Tag Archives: epidemic

New ebola drug appears somewhat effective

Drug trails in Guinea of a new ebola drug suggest that it might have some positive effect on mortality.

A researcher who had seen the data and asked not to be identified told Science that favipiravir did not help all of the patients treated with it at two trial sites in Guinea. In a subset of trial participants who had low levels of Ebola virus in the blood, however, the mortality was just 15%. In similar patients who entered the centers earlier and did not receive favipiravir, mortality was 30%.

The trials with this drug are being conducted without a control group, which makes it harder to pin down the cause of these results. The article also describes several other drugs being readied for testing, some of which are expected to be more effective.

The trials, however, are faced with two issues. First, the easing of the epidemic is making it more difficult to do the studies. And second,

So far, Guinea and Sierra Leone, where Ebola is still infecting dozens of people a week, have refused invitations to join the study. Their main stumbling block is trial design. ZMapp will be the first Ebola treatment that will be tested against a placebo control. “I think that’s the only way to tell whether these drugs are safe and effective,” Lane says. The governments of Guinea and Sierra Leone, as well as Doctors Without Borders, which runs Ebola centers in those countries, have for ethical reasons been reluctant to participate in treatment trials that use a placebo.

The moral dilemma of doing drug tests where some patients get a placebo has always been a problem for medical research. It is therefore not surprising to see it here as well.

Ebola’s rate of growth

The journal Science provides a detailed analysis of the infection rate of ebola, as well a reasonable estimate of the present and future number of cases.

The article makes two key points. First, the trends “…clearly show that the number of cases has roughly doubled every 3 to 4 weeks and that this trend is continuing. If underreporting gets worse, however, it may be even more difficult to discern such trends.”

Second, there is some good news in the worst effected countries.

The number of new cases in some areas at the epicenter of the outbreak– Kenema and Kailahun districts in Sierra Leone and Liberia’s Lofa county–has been dropping, and that’s not a result of underreporting, says Dye. “It has happened for a sufficiently large number of weeks now that we are confident that it’s a real reduction in incidence on the ground, probably related to control measures,” he says. “Our colleagues working on the ground believe it is too.”

One important factor has been the increase in safe burials, Dye says. (The bodies of Ebola victims are very infections.) People in the affected areas have resisted abandoning traditional burial practices that carry a high risk of infection, but in these three areas, local leaders, supported by WHO and others, have come to advocate a change. If that happens elsewhere, says Dye, “we expect to be able to cut out a substantial amount of infection in the community.”

Russian authorities struggle to contain the spread of African swine fever, a deadly virus that attacks pigs.

Russian authorities struggle to contain the spread of African swine fever, a deadly virus that attacks pigs.

Russian authorities have incinerated tens of thousands of pigs and closed roads in the past few weeks, in an attempt to contain an emerging outbreak of African swine fever, a viral disease so lethal to the animals that it has been likened to Ebola. The spread of the disease comes with a heavy economic toll — last year, the Russian Federation lost 300,000 of the country’s 19 million pigs to swine fever, at an estimated cost of about 7.6 billion roubles (US$240 million).

This year there will be more cases of whooping cough in fifty years.

Not good: This year there will be the most cases of whooping cough in more than a half century.

The CDC is trying to figure out what’s going on, but Schuchat said a couple of factors are clearly at work. The formulation for the whooping cough vaccine was changed in 1997, and kids hitting age 13 and 14 now are the first to have been fully vaccinated with five doses of the new vaccine. The new formulation causes less of a reaction, but it may also wear off sooner, Schuchat said.

The older vaccine was made using a whole pertussis bacterium. It was very effective, but it did cause swelling in some kids who got it, and sometimes caused a fever — something that scared parents. It also was widely blamed for causing rare but serious neurological reactions, although Schuchat said studies have not confirmed this.

I imagine the formulation was changed because of the uproar in the 1990s about the dangers of the old vaccine.