Ebola And The Government

      

        When the first signs of an imminent Ebola outbreak first surfaced in Africa, the government in the United Stated were not concerned about the issue until Thomas Eric Duncan, the first Ebola case in the United States, landed at Dallas Fort Worth airport. Since then, all eyes have been focusing on finding a vaccine to fight the virus. So, how has the government gotten involved fighting this virus? Since the virus first emerged in the 70s, the government has been aware of the damage an outbreak can cause, but it was not until the terrorist attack in 2001 when the government started funding scientists and researchers to study the virus and find a vaccine. Additionally, regulations have been established to protect people from contracting and spreading the decease. 

The National Institutes of Health (NIH) is part of the US Department of Health and Human Services, and its main purpose is medical research. NIH started working on an Ebola vaccine after 911 when bioweapons were a big concern at the time. Since 2001, the government has been funding NIH with an average $29 billion annual budget. But, with over 10 years in research, why don’t we have a vaccine yet? In reality, scientists have been working with restrains in resources due to annual budget cuts and inflation. Most funds taken from NIH have been directed toward war weapons and construction. But let’s not blame the government or President Obama for the failure of the Ebola vaccine so far. The government has been able to handle previous cases of spreading virus. For example, if a terrorist attack using Anthrax were to take place, the government currently has a $1.25 billion contract with Emergent BioSolutions (EBS) to supply nearly 29 million doses of anthrax vaccine.

The Centers for Disease Control and Prevention (CDC) was established in 1946 with a $10 million budget, and one critical mission: to fight malaria by killing mosquitoes. Today, the CDC plays an important role at detecting disease outbreaks. Under section 361 of the Public Health Service Act (42 U.S. Code § 264), the U.S. Secretary of Health and Human Services is authorized to take measures to prevent the entry and spread of communicable diseases from foreign countries into the United States, and the CDC has the authority to carry out with these functions. For example, most of us have heard the case of nurse Kaci Hickox refusing to obey a quarantine order in the state of Maine issued by the CDC after coming back from treating Ebola patients in Sierra Leone. Hickox’s argument was that she did not present any of the symptoms and she had tested negative for the virus.

It's important to distinguish between quarantine, and isolation for infection control purposes. They mean different things, but the terms have been used similarly in the news. Quarantine is a preventive measure; it separates and monitors healthy people who have been exposed to the virus to see if they get sick. On the other hand, isolation separates sick people from healthy people to prevent the spread of the disease. 

References:

http://money.cnn.com/2014/10/28/news/companies/ebola-drug-billion/

http://www.npr.org/blogs/health/2014/10/03/353487190/heres-how-an-ebola-quarantine-works-in-the-united-states

http://my.chicagotribune.com/#section/-1/article/p2p-81917322/

http://www.cdc.gov/quarantine/aboutlawsregulationsquarantineisolation.html

Ebola Vaccine Alternative

           On our previous post, “McAfee Engineers Working On Ebola Anti-virus?” we explored the process a vaccine goes through in order to be released to the public for treatment. As the post explained, the development of a vaccine can years to complete. So what other options do Ebola patients have? To this date, more than 15,00 people have contracted the virus and more than 5,400 people have died. WHO (World Health Organization) has announced two candidate vaccines are currently in phase 1 trials (clinical trials) and plans are to bring them to the market as early as January 2015. But, what can be done in the meantime? Well, there is another way to treat Ebola patients until a proper vaccine is released to the market. The method is conducted by transfusing blood, plasma or plasma immunoglobulin fractions from convalescent donors who have fully recovered from the virus and have developed protective and long-lasting immunoglobulin. In the article, “Ebola virus convalescent blood products: Where we are now and where we may need to go,” Thierry Burnouf, from the Graduate Institute of Biomedical Materials and Tissue Engineering, explores the possibilities of these alternatives.

1.    The Past

The use of human convalescent blood products first started in the early 20^th century. It was regularly used to treat various infections since vaccines and other ways of antibiotics were not yet developed. Some of the most common viruses treated by using this method have been:

·      Influenza

·      Mumps

·      Poliomyelitis

·      Typhoid fever

·      Herpes zoster

·      Measles

2.    The Present

Today, new accomplishments in science and technology allow a more controlled and safer procedures. Modern blood transfusion is the key factor when preparing convalescent blood products (See Figure 1).   

a.    Whole blood

In this process, a donor needs to be pre-screened before blood can be collected. Then, blood is collected with an anticoagulant solution and need to be transfused within 24 hours to maintain clotting factors. Furthermore, whole blood has to be stored at 2-6°C for up to 35 days.

During a study in 1999, eight Ebola patients were treated with convalescent whole blood; in which seven survived. It should be known that the efficiency of whole blood was not proved completely during this study.

b.    Plasma

Plasma is obtained by decantation or centrifugation, of whole blood or by apheresis. Apheresis is the preferred mode of collection for many reasons: larger volume collected, possibility of more frequent donations, and absence of impact on the hemoglobin level due to the reinfusion of the red blood cells.

3   The Future
In the absence of a vaccine for Ebola, WHO has approved the use of these alternatives mentioned above under certain conditions that mostly require the safety of patients. At this point, whole blood and plasma seem to be a good alternative to treat patients. However, There are some challenges we need to point out. For example, most countries in West-Africa do not have the proper infrastructures and necessary tools to proceed with this method. Additionally, Having controlled clinical evaluations is also important to establish safe treatments for patients. If regulations established by WHO are followed, this method can be safely applied for future virus outbreaks.

References:

Burnouf, T. Seghatchian, J. 2014. Ebola virus convalescent blood products: Where we are now and where we may need to go. Transfusion and Apheresis Science. Retrieved from:

http://www.sciencedirect.com.mutex.gmu.edu/science/article/pii/S1473050214001724#

http://apps.who.int/iris/bitstream/10665/144032/1/roadmapsitrep_19Nov14_eng.pdf?ua=1

Dr. Bruce Aylward

When you were a kid and people would ask you, what you want to be when you grow up, what did you answer? Perhaps, you wanted to be a firefighter, a doctor, or an astronaut. Are you still in the field where you wanted to be when you were a kid? When I was a kid, I always wanted to be a basketball player, but my dreams got crushed during the Fall of 2006 when I got cut from my high school varsity team because I was not tall enough to play. After my dream in basketball ended, I decided to do the second thing I enjoyed the most; science, and today I will soon get a degree in Chemistry. Having this in mind, few people really become what they want to be in life. This is the case of Dr. Bruce Aylward, a Canadian physician and epidemiologist, who has contributed to science with over 100 peer-reviewed scientific articles and book chapters on immunization and disease eradication. Today, Dr. Aylward is the assistant director-general at the World Health Organization (WHO) fulfilling his dreams of helping people through science.

Dr. Aylward always knew he wanted to help people when growing up. This passion for helping people got him in Memorial University of Newfoundland where he got his medical training. Later, he moved to Vancouver where he continued his medical training focusing in internal medicine and infectious diseases. Before joining the World Health Organization in 1992, Dr. Aylward traveled and worked extensively in developing countries in Africa, Asia and South America. Perhaps his most remarkable work was done towards the eradication of Polio that killed 600,000 people in the United States alone in 1918. During a TED conference in 2011, he shared his desire of a world free of polio, “Our big idea is that the scientific miracle of this decade should the complete eradication of poliomyelitis.” He also shared WHO’s polio eradication program mission to first stop transmission globally by the end of 2014 and have a world polio-free by 2018.  When Aylward first started up the polio eradication program back in the 90s, it was a relatively small program funded by the governments mostly. Today, the program to stop polio is the biggest public health project in history and it has received $9 billion in funding from public and private organizations around the world. The presence of the disease has been reduced to 3 countries: India, Nigeria, and Pakistan. And the number of infected was 341 globally in 2013, whereas the number of annual cases exceeded 600,000 60 years ago.

As Dr. Aylward mentions in his TED presentation, when we think about a technology or science that has changed the world, perhaps a polio vaccine is the first thing that comes to our minds. This is the kind of thing that we take for granted. It is necessary to understand how scientists make a great effort to create vaccines against deadly diseases.  He believes that, “finishing polio is the smart thing to do, and the right thing to do.” Today, Dr. Bruce Aylward serves as assistant director-general for WHO working close with pharmaceutical companies to come up with a vaccine that will stop Ebola from spreading any further.

References:

http://www.who.int/dg/adg/aylward/en/

http://www.polioeradication.org/dataandmonitoring/poliothisweek.aspx

http://www.ted.com/talks/bruce_aylward_how_we_ll_stop_polio#t-6876

McAfee Engineers Working On Ebola Anti-virus?

      Computer viruses represent one way in which malicious code can get into a computer. A virus is a piece of self-replicating code embedded within another program. It can be very harmful, erasing all the data from your computer and damaging your hard drive. In 2007, a virus by the name of Storm Trojan surfaced. It was estimated that 10 million CPUs were compromised around the world. A quick response by antivirus vendors and long working hours in which engineers studied the code led to the creation of an antivirus that contained the virus from spreading any further. So, why can’t scientists do the same to stop the Ebola virus? Can’t McAfee engineers work on an antivirus for Ebola? Why is it taking so long to get a vaccine?     

      Viruses in the real world are not easy to stop. In theory, a vaccine goes through 3 steps: development, testing, and regulation, before massive distribution is processed to treat people infected by the virus.

It has been almost one year since Emile Ouamouno, infamously known as Ebola's patient zero, died in Guinea. So far, more than 14,000 people have contracted the virus and nearly 5,000 have died in Africa, being Liberia, Sierra Leone, and Guinea the 3 most affected countries. The Centers for Disease Control and Prevention (C.D.C) estimated that the number of infected can reach up to 1,367,000 by January 2015 in the worst-case scenario.   

      In reality, the 3-step process to get a vaccine can take years to complete, not to mention it is expensive and complicated. Same as engineers, scientists dedicate thousands of hours to experiment several possibilities that could lead to a possible solution to the virus. 

• During the development stage, scientists conduct basic laboratory research that involves a close study to the virus composition and its origins. During this stage, scientists identify natural antigens that might contribute to the prevention or treatment of the virus. At the end of the stage, a vaccine concept is created. You should know that going from basic research to a vaccine concept can take often 2-4 years depending on the resources and funding scientists have at their disposal.
• The next stage is testing. Here, scientists start testing the candidate vaccine on animals such as monkeys and rats. This process is very important because scientists get to analyze responses to the candidate vaccine, dose amounts, dose efficiency, etc. As the experiments get more complex, scientists make less changes and adjustments until they reach a standard that is safe for human trials. but before going to a large scale trial, the candidate vaccine is tested on a small group of people (between 20-80 subjects). 
• Lastly, a successful vaccine gets licensed and introduced to the market for human use. 

      In conclusion, a vaccine to stop Ebola seems to be still in the works for now. It is need to know that getting from test tubes to humans is a long journey. Vaccines go under the same process as any other drugs. In order to be released to the public, they go through a process of development, testing and regulation. The Centers for Disease Control and Prevention and the FDA examine them very closely. On our next blog, we will discuss some recent studies done by researches that will help us understand more about this virus. Additionally, we will discuss about resources and priorities when it comes to vaccines, it seems that the pharmaceutical industry has been concerned more about about viagra pills than deadly viruses.  Stay tuned.  

References:

http://www.nytimes.com/2014/10/15/world/africa/ebola-epidemic-who-west-africa.html

http://computer.howstuffworks.com/worst-computer-viruses10.htm

http://www.historyofvaccines.org/content/articles/vaccine-development-testing-and-regulation

http://www.foxnews.com/health/2014/10/29/ebola-vaccine-are-there-yet/  

Ebola What?

2009 is definitely a year to remember. The king of pop Michael Jackson passed away, Barack Obama became the first African American president of the United States, and the swine flu (H1N1) threatened to extinguish humans from earth. Thankfully, scientists came up with a vaccine and got the H1N1 under control. Today, humanity once again faces a new threat. Yes, we are talking about Ebola hemorrhagic fever commonly known as Ebola.

Ebola is a deadly virus contrasted by intense fever and internal bleeding. The virus is contracted by direct contact with blood and body fluids of a person infected.  It was first detected in 1976 in the Sudan and the Democratic Republic of Congo. This topic is significant because this virus has been around for about 38 years, but this year’s outbreak has caused global fear and it was proved that even tough we live in a world dominated by the constant change in technology, and our lives have become more and more sophisticated, we are still vulnerable, we are still humans.

In America, we were not very concerned about this virus until the morning of September 30th, when Thomas Eric Duncan, Liberian national, was diagnosed the first Ebola case in the United States. The article “Retracing the Steps of the Dallas Ebola Patient” narrates how Duncan contracted Ebola prior to his arrival to Dallas, Texas. Presumably, Duncan had helped a sick neighbor take to a local hospital back in Liberia. Later, it was discovered that his sick neighbor Marthalene Williams died of Ebola. But how did Ebola spread? How did it start?  Records show that 2-year old Emile Ouamouno in Guinea was patient zero. Ebola’s symptoms can be easily confused since they are very similar to a regular flu, malaria, and typhoid fever. Typically, symptoms appear 2-10 days after exposure to the virus, but it can take up to 21 days for incubation. Here is a list of Ebola symptoms to keep in mind:

•       Fever
•       Headache
•       Muscle Aches
•       Weakness
•       Diarrhea & vomiting
•       Red eyes

Knowing all this, what can we do to stop it? Why can’t scientists invent a cure for all viruses? These and more questions will be answered in upcoming blogs. We will discuss how scientist are fighting against this virus, we will explore what scientists have learned about Ebola from past researches and how the government plays an important role behind all this. Stay tuned.

References:

http://www.cnn.com/2014/10/28/health/ebola-patient-zero/index.html?iid=article_sidebar

http://www.nytimes.com/interactive/2014/10/01/us/retracing-the-steps-of-the-dallas-ebola-patient.html?_r=0

http://www.md-health.com/images/10900003/ebola_path.jpg