Ebola Update

Cases continue to escalate in West Africa

Keeping track of the still rapidly escalating Ebola case count in West Africa is not feasible with this bimonthly publication. So instead we cover other Ebola-related news in this section and refer you to this website to get the latest figures on Ebola http://healthmap.org/ebola/#timeline As of 16 December, the following countries had suspected case and death counts reported by WHO.

In West Africa, Guinea, Sierra Leone and Liberia remain the worst affected with the number of cases continuing to escalate. Mali released from quarantine the last 13 people being monitored for Ebola, and the country was due to be declared free of the virus in January if no further cases were recorded.

Outside of West Africa there has been one case reported in Spain and four in the United States.

Ebola appears to persist in semen of men who have recovered

The WHO issued a statement on 26 November saying that researchers have found that the Ebola virus appears to persist in the semen of men who have recovered from the virus. However, no sexual transmission of the virus has been documented.

The organisation notes that in four studies that investigated persistence of Ebola virus in seminal fluid from convalescent patients (a total of 43 patients), three men who had recovered from Ebola virus disease were reported to shed live virus in semen 40 days, 61 days and 82 days after onset of symptoms, respectively.

The WHO says “men who have recovered from Ebola virus disease should be aware that seminal fluid may be infectious for as long as three months after onset of symptoms. Because of the potential to transmit the virus sexually during this time, they should maintain good personal hygiene after masturbation, and either abstain from sex (including oral sex) for three months after onset of symptoms, or use condoms if abstinence is not possible”.

The Ebola virus is shed in bodily fluids such as blood, vomit, faeces, saliva, urine, tears, and vaginal and seminal fluids.

Amiodarone to be trialled on Ebola patients

The BMJ reports that Ebola patients in Sierra Leone will receive amiodarone, a well-known and cheap anti-arrhythmia drug, in a randomised controlled trial led by the Italian non-governmental organisation Emergency.

According to the report, amiodarone, a multi-ion channel inhibitor and adrenoceptor antagonist, showed in preclinical studies to be a potent inhibitor of filovirus cell entry [Ebolavirus is a filovirus]. It has been used for many decades on millions of patients, so its safety profile is well known.

The phase III trial was due to begin in December.

Candidate vaccine shows promise in phase I trial

An experimental vaccine to prevent Ebola virus disease was well-tolerated and produced immune system responses in all 20 healthy adults who received it in a phase 1 clinical trial conducted by researchers from the US National Institutes of Health, according to a 28 November statement by the NIH. The candidate vaccine, which was co-developed by the NIH’s National Institute of Allergy and Infectious Diseases (NIAID) and GlaxoSmithKline (GSK), was tested at the NIH Clinical Center in Bethesda, Maryland, United States.

NIAID Director Anthony S. Fauci, M.D. said: “Based on these positive results from the first human trial of this candidate vaccine, we are continuing our accelerated plan for larger trials to determine if the vaccine is efficacious in preventing Ebola infection.” The candidate vaccine contains segments of Ebola virus genetic material from two virus species, Sudan and Zaire. The Ebola virus genetic material is delivered by a carrier virus (chimpanzee-derived adenovirus 3 or cAd 3) that causes a common cold in chimpanzees but causes no illness in humans. The candidate vaccine does not contain Ebola virus and cannot cause Ebola virus disease.

l Additional details about this trial, VRC 207, are available at using the identifier NCT02231866

Gavi commits to purchasing Ebola vaccine for affected countries

Plans to purchase millions of doses of an Ebola vaccine to support large-scale vaccination efforts were agreed on December 11 by the board of Gavi, the Vaccine Alliance. The decision means that Gavi will be ready to act as soon as a safe, effective vaccine is recommended for use by the World Health Organization.

The Gavi Board endorsed plans that could see up to US$300 million committed to procure the vaccines, to be used to immunise at risk populations in affected countries. An additional $90 million could be used to support countries to introduce the vaccines and to rebuild devastated health systems and restore immunisation services for all vaccines in Ebola-affected countries.

 Date of upload: 10th Jan 2015


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