A few weeks ago, I took a break from climate change blogging to voice my concern over the recent Ebola outbreak in West Africa. Since then, some good news and some bad news have developed. I can't ask you in real-time which you want first, so I'm just gonna hit you with the bad news to start...
Dr. Sahr Rogers, one of Sierra Leone's bravest and most influential healthcare workers, has lost a battle with the illness and died. It's hard for us here in the cynical, resource-rich West to appreciate the importance of fearless, knowledgeable leadership when proper medical supplies and facilities are lacking. The people of Sierra Leone have lost one of their finest, most dedicated medical professionals, and someone who undoubtedly helped dispel some of the counterproductive superstition surrounding the sickness.
As of August 28, 2014, the official death toll of this latest epidemic had risen to 1,552 people, though some unofficial reports say that total could be grossly underestimated. Even when cases are reported and Ebola is detected, due to other health complications afflicting some patients at the same time, such as influenza or malaria, it can be difficult to determine the specific cause of death. Needless to say, however, the potent pathogen must have played some role in diminishing health and causing the fatalities.
Unlike his American counterparts, Miguel Pajares, the infected Spanish missionary flown back to Spain for treatment, died, and serves as a sobering reminder that the somewhat mysterious ZMapp drug produced from the tobacco plant, the true efficacy and safety of which has yet to be determined, is no guarantee of recovery, perhaps especially so for older patients. Though cleared by the FDA for urgent or compassionate-use cases only, the medicine is in short supply presently and, to date, does not seem to lend itself to rapid production and deployment.
August 12, 2014 at 8:30 AM - The available supply of ZMapp™ has been exhausted. We have complied with every request for ZMapp™ that had the necessary legal/regulatory authorization. It is the requestors’ decision whether they wish to make public their request, acquisition, or use of the experimental drug. Any decision to use ZMapp™ must be made by the patients’ medical team. Drug has been provided at no cost in all cases.
Another Westerner, a German epidemiologist, has contracted the disease and gone home for treatment, and some countries are recalling their staff.
Despite these disappointing developments, and their troubling implications for successful containment, there is some good news...
Brantly and Writebol, the two Americans flown back to Atlanta, have recovered and been released from Emory Hospital.
Pharmaceutical companies are working with the FDA and government agencies to increase production of ZMapp, so the exhausted supply issue may be corrected soon.
"Mapp and its partners are cooperating with appropriate government agencies to increase production as quickly as possible," LeafBio said in a statement on its website. Currently, it's unclear how long it will take to manufacture more of the serum.
And most encouraging of all, if you ask me, is the fact that the NIH will begin testing an experimental vaccine (not just a drug) on human enrollees next week.
The Vaccine Research Center (VRC) has developed an Ebola vaccine candidate in collaboration with Okairos, a Swiss-Italian biotech company recently acquired by GSK. The investigational vaccine, which was designed by VRC scientists, contains no infectious Ebola virus material. It is a chimpanzee adenovirus vector vaccine into which two Ebola genes have been inserted. This is a non-replicating viral vector, which means the vaccine enters a cell, delivers the gene inserts and does not replicate further. The gene inserts express a protein to which the body makes an immune response. The investigational vaccine has recently shown promise in a primate model. The VRC vaccine will enter into a phase 1 clinical trial, which could start enrollment as early as fall 2014, pending approval by the FDA. The VRC is also in discussions with governmental and non-governmental partners regarding options for advancing this candidate beyond Phase I clinical evaluation.
Initial results may be reported as early as October or November.
That's not just good news, that's great news. Let's keep our fingers crossed for a successful trial.
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