Ebola, spread through direct contact with body fluids such as blood and urine, has sickened 1,603 people in West Africa, killing 887, according to the World Health Organization. The disease, first reported in what is now the Democratic Republic of Congo in 1976, can cause bleeding from the eyes, ears and nose. A tiny San Diego-based company provided an experimental Ebola treatment for two Americans infected with the deadly virus in Liberia. The biotechnology drug, produced with tobacco plants, appears to be working. In an unusual twist of expedited drug access, Mapp Biopharmaceutical Inc., which has nine employees, released its experimental ZMapp drug, until now only tested on infected animals, for the two health workers. Kentucky BioProcessing LLC, a subsidiary of tobacco giant Reynolds American Inc. (RAI), manufactures the treatment for Mapp from tobacco plants. The first patient, Kent Brantly, a doctor, was flown from Liberia to Atlanta and is receiving treatment at Emory University Hospital.
Each patient received at least one dose of ZMapp in Liberia before coming to the U.S., according to Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. “There’s a very scarce number of doses,” and it’s not clear how many each patient needs for treatment, Fauci said. “I’m not sure how many doses they’ll get.” Ebola and virology experts believe the use of the Mapp drug for Brantly and Writebol is unusual in the annals of emergency drug treatments. While potentially saving lives, the cases raise questions about who should have the right to receive experimental drugs years before they gain FDA approval.
“There are a lot of Africans that are also dying,” Robert Garry, a virologist at Tulane University, said in a telephone interview. “If we are going to do it for the Americans then we should certainly step up our game for the Africans.” Although no drugs to treat Ebola are approved by U.S. regulators, the Food and Drug Administration can approve an emergency application to provide access to unapproved drugs, Stephanie Yao, an FDA spokeswoman, said in an e-mail.
Approval for emergency drug use outside of a clinical trial can be made within 24 hours, Yao wrote. Shipment and treatment with the drug could begin even before completed written forms are submitted to the FDA, which can approve the use of an experimental treatment by telephone in an emergency. “The FDA stands ready to work with companies and investigators treating these patients who are in dire need of treatment,” Yao said. She declined to say whether the FDA had allowed any drug to be used in the Ebola outbreak.
Erica Ollmann Saphire, a molecular biologist at the Scripps Research Institute in San Diego, worked with Mapp and the other biotechnology companies to develop models of the Ebola virus and potential antibodies. She directs a global consortium given the job of modeling the virus and the mixture of antibodies needed to defeat it. She said the drug was approved for the two American medical workers in Liberia under a compassionate-use doctrine, because it’s not even scheduled for clinical trials until next year. ( By By Robert Langreth, Caroline Chen, James Nash and John Lauerman from Bloomberg.com )
In West Africa, where the Ebola outbreak has claimed nearly 900 lives, the “holy grail” of medical devices could one day help detect deadly viruses before they spread. Right now, health professionals in the field rely on color-changing strips. These rapid test strips react to antibodies in blood samples, letting them detect specific viruses like Ebola within 15 minutes. It’s a very useful test in the middle of an outbreak.
Even better are polymerase chain reaction (PCR) machines, which can analyze DNA from blood samples for more accurate results. Next-generation sequencing machines — which are being tested around the world — can do the same thing, but also have the ability to spot multiple types of viruses. Both, however, are heavier and more expensive than the strips. (PCR machines can cost anywhere from $20,000 to $30,000).
Preventing the next Ebola outbreak could require something more advanced. Think the medical tricorder from “Star Trek”: a portable device that could quickly diagnose a variety of diseases in remote areas. “That is the holy grail now,” Dr. Charles Chiu, director of the Viral Diagnostics and Discovery Center (VDDC) at the University of California, San Francisco, told NBC News.
Devices like Oxford Nanopore’s MinION (a pocket-sized gadget that connects to USB ports) are a good start, he said, but they need to become more powerful and accurate before they can be used widely in the field. One of the problems with early detection is that someone who has early symptoms of Ebola — like vomiting and diarrhea — might not have Ebola at all.
They could have Lassa fever, which affects around 300,000 Africans every year, or something more benign. If a small group of people are showing symptoms in a remote village, sending out a team with strips that only detect Ebola or transporting blood samples back to one of the few labs in Africa with a PCR machine is not very efficient. “In the future, you’re going to see these point-of-care devices that can analyze small amounts of DNA very quickly,” he said. “With a single DNA-based test, you would be able to detect anything.”
A device like that could let mobile teams identify Ebola outbreaks before they hit major cities. Theoretically, Chiu said, the same technology could spot dangerous viruses in animal populations before humans even get infected. “We know most of these agents come from animals, so why not do animal surveillance?” he said. Of course, even the most advanced diagnostic tools aren’t much help if healthcare workers don’t know where they are. That was the problem Médecins Sans Frontières (MSF) faced when they arrived in Guinea.
“If you don’t have basic mapping information, you can’t do things like send health workers out to do a survey,” Kate Chapman, director of the Humanitarian OpenStreetMap Team, told NBC News. Her organization stepped up, using satellite images and volunteers around the world to build maps with roads and town names that proved a lot more useful than the topographical maps MSF started out with.
New technology like drones could make those maps even better. Paired with something like Chiu’s “holy grail” device, fighting Ebola in the future could look very different than it does today. “If something like this was in place,” he said, “where you could detect any kind of infectious agent and you could deploy help where it’s most needed, you could avoid these kinds of outbreaks.” ( By Keith Wagstaff from NBCNews.com ) For more information you can follow also the links below.