12/16/2019 8:22:00 AM New drug offers hope in Ebola-prone locations
Dear Doctor: Our son's work as an engineer is taking him to Kampala, Uganda. He's had to get all sorts of vaccinations, but his mother is concerned that Ebola wasn't on the list. Is there a vaccine yet?
Dear Reader: After decades of research and testing, an injectable vaccine that targets the deadly Ebola virus in humans won approval from the European Union in late November. Known as Ervebo, the vaccine also meets standards of quality, safety and efficacy set forth by the World Health Organization. In the United States, the Food and Drug Administration has placed the vaccine under priority review, but it is not yet available here.
Ebola virus disease, or EVD, is a rare and often fatal illness that affects both humans and nonhuman primates. The family of viruses that cause EVD are found mainly in sub-Saharan Africa, but because the disease is highly contagious, the WHO considers it a potential global threat. The virus is originally transmitted to people from animals, including fruit bats, porcupines and nonhuman primates. It then spreads through direct contact with the blood or bodily fluids of someone who is sick with, or died from, EVD. The average fatality rate of the virus is 50%. There is no evidence of transmission of the Ebola virus by mosquitoes or other insects.
Symptoms can appear from two days to three weeks after infection. The disease typically begins with bodily aches and pains, often including a sore throat or severe headache, accompanied by a fever. Weakness, fatigue, intestinal pain and vomiting are also possible. Some patients experience hemorrhaging, bleeding or bruising, which gave the disease its original name of Ebola hemorrhagic fever.
Health care workers and others tending to patients with EVD, and laboratory workers dealing with the bodily fluids of an infected individual, are at highest risk of contracting the disease. The disease is also easily transferred to family and friends in close contact with someone who is sick, or even with the surfaces and materials the infected person contaminated. There is no cure for EVD at this time. Since its discovery in 1976, the largest outbreak of EVD occurred from 2014 to 2016; more than 11,000 people died in Guinea, Liberia and Sierra Leone.
The new vaccine, which protects against the Zaire species of Ebola, had been in limited use on a "compassionate basis" during the most recent outbreak of the disease in the Democratic Republic of Congo. It has been reported to be more than 97% effective at preventing infection. Still, more than 3,000 cases have been reported, included several in Uganda.
Thanks to the recent bureaucratic green light, nations most at risk of an outbreak will soon begin to receive the vaccine for distribution. The pharmaceutical company Merck reports that it has donated more than 250,000 doses of the vaccine for use by the WHO. With the vaccine now fast-tracked by the FDA, manufacture of the drug is expected to begin in the fall of 2020.
Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health.