Research

THE NEW ENGLAND JOURNAL OF MEDICINE                                                                                 Dec. 3, 2014
By Edward Cox, M.D., M.P.H., Luciana Borio, M.D., and Robert Temple, M.D.

...Studying investigational therapies for EVD presents scientific, practical, and ethical challenges. Not surprisingly, there has been substantial debate about the best and most appropriate study approaches.2,3 It is generally agreed that a trial with a concurrent control group, in which patients are randomly assigned to receive the test drug plus the best available supportive care (BASC) or to BASC alone, would be the most efficient and reliable way to evaluate the safety and effectiveness of candidate products.

 Some people in the health care community, however, have argued against such trials, urging instead use of a historical control — that is, making investigational drugs as widely available as their supply allows and then comparing mortality rates among treated patients with rates that would have been expected absent the drugs, on the basis of past experience with EVD.

Description of efforts by the big drug companies to develop an Ebloa vaccine
THE NEW YORKER    By Vauhine Vara                        Nov. 25, 2014

"...why this race to create an Ebola vaccine among Merck, GlaxoSmithKline, and Johnson & Johnson—three of the world’s biggest drug manufacturers? For years, pharmaceutical companies didn’t invest much in vaccines, partly because they were so costly and complicated to produce: they’re often made out of live bacteria, which are notoriously difficult to work with. But, over the past several years, companies have realized that the difficulties of making vaccines could be an asset, because they can make it more difficult for generic-drug companies to create copycat versions than for prescription drugs. The vaccine market has also been growing more quickly than the prescription-drug market. The World Health Organization estimates, based on various sources, that global vaccine sales rose from five billion dollars in 2000 to twenty-four billion dollars last year...."

Read complete article
http://www.newyorker.com/business/currency/race-ebola-vaccine

NEW ENGLAND COMPLEX SYSTEMS INSTITUTE                                                                        Oct. 27, 2014
ABSTRACT
By Kia Hall and Yaneer Bar-Yam
The number of cases of Ebola in West Africa has been growing exponentially, and projections assume that this dynamic will continue. However, recent case reports from Liberia indicate a change. The number of new confirmed cases reported by WHO has actually diminished for five weeks in a row.
The WHO report suggests that this may be due to underreporting under conditions of high levels of stress of the number of cases taking place.

Here we report that there appears to be a sound reason for the decreasing number of cases—a change in response strategy that is working. Understanding this dynamic is of critical importance for addressing the outbreak in Sierra Leone and Guinea. In particular the number of cases in Sierra Leone continues to grow exponentially.

Discussions with a WHO response coordinator in Liberia indicates that a change in strategy from individual reporting and contact tracing to community based screening for early detection and population wide behavior change happened in mid September.

THE BOSTON GLOBE                                  Nov. 3, 2014

By Carolyn Y. Johnson

Northeastern University researchers use computers to simulate 20 million virtual Ebola outbreaks each week. Yale scientists are building three models that project the spread of the deadly disease. And a team at Boston Children’s Hospital is combing through data to gauge whether medical interventions are working.

....  they are providing a constant stream of evidence that is beginning to reveal the weak spots of the epidemic. For example, scientists’ models are beginning to identify basic patterns of who is being infected and when and how Ebola is being spread, which could help identify the most meaningful ways to intervene.

...According to their model, isolating three-quarters of the patients within the first four days that they show symptoms would help eliminate the disease.

Read complete story

http://www.bostonglobe.com/metro/2014/11/02/ebola-disease-modelers-new-england-help-predict-future-spread-best-strategies/LZHSEGlInJs6SflLWW0yaP/story.html