its first staff member to contract the disease to Germany for treatment. An infected British health worker was flown back to London earlier this week and is still being treated. “The international surge of health workers is extremely important and if something happens, if health workers get infected and it scares off other international health workers from coming, we will be in dire straits,” said Christy Feig, director of WHO communications. Despite the influx of international aid and campaigns by local governments to spread awareness, this case of Ebola is proving almost impossible to control. “Lots of hard work is happening. Lots of good things are happening,” Frieden said at a meeting attended by Liberian President Ellen Johnson Sirleaf on Monday. “But the virus still has the upper hand.” People are no longer dying only of Ebola in infected regions, but of preventable diseases as well. John Moore is covering the outbreak for Getty Images and described the extended devastation during his interview with NewsHour last week. “If you are sick from some other disease, or if you are having a baby, or if you are doing the things we do as humans, you sometimes need medical attention. And without these facilities (hospitals) open, people are sick and dying of things that they shouldn’t be sick and dying of,” he told NewsHour’s Jeffrey Brown. Dr. Frieden emphasized on NPR that the top priority alongside controlling Ebola is getting basic medical care restored in the infected communities. SourceThe end is, unfortunately, not in sight for West African countries stricken with Ebola, according to Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention (CDC). Dr. Frieden, who is currently on a three country tour in West Africa,
By AFP The three nations at the centre of the west African Ebola outbreak were left increasingly isolated as more airlines suspended flights to the crisis zone.
“In light of the analysis of the situation and as requested by the French government, Air France confirms it is maintaining its program of flights to and from Guinea and Nigeria,” the flag carrier said on Wednesday.
Air France’s decision came a day after British Airways said it was suspending flights to Liberia and Sierra Leone until next year due to Ebola concerns.
The moves come as the head of the US’s top public health body warned that the epidemic in Liberia was set to get worse and that many cases of the deadly disease had not been included in the official tally.
“The cases are increasing. I wish I did not have to say this, but it is going to get worse before it gets better,” Tom Frieden, the director of the Centres for Disease Control and Prevention, told a news conference in Monrovia.
“The world has never seen an outbreak of Ebola like this. Consequently, not only are the numbers large, but we know there are many more cases than has been diagnosed and reported,” he said.
Schools in Nigeria will be closed until October 13, according to the BBC, in an attempt to control the spread of the virus.
Students were planning to start school on Monday for the new academic year.
The country said on Thursday a doctor had died from the virus in the southeastern oil city of Port Harcourt in the first case of the deadly virus outside the financial hub, Lagos.
Health minister Onyebuchi Chukwu said the medic died on August 22 after treating a patient who had contact with a Liberian-American man, who brought the virus into Nigeria and died in a Lagos hospital on July 25.
“Following the report of this death by the doctor’s widow the next day, the case had been thoroughly investigated and laboratory analysis showed that this doctor died from EVD (Ebola Virus Disease),” he told reporters in Abuja.
Health ministers from west African nations hit by Ebola will gather in the Ghanaian capital, Accra, on Thursday to discuss responses to the epidemic.
Authorities in the worst-hit nations are scrambling to contain the most serious outbreak of the lethal tropical virus in history, which has killed more than 1,400 people since it erupted early this year.
The United Nations’ envoy on Ebola, David Nabarro, earlier this week criticised airlines who have scrapped flights to Ebola-hit countries, saying the growing isolation “makes it difficult for the UN to do its work”.
Brussels Airlines normally runs four flights a week to Liberia and Sierra Leone and three to Guinea, but has also cancelled several services since Saturday due to the closure of the Senegalese border.
The carrier said it would decide on its future schedule this weekend.
The company committed to providing three separate flights to Freetown, Monrovia and Conakry this week in response to passenger demand and to deliver 40 tonnes of medical supplies from the United Nations.
Only Royal Air Morocco has vowed to stick to its normal flight schedule – once a day to Conakry and every other day on average to Monrovia and Freetown.
“Our approach is supportive rather than mercenary,” airline spokesman Hakim Challot told AFP, adding: “From Casablanca, the take-up of seats to these three countries is extremely low, around 10 per cent”.
UN officials have pledged to step up efforts against the lethal tropical virus, which has infected more than 2,600 and killed 1,427 since the start of the year.
Liberia has been worst hit, with 624 deaths recorded. Guinea, where the outbreak was first detected, has reported 406 deaths, Sierra Leone has 392 and Nigeria five, according to the World Health Organisation.
Last week Democratic Republic of Congo said 13 people had died with symptoms of an unspecified haemorrhagic fever, and performed tests on dozens of others who had come into contact with them.
It subsequently confirmed two Ebola cases, but said they were unrelated to the epidemic currently ravaging west Africa.
Mr Nabarro, who has already visited Liberia, Sierra Leone and Guinea as part of a tour of Ebola-hit nations, arrived in Nigeria on Wednesday.
Nigeria’s health minister warned against complacency in the country’s fight against Ebola, despite only one patient remaining in hospital isolation with the virus after seven patients recovered.
“Nigeria has been successful at containment. But have we eliminated the disease? No,” he told reporters, likening the situation to trapping a wild animal in a cage.
The emergency coordinator for Doctors Without Borders (Medecins sans Frontieres) in Sierra Leone, nurse Anja Wolz, has also warned in the New England Journal of Medicine that the international response to the outbreak is “dangerously inadequate”.
A Senegalese WHO doctor, who contracted Ebola in Sierra Leone, meanwhile arrived in a German hospital, the first patient with the virus to be treated in the country, said Hamburg health department spokesman Rico Schmidt.
And a health worker with the US Centres for Disease Control and Prevention returned to the United States after possible exposure to Ebola while also working in Sierra Leone, the agency said.
By Susan Duclos – All News PipeLine
Sometime during the last week the Public Health Agency of Canada changed its website’s content regarding Ebola transmission. Last week I published a preliminary essay on the Airborne Transmission of Ebola, and more recently comprehensive essays, all citing the Canadian PHA’s section entitled “Mode of Transmission.”
“In the laboratory, infection through small-particle aerosols has been demonstrated in primates, and airborne spread among humans is strongly suspected, although it has not yet been conclusively demonstrated.”
“[A]irborne transmission has not been demonstrated between non-human primates.”
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