Sep 112014

JABSOM research examines Ebola relative

Fadi Youkhana, Managing Editor, Ka Leo O Hawaii | 09/08/14

The most severe outbreak of the Ebola virus has claimed 2,105 lives causing countries to declare lockdown and forcing the World Health Organization to declare a state of emergency.

“Much needs to be done to bring together the reality of outbreak response and actual delivery of vaccines and therapeutics,” said Axel Lehrer, assistant professor at the Department of Tropical Medicine and Medical Microbiology and Pharmacology at John A. Burns School of Medicine. “We therefore need to prioritize our efforts on the nuts and bolts such as simpler, rapid and reliable diagnostics as that has been identified as a consistent weakness in the current outbreak response.

” Lehrer has been working on filovirus vaccines since 2003. A filovirus belongs to a virus family which causes severe fever in humans and nonhuman primates. The Ebola virus belongs to this virus family.

“The entire family of filoviruses causes severe pathology, so a preventive vaccine needs to protect against at least three viruses: Zaire Ebola virus, Sudan Ebola virus and Marburg virus,” Lehrer said. Lehrer and his colleagues are attempting to optimize the final vaccine candidate to raise the level of protection against Zaire Ebola virus. “Our main development path is focused on Zaire Ebola virus (coincidently also the virus responsible for the currently ongoing outbreak in Western Africa),” Lehrer said.

“Although the virus is not considered a threat to the United States, three American doctors have returned to the United States from West Africa to receive treatment after being infected by Ebola while working with humanitarian organizations.” Aid workers Kent Brantly and Nancy Writebol were infected while treating patients. Both were treated and have recovered. Physician Rich Sacra was air lifted from Liberia to Nebraska for treatment after being exposed to the virus while delivering babies at a hospital in Liberia. “The inter-connectedness of the world via air travel could make it feasible that an introduction via an early stage infected person could occur,” Lehrer said. According to Lehrer, most of the filoviruses are endemic to Africa. “This most likely means that the Pacific region does not have an immediate threat of a naturally occurring Ebola virus outbreak,” Lehrer said. Researchers have yet to prove the manner through which the virus initially appears in humans at the first stage of an outbreak. However, it is widely believed that the first patient is infected via contact with an infected animal. Transmission then spreads to other humans via direct contact or exposure to objects that are contaminated. Ebola’s high mortality rate, 91 percent, has prevented patients from recovering.

“In settings with poor hygiene (especially also in medical facilities), the viruses are very dangerous as sick patients will shed a lot of virus and the viruses are very contagious if not neutralized,” Lehrer said. The White House asked Congress on Sept. 5 for $30 million to pay for the Center of Disease Control and Prevention’s efforts to counter the outbreak. The $30 million is an addition to the $58 million already in place to help the developmental and manufacturing of vaccines. New reports surfaced on Sunday of a monkey vaccine which gave the monkeys a “long-term” immunity to Ebola. The experiments were conducted by the National Institute of Health and showed that the monkey’s immunity could last for at least 10 months. The human trials have only been limited to the U.S., but plans are to extend the vaccine trials to the U.K. and Africa. Liberia has suffered the highest number of casualties since the outbreak was detected in March 2014. According to the numbers provided by the Ministry of Health and then reported by the World Health Organization, there have been 1,871 total cases reported in Liberia with 1,089 deaths as of Sept. 5. “Cultural practices in the entire region of Africa include washing the body of a deceased person as well as close contact with the body at a funeral,” Lehrer said.

“This is how typically the first clusters of an outbreak occur and shows one impact of human behavior leading to a favorable situation for the virus to prevail.” The virus was first identified in Guinea and then began to spread into neighboring Sierra Leone and Liberia, forcing the local governments to take several actions including shutting down air travel.

“Sierra Leone and Liberia are countries that have recently experienced civil wars,” Lehrer said. “Therefore their infrastructure as well as stability and order are compromised and basic medical care has been poor.” Guinea, Liberia, Sierra Leone, the Democratic Republic of the Congo, Gabon, South Sudan, Ivory Coast, Uganda, Republic of the Congo and South Africa have had confirmed cases of Ebola and have been listed by the World Health Organization as countries that could risk exposure to the disease. The outbreak in the Democratic Republic of the Congo has claimed 31 deaths, but researchers believe that it is unrelated to the West African outbreak.