Ebola outbreak in West Africa difficult to contain

[MJP]

 

Saudi Arabian man suspected of contracting deadly disease
 
http://www.telegraph.co.uk/news/worldnews/africaandindianocean/sierraleone/11013115/Saudi-Arabian-man-suspected-of-contracting-deadly-disease.html
 
 
New York, Jeddah and also Wales of all places. All 'suspected' cases. Going to be a lot of suspected cases.

On TV news, saying NY not likely have Ebola. Blood test should confirm in next 24 hours.

 

 

There's going to be an endless stream on hacks crying wolf over this.
 

[Asiantravel]

So far, people have been talking about Guinea, Sierra Leone and Liberia and more recently Nigeria.

Now the first death has occurred in Senegal

 

 

http://crofsblogs.typepad.com/h5n1/2014/08/ebola-in-guinea-first-senegalese-death.html

 

http://www.ndarinfo.com/Ibrahima-NIANG-devient-le-premier-senegalais-mort-du-virus-Ebola_a9953.html

[Johpa]

 

The horror stories I know do not include withholding cures. Quiet the contrary, the horror stories involves rushing cures to market whose safety was not demonstrated during phase 2 or 3 trials.

 

TKM-Ebola may not be working so well after all as Writebol has taken a turn for the worse since being administered the serum.  Dr. Brantly received the transfusion and apparently gave up the vial of TKM-Ebola for Writebol so perhaps the antibodies from the transfusion were the key.

 

 

Then the unfolding of this story must be as fascinating to you as it is to me although for perhaps, and hopefully, different reasons.  It appears that Brantly and Writebol did not receive TKM-Ebola but, breaking all FDA protocols received a humanized (-zumab)  plant derived monoclonal antibody (mAb) from a research company called ZMapp, a company funded mostly by the US military, that is the taxpayer. There had been no human trials, no phase 1 trial.  The two patients are reported to have improved upon receiving the mAb drug although it has not yet been ascertained whether it was the drug that generated the improvement or something else. 

 

There are many of us afflicted with terminal diseases whose very few long term hopes include monoclonal antibody based drugs, some of which are in phase 1 trials, which mean they are out of reach for years within current FDA protocols, well past my statistical half-life.  Hopefully this case will highlight the need to streamline and speed up the testing process for mAb based drugs which have very narrow molecular targets and thus tend to have less side effects that other types of drugs.  Because the equal horror to releasing a drug too soon is to keep a potential life saving drug out of reach of those who are going to become a statistic regardless. Let the terminally afflicted decide the level of risk.  I'd sign a legal waiver and take the risk in a heartbeat.

 

 

(And as a minor footnote, Ebola is a highly infectious disease but it is not a highly contagious disease as is influenza.)

 

[F430murci]

 
The horror stories I know do not include withholding cures. Quiet the contrary, the horror stories involves rushing cures to market whose safety was not demonstrated during phase 2 or 3 trials.
 
TKM-Ebola may not be working so well after all as Writebol has taken a turn for the worse since being administered the serum.  Dr. Brantly received the transfusion and apparently gave up the vial of TKM-Ebola for Writebol so perhaps the antibodies from the transfusion were the key.
 

 
Then the unfolding of this story must be as fascinating to you as it is to me although for perhaps, and hopefully, different reasons.  It appears that Brantly and Writebol did not receive TKM-Ebola but, breaking all FDA protocols received a humanized (-zumab)  plant derived monoclonal antibody (mAb) from a research company called ZMapp, a company funded mostly by the US military, that is the taxpayer. There had been no human trials, no phase 1 trial.  The two patients are reported to have improved upon receiving the mAb drug although it has not yet been ascertained whether it was the drug that generated the improvement or something else. 
 
There are many of us afflicted with terminal diseases whose very few long term hopes include monoclonal antibody based drugs, some of which are in phase 1 trials, which mean they are out of reach for years within current FDA protocols, well past my statistical half-life.  Hopefully this case will highlight the need to streamline and speed up the testing process for mAb based drugs which have very narrow molecular targets and thus tend to have less side effects that other types of drugs.  Because the equal horror to releasing a drug too soon is to keep a potential life saving drug out of reach of those who are going to become a statistic regardless. Let the terminally afflicted decide the level of risk.  I'd sign a legal waiver and take the risk in a heartbeat.
 
 
(And as a minor footnote, Ebola is a highly infectious disease but it is not a highly contagious disease as is influenza.)
 

You are correct about ZMapp. I saw that shortly after I posted the above.

--------

Before this emergency use, ZMapp had only been tested in a small number of monkeys. The company reported that all four monkeys who received the treatment within 24 hours of being infected survived. Half of another group of four monkeys who were treated within 48 hours survived.

Brantly and Writebol had been sick much longer than that before being treated, and treatments that work in animals especially such a small number of animals routinely fail to work in human trials.

. . .

A Tale Of Two Drugs: Mapp Vs. Tekmira

ZMapp is not even far enough along to have entered the clinical trial phase, but it may have been chosen in this case instead of the promising experimental drug Tekmira because an ongoing Tekmira trial was just halted by the FDA.

That doesn't mean that all research on Tekmira is over, however. The ongoing trial was halted because healthy patients showed a problematic immune response. But the FDA could still approve a new trial of the drug in sick patients, as the risk-benefit equation would be changed. A potential benefit of surviving a disease that kills 60-90% of patients could outweigh the risks of many potentially problematic side effects.

http://www.businessinsider.com/zmapp-serum-used-to-treat-ebola-infected-americans-2014-8

[Asiantravel]

 

 

 

 

 

I don't find it reassuring what the UK border protection staff are saying about not having any training?

 

Ebola outbreak: suspected case at British immigration centre

 

 

An asylum seeker was suspected of having the deadly Ebola virus after developing symptoms within days of arriving in Britain from Libera, it has emerged.  The  incident shows how easy it would be for the deadly disease to enter Britain through illegal channels.

Border staff at UK airports also claim they have not been trained to deal with suspected cases coming into the country.

Major British hubs like Heathrow have failed to tighten procedures even through airports in Kenya, Ethiopia and South Africa have introduced beefed up screening.

 

 

 

 

http://www.telegraph.co.uk/news/uknews/11003779/Ebola-outbreak-suspected-case-at-British-immigration-centre.html

 

 

 

" Border staff at UK airports also claim they have not been trained to deal with suspected cases coming into the country "

 

 

 

and because of this I would have thought   British Airways should do the same as Emirates

 

 

 

British Airways, which offers flights to Liberia via Sierra Leone, said that the services are operating as normal, though safety and security are the top priority and the company is continuing to monitor the situation closely.

 

 

http://www.bloomberg.com/news/2014-08-04/emirates-alone-in-ebola-shutdown-as-leading-carriers-keep-flying.html

 

 

 

 

Ebola outbreak: BA suspends flights to Sierra Leone and Liberia over virus

 

http://www.telegraph.co.uk/news/aviation/11013996/Ebola-outbreak-BA-suspends-flights-to-Sierra-Leone-and-Liberia-over-virus.html

 

 

 

 

[MJP]

Spanish missionary with Ebola being repatriated . . . 

 

http://www.channelnewsasia.com/news/spain-sends-plane-to/1299524.html

[Asiantravel]

 

Ebola deaths soar to 887 as Nigeria confirms 2nd case

 

http://www.cbc.ca/news/world/ebola-deaths-soar-to-887-as-nigeria-confirms-2nd-case-1.2726862

 

Not really soaring.

 

Looks like the increase is slowing rapidly and it's certainly not hitting any sort of an exponent.

 

 

887  Two or three days ago to 932

 

Ebola outbreak death toll reaches 932 in 4 countries; Nigeria announces 2nd death 

 

http://www.timescolonist.com/sports/cricket/ebola-outbreak-death-toll-reaches-932-in-4-countries-nigeria-announces-2nd-death-1.1297356

 

 

but look at how they are dealing with the dead in Liberia

 

Bodies dumped in streets as West Africa struggles to curb Ebola

 

http://www.reuters.com/article/2014/08/05/us-health-ebola-africa-idUSKBN0G51VF20140805

 

 

[MJP]

 

 

Ebola deaths soar to 887 as Nigeria confirms 2nd case

 

http://www.cbc.ca/news/world/ebola-deaths-soar-to-887-as-nigeria-confirms-2nd-case-1.2726862

 

Not really soaring.

 

Looks like the increase is slowing rapidly and it's certainly not hitting any sort of an exponent.

 

 

887  Two or three days ago to 932

 

Ebola outbreak death toll reaches 932 in 4 countries; Nigeria announces 2nd death 

 

http://www.timescolonist.com/sports/cricket/ebola-outbreak-death-toll-reaches-932-in-4-countries-nigeria-announces-2nd-death-1.1297356

 

 

but look at how they are dealing with the dead in Liberia

 

Bodies dumped in streets as West Africa struggles to curb Ebola

 

http://www.reuters.com/article/2014/08/05/us-health-ebola-africa-idUSKBN0G51VF20140805

 

 

 

 

It's still not soaring. If it was soaring I'd have expected geometric expansion. These numbers actually suggest it's slowing markedly.

[Asiantravel]

 

 

 

Ebola deaths soar to 887 as Nigeria confirms 2nd case

 

http://www.cbc.ca/news/world/ebola-deaths-soar-to-887-as-nigeria-confirms-2nd-case-1.2726862

 

Not really soaring.

 

Looks like the increase is slowing rapidly and it's certainly not hitting any sort of an exponent.

 

 

887  Two or three days ago to 932

 

Ebola outbreak death toll reaches 932 in 4 countries; Nigeria announces 2nd death 

 

http://www.timescolonist.com/sports/cricket/ebola-outbreak-death-toll-reaches-932-in-4-countries-nigeria-announces-2nd-death-1.1297356

 

 

but look at how they are dealing with the dead in Liberia

 

Bodies dumped in streets as West Africa struggles to curb Ebola

 

http://www.reuters.com/article/2014/08/05/us-health-ebola-africa-idUSKBN0G51VF20140805

 

 

 

 

It's still not soaring. If it was soaring I'd have expected geometric expansion. These numbers actually suggest it's slowing markedly.

 

 

 

 I don't know   Maybe CBC just like to use the word ‘ soaring ‘

they also used it on 2 July , when they said  “ deaths from Ebola virus soaring to 467 “

 

http://www.cbc.ca/news/health/ebola-outbreak-time-to-try-experimental-drugs-jeremy-farrar-says-1.2694170

 

 

 

06 Aug 14 - 55/day

04 Aug 14 - 57/day

02 Aug 14 - 43/day

29 Jul 14 - 38/day

27 Jul 14 - 23/day

23 Jul 14 - 12/day

17 Jul 14 - 10/day

 

http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4240-ebola-virus-disease-west-africa-6-august-2014.html

 

[MJP]

Potentially not good . . .

 

Suspected Ebola victim dies in Saudi Arabia

 

http://www.bbc.co.uk/news/health-28678699

[MJP]

Ebola outbreak: nurse who treated first victim in Nigeria dies

 

Nurse and five other people now battling the virus had helped care for Liberian-American Patrick Sawyer, who died from Ebola.

 

http://www.theguardian.com/world/2014/aug/06/ebola-outbreak-nurse-nigeria-dies

[Johpa]

 

It's still not soaring. If it was soaring I'd have expected geometric expansion. These numbers actually suggest it's slowing markedly.

 

 

I just watched an interesting piece on CNN. The death toll is mounting but, as you note, nothing whatsoever to indicate a geometric expansion.

 

They interviewed some folks associated with the development of the drug ZMapp who were as surprised as anyone that someone well above their own pay grade made the incredibly bold decision to use the drug on these two patients.  The piece suggested that the majority of the available supply of the drug was given to these two patients, which is bad news for the primate who was next in line to be tested.  There was no indication of how long it would take to make more of this particular drug serum as it seems to be comprised of several targeted monoclonal antibodies developed by both US and Canadian researchers.  The good news is that some of the monoclonal antibodies used in ZMapp are harvested using plants, and not animals, a faster and more economic method of harvesting monoclonal antibodies.  Hopefully having two patients at Emory University whose bodies can be monitored in real time at the cellular level in the adjacent pathology labs can produce a quantum leap in understanding of how this virus works in humans and how this particular cocktail of drugs works, or more specifically whether a subset of the drugs in the current serum are doing the real work of shutting down the virus. 

[MJP]

Emergency World Health Organization summit on Ebola in Geneva

 

The World Health Organization is beginning a two day emergency meeting to discuss new measures to tackle the Ebola virus.

 

http://www.bbc.co.uk/news/health-28670545

[Asiantravel]

 

 

It's still not soaring. If it was soaring I'd have expected geometric expansion. These numbers actually suggest it's slowing markedly.

 

 

I just watched an interesting piece on CNN. The death toll is mounting but, as you note, nothing whatsoever to indicate a geometric expansion.

 

They interviewed some folks associated with the development of the drug ZMapp who were as surprised as anyone that someone well above their own pay grade made the incredibly bold decision to use the drug on these two patients.  The piece suggested that the majority of the available supply of the drug was given to these two patients, which is bad news for the primate who was next in line to be tested.  There was no indication of how long it would take to make more of this particular drug serum as it seems to be comprised of several targeted monoclonal antibodies developed by both US and Canadian researchers.  The good news is that some of the monoclonal antibodies used in ZMapp are harvested using plants, and not animals, a faster and more economic method of harvesting monoclonal antibodies.  Hopefully having two patients at Emory University whose bodies can be monitored in real time at the cellular level in the adjacent pathology labs can produce a quantum leap in understanding of how this virus works in humans and how this particular cocktail of drugs works, or more specifically whether a subset of the drugs in the current serum are doing the real work of shutting down the virus. 

 

 

maybe they just got carried away by these graphs

 

 

[nottocus]

It's going to combine with MERS and become airborne MERBOLA.

[Asiantravel]

[Ricardo]

So far, people have been talking about Guinea, Sierra Leone and Liberia and more recently Nigeria.

Now the first death has occurred in Senegal

 

 

http://crofsblogs.typepad.com/h5n1/2014/08/ebola-in-guinea-first-senegalese-death.html

 

http://www.ndarinfo.com/Ibrahima-NIANG-devient-le-premier-senegalais-mort-du-virus-Ebola_a9953.html

 

Just to point out that, although he was Senegalese, both reports say he was buried in Guinea-Conakry, not "in Senegal" after all.