Like the Ebola outbreaks raging in West Africa, the World Health Organization (WHO) desperate for a way to help people infected, is to reconsider a potential treatment Ebola tried in 1976, after the first documented outbreak of the deadly viral disease using the blood of people who have recovered from an infection to treat those who are still fighting against the virus. "Convalescent Serum is high on our list of potential therapies and has been used in other homes (eg in China during SARS)," the WHO said in a written statement to Science Insider . "There is a long history of use, a lot of experience of what needs to be done, that the standards and norms must be respected."
There are no official plans to administer the convalescent serum sick, but WHO said it will assess whether the treatment approach was "safe and feasible" and was already working with officials in areas affected by Ebola to strengthen blood banking systems there. These movements are as scientists debate the mixed results of past use of convalescent serum. "The jury is still out" on the approach, said Daniel Bausch, an Ebola expert at Tulane University in New Orleans, Louisiana. However, he and others believe that therapy should be explored. "I think we have a moral imperative to push forward with all scientifically plausible manner, "said Bausch.
the Ebola virus has sickened at least 2,127 people and killed in 1145 them Sierra Leone, Guinea, Liberia and Nigeria. These figures can "significantly underestimate the scale of the epidemic," WHO warned Thursday. It is already the largest Ebola outbreak ever recorded and the unprecedented number of deaths has led to calls to try experimental therapies that are in the early stages of development. on Tuesday, an ethics committee of the wHO said it was ethics in the particular case using unapproved treatments such as Ebola zmapp, a mixture of antibodies that has been tested in animals and has been given to both the US health care workers who fell ill in Liberia. Other experts advocate the use of drugs that are approved to treat other diseases, but they can help patients with Ebola, too. And Nigeria would explores a controversial treatment called Nano Silver.
As for convalescent serum used to treat patients, it is an attractive option for a number of reasons, says Bausch. Get blood transfusions became commonplace; no approval bodies such as the United States Food and Drug Administration or European Medicines Agency is required and affected countries in West Africa many people survived Ebola, which means it can be a serum supply. In fact, the therapy has already been tried in the current epidemic. One of two health workers from the United States that has been treated with zmapp, Kent Brantly, earlier received a transfusion of blood of a boy of 14, he had treated and who had survived Ebola.
But as the other treatments being discussed, it is far from proven that the convalescence serum will help patients Ebola. The idea is simple: Because survivors are usually developed antibodies to fight the virus, the transfer of their blood could help patients. In the past, the strategy was used to treat people with SARS, and Lassa fever, viral hemorrhagic fever, such as Ebola. David Heymann, an epidemiologist at the London School of Hygiene & Tropical Medicine and a former executive director of communicable diseases at WHO, said that the use of the therapy in 1976 is encouraging. Heymann, who was part of a team investigating the outbreak in Zaire, stayed for 2.5 months collecting a unit of blood each week to survivors, he said. The epidemic ended before the serum could be used in Africa, but some of it was given later that year to a researcher in the UK who accidentally pricked himself infected while transferring the blood of a Guinea pig infected with Ebola virus. He survived. "The blood was stored in South Africa and the CDC in Atlanta, but I do not know what happened," says Heymann.
serumof Convalescent tried again in 1995 in an epidemic of Ebola in Kikwit in the Democratic Republic of Congo. Kikwit General hospital doctors treated eight Ebola patients with blood donated by five people who survived their infections. Seven of those receiving the serum also survived. A reanalysis later however, concluded that the patients survived long enough their infection before receiving the serum they would probably have recovered without it. And a study in rhesus macaques, published in 07, found no benefit of transferring blood convalescent monkeys. "There are a lot of variables and quality of immune blood or serum may vary considerably from one person to another," said Thomas Geisbert, a researcher at the University of Texas Medical Branch in Galveston and one of the authors of this study.
WHO clinical Filovirus working group, convened in response to the current outbreak, reviewed the evidence on the serum of convalescents at a meeting in Geneva, Switzerland, at the end of July says Bausch, part of the group. A plan has been proposed to steal the blood of Ebola survivors in the United States and Geisbert or Heinz Feldmann, a researcher at the National Institute of Allergy and Infectious Diseases, try the therapy in non-human primates, says Bausch. But Geisbert, in an e-mail, notes that there are "no current plans to test this in non-human primates" and there was "no formal request from any agency" if he and Heinz "are both willing and ready to do whatever is necessary to support the response. "Tom Solomon, director of the Research Unit of the Health Protection UK in emerging infections based at the University of Liverpool, he said he is also considering a therapy trial in humans." We are in discussions with WHO and an international group of partners to develop a test and looking both convalescent plasma and new therapies ", he said. If the serum is tested on humans, check to advance that can neutralize the virus, said Stephan Günther, a virologist at the Bernhard Nocht Institute for tropical medicine, who is now in Nigeria. "Otherwise, you do not have to give serum." neutralization could be measured in the cell culture with a real virus or a virus of the recombinant vaccine expressing Ebola area virus protein, Günther said.
Although work therapy, there are challenges. the first is the risk of infecting patients with other pathogens such as HIV or hepatitis C. Get the blood of patients cured in the first place can also be a problem, says Bausch. "Blood is an entity that people pay much attention to West Africa. When people feel like they are losing blood, which is an important thing and bad, "he said. Yet try the therapy in non-human primates and then implement in affected countries in West Africa is logical, says Bausch. "It's going to be complicated, it will be difficult to do, but at some point, we'll just try to dive and move forward." Robert Colebunders, a clinical infectious diseases at the University of Antwerp in Belgium , who was involved in treating Ebola patients in the home in 1995, said that if there are survivors willing to donate blood, doctors should try therapy. "And then they need to follow up scientifically, so we learn something. "
However, the WHO warned today in a statement, focus on untested therapies is" creating unrealistic expectations. ... The public needs to understand that these medical products are under investigation. They have not yet been tested in humans and are not approved by regulatory authorities, beyond the use for compassionate care. "
Focusing on therapies is also distracted what really needs to be done, said Steven Riley, an infectious disease epidemiologist disease at Imperial College London. "We do not need to export drugs. We need to export the gold standard public health process, "he said. Infectious disease experts agree that monitoring of those who have been in contact with an infected person and isolate is the key containing the deadly virus
* Ebola files :. given the current Ebola outbreak unprecedented in terms of the number of people killed and the rapid geographic spread, science and science Translational Medicine made a collection of research articles and news on the viral disease available for researchers and the general public.
0 Komentar