Ebola News 3/26

[Buster's Uncle]

New Ebola infections continue to drop, Guinea still a concern
Reuters  10 hours ago



Children come forward to get their feet disinfected after a Red Cross worker explained that they are spraying bleach, and not spraying the village with the Ebola virus, in Forecariah January 30, 2015, REUTERS/Misha Hussain



ABIDJAN (Reuters) - The three nations hardest hit by West Africa's Ebola epidemic recorded the lowest weekly total of new cases so far this year in the week leading up to March 22, the World Health Organization (WHO) said on Wednesday.

The figures are a further indication that the outbreak, which has killed more than 10,300 people across Guinea, Liberia and Sierra Leone, is waning. But there are still worrying signs that the disease is not yet under control in Guinea, the U.N. health agency said in its weekly report.

Seventy-nine new confirmed cases of Ebola were reported in the three countries during the week. Forty-five of those were in Guinea. And in a minor setback, Liberia reported its first new case in three weeks.

The falling number of new cases in Sierra Leone and Liberia as well as a receding zone of transmission mean that treatment capacity now far exceeds demand there, and the WHO is working with local authorities to dismantle surplus centres.

Even Guinea, which has seen a rise in new cases in recent weeks, saw some improvement, with instances of new infections declining nationwide. However, the WHO cautioned that authorities had yet to pin down and isolate the sources of new cases.

"The fact that fewer than half of cases arose from known contacts, and the number of reported unsafe burials has increased suggests that the outbreak in Guinea continues to be driven by unknown chains of transmission," it said.


http://news.yahoo.com/ebola-infections-continue-drop-guinea-still-concern-080650599--business.html

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Liberia says first Ebola patient in a month is isolated case
AFP  19 hours ago



An adhesive bandage is placed on the arm of a volunteer after she was administered an experimental Ebola vaccine at Redemption Hospital in New Kru Town, a suburb of Monrovia, on February 2, 2015 (AFP Photo/Zoom Dosso)



Monrovia (AFP) - A Liberian woman who last week became the country's first Ebola patient in more than one month has not passed on the infection to anyone else, a senior official said Wednesday.

The case was a setback to hopes that Liberia, once the worst Ebola-hit country, would soon be officially declared free of the deadly disease.

"The patient is in a stable condition. She is responding to treatment," said Francis Karteh, the head of Liberia's Ebola Incident Management Team.

"She had contact with more than 50 people. We have been following these people and they are all home with no sign of Ebola yet."

In a boost to Liberia's efforts, the frontline Doctors Without Borders (MSF) aid agency announced it was stopping its work at a 250-bed Ebola treatment centre in Monrovia, the largest in the country, "due to the decreased number of Ebola cases".

"The cessation of activities will allow MSF to prepare the structure for the handover to the Liberian ministry of health," the group said in a statement, adding that it would remain "vigilant and ready to respond in case the number of Ebola cases rises again".

Liberia's newest Ebola case is the wife of a cured Ebola patient, a source said.

Liberia has recorded more than 4,000 Ebola deaths but was at an advanced stage of recovery, expecting to be declared Ebola-free by mid-April before the latest case in the capital Monrovia.

During a visit to the JFK Hospital in Monrovia, the largest in the country, Liberian President Ellen Johnson Sirleaf "thanked God" that only one person had been identified so far, an official statement said.

"So far, we're very pleased with their response and the ability to contain the virus," the statement said quoting Sirleaf as saying on Monday.

Since the outbreak began in December 2013, 24,753 people in nine countries have been infected with the virus, and 10,236 of them have died, according to the latest figures.

All but 15 of those deaths have occurred in Liberia and its neighbours, Sierra Leone and Guinea.

But the tide seemed to have turned in Liberia, which six months ago was reporting more than 300 new cases a week.

The World Health Organization (WHO) announced earlier this month that no new case of the deadly virus had been registered in Liberia since February 19.


http://news.yahoo.com/liberia-says-first-ebola-patient-month-isolated-case-144722606.html

[Buster's Uncle]

Ebola 'Supervirus' Is Unlikely, Experts Say
LiveScience.com
By Laura Geggel  1 hour ago



Researchers isolated this Ebola virus from patient blood samples collected in Mali.



The Ebola virus that is causing the current outbreak in West Africa is not mutating as quickly as earlier reports had suggested, a new study finds. This finding helps allay fears that the virus could change into a more infectious or deadly form, the researchers said.

In the study, published online today (March 26) in the journal Science, researchers compared virus samples from people in Africa who became infected with Ebola up to nine months apart. They found that the viruses' genetic sequences were almost identical, meaning that the virus had undergone relatively few mutations — or changes in the genetic sequence — over that time period, the researchers said

"We do not see any evidence that the virus is mutating any more rapidly than has been reported in previous outbreaks," said Thomas Hoenen, a postdoctoral fellow in virology at the National Institutes of Health and one of the researchers on the study.

The new results are welcome news, experts said. In a 2014 study published in the journal Science, researchers had suggested that the Ebola virus in the West African epidemic was mutating twice as fast as other Ebola virus strains. In that study, researchers compared viral samples that were taken from people who became infected only three months apart, a relatively short time period, Hoenen said.

That finding "was surprising to us, so we wanted to look at a data set that goes over a much longer period of time," Hoenen told Live Science.

In the new study, the researchers compared viral samples collected from patients who were infected in Guinea in March 2014, Sierra Leone in June 2014 and Mali in November 2014.

The researchers found that the samples from March and November differed by only 20 nucleotide sout of 19,000. (Nucleotides hold the "letters" of the genetic code — for example, guanine (G) or adenine (A)). 

None of the mutations that the researchers observed in the study will increase the severity or change the transmissibility of Ebola, the researchers said.

Researchers have been studying Ebola's mutation rate in part because the virus is an RNA virus, meaning it uses RNA, rather than its cousin DNA, for its genetic material. RNA viruses generally have higher mutation rates than DNA viruses, said Angela Rasmussen, a research assistant professor of microbiology at the University of Washington, who was not involved in the new study.

"[RNA viruses] don't have proofreading capabilities," like DNA viruses do, Rasmussen said. "If they make a mistake, they can't identify that and go back and fix it."

The new study suggests that the Ebola virus's mutation rate in West Africa is fairly similar to that of other RNA viruses, such as rhinovirus, the virus that causes the common cold, Rasmussen said.

The new study brought Rasmussen "a sense of relief," she told Live Science.

"It doesn't appear to be a supervirus," she said. "It basically indicates that our drugs and vaccines that were developed for Central African strains will probably still be effective against West African strains."

The Ebola outbreak in West Africa has now sickened more than 25,000 people and killed more than 10,300 people since it began, according to the Centers for Disease Control and Prevention. Several drug and vaccination trials are underway to help treat and prevent the disease.


http://news.yahoo.com/ebola-supervirus-unlikely-experts-182308531.html

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American who contracted Ebola improves, in serious condition
Associated Press  25 minutes ago



BETHESDA, Md. (AP) — Doctors say an American health care worker who contracted Ebola while volunteering in a Sierra Leone treatment unit has improved to serious condition at the National Institutes of Health.

The agency announced Thursday that the patient's status improved from critical condition. He is being treated at the NIH's hospital near Washington.

The patient was flown in isolation from Sierra Leone on a chartered plane and arrived March 13. The NIH said initially that the patient was in serious condition, but announced last week that his status had been downgraded to critical.

The patient's name and age have not been released. He is a clinician working with Partners in Health, a Boston-based nonprofit organization, which has been treating patients in Liberia and Sierra Leone since November.

"Our colleague is doing much better," Partners in Health co-founder Paul Farmer said in a statement. "In fact, he has, in the opinion of some of the best doctors and nurses in the world, turned the corner. He is likely a long way from discharge, but is improving on all fronts."

The organization said ten other clinicians who had been in contact with the infected health care worker are also being monitored but don't appear to be showing symptoms


http://news.yahoo.com/american-contracted-ebola-improves-serious-condition-170751049.html

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Study finds no sign Ebola virus is mutating out of control
Reuters
By Will Dunham  1 hour ago



WASHINGTON (Reuters) - There is no sign the Ebola virus is mutating in an accelerated way that could make it more virulent or thwart vaccines or drugs under development despite some earlier fears to the contrary, researchers said on Thursday.

Earlier analyses had suggested to some experts that the virus might have been mutating at twice the rate observed in previous outbreaks, raising fears it could become even deadlier.

But a study backed by the U.S. National Institutes of Health and published in the journal Science found the virus was changing at about the same rate as in prior outbreaks.

"The data really shows that the virus isn't changing any more than would be expected. So, for example, it doesn't appear to be becoming more virulent or more transmissible," said virologist David Safronetz of the NIH's National Institute of Allergy and Infectious Diseases (NIAID), one of the researchers.

"I would say it's definitely reassuring," Safronetz added.

The biggest Ebola outbreak to date, centered in three West African countries, has killed more than 10,000 people but is showing signs of waning.

The researchers analyzed genetic information on the virus from samples taken over nine months last year from patients in Guinea in March, patients in Sierra Leone last June and patients last November in Mali who were infected in Guinea.

The routine genetic changes observed indicate the viral mutations are not likely to affect diagnostic testing or the effectiveness of experimental Ebola vaccines or drugs, the researchers said.

There are no approved vaccines or medicines for Ebola. There had been concern that a rapidly mutating virus could present a tricky moving target that could complicate efforts to develop ways to prevent and treat the virus.

"This does not appear to be a moving target," said Dr. Anthony Fauci, NIAID's director.

Ebola is transmitted only through direct contact with the blood or body fluids of an infected person. Fauci said the findings also allay concerns raised by some last year that a rapidly changing virus could change how Ebola is transmitted, becoming airborne or respiratory.

Also in the journal Science, researchers led by Yoshihiro Kawaoka of the University of Wisconsin and the University of Tokyo described promising results in monkeys from an experimental vaccine, one of several in the works.

They called it a safe, inactivated whole-virus vaccine that primes the recipient's immune system with the full complement of Ebola viral proteins and genes.

(Reporting by Will Dunham)


http://news.yahoo.com/study-finds-no-sign-ebola-virus-mutating-control-180245434.html

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Ebola virus has mutated less than scientists feared: study
AFP  47 minutes ago



Medical staff clean their protection suits as part of the fight against the Ebola virus on March 8, 2015 at the Donka hospital in Conakry (AFP Photo/Cellou Binani)



Washington (AFP) - The Ebola virus is not mutating as quickly as scientists had feared, which is good news for treating the disease and preventing its spread, a study showed Thursday.

Previous research based on limited data had suggested that Ebola was mutating twice as quickly as in the past, researchers said in the journal Science.

But scientists who sequenced four Ebola samples taken in Mali between October and November found no significant genetic changes compared to samples taken at the beginning of the epidemic in March 2014.

"The Ebola virus in the ongoing West African outbreak appears to be stable -- that is, it does not appear to be mutating more rapidly than viruses in previous Ebola outbreaks, and that is reassuring," said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID).

Ebola diagnostic tests, antibodies and experimental vaccines are based on the genetic make-up of the virus at a particular moment. If too much genetic variation occurs, diagnosis of new, mutated forms might not be possible and vaccines and antibodies could become ineffective.

Mutations could also potentially lead to more severe symptoms or a virus that spreads more easily, the scientists said.



A health worker prepares a vaccination at a health center in Conakry, Guinea on March 10, 2015, during the first clinical trials of the VSV-EBOV vaccine against the Ebola virus (AFP Photo/Cellou Binani)


In August, virologists studying 99 virus genomes from patients in Sierra Leone found a large number of mutations.

But in the study published Thursday, the Ebola samples collected in Mali were found to be similar to those collected elsewhere in the past.

The new data "adds yet more confidence that a vaccine strategy should work," said Jim Kent of the University of California, Santa Cruz, who has set up an Ebola virus genome database.

But a co-author on the earlier Sierra Leone study, Kristian Andersen of the Broad Institute, warned that new treatments and vaccines could result in virus mutations that will help Ebola survive them.

Ebola has killed more than 10,000 people in west Africa out of nearly 25,000 infected since the start of 2014, mainly in Liberia, Sierra Leone and Guinea.


http://news.yahoo.com/ebola-virus-mutated-less-scientists-feared-study-224448380.html

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Ebola Death Rates Vary Widely by Age Group
LiveScience.com
By Agata Blaszczak Boxe  March 25, 2015 6:31 PM



A student in Sierra Leone at an infection control workshop led by the U.S. Centers for Disease Control and Prevention.



Young children who are infected with Ebola may be more likely to die from the virus than older children or adults who are infected, according to a new study.

In the study, researchers examined Ebola cases in children younger than 16 during the current outbreak in Guinea, Liberia and Sierra Leone, and compared them with adult cases. They found that the outbreak's death rate has been higher among younger children than among older children and adults.

The disease has killed about 90 percent of infected children under age 1, and about 80 percent of kids ages 1 to 4 who have been infected. Older children who have been infected with Ebola may have a much better chance of surviving, as the death rate has been lower — 52 percent — for children ages 10 to 15. Among children older than 15 and adults, the mortality rate was 65 percent.

"The very youngest of children — neonates  —appear to have the worst outcomes from Ebola," study co-author Dr. Robert Fowler, an associate professor of critical-care medicine at the University of Toronto, said in a statement. (Neonates, or newborns, are babies younger than 1 month.)

There are a number of factors that may explain the high Ebola mortality rate in newborns, Fowler said. For instance, the youngest children are often heavily dependent on others to care for them, and their caregivers may have also been sick with Ebola. Younger kids may also be particularly prone to dehydration and metabolic abnormalities that result from vomiting and diarrhea, which are common symptoms of the disease.

To prevent dehydration, children need to receive a sufficient amount of fluids, which are usually administered intravenously when the children can no longer keep fluids down because they have been vomiting, Fowler said.

However, getting those fluids into the body by "placing intravenous catheters in young children can be challenging," he said.

The study shows that Ebola affects young children differently from adults, study co-author Christl Donnelly, a professor at Imperial College London, said in a statement.

Therefore, "it's especially important that we get them [children] into treatment quickly," she said. "We also need to look at whether young children are getting treatment that's appropriate for their age."

The researchers were surprised by the relatively low mortality rate among children ages 10 to 15, said study co-author Dr. Christopher M. Dye, head of the World Health Organization's Ebola epidemiology team in Geneva.

"That has not been seen before for Ebola, and we have been able to uncover this partly because this large epidemic has generated so much data," Dye told Live Science. "Put another way, usually we expect to see higher case fatalities from infections only in the very youngest and the very oldest, but the pattern here is different."

The new study was published today (March 25) in the New England Journal of Medicine.


http://news.yahoo.com/ebola-death-rates-vary-widely-age-group-223154533.html

[Buster's Uncle]

Two experimental Ebola vaccines pass safety test in African trial
Reuters
By Sharon Begley  1 hour ago



Some of the ultrastructural morphology displayed by an Ebola virus virion is revealed in this undated handout colorized transmission electron micrograph (TEM) obtained by Reuters August 1, 2014. REUTERS/Frederick Murphy/CDC/Handout via Reuters



NEW YORK (Reuters) - Two experimental Ebola vaccines, one from GlaxoSmithKline PLC and the other from biotech start-up NewLink Genetics Corp, "appear to be safe" part way through a clinical trial being conducted in Liberia, the U.S. National Institutes of Health (NIH) said on Thursday.

The two vaccines, each given in a single injection, are being tested for safety and efficacy on more than 600 people in Liberia in a mid-stage clinical trial sponsored by the National Institute of Allergy and Infectious Diseases, a branch of NIH.

The Ebola epidemic that began in West Africa one year ago has killed more than 10,200 people, but a decline in new cases in the most affected countries, Liberia, Guinea and Sierra Leone, has led to hopes that it may be ending.

Based on the encouraging safety results, the study may now advance to the next phase of efficacy testing, in which additional volunteers are injected with the GSK vaccine, the NewLink vaccine, or a dummy shot and assessed to see whether their immune system responds by producing anti-Ebola antibodies.

No volunteers are intentionally exposed to the often-deadly virus. Instead, the immune response is considered an acceptable proxy for how effective the vaccine would be if someone were exposed.

"We are grateful to the Liberian people who volunteered for this important clinical trial and encouraged by the study results," NIAID Director Dr. Anthony Fauci said in a statement. "Now we must move forward to adapt and expand the study so that ultimately we can determine whether these experimental vaccines can protect against Ebola virus disease and therefore be used in future Ebola outbreaks."

The trial of the GSK vaccine, which was developed with NIAID scientists, and the NewLink vaccine, developed by the Public Health Agency of Canada and licensed to NewLink, began on Feb. 2 in Monrovia, Liberia. Neither the volunteers nor the researchers know who received which vaccine or the saline injection.

The researchers will continue to enroll volunteers in the trial through late April, aiming for about 1,500 people. They especially want to enroll more women, who made up only 16 percent of the first group, to be sure there are no gender-based differences in immune response or side effects.

The volunteers will be followed for at least a year, with blood samples tested six and 12 months after vaccination to determine how long the immune response lasts.

(Reporting by Sharon Begley; Editing by Bernard Orr)


http://news.yahoo.com/two-experimental-ebola-vaccines-pass-safety-test-african-214424319--finance.html

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US Ebola patient's condition improves: NIH
AFP  3 hours ago



People walk past a billboard reading "Stop Ebola" in Freetown on November 7, 2014 (AFP Photo/Francisco Leong)



Washington (AFP) - An American healthcare worker in treatment after becoming infected with the Ebola virus in Sierra Leone has improved and is now in serious condition, the National Institutes of Health said Thursday.

The patient, who has not been identified, was evacuated from Sierra Leone on March 14 and brought to the NIH's Clinical Center in Bethesda, Maryland just outside Washington for treatment.

"The status of the patient with Ebola virus disease being treated at the NIH Clinical Center has improved from critical to serious condition," the NIH said.

The medical charity Partners in Health said the patient is a clinician who worked in Sierra Leone, which along with Liberia and Guinea is struggling to emerge from the worst Ebola outbreak in history.

The NIH's clinic is equipped with state-of-the-art isolation facilities and is staffed with infectious disease and critical care specialists.

The NIH is the premier US medical research center in the United States.

An American nurse, Nina Pham, was treated at the clinic after she was infected with the Ebola virus at a Texas hospital by a Liberian, Thomas Eric Duncan, who had initially been misdiagnosed.

Pham was declared free of the Ebola virus on October 24, but Duncan died.

More than 10,000 people have died of the virus since the outbreak was identified in early 2014.


http://news.yahoo.com/us-ebola-patients-condition-improves-nih-203256077.html

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Two Experimental Ebola Vaccines Appear to Be Safe in Trial
Proving that the vaccines are effective is the next step in the research
The Wall Street Journal
By Thomas M. Burton  March 26, 2015 7:08 p.m. ET



Two experimental Ebola virus vaccines appear to be safe, based on a trial with 600 people in Liberia, the U.S. National Institute of Allergy and Infectious Diseases said Thursday.

NIAID, part of the National Institutes of Health, has been testing a vaccine produced by the NIH and GlaxoSmithKline PLC, and another one developed by the Public Health Agency of Canada. That latter vaccine has been licensed to NewLink Genetics Corp. and Merck & Co.

The safety goals for the vaccines have been met, but proving that they are effective—the next step in the research—now appears to be a more complicated project than originally envisioned. Investigators had planned to enroll 27,000 people in Liberia at a high risk of developing Ebola, such as health-care workers.

However, the rate of Ebola infection in Liberia has declined rapidly, and there hasn’t been even one confirmed Ebola case since Feb. 19. So the leaders of the trial, including Drs. H. Clifford Lane of NIAID and Stephen Kennedy and Fatorma Bolay in Liberia, have decide to explore the possibility of expanding the trial to other West African countries that have continued to suffer under the virus.


http://www.wsj.com/articles/two-experimental-ebola-vaccines-appear-to-be-safe-in-trial-1427411300?mod=yahoo_hs

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Ebola is most deadly among babies, young children, study finds
Reuters
By Kate Kelland  March 25, 2015 5:02 PM



Health workers take the temperature of a boy who came in contact with a woman who died of Ebola virus in the Paynesville neighborhood of Monrovia, Liberia, January 21, 2015. REUTERS/James Giahyue



LONDON (Reuters) - The Ebola virus causing a devastating epidemic in West Africa is far more deadly in children than in adults, killing around 90 percent of babies under one who become infected, researchers said on Wednesday.

A study led by scientists at the World Health Organization (WHO) and Imperial College London found that, although infection rates are lower in children than adults, babies and toddlers who get the disease have a far slimmer chance of survival.

The virus, which causes hemorrhagic fever and induces internal and external bleeding, profuse vomiting and diarrhea, is killing 90 percent of infants in the current outbreak and around 80 percent of children aged between one to four years, the scientists found.

Older children are much more likely to survive the disease - it has killed 52 percent of those infected aged 10 to 15.

"These findings show that Ebola affects young children quite differently to adults, and it's especially important that we get them into treatment quickly," said Christl Donnelly, who co-led the study Imperial's Centre for Outbreak Analysis and Modelling.

"We also need to look at whether young children are getting treatment that's appropriate for their age."

The world's worst Ebola epidemic has killed more than 10,200 people in total in the three most affected countries of Guinea, Liberia and Sierra Leone since March 2014 when it was first confirmed in the forest region of Guinea.

As of March 2015, almost 4,000 children under 16 have been affected by Ebola in the current epidemic.

Donnelly's team, whose work was published in the New England Journal of Medicine on Wednesday, analyzed data on Ebola cases in children under 16 in Guinea, Liberia and Sierra Leone.

As well as the higher risk of death in younger children, they found the incubation period - the time between becoming infected and showing symptoms - was 6.9 days in children under a year, compared with 9.8 days in children aged 10 to 15.

There were also differences in symptoms, with children more likely than adults to have a fever when they first see a doctor but less likely to have difficulty breathing or swallowing, or to have pain in the abdomen, chest, joints or muscles.

"The very youngest of children - neonates - appear to have the worst outcomes from Ebola," said Robert Fowler, a co-researcher on the study from the University of Toronto.

He said the findings about how children suffer more show the need to "evolve more dedicated and specialized means of caring for them in an Ebola outbreak".

(Editing by Gareth Jones)


http://news.yahoo.com/ebola-most-deadly-among-babies-young-children-study-210257137.html