Evening Ebola Update, Thurs, 2/5: Sharp rise in EBOV cases in West Africa/Avigan useful before Day 3 of symptoms/ Efficacy of Avigan hard to judge because comparison trials didn’t come off.   Leave a comment

2/5/15

Dear Colleagues:

l.  BBC News Africa reports that WHO recorded 124 new EBOV cases last week.  There were 80 new cases in Sierra Leone, 39 new EBOV cases in Guinea, and 5 new EBOV cases in Liberia.  The previous week WHO recorded a minimum number of cases and thought the EBOV epidemic may have ‘turned the corner’.  Guinea is particularly difficult to work in because Guineans fear and are antagonistic toward EBOV HCW.  See this disturbing new WHO report at: http://www.bbc.com/news/health-31140987

2.  NY Times reports today that the trial of Avigan (favipiravir) in Guinea has produced good results in EBOV patient with low or moderate viral counts (Day 3 of symptoms or earlier), but not in patients with high viral counts (Day 5 of symptoms or later).  Avigan works by inhibiting viral RNA dependent RNA polymerase.  Avigan does not inhibit human RNA or DNA synthesis and is not toxic to human cells.  The drug is approved for stockpiling against influenza virus.  See: http://www.nytimes.com/2015/02/05/science/ebola-drug-has-encouraging-early-results-and-questions-follow.html for the NY Times article.

3.  NY Times reports that determining the true efficacy of Avigan in the Guinea is problematic because the Avigan trial was to be performed in tandem with a convalescent blood transfusion trial and a brincidofovir trial.  The convalescent blood transfusion trial has not begun yet; the brincidofovir trial has been discontinued for lack of patients.  I expect some patients who presented later than Day 3 with symptoms were given both convalescent blood transfusion and Avigan in the Guinea trial of Avigan.  No experimental drug treatment should be denied an EBOV patient given the high EBOV mortality.  Moreover, Europeans and Americans with EBOV infections transported out of Africa to U.S. and European hospitals have received multiple drug treatments for EBOV as well as convalescent blood transfusions.

RGL, MD

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Posted February 5, 2015 by levittrg in Ebola

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