Wouldn’t it be nice to be able to time travel back and just properly isolate the various patient zeroes from the current outbreak?
So, first up – here is the latest news on the current outbreak.
First up, the number of infected, and the number of fatalities in the West Africa outbreak was 3685, with 1841 deaths, as at 31 August. These data, along with the following picture are taken from the September 5 World Health Organisation (WHO) situation report.
Below is a link to the WHO roadmap for scaling up international response to the outbreak. Important point – this roadmap is designed to stop transmission in infected countries within 6-9 months, and to prevent international spread.
One interesting point is, at the date of publication, 40% of infections had occurred within the previous three weeks.
All in all, the picture of an outbreak with the ability to explode past an epidemic into a pandemic if handled incorrectly. Thankfully, the strains involved have shown no propensity for aerosol spread so infection containment procedures are relatively simple.
Current containment protocols have somewhat limited the spread of disease, with more than 80% of cases occurring in 9 out of the 42 districts in Guinea, Liberia, and Sierra Leone that have reported cases (Lofa, Kailahun, Kenema, Gueckedou, Montserrado, Macenta, Conakry, Margibi, and Nimba).
The aid workers, doctors and various healthcare professionals involved will be facing an uphill battle unfortunately. Cultural response to must be managed to limit spread of disease, and although WHO has mandated that increased social mobilisation and community engagement is to be one of the cornerstones of their containment strategy, there is always the possibility of said communities not cooperating.
Really, what’s more to be said? A response is being applied, and only time will tell whether more drastic measures need to be taken. I must admit that epidemiology was never one of my favourite subjects.
Recent advances in the treatment of Ebola
Currently, the most successful treatment for Ebola is ZMapp, with a 71.5% success rate. Something to note though is that the current outbreak has an ~53% lethality, so it’s difficult to get a good picture of how effective ZMapp is. Granted, it’s more than a little heartless to do a proper randomised double-blind test on the efficacy of Ebola treatments, don’t you think?
Currently there are three additional treatments that have been shortlisted (Favipiravir, TKM-Ebola and BCX4430) and two vaccinations (NAID/GSK and VSV-EBOV). Testing has shown that the majority of these protect monkeys and mice from Ebola.
Another target for future Ebola treatments is development of compounds that will selectively block the entry of Ebola virus into host cells by disrupting the interaction between Ebolavirus spike glycoprotein (GP) and the endo/lysosomal cholesterol transporter protein Niemann–Pick C1 (NPC1). Tests performed in 2011 showed that cells deficient in the NPC1 protein were protected against infection against Ebola.1
For further reading, the following two links to Nature articles are some additional commentary on the current outbreak and what can be done to help treat/contain it.
Stay angry my friends.
1: Côté M, Misasi J, Ren T, Bruchez A, Lee K, Filone CM, Hensley L, Li Q, Ory D, Chandran K, Cunningham J. 2011. Small molecule inhibitors reveal Niemann-Pick C1 is essential for Ebola virus infection. Nature. 2011 Aug 24;477(7364):344-8