Evening Ebola Update, 2/27: MSF says viral counts down 50% in their EBOV pts./Why resp. transmission is not ‘very likely’/ZMapp gets RCT in Liberia   Leave a comment

2/27/15

Dear Colleagues:

l.  Dr. Racaniello of Virology Blog has written a rebuttal to Osterholm’s recent Ed/Op in the NY Times which stated that EBOV respiratory transmission is ‘very likely’.  Dr. Racaniello argues that the same facts that Osterholm used to say respiratory transmission is ‘very likely’ can be used to say that respiratory transmission is very unlikely.  See the rebuttal arguments at: http://www.virology.ws/2015/02/21/ebolavirus-will-not-become-a-respiratory-pathogen/

2.  NIH announced today that a trial of ZMapp will begin in Liberia as a randomized clinical trial (RCT).  Both arms of the trial will receive optimized medical care, but one arm will also receive ZMapp.  Once this trial is completed (100 volunteers in each arm), another experimental drug will be tested against the more effective of the ZMapp and no ZMapp arms.  After this second RCT, another experimental drug will be tested against the more effective of the second RCT.  And so on.  See a understandable explanation of the RCT of ZMapp and several other experimental drugs to follow the original ZMapp RCT at: http://www.nih.gov/news/health/feb2015/niaid-27.htm

3.  Nature 25 February in Comments has published on-line an article by Yozwiak, et. al. from The Broad Institute at Harvard on the value of immediate open-sourcing of genomes of infectious agents in the current EBOV epidemic and future infectious outbreaks.  The Broad Institute has immediately open-sourced all of the EBOV genomes sequenced from West Africa, starting last August and continuing to today at virological.org  (Fifty one new EBOV genomes from the Kenema Hospital in Sierra Leone sequenced last December and January were added today).  See the Yozwiak, et. al. Comment at: http://www.nature.com/news/data-sharing-make-outbreak-research-open-access-1.16966 and all 96 EBOV genomes from The Broad Institue at: http://virological.org/t/mid-early-release-96-ebov-genomes-from-sierra-leone/96.  The authors are calling for a meeting of all the ‘big name’ Infectious disease associations/organizations to make open-sourcing of infectious agent genomes the norm.

4.  The Guardian reports today that an infected person escaped from quarantine in Freetown, Sierra Leone, and returned to his village thereby infecting as many as 50 other persons with EBOV.  The village has now been quarantined.  This tragedy shows how a single infected person can restart a outbreak or epidemic.  See: http://www.theguardian.com/world/2015/feb/27/ebola-sierra-leone-village-lockdown-31-new-cases

5.  NY Times reports on a AIDS conference in Seattle where MSF stated that their number of EBOV treatment centers has decreased from 22 to 8 centers; that the EBOV viral counts in their patients have decreased by 50%; and that EBOV mortality in their centers has decreased from 62% to 52%.  The viral counts may have decreased because of better EBOV precautions so patients receive a lesser EBOV inoculation or because EBOV has mutated to a less lethal form.  See: http://www.nytimes.com/2015/02/27/health/fatality-rate-in-west-africa-ebola-clinics-is-dropping.html?_r=0

RGL, MD

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Posted February 28, 2015 by levittrg in Ebola

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