In the field disease fighters now fear Ebola will become endemic in West Africa for cultural reasons.
Why Ebola won’t go away in West Africa
http://www.mprnews.org/story/2015/06/20/npr-ebola-west-africa
Health Jason Beaubien Jun 19, 2015
Despite dramatic drops in the overall numbers of reported cases, Sierra Leone and Guinea are still struggling to stop the deadly disease.
Case tallies in both countries have dipped towards zero in the past few months, only to bounce back up. Sierra Leone reported 14 new cases this week and Guinea counted 10.
To try to finally wipe out Ebola once and for all, Sierra Leone President Ernest Bai Koroma ordered the military last week to enforce new community-wide quarantines around the most recent cases.
“The curfew restrictions and the soldier activities will last for a 21-day period,” President Koroma declared on TV last week. Anyone caught violating the quarantine will be arrested, he ordered.
People aren’t allowed to leave the quarantined communities, and the government has imposed a curfew from 6 p.m. to 6 a.m. The new restrictions are aimed at “ending the secret movement of cases, contacts, and dead bodies that has propagated transmission over the past two months,” the World Health Organization said.
Guinea arguably is in a worse position than Sierra Leone. The outbreak has been going on longer in Guinea. Cases are more geographically widespread, and some rural communities in Guinea have blocked health workers from entering.
“I think it’s going to be very difficult to actually get to zero cases and stay at zero cases in Sierra Leone and Guinea,” says Dr. Daniel Lucey, a professor of immunology at Georgetown University, who just returned from Guinea last week.
Lucey has worked as a doctor on Ebola treatment wards in both Sierra Leone and Liberia. He still sees major problems facing the Ebola eradication effort.
One bad sign is that people continue to die from Ebola at home and are only diagnosed as having the disease after death. “That means they’ve been sick for days, possibly weeks, and so they’re contagious,” he says. “Who did they expose? It’s hard to know once they’re dead.”
To gain the upper hand against the outbreak, health officials need to be able to track down anyone who may have been exposed to the virus. Currently they’re monitoring more than 2,000 contacts of Ebola patients in the region. Yet, despite this, sick people keep turning up who aren’t on any known contact list. “We don’t have the degree of control that’s essential to stop the epidemic,” Lucey says.
To get control of this outbreak, health officials need to be able to go visit the contacts who are being monitored for Ebola. They have to get blood samples to laboratories. They have to be able to transport patients to isolation wards and safely bury anyone who’s died of the disease.
In remote parts of West Africa, with poorly-maintained dirt roads, this is difficult in the best of times. It’ll get even more difficult as seasonal rains kick in to full gear, Lucey says. “If we haven’t been able to succeed in the last six months during the dry season, how are we going to succeed in the next six months in the rainy season?”
Lucey concedes that there has been incredible progress against Ebola. At the apex of this outbreak last fall, there were more than a thousand cases being reported each week. Now we are down to only about two dozen new cases each week.
But those last few cases may be the hardest to stamp out, Lucey warns. And if the outbreak doesn’t get completely stopped soon, he says, there’s a danger Ebola could become endemic in the region.
Score one for USMRID!
U.S. Army Medical Research Institute of Infectious Diseases found Zoloft and Vascor were 70% and 100% effective in removing the Ebola virus from the blood of mice.
Drugs to fight Ebola may already be in your medicine cabinet
Posted: Sunday, June 21, 2015 12:00 am
BY KAREN KAPLAN/LOS ANGELES TIMES
Researchers have found two drugs that saved the lives of mice infected with the deadly Ebola virus, and you may have them in your medicine cabinet already.
Zoloft, an antidepressant that has been on the market since 1991, cured 70 percent of mice that had the virus in their blood. Vascor, a heart drug approved by the U.S. Food and Drug Administration in 1990, cured 100 percent of the infected mice.
Zoloft and Vascor were just two of about 2,600 drug compounds tested for their ability to disable Ebola viruses and the closely related Marburg virus, according to a report published in the journal Science Translational Medicine. Both types of viruses cause hemorrhagic fevers that can be fatal in up to 90 percent of cases.
The current Ebola outbreak in West Africa has killed 11,162 people and sickened 27,181 since claiming its first victim in December 2013, according to the World Health Organization.
Researchers in government labs and pharmaceutical companies have been scrambling to develop new drugs to fight the virus, and while they have come up with several promising candidates, all of them have months or years of testing ahead of them.
A team from the U.S. Army Medical Research Institute of Infectious Diseases, the University of Virginia and Horizon Discovery Inc., of Cambridge, Mass., decided to take a different approach. Instead of creating a new drug from scratch, they set out to determine whether an existing drug could be deployed to fight Ebola.
They began with a “library” of 2,635 compounds that included FDA-approved drugs, amino acids, food additives, vitamins and minerals.
Each of the candidates was tested on a version of the Ebola virus that had been engineered to glow green when exposed to ultraviolet light. A candidate was considered successful if it dulled the green signal by at least 40 percent and also did little or no harm to a sample of uninfected cells derived from the kidneys of African green monkeys.
A total of 171 compounds passed this first round of testing. From this list, the researchers picked 30 that seemed most promising and tested them further in the kidney cells and in human liver cancer cells. They found that 25 of the compounds were able to block Ebola’s entry into cells by more than 90 percent.
For the next round, the researchers picked eight compounds to test in mice. Drug treatment began one hour after the animals were infected with a mouse version of Ebola and continued for up to 10 days.
Three of the compounds had no discernible effect, and all of the mice who got them were dead within eight days. Three other candidates allowed 10 percent, 30 percent and 40 percent of the mice to live for 28 days.
But Zoloft (also known by the generic name sertraline) and Vascor (generic name bepridil) had more encouraging results. Of the 10 mice that got Zoloft, seven survived for 28 days. Even better, all 10 of the mice treated with Vascor were alive 28 days after infection. For the sake of comparison, all of the untreated mice that served as controls were dead within nine days.
The two drugs were then tested in cell cultures against a larger group of Ebola and Marburg viruses. Both medications were able to fight all of the viral strains, including a Zaire Ebolavirus, the type now circulating in West Africa.