Photo by Cynthia Goldsmith. Image by the Associated Press
Public Health Image Library, #10816. Dr. Brantly: ‘I am thrilled to be alive’
So what exactly is Ebola? The U.S. Centers for Disease Control and Prevention (CDC) describes Ebola virus disease (EVD), Ebola hemorrhagic fever (EHF), or simply “Ebola” as a group of viruses that affect several organ systems in the body, followed by internal and external bleeding. The World Health Organization (WHO) agrees with Caldwell, calling it “one of the world’s most virulent diseases.” Genus Ebolavirus contains five distinct species with Zaire ebolavirus (EBOV) strain, the most deadly. The virus is named after the Ebola River in Yambuku, Democratic Republic of Congo (formerly Zaire), where one of the first outbreaks occurred in 1976. This, however was not patient zero according to the CDC, and the story of a 2 year old as patient zero could not be confirmed either. The virus is spread through personal contact with infected person or animal (dead or alive). As of September 10 2014, WHO and the CDC reported a total of 4,846 suspected cases and 2,375 deaths worldwide–more than half from Liberia. The current supportive treatment recommended by CDC includes: keeping the patient hydrated, observing and maintaining balanced vital signs and treating any associated infections-all in isolation, by caregivers with impermeable gowns, gloves, and facial protection mask.
Here at home, two United States missionaries Dr. Kent Brantly and Nancy Writebol infected with the deadly Ebola virus were flown separately from Liberia to Emory University Hospital in Atlanta, GA–the first human patients with Ebola in the US. Brantly and Writebol were treated with an experimental drug “ZMapp,” and released from the hospital with no signs of the virus in their system.
ZMapp was developed by the biotech firm Mapp Biopharmaceutical Inc., a San Diego, CA based company with Kentucky connections. The drug was a three-mouse monoclonal antibody (proteins that the immune system uses to identify and kill harmful or foreign cells). In other words, mice were exposed to parts of the Ebola virus, antibodies were generated within the mice’s blood and later harvested to create the medicine. The protein can also be made from tobacco plants. Mapp Biopharmaceutical Inc., has been collaborating with the National Institutes of Health and the Department of Defense on responsibly countering weapons of mass destruction for several years.
In early August, at a news conference concluding the US-African leaders’ summit in Washington DC—the first of its kind; when asked about the experimental drug, President Barack Obama responded “We’ve got to let the science guide us.” According to the CDC and FDA, ZMapp and other drugs including the Canadian experimental Ebola vaccine “VSV-EBOV” donated to WHO, have never been tested on humans—thus pending FDA approval for Ebola treatment. It is safe to say that the CDC and FDA are on point with their analysis–more testing is required.
Some have frowned upon this, like Macauley from Sierra Leone. In perspective, Macauley does have a point, however, it is important to understand how the US handles these important issues. Yes, the FDA can be more than strict and sometimes bureaucratic in its daily operations, but the work they do speaks for itself. What this translates to, is excellence in the treatment of diseases and making on-point medical and technological resolutions. Lack of oversight is definitely not what the world needs, and the US happens to be very thorough in making these type of calls. In addition, let us not forget the alternative if Liberians were the first to receive ZMapp—the news headlines would probably be printing something like, “Poor Liberians used as lab rats for heartless American drug companies.” As of date, the US government, including the CDC have committed more than $100 million since the outbreak started, and president Obama just announced a new 500 bed treatment centers in Monrovia in the coming weeks. So, we are all in this together.
Breakthrough in Kentucky.
Residents of Liberia, Sierra Leon, Guinea, and the Congo have seen the worst death cases from the outbreak compared to their neighbors, Nigeria. The Nigerian Department of health–the first to map the Genome sequence data of the Zaire strain for better diagnostics, did so, due to better technology, modern facilities, and more resources in general. All these countries were knowledgeable about the Ebola virus, but knowledge on its own was not enough as the situation unfolded. Nigeria, the most populated country in the region (about 178.5 million)—classified as high risk, also had the resources to aggressively combat the issue, resulting in less than 10 deaths in the entire country compared to about 1,307 deaths in Liberia (about 4.3 million total population).
Currently, CDC confirms that Ebola poses no substantial risk to the U.S. general population. Doctors from Emory Hospital confirmed that, for a patient to be allowed to leave the isolation unit, two blood tests had to come back negative for the Ebola virus. Thus their bodily fluids, like blood, sweat and feces, would no longer be infectious. Spokesman for ZMapp manufacturer, David Howard, shared that limited quantities of the drug were provided to Emory Hospital. (Some might be saying, “Really? Here in our backyard?” The answer is “Yes,” just about 185 miles west of Berea, is the Kentucky Bio-processing facility in Owensboro, KY.) that has played a groundbreaking role in the fight to combat bio-terrorism. This brings to mind a moral lesson, “Whatever you do, do it well,” because you never know who is, or will be affected by your work. Significant recoveries in the United States and Nigeria offers hope that this too (Ebola), shall pass.
Knowledge + Resources = Breakthrough.
Some crises like the Ebola outbreak, reveals that Knowledge alone is not enough, but together with Resources, great things happen.
Photos by Jenny Sevcik (The Associated Press). Kentucky BioProcessing facility in Owensboro, Ky.