Thursday, August 22, 2019

This Is The (Way) The Modern World (Should Work)!

Science
WorksVille


Look.

I know that the the latest outbreak of Ebola is a very bad and scary thing for all those affected and for all those trying to help.

Here is the lede of a piece published earlier this week in the online, Boston Globe adjacent, biomedical mass media journal StatNews by Joel Breman:

In 1976, a mysterious viral disease swept through the isolated forest village of Yambuku in northern Zaire. I was part of the international team that investigated the outbreak, identified the virus causing it, and named it after the nearby Ebola River. The deadliness of the disease — of the 318 people infected with the virus, 280 died — captured the world’s attention, briefly.

Twenty years later, Zaire came apart at the seams, was renamed the Democratic Republic of the Congo, and became the theater of operations for two wars involving nine countries and more than two dozen militias. Those conflicts, centered at the eastern end of DRC, killed more than 5 million people but barely registered with the rest of the world. Armed militias continue to hold violent reign there.

Last year, in the middle of the former war zone, Ebola re-emerged, as it has 25 other times in sub-Saharan Africa. In this latest outbreak, 2,850 people have been infected with the virus to date and nearly 1,900 have died — the second-worst Ebola epidemic on record — and we are not close to containing it, despite the best efforts of a thousand health professionals on the ground...


Now.

Reading that, and seeing and hearing all about it on the electronic proMedia, you may have missed the news about the on-the-ground, multi-pronged clinical trial that has been going on during this latest outbreak.

The following is from a report in the straight science journal Nature by Amy Maxmen published just one month ago:

...The race to develop treatments for Ebola has accelerated since the largest epidemic in history devastated West Africa between 2014 and 2016. Scientists responding to the ongoing outbreak in the Democratic Republic of the Congo (DRC) have enrolled more than 500 participants in an unprecedented study of experimental drugs, vaccinated nearly 170,000 people, and sequenced the genomes of more than 270 Ebola samples collected from the sick.

“This outbreak is clearly a milestone for rigorous, good research,” says David Heymann, an epidemiologist at the London School of Hygiene and Tropical Medicine. “We will get definitive answers.”...

{snip}

...Working in a conflict zone has forced researchers to adapt and persevere to an extraordinary degree. They have learnt how to conduct rigorous studies in areas where killings, abductions and arson are commonplace, and where Ebola responders have come under repeated attack. Although biomedical advances alone cannot defeat Ebola, scientists studying this outbreak remain hopeful that their growing knowledge will help end it — and limit those to come.

“It is not easy,” says Jean Jacques Muyembe Tamfum, a microbiologist who helped to discover Ebola and now directs the National Institute for Biomedical Research (INRB) in Kinshasa. “You are doing this and people are shooting.”

He and other Congolese researchers are also working to ensure that any advances will benefit their homeland, which has experienced more Ebola outbreaks than any other. “It is very important to have the research done here because at the end of the day, Ebola is our problem,” says Sabue Mulangu, an infectious-disease researcher at the INRB...


Which, in and of itself is a good thing, because this trial is being done the right way with responsible NGO's, first world researchers, and Congolese folks doing the real, hard slogging all working together for a common cause.

And then last week there was a report that the trial was being re-tooled in midstream for the very, best of reasons.

Kai Kupfershmidt had the story in the other big straight science journal Science:

A trial of four experimental Ebola treatments carried out in the Democratic Republic of the Congo (DRC) has been stopped early after two of them showed strong signs of being able to save patients’ lives. The preliminary results were reported this morning by Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases (NIAID) in Bethesda, Maryland, one of the partners in the study. The two treatments will now be made widely available and could help end the yearlong outbreak in the DRC, which has already killed more than 1800 people, scientists say...

{snip}

...In the 41% of trial participants who sought treatment early after infection and had lower levels of Ebola virus in their blood, the two new treatments had astonishing success: Mortality plummeted to 6% in the Regeneron antibody group and to 11% with mAb114. (With ZMapp and remdesivir, mortality rates in people with low viral load were 24% and 33%, respectively.)...



This is not an outright cure as infected folks with high viral loads still succumbed at rates of 60% after they received one of the two treatments, which consist of antibodies that bind to the outer coat of the virus. However, the news here is really and truly promising because now, for the first time viable and efficacious treatment strategies are emerging that will give folks and powerful incentive to seek out medical help as early as possible. In addition, early results with a larger scale vaccine trial that is going at the same time are also promising:

...A separate study taking place in the DRC has shown that Merck’s Ebola vaccine, which has been given to 180,000 people in the current epidemic, also powerfully reduces mortality, even when it fails to prevent infection...


This really is the way the modern world should (and can) work.


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Non-parenthetic earworm in the post title need scratching?....This.

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5 comments:

e.a.f. said...

yes, the world wasn't that interested in the deaths of 5 million people, but Ebola can get on a jet and come to Europe, North America, etc.

Its amazing the people working on medication to deal with the disease have done so well, under truly difficult conditions. we can only hope drug companies don't make the drug so expensive people in Africa can't afford it.

thank you for the article.

RossK said...

e.a.f.--

Given my day job, I do my best not to jump on the biomedical science discovery hype heap around here, but this looks to be the real deal.

Having said that, there are two caveats....One, while a group I'm involved with does develop antibodies, this is most definitely not my field...Second, due to the speed with which this has all gone down there is no peer reviewed literature out there yet so there is that grain of a grain of salt to be taken which is why I've mostly quoted hard nose science journals here.


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Danneau said...

Any idea who did the research, and where it was done, to develop these treatments?

Lew said...


“Trump’s decision to eliminate the Ebola funds was announced at nearly the same time as the World Health Organization issued a bulletin declaring a new outbreak of Ebola in the Democratic Republic of the Congo.”

https://foreignpolicy.com/2018/05/09/ebola-is-back-and-trump-is-trying-to-kill-funding-for-it/

“But while the US is staying back, officials from other countries, including Canada and the United Kingdom, as well as NGOs and humanitarian groups are sending personnel to help with the Ebola crisis. As of October 15, there were 450 responders on the ground.“

https://www.vox.com/2018/10/25/18015780/ebola-outbreak-2018-drc-congo-security-trump-cdc

“But there is no justification for the administration to contribute a mere $31 million to combat the disease this year, according to the journal Nature, at a moment when far greater resources are required for an effective response.”

"The U.S. cannot allow EBOLA infected people back. People that go to far away places to help out are great — but must suffer the consequences!" - Donald Trump

https://www.usatoday.com/story/opinion/2019/07/22/trump-tweets-show-germaphobe-ill-equipped-for-us-ebola-crisis-column/1779930001/

The modern world must find a way to work in spite of Donald Trump.

e.a.f. said...

I liked the article you wrote because it explained how the research was done and it certainly does look promising. The work appears to have been carried out by very dedicated people and they are to be commended for their efforts. they truly are amazing!

Lew's last line, about the world having to work around Trump, good call. it does not surprise me that Trump would want to ensure no one comes back to the U.S.A., who has worked on Ebola. He is most likely scared shitless he'll contract it.

In my opinion, American society would not be able to deal with an outbreak from Ebola. Other western countries are perhaps no better equipped, but we do have health care systems in place, which are government funded and run. There is a system in place. The U.S.A., not so much.

Ebola needs a medicine, just as HIV/AIDS needed one/several to contain the spread of the disease. But as with HIV/AIDS some politicians and non politicians, didn't pay attention because it wasn't considered "mainstream". We know how that turned out in Canada, with the tainted blood.

The world is both a very large place and very small. Nothing stays in one place anymore. Thankfully the researchers are doing a great job under very difficult circumstances.