l. NEJM published on-line only tonight two articles on safety/immunogenics of a chimpanzee adenovirus Type 3 vaccine (cAd3-EBO) encoding the glycoprotein (GP) from Zaire and Sudan species of EBOV (note vaccine is bivalent because it encodes GP of two species). The Original Article by Ledgerwood, et. al. tested cAd3-EBO at two different doses in two groups of 10 patients. The vaccine was safe at both doses and delivered immunogenicity at both dose (higher dose provided more immunogenicity). See the Ledgerwood, et. al article at: http://www.nejm.org/doi/full/10.1056/NEJMoa1410863?query=featured_ebola#t=articleTop.
2. An accompanying NEJM Editorial by Bausch at Tulane University notes that the cAd3-EBO vaccine produces both humoral and cell-mediated immune responses and that the higher dose vaccine produced 70% more CD8 T-cell response than the lower dose vaccine. One high fever/low white count developed in the high dose vaccine test group. Brausch’s Editorial in Paragraph 3 lists the practical questions which need to be answered in further human tests on this vaccine. See the Editorial at: http://www.nejm.org/doi/full/10.1056/NEJMe1414305?query=TOC
4. The open source journal Viruses has a Special Issue related to the Filoviruses. A Letter within this Special Issue by Kuhn, et. al. entitled ‘Filovirus RefSeq Entries…’ has a Figure 1 which nicely depicts the differences betwee Ebola and Marburg and the differences between the Ebola species by genomic differences. For non-virologists like myself, Figure 1 is much easier to understand than phylogenetic trees. See the Kuhn, et. al. Letter and Figure 1 at: http://www.mdpi.com/journal/viruses/special_issues/filovirus_2014_2015.
5. ACAPS Global Emergency Review 25 November shows the distribution of Severe Humanitarian Crises in the world. Most of these severe crises are located in West and Central Africa-the same locations as the EBOV epidemic. When I reviewed the environmental charts of these African countries in ‘Atlas of Africa’ by Campbell, Porter, Lye, the countries have the following in common: tropical rainforests, rainforests seriously damaged in recent years, and the intersection of Muslim, Christian, and Traditional religions in Africa. See the ACAPS review at: http://geo.acaps.org/
6. PLoS Computational Biology published on-line 13 November an article by Generous, et.al. from Los Alamos that reports Wikipedia can be used to accurately monitor and forecast global disease up to 28 days in advance (limit of the study). This can even be done for countries in which there is no official data. The article is complementary to a previous article that showed how mobile phone data could be used to track EBOV in Sierra Leone. See the Generous, et. al. article at: http://www.ploscompbiol.org/article/info:doi/10.1371/journal.pcbi.1003892#abstract1
I will be on the road tomorrow and may not have access to Internet connectivity, depending on the weather in the Midwest. If no Internet connection, the next blog posting will be this coming Friday.
A surreal moment at my St. Louis hospital today- a National Guard Humvee parked outside our hospital entrance to give all HCW a sense of security at work today. Guardsmen were on site, but not within view of staff or patients.
Happy Thanksgiving to Everyone,.