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Vaccine Candidates and the Future of Ebola

The VRC has been working on developing a vaccine for the Ebola virus based upon a type of chimpanzee cold virus called adenovirus type 3. This adenovirus is used as a vector that delivers genetic material, but it only inserts the material rather than replicating as well. This gene inserted contains a protein that prompts the human immune system into responding. It is important to note that the vaccine does not contain infectious Ebola materiel. The vaccine has already been tested through Phase 1 in the United States and was found to be safe. Recently, it went through the 2nd phase of testing and initial results have been found and indicate the vaccine to be safe for human use. This means that soon Phase 3 of testing is expected to begin. Another vaccine candidate, referred to as VSV-ZEBOC , is also currently undergoing testing. This vaccine uses a genetically modified version of vesicular stomatitis virus, a virus that primarily affects cattle. It is now being used to carry a gene segment from the Ebola virus. Out of 40 adults that received this vaccine as part of phase 1 testing, it has been found to be safe, and is now currently being testing in the PREVAIL vaccine trial being done in Liberia. Extensive work is being done to find a cure including more trial vaccines, pharmaceutical options such as the BCX4430 drug that is currently in phase 1 of testing, along with a mixture of methods referred to as ZMapp.  These tests are ongoing around the world, and everything possible is being done to make sure we know as much as we can about the Ebola virus. It is important that we remain calm and informed in situations such as these,  fear is an unnecessary hindrance when we could be aiding in the fight for a cure. I highly suggest looking at statistics that can be found here: http://apps.who.int/gho/data/view.ebola-sitrep.ebola-summary-20141112?lang=en and are updated rather frequently. Information regarding vaccines and possible cures that I referenced and more information on them can be found on the following website: http://www.niaid.nih.gov/topics/ebolamarburg/research/pages/default.aspx

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A New Method of Detection

               The current method of detection for the Ebola virus is a method called PCR(Polymerase chain reaction) which amplifies a single or a few copies of a piece of DNA then generates anywhere from a thousand to a million copies of the selected DNA sequence.  In reference to Ebola detection, this can be used to identify the specific gene containing Ebola and tested using the patients DNA to see if their DNA tests positive as being a carrier of the Ebola virus. Recently, a more rapid method of detecting antigens in Ebola was developed that works much like a pregnancy test. There are several pros and cons of using this new method and they are as follows

Pros

·         Faster

·         Portable

·         Less Expensive

Cons

·         Less predictable results

·         More susceptible to reader error

·         Less able to detect low concentrations of the virus

Knowing this, the new method of detection is only used when PCR is not available or the amount of patients showing symptoms is too great to spend time on PCR. Even then, only certain people, who have been extensively trained in its use, can administer the test. A full report on this new method can be found on the following website:

http://apps.who.int/iris/bitstream/10665/160265/1/WHO_EVD_HIS_EMP_15.1_eng.pdf?ua=1

               There are many other methods along with these that can be used depending on the stage of infection the patient is at. For a patient that has just begun displaying symptoms, the most options are available. Elisa testing and IgM ELISA are some of the methods that can be used and the results of such are similar to that of PCR testing which can also be done along with virus isolation. Later in the course of disease, fewer testing options are available, leaving only IgM and IgG antibodies. Finally, in deceased patients, virus isolation and PCR are once again possible methods along with Immunohistochemisty testing (IHC) which is a process of detecting antibodies. This information and more on detection can be found at the following location:

http://www.cdc.gov/vhf/ebola/diagnosis/

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Prevention/Control

To begin, I would like to note facts about treatment and the people most at risk for contracting disease. Medical Workers, people in contact with infected, and anyone who comes in direct contact with the diseased carriers of the virus have the highest risk of infection. Once contracted there are several methods of treatment in various stages of trial that can be used dependent upon the specifics of the strain involved. Severe patients require intensive care including injections of fluids containing electrolytes as patients can become severally dehydrated. It is important to note that it is possible to recover with the appropriate medical care, which includes monitoring and adjustments of treatment from patient to patient as there is no specific cure for the disease. In order to prevent contraction of the disease there are several important factors that can aid in the control and aversion of the Ebola virus. Animal handling, such as in the meat packing industry should never be performed without gloves and other protective gear to avoid any contact with bodily fluids such as blood and fecal matter among other things. Along with the general avoidance of fruit bats and monkeys/apes without proper gear, consumption should be avoided. If avoidance is not possible, it is vital that the meat is cooked properly. Protective gear should also be worn when in contact with human patients and hand washing is required after contact is made. As stated in a previous post, sexual transmission, while not currently a definite carrier of contagions, is entirely possible and as such any protective measures should be made when possible. People who have come into contact with others that have tested positive for the disease are to be monitored for a 21 day period (Period of Incubation for the virus) to ensure that they have not contracted the virus as well. As with any virus, community engagement is a vital aspect in outbreak situations as it allows for a more successful control of the outbreak. This would include having a good laboratory for research and identification of the virus, as well as surveillance of those known to have come in contact/ are at risk for contraction, and contact tracing. This information was found at the following location which will provide further information on the subject’s if wanted.

http://www.who.int/mediacentre/factsheets/fs103/en/

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The Facts About Ebola

               The Ebola virus disease of EVD was formerly known as Ebola haemorrhagic fever has severe affects and is often fatal in humans. It is believed that this virus began in animals such as bats and primates and was transferred to humans, and is now transferred through human-to-human contact through fluids. However, it is unknown whether this includes sexual transmission. An important thing to note about transmission is that unlike popular belief would dictate, the Ebola virus is not airborne, at least not in any way that would affect the human population was not susceptible to the airborne form of the disease known as Ebola Reston. The fatality rates of Ebola can vary, depending on the strain and the treatment methods use, but generally it ranges from 25% - 90% with the average fatality rate being 50%. There is currently no vaccine available for the Ebola virus, but 2 possible candidates exist and are currently going through testing and are showing positive signs.  People that do contract the virus are not actually contagious until symptoms are developed which include fever, headache, muscle pain, weakness, fatigue, diarrhea, vomiting, abdominal pain, and unexplained hemorrhage. These symptoms can appear anywhere from 2-21 days after exposure as that is the incubation period of the virus, however the average period of incubation is 8-10 days. Once symptoms show up, the person remains infectious as long as their blood contains the virus, meaning they are still infectious even after their death.  This information and additional information can be found on the following websites:

http://www.cdc.gov/vhf/ebola/symptoms/

http://www.who.int/mediacentre/factsheets/fs103/en/

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This blog is a part of my high school genetics project based upon our research and findings on the Ebola virus. This research began while we read The Hot Zone by Richard Preston, detailing the discovery of the Ebola virus and several accounts of contact made with the virus after its discovery. This includes different strains of the virus, as there are many variations, including some that are not capable of taking a human host, such as the Reston strain. I will be using this blog as a way to inform the general population on the facts that we have on Ebola with my hope being to spread awareness rather than fear of the virus. That being said, The Hot Zone does have some rather freighting depictions of the effects of the virus, but I believe it is a great way to begin research on the topic, as the accounts are more accessible and are presented in a way that is more gripping to the general public than scientific research papers may be.  It is important to note the time frame of the novel as well, as it is set around the time of discovery of the virus and throughout the late 80’s. This is why the virus is presented in such a way, as we had much less information about it than we do now. However, that does not necessarily mean we have all the information, as several organizations are still working toward gathering further information about the virus, but we know much more now than we did back then.  Throughout my posts, I will be detailing what we know about the Ebola virus and the work being done involving treatment and possible cures, using information found on reliable websites that I will provide sources for in case the readers of this blog would like to continue research. As a final note, I would like to state that the Ebola virus while dangerous, does not have to be something that we think of as a world ending epidemic, rather as a problem that can be solved by working together to find a solution to our struggle.