l. mBio has published on-line an article by Kugelman, et. al. of MIT, NIAID, Harvard, USAMRIID documenting the ‘drift’ in the Ebola Makona strain in West Africa now from the Ebola Zaire strain in Central Africa. The authors documented that some mutations affected genes targeted by Tekmira, ZMapp, monoclonal antibodies, and small interfering RNAs. The affected genes include GP (glycoprotein), VP24, and VP35. See the entire article especially Table 1 at: http://mbio.asm.org/content/6/1/e02227-14/T1.expansion.htmlg.
2. The authors conclude that these recent EBOV mutations will affect the activity of experimental drugs and vaccines soon to undergo Phase 3 trials in West Africa. These drugs and vaccines should be tested against the most recent EBOV strains sequenced. NBC News has an interview with Dr. Kugelman at: http://www.nbcnews.com/storyline/ebola-virus-outbreak/mutant-ebola-virus-may-evade-drugs-study-finds-n289896
3. The Lancet has published a Correspondence by Bannister-Tyrrell, et. al. from the Medical Anthropology Unit at the Institute of Tropical Medicine in Antwerp re: how West Africans look upon convalescent blood from EBOV survivors used as treatment for current EBOV patients. If current patients do not recover after transfusions with convalescent blood, then West Africans interpret the deaths as due to the blood transfusions. The donors are stigmatized and EBOV patients hidden by families.
4. HCW need to educate West Africans and pay attention to their fears and misunderstandings. For instance, schools opened today in Guinea, but parents did not send their children because parents saw masked people spraying the classrooms with an unknown substance. It was probably bleach or insecticide, but no one in charge told the parents or teachers or workers what was going on. See the Bannister-Tyrrell correspondence at: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)62392-8/fulltext
5. The Lancet Infectious Disease has posted on-line Correspondence by Chowell, et. al. from the Biodesign Center at Arizona State University re: the effectiveness of diagnosis of pre-symptomatic EBOV patients in controlling the EBOV epidemic. According to the authors’ model, if patient isolation of >65% is achieved, and 25% of pre-symptomatic EBOV patients are diagnosed by PCR testing, then the EBOV epidemic can be controlled.
See the entire Correspondence at: http://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2814%2971084-9/fulltext
Postscript: NPR yesterday carried an interview with an entomologist on why ants don’t have traffic jams as they march in a line to obtain food. The entomologist answered: ants do not show ‘aggressive behavior’ as they march; ants do not ‘rubberneck’ minor accidents; ants remain disciplined the entire time of their march. NPR concluded these behaviors could avoid human traffic jams on highways as well. It seems to me that the ants’ behaviors also serve as good behaviors for humans in general.
Nota Bene: Please note that the SHEA journal article on pulsed Xenon UV light for killing C. difficile and MRSA and VRE referenced this morning did not contain clinical infection data, but only environmental cultures. Clinical trials with pulsed Xenon UV light must be performed to validate the SHEA journal article.