Science

Evaluating Clinical Trial Designs for Investigational Treatments of Ebola Virus Disease

Fri, 2015-04-17 22:06 — mike kraft

PLOS MEDICINE by Ben Cooper and others April 14, 2015
Experimental treatments for Ebola virus disease might reduce EVD mortality. There is uncertainty about the ability of different clinical trial designs to identify effective treatments, and about the feasibility of implementing individually randomised controlled trials during an Ebola epidemic

A treatment evaluation programme for use in EVD was devised using a multi-stage approach (MSA) with two or three stages, including both non-randomised and randomised elements. The probabilities of rightly or wrongly recommending the experimental treatment, the required sample size, and the consequences for epidemic outcomes over 100 d under two epidemic scenarios were compared for the MSA, a sequential randomised controlled trial (SRCT) with up to 20 interim analyses, and, as a reference case, a conventional randomised controlled trial (RCT) without interim analyses.

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http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001815

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Yes, We Were Warned About Ebola

Tue, 2015-04-07 19:09 — mike kraft

NEW YORK TIMES OP-ED By BERNICE DAHN, VERA MUSSAH and CAMERON NUTT April 7, 2015
MONROVIA, Liberia — The conventional wisdom among public health authorities is that the Ebola virus, which killed at least 10,000 people in Liberia, Sierra Leone and Guinea, was a new phenomenon, not seen in West Africa before 2013. (The one exception was an anomalous case in Ivory Coast in 1994, when a Swiss primatologist was infected after performing an autopsy on a chimpanzee.)

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Laboratory support during and after the Ebola virus endgame: towards a sustained laboratory infrastructure

Fri, 2015-03-27 20:05 — mike kraft

EUROSURVEILLANCE by I. Goodfellow, C. Reusken, and M. Koopmans

March 26, 2015

The Ebola virus epidemic in West Africa is on the brink of entering a second phase in which the (inter)national efforts to slow down virus transmission will be engaged to end the epidemic. The response community must consider the longevity of their current laboratory support, as it is essential that diagnostic capacity in the affected countries be supported beyond the end of the epidemic.

The emergency laboratory response should be used to support building structural diagnostic and outbreak surveillance capacity.

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Ebola pioneer, stem cell researcher honoured with Canada Gairdner Awards

Thu, 2015-03-26 21:38 — mike kraft

CANADIAN PRESS March 25, 2015
One of the co-discoverers of the Ebola virus and a leading Canadian stem cell researcher are among this year's winners of the prestigious Canada Gairdner Awards.

Dr. Peter Piot is the recipient of the Canada Gairdner Global Health Award, recognizing his work on the discovery of the Ebola virus in 1976 and his leadership in the global response to the HIV-AIDS epidemic.

Dr. Janet Rossant, chief of research at Toronto's Hospital for Sick Children, is the recipient of the 2015 Canada Gairdner Wightman Award, which honours a Canadian who has demonstrated outstanding leadership in medicine and medical science.

Five international scientists are also being honoured with Canada Gairdner Awards, two each from the United States and Japan and one from Switzerland....

Dr. Peter Piot won the 2015 Canada Gairdner Global Health Award in recognition of his work on the discovery of the Ebola virus in 1976 and his leadership in the global response to the HIV-AIDS epidemic. (David Azia/Associated Press)

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Ebola virus not mutating as quickly as thought

Thu, 2015-03-26 21:17 — mike kraft

SCIENCE NEWS by Ashley Yaeger March 26, 2015

(Scroll down for full study.)

The virus causing the current Ebola epidemic in West Africa is not evolving as quickly as some scientists had suggested.

REGULAR RATE A genetic analysis suggests that the Ebola virus, shown here in orange, is not evolving as fast as expected.

In a paper last August, researchers reported that the virus (Zaire ebolavirus) was altering its genes almost twice as fast as it had during previous Ebola outbreaks in Central Africa (SN: 9/20/14, p. 7). However, a new genetic analysis shows that the virus is mutating at roughly the same rate as in past outbreaks, researchers report online March 26 in Science. The finding suggests the virus has not become more virulent or transmissible during the West Africa outbreak.

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FDA approves Corgenix's Ebola test for emergency use

Sat, 2015-02-28 03:16 — mike kraft

REUTERS Feb. 26, 2015

Diagnostics company Corgenix Medical Corp said on Thursday U.S. health regulators had approved its rapid Ebola test for emergency use, in response to the world's worst outbreak of the virus that killed more than 10,000 so far.

The company's ReEBOV Antigen Rapid Test, which involves putting a drop of blood on a paper strip and waiting for at least 15 minutes for a reaction, was cleared by the World Health Organization last week.

The test is less accurate than the standard test, which has a turnaround time of 12-24 hours, but is easy to perform and does not require electricity. It is able to correctly identify about 92 percent of Ebola-infected patients and 85 percent of those not infected with the virus, the WHO said.

The WHO is still assessing four or five other rapid test candidates.

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http://www.reuters.com/article/2015/02/26/us-health-ebola-testing-idUSKBN0LU1OO20150226

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Decision on Ebola mass vaccination in August at earliest: WHO

Fri, 2015-02-27 16:21 — mike kraft

REUTERS by Stephanie Nebehay Feb. 27, 2015

GENEVA -- An independent advisory body will decide in August at the earliest on whether to recommend widespread introduction of an Ebola vaccine, depending on results of clinical trials and the epidemic's course, the World Health Organization said on Friday.

All three worst-hit countries in West Africa - Guinea, Liberia and Sierra Leone - aim to conduct phase III final-stage clinical trials of experimental vaccines.

Liberia is already testing both the GlaxoSmithKline and Merck-NewLink vaccines, while Sierra Leone and Guinea are due to announce plans soon....

WHO spokesman Christian Lindmeier, reporting on a three-day meeting of experts, told a news briefing: "Vaccine introduction is by no means a given and will depend on the results of clinical trials and recommendations from WHO's Strategy Advisory Group of Experts (SAGE) on vaccines and immunization....

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Use of Group Quarantine in Ebola Control — Nigeria, 2014

Fri, 2015-02-13 23:18 — mike kraft

Morbidity and Mortality Weekly Report (MMWR)

CDC Feb. 13, 2015

by Cheri Grigg, DVM1,2, Ndadilnasiya E. Waziri, DVM3, Adebola T. Olayinka, MD3, John F. Vertefeuille, PhD4

On July 20, 2014, the first known case of Ebola virus disease (Ebola) in Nigeria, in a traveler from Liberia led to an outbreak that was successfully curtailed with infection control, contact tracing, isolation, and quarantine measures coordinated through an incident management system.

During this outbreak, most contacts underwent home monitoring, which included instructions to stay home or to avoid crowded areas if staying home was not possible. However, for five contacts with high-risk exposures, group quarantine in an observation unit was preferred because the five had crowded home environments or occupations that could have resulted in a large number of community exposures if they developed Ebola.

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http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6405a3.htm?s_cid=mm6405a3_x

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Doctors Who Treat Ebola Feel More Socially Isolated

Fri, 2015-02-13 22:59 — mike kraft

LIVESCIENCE.COM by Rachael Rettner Feb. 13, 2015

Doctors who take care of very sick Ebola patients may feel socially isolated, but surprisingly, they may not feel more stressed than usual, a new study from Germany suggests.

Researchers surveyed 46 health care workers who treated Germany's first Ebola patient in August 2014, as well as 40 health care workers who worked in the same hospital but did not treat the Ebola patient.

The researchers who did the study hypothesized that the people who treated the Ebola patient would have more symptoms of psychological distress because they were working in a challenging environment that presented a risk that they could become infected with the deadly virus.

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Lack of Effect of Lamivudine on Ebola Virus Replication

Thu, 2015-02-12 23:25 — mike kraft

CDC EID JOURNAL by Lisa E. Hensley, Julie Dyall, Gene G. Olinger, and Peter B. Jahrlin (NIH) Feb. 12, 2015

The unprecedented number of Ebola virus disease (EVD) cases in western Africa has compelled the world to consider experimental and off-label therapeutics to mitigate the current outbreak. For clinicians, approved drugs are an attractive solution because of known safety profiles and availability.

Oral lamivudine (GlaxoSmithKline, Brentford, UK), a US Food and Drug Administration–approved anti-HIV drug, has been suggested as a possible antiviral agent against Ebola virus (EBOV). In September 2014, a Liberian physician, Dr. Gorbee Logan, reported positive results while treating EVD with lamivudine (1). Thirteen of 15 patients treated with lamivudine survived presumed EVD and were declared virus free. Clinical confirmation of EVD in these cases remains to be verified....

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