Ebola News Roundup

• "Ebola outbreak grows by 6 in DRC"--CIDRAP.

       According to the World Health Organization (WHO) online Ebola dashboard, the DRC confirmed 6 more Ebola cases yesterday, raising the overall outbreak total to 2,793. Health officials are still investigating 396 suspected cases. Only one new death has been recorded in the past 2 days, raising the fatality total to 1,867.

      In its weekly outbreak overview yesterday the WHO noted 257 cases in the last 21 days, or an average of 86 cases per week in the past 6 weeks. The majority of recent cases have come from Beni (46%) and Mandima (23%).

      "Substantial rates of transmission continue within outbreak affected areas of North Kivu and Ituri provinces, with demonstrated extension to new high-risk areas and across borders in recent months, although without sustained local transmission in these areas," the WHO said the Disease Outbreak News update.

     No new cases have been recorded in Goma. As of Aug 3, all 256 contacts related to the first confirmed case in Goma Health Zone finished their 21-day follow up period. Of the four total cases reported in that city, two patients have died and two are currently being treated in an Ebola treatment center. Almost all contacts (98%) in that city have been vaccinated.

     Health workers continue to become infected with the deadly virus.

     "In the last 21 days, 14 new cases were reported among health workers from Mandima (5), Beni (4), and one each in Katwa, Mambasa, Masereka, Oicha, and Vuhovi. Cumulatively, 149 (5% of all cases) healthcare workers have been infected to date," the WHO said.

• "The CDC shut down an Army lab that’s working on an Ebola vaccine"--Army Times. The U.S. Army Medical Research of Institute of Infectious Diseases at Fort Detrick, Maryland, was shutdown due to violations found in June by the Centers for Disease Control and Prevention, and will remain so until the violations are fixed and it is re-instated with the Federal Select Agents Program, which allowed it to handle dangerous biological specimens.
• "GSK ends development of Ebola vaccine, hands work to U.S. institute"--Reuters. British drugmaker GlaxoSmithKline is giving up its work on developing three potential vaccines against the deadly Ebola and Marburg viruses because there is no money in it, but will transfer the vaccines (by which, I presume, they mean the intellectual property and research) to the Sabin Vaccine Institute in Washington, D.C.
• "Uganda Starts Largest-Ever Ebola Vaccine Trial"--Voice of America. From the article: "The experimental Johnson & Johnson vaccine will be administered to health care professionals, as well as ambulance drivers, burial teams and cleaners. The trial is expected to last two years and cover 800 people in the Mbarara district in southwest Uganda." The article also reports that "There are no licensed treatments for Ebola, but one vaccine, manufactured by Merck, was used effectively at the end of the 2013-2016 outbreak in the DRC and has been used during the current epidemic. Over 180,000 people have received this vaccine." The need for a different vaccine may be because the current strain differs from that in the 2013-2016 outbreak.
• "We must redouble efforts to tackle the underlying sources of Ebola"--Gulf News. David Malpass, president of the World Bank Group, says that the only way to effectively eliminate Ebola is to continue to pour money into Africa to raise natives out of poverty. Something, I would add, that we've been doing for decades without success.
• "Is Ebola Evolving Into a More Deadly Virus?"--The New Yorker. Some key information to understand the current outbreak:

This July, the World Health Organization declared that an outbreak of Ebola in the provinces of Ituri and North-Kivu, in the eastern Democratic Republic of the Congo, was a “public health emergency of international concern.” This particular strain of the virus, which first appeared in the region in 2018 and hasn’t been given a formal name—I’ll call it Kivu Ebola—is a variant of a species known as the Zaire Ebola virus. As of last Saturday, 2,753 cases of Kivu Ebola have been reported, with 1,843 deaths. There appear to be many undiscovered cases in the region, too. Ella Watson-Stryker, a social scientist with Doctors Without Borders, who has been studying the outbreak, said that around half of all Ebola patients admitted to treatment centers in eastern Congo aren’t part of any known chain of transmission. In other words, the infected person has caught Ebola from somebody whom disease investigators haven’t yet identified. “A lot of transmission is not being seen, but nobody knows the exact amount,” Watson-Stryker told me.

(Underline added). However, the main subject of the article is how easy it is for the virus to mutate. The author explains:

     An Ebola particle is a very small, filament-shaped object, made of six different structural proteins. Ebola’s genetic code, or genome, is contained in a strand of ribonucleic acid, or RNA, that is coiled tightly in the core of the particle. The genome, which has some nineteen thousand letters in it, holds the master designs of Ebola’s proteins.

      RNA viruses—which range from Ebola to measles and influenza— tend to produce errors, or mutations, in their code when they copy themselves. Most mutations are either bad for the virus or have no effect on it. Every now and then, however, a virus gets a mutation that benefits it. In fact, the production of errors during copying plays an important role in the long-term survival of viruses. As time goes by and the virus makes inaccurate copies of itself, slightly different varieties of the virus arise. The different varieties are called lineages. ...

       Considered as a life-form, the Kivu Ebola isn’t a single organism but, rather, an immense swarm of particles that jumps from victim to victim. Each particle in the swarm possesses a biological drive to copy itself. As the particles copy themselves, they compete with all the other particles for survival. Ebola particles copy themselves every eighteen hours. This is the generation time of the virus—the time it takes for a particle of Ebola to get inside a human cell and potentially create thousands of identical copies of itself in the cell. The copies then exit the infected cell and drift into the bloodstream, infecting more cells. Early in the disease, Ebola patients tend to get sicker in downward lurches. In some patients, the lurches are spaced roughly eighteen hours apart, as each new generation of particles floods the body. An infected person’s bodily fluids are lethally infectious, because they are filled with Ebola particles. If some of those particles get into new people, the virus spreads.

     By now, the Kivu Ebola swarm has been going through its eighteen-hour replication cycle in humans for more than a year. Some virologists wonder whether Kivu Ebola could start evolving, or whether it has already started to evolve, in a way that makes it more dangerous to people—perhaps by becoming more contagious, in which case it would get much harder to control. ...

Read the whole thing.