Evening Ebola Update, Tues, 12/23: We need medical anthropologists help/cAd3 vaccine safe in Africans, but LESS IMMUNOGENIC   Leave a comment

’12/23/14

Dear Colleagues:

1.   Somatosphere 26 September has an article entitled  ‘Ten Things Anthropologists Can Do to Fight the West Africa Ebola Epidemic’.  The article is written by Abramowitz, a medical anthropologist from the University of Florida.  Somatosphere is a collaborative website for medical anthropology, science/technology, cultural psychiatry, and psychology.  The author states that medical anthropologists can help in the EBOV fight by accurately determining the death counts, recruiting students to help with field work, teaching HCW how to interact with villagers to obtain facts rather than cold stares, sharing local contacts, tracing black markets.  Medical anthropologists are trained in working with populations in crisis.  See: http://somatosphere.net/2014/09/ten-things-that-anthropologists-can-do-to-fight-the-west-african-ebola-epidemic.html for this eye-opening article (for me).  In my opinion, we need the kind of information that medical anthropologists are trained to obtain from local populations to be successful in the fight against EBOV.  We should be welcoming their help, which has not always been the case.

2.  The Lancet 22 December has a Comment (really an Editorial) by Sridhar from the Jenner Institute at University of Oxford on an Article by Kibuuka, et. al. from Makerere University in Uganda and NIH on the safety and immunogenicity of EBOV/Marburg virus glycoprotein vaccine in a Phase 1b trial on healthy Ugandans.  The Kibuuka, et. al. study is scientific and detailed; Sridhar summarizes the study for Lancet readers.  See his Comment at: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)62445-4/fulltext.  The complete Kibuuka, et. al. paper can be read at: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)62385-0/fulltext

3.  Kibuuka, et. al. studied the chimpanzee adenovirus vector (cAd3) encoded with glycoprotein from EBOV or EBO or Marburg virus in healthy Ugandans.  The previous Phase 1 study had been done in the U.S., so researchers needed to know whether the cAd3 vaccine was safe and immunogenic in Africans (as cAD3 was in U.S. volunteers).  The researchers found the vaccine was safe and immunogenic.  But the number of Ugandan volunteers who developed immunogenicity was significantly less than the number of U.S. volunteers who developed immunogenicity; 57% of Ugandans c/w >90% of U.S. volunteers for EBOV.  In both U.S. and Ugandan trials the immunogenicity lasted one year.  See: http://www.nejm.org/doi/full/10.1056/NEJMoa1410863?query=featured_ebola#t=article for the NEJM report on the U.S. Phase 1 trial of cAd3 vaccine.  The lesser percentage of Ugandans who developed immunogenicity against EBOV raises questions on why as well as how the percentage can be increased.

RGL, MD

P.S.  For readers who have a love of chocolate during this holiday season, there is an article in New Scientist 20 December on pages 55-57 on ‘Chocolate’s dark secrets’ by Lesley Evans Ogden.  Hint: Microbes are involved.

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Posted December 24, 2014 by levittrg in Ebola

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