Abstract Science: Ebola, August 3-7
The Ebola outbreak, one year later, promising data from a vaccine trial, what we've learned from the global health response and how to build a better one. This week in Abstract Science.
(Scientific American, 8/4/2015, Dina Fine Maron)
Findings published this week in The Lancet from a clinical trial in Guinea provide the first-ever evidence of vaccine protection against the deadly Ebola virus. The vaccine candidate, engineered by the Public Health Agency of Canada and now produced by NJ-based Merck, contains the Ebola-Zaire surface protein stitched into a disabled version of vesicular stomatitis virus (VSV). The animal virus serves as a vector for the Ebola gene during vaccination. Using a ring vaccination approach—when only immunizing people in close contact with an isolated infected patient—investigators found that individuals vaccinated immediately after coming in contact with an exposed individual were 100% protected compared to those whose vaccinations were delayed slightly. There were 14 infections in the delayed vaccination group, which functioned as the control group. Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases (NIAID), provides some good perspective on what to make of these unprecedented findings, what the data doesn't tell us and why we shouldn't assume we can rely on vaccination alone to end Ebola.
(Wired Science, 8/4/2015, Katie Palmer)
The promising interim data from the Guinea trial (see article above) prompted the medical humanitarian group, Doctors Without Borders, to recommend that distribution of the vaccine begin as soon as possible in the West African countries where the outbreak began and where people continue to die of Ebola. While this makes sense from a humanitarian standpoint, it also means researchers won't be able to collect better and more complete data on the vaccine's efficacy, which is what regulators look for when they're deciding to approve a drug. Here's why.
(Nature, 8/5/2015, Declan Butler)
It was only a year ago that the World Health Organization declared Ebola a public health emergency. The outbreak in West Africa spurred researchers and public-health experts to call for a major overhaul of the world's approach to epidemic threats, including better monitoring for the emergency and re-emergence of pathogens, and dramatic improvements in the public health systems of poor countries that oftentimes are on the frontline of epidemics. Also at the top of the list: nimble task forces capable of responding rapidly and forcefully to outbreaks and a global fund to develop countermeasures such as drugs and vaccines.
(Nature, 8/5/2015, Trudie Lang)
With lives hanging in the balance, researchers prepared and approved study protocols last fall for experimental Ebola drugs over an unprecedented 12-week period, only to face bureaucratic and logistical delays in getting the drugs to patients. But a year after the WHO declared Ebola a public health emergency there is still no treatment for the disease, which is often fatal. To alleviate these kinds of bottlenecks in the future, governments need to ensure that the world is "research ready" by properly funding and empowering the WHO to oversee the design and implementation of an on-call global task force of clinical-trial staff, this commentary in Nature suggests.
—Compiled by Senior Scientific Writer Regina McEnery