Three of the world’s leading Ebola specialists have called for experimental drugs and vaccines to be offered to people in West Africa affected by an outbreak of the deadly virus…report by ABC News

Noting that American aid workers who contracted Ebola in Liberia were given an unapproved medicine before being evacuated to the US, the specialists – including Peter Piot, who co-discovered Ebola in 1976 – said Africans affected by the same outbreak should get the same chance.

Dr Piot, David Heymann and Jeremy Farrar – all influential infectious disease professors – said there were several antiviral drugs, monoclonal antibodies and vaccines under study for possible use against Ebola.

“African governments should be allowed to make informed decisions about whether or not to use these products – for example to protect and treat healthcare workers who run especially high risks of infection,” they wrote in a joint statement.

The World Health Organisation (WHO), “the only body with the necessary international authority” to allow such experimental treatments, “must take on this greater leadership role”, they said.

“These dire circumstances call for a more robust international response,” they added.

Almost 900 people in Guinea, Sierra Leone and Liberia have been killed by Ebola and more than 1,600 infected since the virus started spreading in Guinea in February.
Experimental drug shows some success

Two American aid workers who fell sick with Ebola in Liberia saw their conditions improve by varying degrees after they received an experimental drug called ZMapp, developed by San Diego-based private biotech firm Mapp Biopharmaceutical.

Nancy Writebol, 59, has arrived in the US after being flown from Liberia and is being treated by infectious disease specialists at Emory University Hospital in Atlanta.

Ms Writebol is in the same isolation ward as Kent Brantly, 33, an Ebola-infected American doctor who was able to walk into the hospital when he arrived by ambulance on Saturday.

The pair are believed to be the first Ebola patients ever treated in the US, and health officials have said the virus does not pose a significant threat to the public.

Dr Piot, Dr Farrar and Dr Heymann questioned why Africans were not being given the same chance to try the experimental drug.

If the deadly virus was raging though wealthy countries, they said, medical agencies “would begin discussions with companies and labs developing these products and then make rapid decisions about which of them might be appropriate for compassionate use”.

“Experimental treatments shouldn’t be rolled out generally without prior safety testing,” they said in their statement.

“But in the face of the critical challenge in West Africa, the WHO and Western medical agencies should be helping countries weigh the risks and benefits of limited deployment of the best [drug and vaccine] candidates to those in the greatest need, while continuously monitoring safety and efficacy.”

A spokesman for the Geneva-based WHO said it “would not recommend any drug that has not gone through the normal process of licensing and clinical trials”.

Relatives dumping bodies in Streets to avoid quarantine
In the Liberian capital of Monrovia, relatives of Ebola victims defied government quarantine orders by dumping infected bodies in the streets, officials said.

Information minister Lewis Brown said some people may be alarmed by regulations imposing the decontamination of victims’ homes and the tracking of their friends and relatives.

With less than half of those infected surviving the disease, many Africans regard Ebola isolation wards as death traps.

“They are therefore removing the bodies from their homes and are putting them out in the street. They’re exposing themselves to the risk of being contaminated,” Mr Brown said.

“We’re asking people to please leave the bodies in their homes and we’ll pick them up.”

In Sierra Leone and Liberia, where the outbreak is now spreading fastest, authorities have deployed troops to quarantine the border areas where 70 per cent of cases have been detected.

A presidential aide from Sierra Leone said the soldiers would “deter relatives and friends of suspected and Ebola patients from forcefully taking them from hospitals without medical consent”.

Complete and Original Post by ABC News

An experimental serum given to Christian aid workers infected with the deadly Ebola virus was manufactured by a San Diego pharmaceutical firm using plants, the company and U.S. health authorities disclosed Monday…report by LA Times.

As Dr. Kent Brantly fights for his life in a special containment unit at Emory University Hospital in Atlanta, and missionary Nancy Writebol prepares to be evacuated from Liberia on Tuesday, details began to emerge about a mysterious treatment they were given shortly after they became infected.

The drug, which was produced by Mapp Biopharmaceutical Inc., is called ZMapp and has not been evaluated for safety in humans, according to a company statement.

“As such, very little of the drug is currently available,” said company President Larry Zeitlin in a statement.

The drug is a cocktail of three “humanized” monoclonal antibodies that are manufactured in a group of fragrant plants or bushes known by the genus name Nicotiana.

Monoclonal antibodies fight viral invaders by locking onto antigens – projections on the surface of a virus that are used to cling to and then enter target cells in the body.

In the case of the Ebola virus, these antigens project like spikes from the virus’ long, spaghetti-like body.
Once these antigens lock onto the surface of a cell, the virus enters and uses the host cell’s machinery to begin mass-producing copies of itself. Antibodies, which can be produced by the immune system or administered as a drug, thwart the ability of antigens to lock onto target cells.

A CNN report that the drug had prompted a “miraculous” recovery and that Brantly’s condition improved within an hour after treatment was greeted with skepticism by longtime Ebola virus researchers.

“I would be ecstatic if Larry’s product helped save these people, but I also need to be extremely cautious,” said Thomas Geisbert, a professor of microbiology and immunology at the University of Texas Medical Branch at Galveston.

“To say the whole thing cleared up in an hour, that doesn’t happen in reality,” Geisbert said. “That’s like something that happens in a movie.”

Ebola virus infection typically begins with flu-like symptoms, such as achy muscles, fever and malaise. As the disease progresses, patients suffer bleeding, rashes, vomiting and diarrhea. If the patients do not receive proper medical care, they can suffer deadly organ failure from the loss of fluids.

Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Disease, said the company had manufactured only three “courses” of the drug, and that two of them were provided to the American patients.

“This was the first time it was put into humans, because all the previous work was done on animals and the results had been encouraging,” Fauci said.

Fauci said it was hard to say whether or not the medication had been effective. “If you ask Sanjay Gupta, he says the effect was dramatic, but when you have one patient, you have nothing to compare it to. You can’t make a definitive statement,” Fauci said.

Fauci’s agency provided a statement Monday describing how the drug came to be administered to Brantly and Writebol.

The Christian aid organization Samaritan’s Purse had contacted U.S. Centers for Disease Control and Prevention officials in Liberia to discuss the status of experimental treatments they were aware of, the statement said.

Those officials referred the aid group to a National Institutes of Health scientist who was assisting in the Ebola outbreak response in West Africa.

“The scientist was able to informally answer some questions and referred them to appropriate company contacts,” the statement read. “She was not officially representing NIH and NIH did not have an official role in procuring, transporting, approving or administering the experimental products.”

Though some have criticized the decision to transport Brantly and Writebol to the U.S. for treatment, fearing that it would cause the disease to spread here, officials say it is “extraordinarily unlikely.”

Proper hospital procedures will keep the virus isolated, they say, and afford the two patients care that will enable their bodies to fight off the virus.

There is no vaccine or cure for Ebola. The virus has a mortality rate as high as 90%, depending on the strain. It is transmitted through bodily fluids, but not through the air, experts say.

Complete and Original Post by LA Times

With dozens of local doctors and medical staff among the dead, U.S. and foreign experts are preparing to flood into West Africa to help fight the deadliest Ebola outbreak on record…report by LA Times

Although two Americans, Dr. Kent Brantly and health worker Nancy Writebol, have contracted the disease, health experts say foreigners taking careful precautions should not be at serious risk.

But more than 60 local medical staff, about 8% of the fatalities, have died in Sierra Leone, Liberia and Guinea — poor countries with weak, overloaded healthcare systems that are ill-equipped to handle the outbreak.

Ebola expert G. Richards Olds, dean of medicine at UC Riverside, compared local healthcare workers there to doctors who donned beaked masks, leather boots and long, waxed gowns to fight the plague in medieval Europe.

“This is one of the few cases in modern times of true healthcare heroism,” Olds said. “They’re taking some significant risks, as you can see, to help others.”

Among the dead are Liberia’s Dr. Samuel Brisbane, and Dr. Sheikh Umar Khan, a top Sierra Leone doctor who treated dozens of patients. Khan was described as a national hero by his country’s health ministry. Three nurses working with him died the same week he perished.

Dr. Tom Frieden, head of the Centers for Disease Control and Prevention, said Sunday the U.S. plans to send 50 public health officials to West Africa in the next 30 days to help fight the disease.

He said Brantly, who arrived in the U.S. on Saturday and is undergoing treatment, appears to be getting better. Writebol is expected to arrive in the U.S. this week. Both contracted the disease in Liberia.

The World Health Organization said Friday that it planned to fly hundreds more medical staff into West Africa to stem the spread of the disease and trace those who had contact with infected people.

Dubai-based airline Emirates, the Mideast’s largest carrier, said Sunday that it halted flights to Guinea because of concerns about the spread of the Ebola virus, which has killed more than 700 people since March.

The protective gear required to confront the disease consists of rubber boots, medical scrubs, two pairs of rubber gloves, a waterproof, airtight yellow suit, a rubber apron, a rubber bib, a rubber hood and a mask. It is a suffocatingly hot outfit in West Africa’s tropical heat.

There’s a complex five-minute procedure to put the gear on, take it off and determine whether gowns can be reused. One mistake can be fatal.

Medical hygienists, who clean up after patients and dispose of fluids including blood, vomit and diarrhea, are the most at risk.

Olds said Ebola is less infectious than SARS, the airborne disease that spread from Asia around the world in 2003, but it is far more deadly.

Although Ebola is highly infectious, it’s not transmitted by air, and when a doctor or nurse sickens, it usually means something has gone wrong in the complex process of robing and disrobing.

In West African public hospitals, some employees are working 12-hour shifts. Whether it’s heat (the temperature inside suits can rise to more than 100 degrees), long hours, exhaustion, lack of staff or lack of training, fatal mistakes have been made.

Health workers from organizations such as “Doctors Without Borders” and other relief agencies also do outreach work in West African communities to try to persuade frightened people infected with the virus to come to treatment facilities. Most of the outreach work is done without protective clothing or masks.

Medical staff do not approach closer than two yards when assessing sick people. If they have to enter a house to see an ill person who can’t move, they don their gowns and protective layer.

Doctors Without Borders nurse Monia Sayah, who returned home to the U.S. recently after months working in Guinea treating patients, said she felt safe in her protective medical clothing, despite the fact many doctors and health staff had sickened and died.

Doctors Without Borders has never had an Ebola fatality.

“We have very strict measures to avoid infection. We use a set of behaviors. It’s very important the way we dress up and the way you dress down. We use a buddy system to make sure you don’t make a mistake when you are putting on or taking off the gown,” Sayah said.

Doctors Without Borders was also meticulous about minimizing the use of sharp objects in the treatment centers.

Intravenous needles were used only when absolutely necessary. Patients weren’t given knives and forks to cut their food. Instead the food was cut up for them outside the isolation unit.

Chlorine, among other disinfectants, was used in the treatment facilities to sanitize boots, clothing and other items, Sayah said.

Frieden said Sunday that Americans should not fear Ebola taking hold in the U.S.

“Any U.S. hospital following CDC’s infection control recommendations can safely manage a patient with Ebola hemorrhagic fever,” he said on Twitter.

Doctors Without Borders has been “caring for patients with Ebola in rudimentary facilities in Africa and has never had one of their health workers infected,” he said, adding that meticulous procedures prevented the virus from spreading.

Complete and Original Post by LA Times