Evening Ebola Update, Fri, 11/21: Liberia EBOV decreasing/’Shed’ GP causes ‘leaky’ vessels/Prompt vaccin. will end EBOV   Leave a comment

11/21/14

Dear Colleagues:

1.  NY Times reports that 6 people, including one physician, have died of EBOV in Mali as a result of contact with the Grand Iman who traveled from Guinea to Mali with EBOV.  Other sources have reported that 20,000 people attended the iman’s burial in Guinea (he was transported back to Guinea after dying) and 3,000-4,000 people touched his body at the burial ceremony.

2.  The Lancet today contains Correspondence re: rebuilding health systems in West Africa vs. treatment with vaccines/experimental drugs. Both sides of the question are presented in: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)62236-4/fulltext

3.  WHO announced that DRC is now free of EBOV disease.  It has been 42 days without a new case of EBOV.  A total of 66 cases were diagnosed previously.  WHO attributes DRC’s rapid response teams (mobile teams including mobile labs) with stopping the outbreak in DRC.

4.  NY Times reports that EBOV epidemic in Liberia is slowing.  As a result, U.S. troops will build a total of 500 beds in Liberia, not the originally planned 1700 beds.  The epidemic in Sierra Leone continues to mount; the situation in Guinea is not well documented.

5.  PLoS Current Outbreaks posted an article by Fisman and Tuite from University of Toronto, Ontario, Canada, re: number of vaccination doses and timing to reduce the reproductive rate of EBOV in West Africa to < 1 and stop the epidemic.  The authors report that 3-4 million doses of vaccine given by January, 2015, will stop the epidemic (Re = 0.9).  (Without a vaccination program the authors project the EBOV epidemic to peak in April-May, 2015).  The later in 2015 the vaccinations are given, the less effect the vaccinations will have on the EBOV epidemic.  There is a ‘closing window of opportunity’ with a vaccination program.  See the complete article and its understandable charts/figures at: http://currents.plos.org/outbreaks/article/projected-impact-of-vaccination-timing-and-dose-availability-on-the-course-of-the-2014-west-african-ebola-epidemic/

6.  PLoS Pathogens posted an article by senior author Volchkov, et. al, from the University of Lyon, France,. re: shed GP (glycoprotein) from EBOV which (unlike secreted GP) binds to macrophages and dendritic cells in an infected patient and produces release of cytokines which make vacular endothelium ‘leaky’.  The TLR4 receptor is the mediator for this process, so anti-TLR 4 antibodies could prevent the cytokine release.  See: http://www.plospathogens.org/article/info:doi/10.1371/journal.ppat.1004509 for this article.

RGL, MD

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Posted November 21, 2014 by levittrg in Ebola

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