Posted on 20TH FEB 2017
tagged Ebola, Worldwide

A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

In this update:
[1] News
- Africa CDC
- BSL-4 air hoses
- Health security
- Sierra Leone
[2] Research
- Landscape fragmentation
- Adaptive mutations
- Risk factors predictive of mortality
[3] Vaccine
- China rAd5-EBOV vaccine

[1] News
- Africa CDC
Date: Wed 15 Feb 2017
Source: Reuters [edited]

Africa's new continent-wide public health agency could help prevent a repeat of the disastrous Ebola epidemic by monitoring diseases across country borders and deploying a rapid task force at the 1st signs of an outbreak, health experts said.

The African Union (AU) launched the Africa Centers for Disease Control and Prevention (Africa CDC) on [31 Jan 2017] at its headquarters in Ethiopia. Epidemiologists began disease surveillance work there this month [February 2017].

The agency will have regional centers equipped for lab testing in Egypt, Nigeria, Gabon, Zambia, and Kenya, and will expand an emergency volunteer corps created during the Ebola epidemic to thousands of health workers across the continent.

"What the Africa CDC can truly contribute is to bring (international disease) response closer to the countries," said incoming director John Nkengasong, a virologist and senior official at the US CDC. The agency will focus on strengthening national health systems through its regional networks, Nkengasong said, making countries less reliant on overseas medical aid, staff and equipment during outbreaks.

[Byline: Nellie Peyton]

- BSL-4 air hoses
Date: Fri 17 Feb 2017 4:14 PM ET
Source: CBC (Canadian Broadcasting Corporation) News, Reuters report [edited]

The US Centers for Disease Control and Prevention [CDC] have closed down its highest security [BSL-4] laboratories after discovering that hoses that supply air to scientists wearing special protective suits were never approved for that use, the agency said on [Fri 17 Feb 2017].

"We have no evidence that anybody has suffered ill health effects from breathing air that came through these hoses," Stephan Monroe, associate director for laboratory science and safety at the CDC, told Reuters.

Monroe said he was confident that scientists were not exposed to pathogens because the air they breathed passed through HEPA filters. The suits they wear also use positive air pressure to prevent pathogens from entering the suit.

- Health security
Date: Sat 18 Feb 2017 11:26 pm CAT
Source: KT Press [edited]

President Paul Kagame on [Sat 18 Feb 2017] told the annual Munich Security Conference (MSC) that throwing huge sum of money is not the answer to addressing health security challenges. It is by building strong and lasting systems that the world will tackle the problems creating health insecurity, said Kagame, who was speaking on a high-level panel.

Kagame was on panel with Microsoft's Bill Gates, Norwegian PM Erna Solberg, Peter Salama from the World Health Organization [WHO] and International Rescue Committee (IRC) chief Ed Miliband.

The panel was discussing health security "Small Bugs, Big Bombs". Using the Rwanda experience, Kagame said: "We have to get primary health system in place if we are to have a hope of beating pandemics."

[Byline: Jean de la Croix Tabaro]

- Sierra Leone
Date: Sat 18 Feb 2017
Source: Sierra Express Media [summ., edited]

On Sat 18 Feb 2017, as part of its Corporate Social Responsibility (CSR), the Sierra Leone Brewery Limited (SLBL) commissioned a post-Ebola water and sanitation project that includes a toilet and a water well at the Sierra Leone Muslim Community School (SLMC) in Constituency 098, Bottom Oku, Wellington, on behalf of Heineken Africa Foundation.

[Sanitation and clean water are critical to public health. - Mod.LK]

[2] Research
- Landscape fragmentation
Date: Tue 14 Feb 2017
Source: Nature Scientific Reports [edited]

[Citation. Rulli MC et al. The nexus between forest fragmentation in Africa and Ebola virus disease outbreaks. Sci. Rep. 7, 41613. doi: 10.1038/srep41613 (2017) http://www.nature.com/articles/srep41613]

There's a nexus between the index cases (the 1st people infected by Ebola virus) and deforestation, especially close to forest margins fragmented and disturbed. In these cases, human populations can be particularly exposed to ebolavirus infections because of the higher likelihood for humans to be in contact with disease reservoirs.

- Adaptive mutations
Date: Wed 15 Feb 2017
Source: Bioinformatics [edited]

[Citation. Pappalardo M, Reddin I, Cantoni D, et al. Changes associated with Ebola virus adaptation to novel species (15 Feb 2017 online). Bioinformatics btx065. https://doi.org/10.1093/bioinformatics/btx065]

Ebola viruses are not pathogenic but can be adapted to replicate and cause disease in rodents. Here, we used a structural bioinformatics approach to analyze the mutations associated with Ebola virus adaptation to rodents to elucidate the determinants of host-specific Ebola virus pathogenicity.

Results: We identified 33 different mutations associated with Ebola virus adaptation to rodents in the proteins GP, NP, L, VP24, and VP35. Only VP24, GP and NP were consistently found mutated in rodent-adapted Ebola virus strains. Fewer than 5 mutations in these genes seem to be required for the adaptation of Ebola viruses to a new species. The role of mutations in GP and NP is not clear. However, 3 VP24 mutations located in the protein interface with karyopherin [alpha]5 may enable VP24 to inhibit karyopherins and subsequently the host interferon response. Three further VP24 mutations change hydrogen bonding or cause conformational changes. Hence, there is evidence that few mutations including crucial mutations in VP24 enable Ebola virus adaptation to new hosts. Since Reston virus, the only non-human pathogenic Ebolavirus species circulates in pigs in Asia, this raises concerns that few mutations may result in novel human pathogenic Ebolaviruses.

- Risk factors predictive of mortality
Date: Thu 16 Feb 2017
Source: Top News [edited]

[Citation. Hartley M-A et al. (2 Feb 2017) Predicting Ebola severity: A clinical prioritization score for Ebola virus disease. PLOS Neglected Tropical Diseases. 11(2): e0005265. doi:10.1371/journal.pntd.0005265]

In the latest outbreak, which raged in Guinea, Liberia, and Sierra Leone from 2014 to 2016, 28 616 people were infected with virus and 11 310 people died. Doctors might be able to improve the odds of surviving by looking for a few warning signs in people who need to be treated more intensively, Mary-Anne Hartley, of the international charity GOAL Global and the University of Lausanne in Switzerland, and colleagues report 2 Feb [2017] in PLOS Neglected Tropical Diseases.

Top risk factors for dying from Ebola [Ebola virus disease (EVD)]:
- High viral load: Patients with lots of virus in their blood were 12.6 times as likely to die as those with a low viral load. [High viral load was considered to be Ct [value] less than 20].
- Age: Children under 5 were 5.4 times as likely to die as were people between 5 and 25; people over age 45 were 11.6 times as likely to die.
- Disorientation: The symptom was associated with more than 94 percent of Ebola fatalities and increased the risk of dying by 13.1 times.
- Hiccups
- Diarrhea
- Red, inflamed eyes
- Labored breathing or shortness of breath
- Muscle pain
- Delayed treatment - The risk of dying increased 12 percent each day an infected person put off treatment for the first 10 days after symptoms started.

[3] Vaccine
Date: 14 Feb 2017
Source: Dunia Leo [edited]

China says its 1st domestically-developed Ebola vaccine is a major medical breakthrough as it passed the Phase II clinical test and gains permission for clinical trials overseas.

State broadcaster China Central Television (CCTV) cited a report by the country's Academy of Military Medical Sciences (AMMS), the developer of the rAd5-EBOV vaccine, as saying that tests show that the vaccine is both safe and protective.

One single shot is capable of producing an antibody against Ebola virus "14 days after inoculation with the amount reaching the peak resistance at 28 days," the AMMS said. It went on to say that the restructured vaccine was developed based on the 2014 gene type and particularly the type of the virus that plagued West Africa. The rAd5-EBOV vaccine has been reportedly successful in clinical trials in 500 cases of Ebola infection in Sierra Leone.

[Compiled by: Celeste Whitlow ]

Communicated by:

[A map showing the distribution of EVD cases as of 27 Mar 2016 can be seen at http://apps.who.int/ebola/sites/default/files/thumbnails/image/sitrep_ca....

Liberia http://healthmap.org/promed/p/54
Guinea http://healthmap.org/promed/p/45
Sierra Leone http://healthmap.org/promed/p/46
- Mod.LK]

See Also
Ebola update (07): research, economy 20170213.4836546
Ebola update (06): research, treatment, funding 20170206.4819835
Ebola update (05): news, vaccine, funding, documentary films 20170129.4801064
Ebola update (04): research 20170123.4786222
Ebola update (03): news, research 20170115.4767977
Ebola update (02): news, research, vaccine, comment 20170108.4750411
Ebola update (01): News, research, vaccine 20170103.4738060
Ebola update (72): vaccine, research, NGO, media 20161226.4724859
Ebola update (71): research, economy 20161218.4706276
Ebola update (70): news, research, economy, funding 20161211.4690740
Ebola update (69): news, NGO, research, economy, funding, vaccine 20161204.4675615
Ebola update (68): news, economy 20161127.4657148
Ebola update (67): news, research, funding 20161120.4642402
Ebola update (66): news, research, funding, economy 20161115.4629793
Ebola update (65): news, research, commentary, economy, funding, vaccine 20161106.4609611
Ebola update (64): news, research 20161030.4595759
Ebola update (63): news, research 20161023.4579436
Ebola update (62): news, research, treatment, funding 20161017.4564066
Ebola update (61): news, funding, economy 20161009.4547627
Ebola update (60): news, research, economy 20161002.4531285
Ebola update (59): news, research, funding 20160925.4514591
Ebola update (58): news, research, funding, vaccine 20160918.4497393
Ebola update (57): news, research, funding 20160911.4481043
Ebola update (56): news, vaccine, research 20160904.4465145
Ebola update (55): research, funding 20160828.4446844
Ebola update (54): rapid test recall, nurse, research 20160821.4431433
Ebola update (53): Guinea, research 20160814.4415032
Ebola update (52): funding, research 20160808.4400521
Ebola update (51): funding, research, miscellaneous 20160731.4383179
Ebola update (50): Liberia, Sierra Leone, research 20160724.4366266
Ebola update (49): Sierra Leone, research, history 20160717.4350351
Ebola update (48): CDC, research, funding, economy 20160710.4336146
Ebola update (47): Liberia, US preparedness, funding, research 20160703.4323924
Ebola update (46): Liberia, Sierra Leone, treatment comment, research, funding 20160626.4310569
Ebola update (45): Liberia, vaccine, treatment, funding, research 20160619.4296380
Ebola update (44): Liberia, WHO, funding, research 20160612.4283379
Ebola update (43): digital wallet response, Guinea, diagnostic assay 20160605.4266788
Ebola update (42): Guinea, vaccine, research 20160529.4253046
Ebola update (41): update, funding 20160522.4238249
Ebola update (40): Liberia, Sierra Leone, research, vaccines 20160514.4222416
Ebola update (39): Guinea persistence in semen, Liberia, research, vaccine 20160508.4209313
Ebola update (38): WHO sitrep. evolution rate, Liberia, Sierra Leone, research 20160501.4195742
Ebola update (37): Guinea, Liberia, diagnostics, vaccine, funding, research 20160427.4187854
Ebola update (36): Guinea, Liberia, vaccine, research 20160421.4172812
Ebola update (35): vaccine, comment 20160418.4167038
Ebola update (34): Guinea, Liberia, comment, vaccine funding 20160417.4165862
Ebola update (33): Guinea, Liberia, Sierra Leone, research, funding, vaccine 20160413.4158203
Ebola update (32): Liberia, Guinea, support 20160410.4150454
Ebola update (31): Liberia, Guinea re-emergence, research, funding 20160406.4142990
Ebola update (30): Liberia re-emergence, Uganda NOT, RFI 20160404.4136987
Ebola update (29): Liberia re-emergence, Guinea contacts, news, RFI 20160402.4134878
Ebola update (28): news, research, vaccine 20160330.4128527
Ebola update (27): Ebola Reston virulence, Africa suspicious deaths RFI, news 20160327.4121931
Ebola update (26): Guinea flare-up, Liberia 20160324.4114807
Ebola update (25): Guinea flare-up, Liberia, Sierra Leone, research 20160320.4107350
Ebola update (24): Guinea, confirmed 20160317.4101955
Ebola update (23): comment, pregnant women, news, research 20160316.4098040
Ebola update (22): long-term sequelae, news, research 20160313.4090091
Ebola update (21): Sierra Leone, herd immunity, possible new drug 20160310.4081498
Ebola update (20): new antiviral, prevention 20160306.4073116
see archives for older ProMED reports