Serum Brings Hope For SARS Cure

IOL ^ | 5-7-2003

[blam]

Serum brings hope for SARS cure

May 07 2003 at 09:24AM

Hong Kong - Serum taken from the blood of Hong Kong patients who have recovered from SARS, has been effective in treating some victims who had earlier not responded to anti-viral treatment, said doctors.

However, they said more standardised testing would be needed before serum treatment could even be considered as a replacement for the combination of Ribavirin and steroids currently used in Hong Kong hospitals to treat SARS.

Gregory Cheng, Associate Professor of Medicine and Therapeutics at Chinese University, said 20 patients who failed to respond to Ribavirin treatment had been given the serum, while another batch of 20 had continued to receive high dosage steroid treatment.

Serum is obtained from patients who have developed antibodies in their blood after recovering from SARS.

"From those who received serum, a majority could be discharged after the 21-day recovery period," said Cheng adding the treatment had shown no side-effects so far.

Since the outbreak of Severe Acute Respiratory Syndrome (SARS) seven weeks ago, 193 have died while 1 646 have been infected in the territory.

A rise in the fatality rate in recent weeks has sparked concerns about the anti-viral drug Ribavirin which carries serious side-effects including possible damage to the liver and heart.

Cheng said about 70 patients had received serum treatment, of whom an estimated 70 percent should be discharged after 21 days, although "this was not a accurate reflection of its effectiveness".

He said more than 20 patients had been given the treatment in the past week and were not included in the analysis while other patients had been in hospital a long time and serum had been used as a "last desperate measure".

"Under these conditions, serum is not effective. It should be used in the first weeks of SARS symptoms occurring," he said.

Cheng stressed "the study is relatively small" and more tests were needed - before serum use could even be considered "the major second-line treatment".

"There is also a risk, though small, that the serum from the donor could still contain viruses even though donors are screened for viruses like hepatitis," he warned. - Sapa-AFP

[aristeides]

Another story on the serum treatment.

[blam]

SARS Threatens To Wreck Asian Markets

[riri]

I saw this. Interesting.

I'd be scary taking serum though. God knows what you could end up with, if you survive the bout with SARS.

[Hank Kerchief]

I'd be scary taking serum though. God knows what you could end up with, if you survive the bout with SARS.

Why do you say that. Serum/gamma globulin is both safe and effective, and, personally, have been amazed it was not used sooner, especailly once there were a fairly large number of patients who recovered from SARS.

Hank

[riri]

There is also a risk, though small, that the serum from the donor could still contain viruses even though donors are screened for viruses like hepatitis,

Small risk, I guess.

[Hank Kerchief]

There is also a risk, though small, that the serum from the donor could still contain viruses even though donors are screened for viruses like hepatitis,

Small risk, I guess.

I wasn't criticizing, just wondering if you had some specific risk in mind. You are right there is risk (but there is risk in everything), and you are also right, considering the alternative, the risk seems small.

Do you have any idea why they have waited so long to try serum therapy? It simply amazes me.

Hank

[riri]

Pig Slaughtering is Halted in Several of China's Provinces Could Cut Chinese Pork Production in Half

By Charles Ortleb

Channelnewsasia.com has reported that "People's Food Holdings will temporarily halt pig slaughtering at locations in several provinces of China and delay the start of a new plant due to concerns over the SARS outbreak."

According to the report, the plants that were closed accounted for half of all the pork sales by People's Food Holdings last year.

The report also notes that the company "will also stop the purchase of live pigs from suppliers in Hunan, Sichuan, Inner Mongolia and Henan Province."

Henan Province is one of he places where a SARS-like epidemic called PRRS (and various other bizarre and complicated names) has affected pigs for many years. Pigs with PRRS often develope coronavirus infections but it has yet to be established if the SARS-associated coronavirus is one of them. Japanese researchers have performed research that indicates that coronaviruses pass back and forth easily between people and pigs.

More from Charles Ortleb.

[riri]

Do you have any idea why they have waited so long to try serum therapy?

Actually, there were reports of serum (or maybe it was injection of antibodies) very early on. I will dig around and see if I can find it. Either way, if I remember correctly, it seemed promising at first and then I never read about it again.

[aristeides]

Too low-tech, so that there are fewer possibilities of research grants and professional advancement? Too much liability risk?

[Hank Kerchief]

Too low-tech, so that there are fewer possibilities of research grants and professional advancement? Too much liability risk?

You are very cynical, so are very likely correct. It is still a mystery to me why there is so little done in this area. Historically, plague, and other "epidemics," have been halted by the use of serum therapy.

Hank

[FairOpinion]

Here is an article about the same thing, but with a bit more details. Note the mention of 50% fatality rate among older patients.

From UK Telegraph:
Doctor finds 'blood serum cure for Sars'
By Adam Luck in Hong Kong
(Filed: 11/05/2003)


A doctor in Hong Kong who survived Sudden Acute Respiratory Syndrome is pioneering a treatment based on his own blood to help patients who do not respond to conventional anti-viral drugs.

Prof Gregory Cheng claims a success rate of more than 60 per cent for the experimental treatment for Sars, which has killed 526 people throughout the world. It involves giving patients a transfusion of serum produced from blood donated by recovering Sars sufferers, who appear to have built up antibodies after being exposed to the virus.

So far 70 patients have been treated with the convalescent serum and most showed rapid improvement within days. With the mortality rate rising to an estimated 50 per cent among older patients - who are less likely to respond to conventional treatment - Prof Cheng is optimistic that his therapy could become an alternative treatment.

"This was an unproven and unknown treatment," said Prof Cheng, of the Department of Medicine at Hong Kong's Chinese University, "but at the time we had patients deteriorating in front of our eyes and this was a logical alternative.

"I felt that it was justifiable and we explained the risks involved to the patients and their relatives. We are very pleased with how it has gone. Obviously, this is in its early stages but the results have been very encouraging.

"Not only has this helped patients who have been beyond the help of the conventional treatment but many new Sars patients are now asking to be treated by this method."

The transfusions are performed during the second week of infection when the Sars virus is at its peak and victims are most vulnerable. In some cases, patients have received several transfusions.

Although not all those treated with the serum have recovered none has died so far. "They just take longer to recover or are still in hospital," said Prof Cheng.

Until now, doctors in Hong Kong - which is leading the Sars treatment - have relied on a cocktail of Ribavirin - which represses viruses - and steroids to help patients.

Potential side effects include damage to the heart, liver and blood and also deformities in unborn children.

So far the treatment using serum - which is blood stripped of its red and white blood cells - has produced no obvious side effects.

Prof Cheng, who is based at the Prince of Wales Hospital in Kowloon, said that tackling Sars with convalescent serum was a logical extension of existing techniques. Serum that is rich in antibodies is already used to treat viral infections such as hepatitis B and HIV.

But whereas most serum is produced to internationally accepted standards and carefully filtered for other dangerous viruses, the Hong Kong team could not guarantee a uniform amount of antibodies in each transfusion.

However, Prof Cheng decided that the risk was "justifiable". He said: "We tried the treatment on a couple of our colleagues and some did have a quite quick recovery rate. Although this was not a controlled trial we felt encouraged and began to use it more.

"We need to complete experiments to document the viral infection and compare this between a treatment group and those who have not been given the serum treatment."

http://news.telegraph.co.uk/news/main.jhtml?xml=/news/2003/05/11/wsars11.xml&sSheet=/news/2003/05/11/ixworld.html/news/2003/05/11/wsars11.xml

[blam]

"Although not all those treated with the serum have recovered none has died so far. "They just take longer to recover or are still in hospital," said Prof Cheng."

Apparently wouldn't kill you to try it.