Posted on 27TH MAR 2017
tagged Ebola, Worldwide

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

In this update:

South Korea BL-4
CDISC data standards
Ebola virus proteins
Interferon treatment
Treatment options

16 Mar 2017 Korea to open 1st [BSL-4] virus biosafety laboratory
[South Korea is close to opening its 1st laboratory fully equipped for experiments with the deadliest of human viruses, such as Ebola. According to the Korea Centers for Disease Control and Prevention, the country's 1st biosafety level 4 (BL-4) lab is ready to open in Osong, a biotech complex in North Chungcheong Province.]

18 Mar 2017 Guinea: Ebola virus: although ended, survivors still suffer in Guinea
[A charity has reported that months after the [Ebola virus disease (EVD)] epidemic ended in Guinea, numerous survivors still suffer from physical and mental effects of the epidemic, having insufficient access to healthcare due to lack of funds. More than 1000 Guineans survived the epidemic, which lasted about 42 days with a couple of flare ups some months after the country was declared EVD-free. Most of them are said to suffer from depression as well as post-traumatic stress disorder, the Alliance for International Medical Action (ALIMA) reports. More are said to suffer from physical discomforts such as joint pains, chronic fatigue, and headaches. Despite their health problems, they can barely afford access to health care.
"It is important that survivors and their families have access to quality care because many are unable to work and cannot afford to pay their own care," ALIMA said in a statement.]
[It is critical for West Africa and supporting countries to address both physical and mental sequelae of the Ebola outbreak, just as they would after a war. - Mod.LK]

23 Mar 2017 New CDISC data standard aids development of therapies for Ebola virus
[The Clinical Data Interchange Standards Consortium (CDISC) and the Infectious Diseases Data Observatory (IDDO) announce the availability of a new standard to assist in the collection, aggregation and analysis of Ebola virus disease (EVD) research data. This standard is for use in EVD trials, leading to potential treatments and public health surveillance for this disease.]

25 Mar 2017 Liberia: Economy struggling 3 years after Ebola outbreak
[Three years on from an outbreak of Ebola virus disease (EVD) that killed more than 11 000 people, countries in West Africa are still struggling to deal with its effects. The IMF [International Monetary Fund] predicts Liberia's fragile economy will shrink significantly in 2017. However, a USD 300 million rehabilitation project of Mount Coffee Hydropower offers a glimmer of hope. President Ellen Johnson Sirleaf saw the electricity provision initiative as an economic opportunity.]

16 Mar 2017: How do Ebola virus proteins released in exosomes affect the immune system?
[Cells infected by the deadly Ebola virus may release viral proteins such as VP40 packaged in exosomes, which, as new research indicates, can affect immune cells throughout the body, impairing their ability to combat the infection and to seek out and destroy hidden virus. The potential for exosomal VP40 to have a substantial impact on Ebola virus disease is examined in a [new] review article. The article is available free on the DNA and Cell Biology website until 13 Apr 2017.
Citation. Pleet M., DeMarino C., Lepene B., et al. The Role of Exosomal VP40 in Ebola Virus Disease. DNA and Cell Biology. Feb 8. doi: 10.1089/dna.2017.3639
Abstract. Ebola virus (EBOV) can cause a devastating hemorrhagic disease, leading to death in a short period of time. After infection, the resulting EBOV disease results in high levels of circulating cytokines, endothelial dysfunction, coagulopathy, and bystander lymphocyte apoptosis in humans and nonhuman primates. The VP40 matrix protein of EBOV is essential for viral assembly and budding from the host cell. Recent data have shown that VP40 exists in the extracellular environment, including in exosomes, and exosomal VP40 can impact the viability of recipient immune cells, including myeloid and T cells, through the regulation of the RNAi and endosomal sorting complexes required for transport pathways. In this study, we discuss the latest findings of the impact of exosomal VP40 on immune cells in vitro and its potential implications for pathogenesis _in vivo_.]

21 Mar 2017: Treatment with interferon may ease symptoms of Ebola patients
[A pilot study of a class of drugs used to treat hepatitis and some forms of multiple sclerosis has been shown for the 1st time to ease symptoms of Ebola patients, while also increasing their survival.
Citation. Kader Konde M., Baker D.P., Traore F.A., et al. (22 Feb 2017). Interferon Beta-1a for the treatment of Ebola virus disease: A historically controlled, single-arm proof-of-concept trial. PLoS One http://dx.doi.org/10.1371/journal.pone.0169255
Abstract. To date, there are no approved antiviral drugs for the treatment of Ebola virus disease (EVD). Based on our in vitro evidence of antiviral activity of interferon (IFN)-Beta activity against Ebola virus, we conducted a single arm clinical study in Guinea to evaluate the safety and therapeutic efficacy of IFN Beta-1a treatment for EVD. Nine individuals infected with Ebola virus were treated with IFN Beta-1a and compared retrospectively with a matched cohort of 21 infected patients receiving standardized supportive care only during the same time period at the same treatment unit. Cognizant of the limitations of having treated only 9 individuals with EVD, the data collected are cautiously considered. When compared to supportive care only, IFN Beta-1a treatment seemed to facilitate viral clearance from the blood and appeared associated with earlier resolution of disease symptoms. Survival, calculated from the date of consent for those in the trial and date of admission from those in the control cohort, to the date of death, was 19 percent for those receiving supportive care only, compared to 67 percent for those receiving supportive care plus IFN B-1a. Given the differences in baseline blood viremia between the control cohort and the IFN-treated cohort, an additional 17 controls were included for a subset analysis, from other treatment units in Guinea, matched with the IFN-treated patients based on age and baseline blood viremia. Subset analyses using this expanded control cohort suggests that patients without IFN B-1a treatment were ~ 1.5-1.9 fold more likely to die than those treated. Viewed altogether the results suggest a rationale for further clinical evaluation of IFN Beta-1a.]

22 Mar 2017: Silence is golden: Suppressing host response to Ebola virus may help to control infection
[The findings, which appear in the Journal of Virology [see citation below], could lead to new treatment options for Ebola virus disease.
The Ebola virus is transmitted to people from wildlife, potentially bats, and spreads in the human population through human-to-human transmission. Currently there are no licensed Ebola virus vaccines but two potential candidates are undergoing evaluation.
Prior studies by others have shown the Ebola virus activates a defense program in macrophages through a process normally used by bacteria but not by viruses. The Ebola virus activates the macrophages through Toll-like receptor 4 (TLR4). Macrophages use TLR4 to sense bacterial infections and then activate a defense program evolved to fight bacteria. Unfortunately, activation of TLR4 by Ebola virus may lead the macrophages in the wrong direction and they mount an inappropriate immune response. This leads to the production of immune modulators that may be harmful and deteriorate Ebola virus disease.
Using the Reston virus, a cousin of the Ebola virus, that does not cause disease in humans, researchers at Boston University School of Medicine (BUSM) examined how macrophages responded to Ebola compared to the Reston virus. Surprisingly and in contrast to Ebola virus, Reston virus-infected macrophages were not activated. In addition, the researchers found by using drugs that inhibit TLR4 activation, it was possible to keep macrophages that are exposed to Ebola virus silent.
"We used transcriptomics analysis performed by our collaborators at the University of Washington, Seattle and other assays to look specifically at the inflammatory response in infected macrophages," explained corresponding author Elke M├╝hlberger, PhD, associate professor of microbiology at BUSM. "This lack of activation in human macrophages might be one of the reasons why Reston virus does not cause disease in humans. More importantly, it showed that it is possible to keep macrophages that are exposed to Ebola virus silent by using drugs that inhibit TLR4 activation. This could be a promising treatment option for Ebola virus disease."
The researchers hope this study will allow for new insight for treating other hemorrhagic fever viruses in addition to Ebola virus.
Citation: J Olejnik, A Forero, LR Deflub├ę et al.. Ebolaviruses associated with differential pathogenicity induce distinct host responses in human macrophages. Journal of Virology, March 2017 DOI: 10.1128/JVI.00179-17]

23 Mar 2017: Doctors in Liberia test new Ebola vaccine
[It has been 3 years since the United Nations declared an Ebola outbreak in parts of West Africa. Yet doctors still do not know how the virus was passed from animals to humans.
More than 10 000 people died from the disease across the region. Doctors in Liberia are now testing a new vaccine on survivors.]
[The report does not state which vaccine is in trial in Liberia. There are at least 2 vaccines that have been in trial, the investigational vaccine Ad26.ZEBOV, developed by Janssen Vaccines & Prevention B.V., one of the Janssen Pharmaceutical Companies of Johnson & Johnson, and MVA-BN-Filo, developed by Bavarian Nordic. Whether one of these vaccines or another is the one in trial is not stated. - Mod.LK]

[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....

ProMED HealthMaps:
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 (11): news, vaccine, research 20170312.4896304
Ebola update (10): news, research 20170305.4881172
Ebola update (09): news, research, funding 20170226.4866142
Ebola update (08): news, research, vaccine 20170219.4850524
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
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Ebola update (54): rapid test recall, nurse, research 20160821.4431433
Ebola update (53): Guinea, research 20160814.4415032
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Ebola update (31): Liberia, Guinea re-emergence, research, funding 20160406.4142990
Ebola update (30): Liberia re-emergence, Uganda NOT, RFI 20160404.4136987
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Ebola update (27): Ebola Reston virulence, Africa suspicious deaths RFI, news 20160327.4121931
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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