WHY EBOLA VACCINE MAY NOT STOP EPIDEMIC

[cronus]

http://www.nextgov.com/health/2014/10/w ... mic/97805/

WHY EBOLA VACCINE MAY NOT STOP EPIDEMIC

Dr. Jesse Goodman, is a specialist in infectious diseases and the director of COMPASS, a Georgetown University center that informs policy on public health and product development. Until February 2014 he was the chief scientist of the US Food and Drug Administration (FDA). Goodman spoke with Ebola Deeply about the challenges of developing Ebola vaccines and experimental treatments.

How are the control tests for Ebola vaccines going?
The earliest human trials—that is, initial safety studies in small numbers of volunteers—are underway. There are several more vaccines in production that have not yet been tested in human beings, but which appear to be effective in primates. One is made by a company called Profectus, and the other is made using Modified Vaccinia Ankara (MVA), which has been used in a number of vaccines including smallpox. In this case it’s designed to produce non-infectious virus-like particles that display the Ebola virus glycoprotein.

We just don’t know how long it’s going to take for them to be declared safe, or even if they’ll be effective. People are working very quickly to get initial human studies done, and also to scale up potential manufacturing for the leading candidates. But it’s a complex business and none of these vaccines has so far been manufactured in large amounts. Even by next spring is pretty optimistic; things usually take longer than people project.

What are the biggest challenges, besides the time constraints, of producing an Ebola vaccine?
These are complex vaccines that involve a live virus and you always have to have very well-controlled production. Cost is one factor: I think it’s hard to predict, but these are not going to be inexpensive to produce. However, many public health experts have said that if we have a safe and effective vaccine, the cost mustn’t get in the way of it reaching communities.

With all experimental treatments, including vaccines, it’s really important not to make presumptions that they will work. It would really be a shame if we’re not able to learn what works and what doesn’t, for the next outbreak or if this one continues over an even longer period. A vaccine could be a really important tool, but if we don’t have solid studies that show that it works and is safe, I think it would be really problematic just to immunize huge numbers of people with a vaccine we don’t understand.

It’s important for people to realize that a lot of vaccines in testing don’t pan out the way we hope. If you’re going to give them to huge numbers of healthy people, it’s really important to have confidence and to be able to explain any adverse affects to people; to say, we did a study of “x” amount of people and it reduced Ebola infection by “x” percent. We’d hope it would be 100%, but at this point we don’t know what is possible. One HIV vaccine that was trialed was shown to actually increase acquisition of HIV.

It’s also important to consider the mistrust that people feel when they don’t know enough about a vaccine and how it works. There have been polio vaccine campaigns that were seen as an attempt to kill people, and obviously they are not, so I think it’s very important to inform as much as you can, and forge that trust. Similarly, if control studies are done in West Africa, it’s very important that the countries themselves use effective communication with participants. Healthcare workers have both a higher risk of disease and are likely to better understand that something is experimental. So it may be that such people are more interested in taking part in the studies.

(continued)

http://news.sciencemag.org/health/2014/ ... ine-issues

[Blind groper]

The first ebola vaccine has already been under test, and seems safe. It has been shown to induce an immune response also. So far, we do not know how effective it will be against ebola, and the next trial is due to start very soon, in which lots of people in west Africa will be vaccinated, and their subsequent rate of infection will be recorded. There will be no placebo control, since this is considered unethical, if the vaccine does help. Assuming this vaccine works, it will be available in large amounts by March 2015.

[cronus]

The first ebola vaccine has already been under test, and seems safe. It has been shown to induce an immune response also. So far, we do not know how effective it will be against ebola, and the next trial is due to start very soon, in which lots of people in west Africa will be vaccinated, and their subsequent rate of infection will be recorded. There will be no placebo control, since this is considered unethical, if the vaccine does help. Assuming this vaccine works, it will be available in large amounts by March 2015.

We'll see then? Keeping folks calm when they should panic and close down 'the global socio-economic system' to slow disease spread is a risk in itself. We'll see. Won't be long.

[Blind groper]

It is also possible to diagnose ebola from a distance. A video camera connected to a smart phone with the right app can do it. Apparently, there are rhythmic but tiny movements in the skin which permit the pulse to be measured. Also the heightened colour of skin when fever strikes. These two together permit diagnosis of ebola even when no human doctor is present. With 100% diagnosis, the spread can be limited.

[cronus]

It is also possible to diagnose ebola from a distance. A video camera connected to a smart phone with the right app can do it. Apparently, there are rhythmic but tiny movements in the skin which permit the pulse to be measured. Also the heightened colour of skin when fever strikes. These two together permit diagnosis of ebola even when no human doctor is present. With 100% diagnosis, the spread can be limited.

It can also be spread by door knob and toilet seat in a way other diseases don't. Will you be pointing that smart phone ahead like dowsing rod where ever you go? Your confidence in technology is not unusual for the times...

[Blind groper]

Actually, scumple, those methods of transmission would be quite unusual. 70% of the current cases are spread by contact with corpses. Seems to me that there is a clear set of approaches to reduce numbers of cases just by reducing contact with corpses. If our 21st Century technologies cannot permit burying infected corpses without human skin contact, something is seriously wrong!

[JimC]

Actually, scumple, those methods of transmission would be quite unusual. 70% of the current cases are spread by contact with corpses. Seems to me that there is a clear set of approaches to reduce numbers of cases just by reducing contact with corpses. If our 21st Century technologies cannot permit burying infected corpses without human skin contact, something is seriously wrong!

The problem is using technology for such purposes that in regions with non-existent or fractured infrastructure...

[cronus]

They've took the edge of the exponential growth in the countryside but not in the capital. That is interesting. You would expect more educated folks taking on board safety campaigns and resources to slow the spread in the capital. Unless it is passing via intermediary contact more efficiently in urban areas? Could be something in the way modern cities are constructed and their social activities organised makes it easier for the virus to strike? Not found in enough cities to see a pattern yet? Will have to wait until the Ebola virus escapes Africa and goes on a world tour?

[cronus]

Cities have a lot more social velocity. Transport systems, even primitive ones, will allow lots of multi-person surface contact. Same with public amenities like toilets and cafes.

[Blind groper]

Ebola will leave Africa numerous times, and infected people in other nations will end up in isolation wards in our hospitals, and such cases will be numerous. However, ebola will not go on a world tour. Each and every time it leaves Africa it will be stopped in its tracks by good medical action. Ebola is not difficult to control, if the resources are there.

The problem is that in Africa, the resources are not there, and the people are not educated into how to deal with it. Instead, they turn to witch doctors and other disastrous superstitions.

[cronus]

Ebola will leave Africa numerous times, and infected people in other nations will end up in isolation wards in our hospitals, and such cases will be numerous. However, ebola will not go on a world tour. Each and every time it leaves Africa it will be stopped in its tracks by good medical action. Ebola is not difficult to control, if the resources are there.

The problem is that in Africa, the resources are not there, and the people are not educated into how to deal with it. Instead, they turn to witch doctors and other disastrous superstitions.

In a economic collapse though....where resources become scarce? it'll be wipe out time.

[Blind groper]

Do you enjoy predicting disaster, scumple? I can just see it. In his evil palace, scumple is bent over and rubbing his hands in glee. "They are all going to die, ha ha," quoth he.

[cronus]

Do you enjoy predicting disaster, scumple? I can just see it. In his evil palace, scumple is bent over and rubbing his hands in glee. "They are all going to die, ha ha," quoth he.

No, I'm the tallest meercat in the tallest tree crying danger every so often, my role in the troop.