How U.S. ‘Noah’s Ark’ Offers World Hope Over Ebola Virus
Over a decade ago, Emory University Hospital built its serious communicable disease unit. But it faced its share of doubters then. At a ti...
http://www.africaeagle.com/2014/08/how-us-noahs-ark-offers-world-hope-over.html?m=0
Over a decade ago, Emory University Hospital built its serious communicable disease unit. But it faced its share of doubters then. At a time when the threat of infectious diseases in the United States (U.S.) seemed to have receded—replaced by worries over conditions like obesity and type-2 diabetes—the centre appeared unnecessary.
But last week, when Emory got word that two Americans were infected with Ebola and would need to be evacuated from West Africa, health experts were all too glad the unit existed.
“I have to admit, a lot of people saw this as Noah’s Ark,” says Dr. Bruce Ribner, the infectious disease specialist at Emory University Hospital leading the care of the American patients with Ebola virus. “They thought, ‘You are not going to have any activity there, you’re just wasting your time with all that.”
Now, Ribner is fielding an average of 100 emails a day from hospitals here and abroad seeking consultations, and there’s a caravan of news vans seemingly permanently parked along the sidewalk in front of the hospital, with news crews braving the thick Georgia heat in pitched tents on the grass.
“When news of the patients finally came, we said, ‘This is what we’ve been preparing for, for 12 years,” Ribner says in an interview with TIME. Indeed, the infectious disease team caring for the patients with Ebola have been practising the process of receiving and treating patients with serious diseases—like Ebola, SARS or anthrax—about two times a year every year since 2002, when it created its programme and isolation unit with the help of the CDC.
Dr. Alexander Isakov, who helped get the patients from their landed flight to the isolation room, remembers first hearing the news and thinking: Here’s a chance to finally activate all that they had been preparing for, to help people get better. “It’s gratifying,” he says.
Treating the patients
Though Emory’s isolation unit was created with this precise type of health emergency in mind, experts stress that nearly all American hospitals are equipped and prepared to receive a patient suspected to have contracted Ebola. When both patients were moved from the ambulance into the hospital, choppers ahead captured footage of the full-body protective suits with air purifying respirators that were worn by the team. Emory says it’s trying to re-message the idea that physicians need to dress in what some are calling “moon suits” to care for a patient.
“Of course the message goes out that you have to dress like some sort of space person,” says Ribner. “Which is an unfortunate message.” The CDC recommends that anyone entering a patient with Ebola’s room wear at least gloves, a gown, eye protection and a face mask, with the acknowledgement that depending on the amount of fluids being excreted, more may be needed. The hospital agrees with this advice, and Ribner says his nurses felt more comfortable wearing the full-body suits. One of the features of Ebola virus infection is diarrhea. “One [reason from our nurses] was just pragmatic: I don’t want my shoes full of feces. The other was, ‘You know what? These are kind of comfortable,” says Ribner.
(The patients at Emory have requested privacy, but one released a statement Saturday saying he was getting “stronger every day.”)
Now that more cases of Ebola are spreading in Lagos, a highly trafficked city in Nigeria, the possibility for more patients in the U.S. is not out of the realm of possibility. “If we had to accept other Ebola patients—and we’ve been in contact about possibly doing that—we could do it,” said Dr. G. Marshall Lyon, one of the Emory physicians treating the patients with Ebola. Lyon says the unit also has a contract with the CDC to handle their employees, should any of them be exposed to serious communicable diseases.
A new age of infectious diseases
While Ebola is new in the U.S., it’s not a novel virus and health experts remain confident that the outbreak will eventually subside. Still, the current Ebola outbreak, the deadliest in history, begs the question: Is the U.S. prepared for other infectious and even unknown, emerging diseases?
“We live in a world where we are all connected by the air we breathe, the water we drink, the food we eat, and by airplanes that can bring disease from anywhere to anywhere in a day,” says CDC Director, Dr. Tom Frieden.
“That’s why it’s so important to strengthen global health security and work with countries all around the world so they can do a better job finding threats.” (In recent months, the CDC experienced two lapses in lab safety that raised skepticism about protection oversight, to which Frieden assures, “We blew the whistle on ourselves and began a comprehensive and aggressive programme to address lab-safety here.”)
In his opinion, the U.S. is facing three threats when it comes to emerging disease: new infections and organisms spreading in different places; drug-resistant bacteria; and intentionally created organisms. “Those risks require us to put in place robust systems,” he says.
Lyon says he remembers reading an article about 20 years ago stating the age of infectious disease was over. It couldn’t have been more wrong. “The bugs have evolved and kept us on our toes,” he says. “We have to deal with things like tuberculosis and measles having a resurgence.”
In 2009, H1N1 emerged as an influenza virus with little known about its transmission or how virulent it was. Ribner says, “We were really lucky” it wasn’t more lethal. “Do I foresee down the road that we could have a more virulent influenza strain? We’ve had them in the past, so yeah, we could,” he says. “Would we handle it? We would handle it as best we could.”
Learning on the job
Having two patients with Ebola under treatment in the U.S. not only gives them a better shot at life, but it grants doctors the opportunity to learn something. “We have the unique opportunity to look at a disease that we don’t usually see here,” Dr. Aneesh Mehta, the Emory physician who had what he calls the “honor” to be the first doctor to receive an Ebola patient into the isolation room. “For these two patients, if they agree to participate in research down the road, we will be able to really look in-depth at the pathogenesis and the immunological response to Ebola in ways that can’t be done in Africa.”
Mehta says the drills at Emory—as well as the attention being paid to the effectiveness of governmental responses to this pathogen—will help experts better understand how to take care of patients in the larger context of our health care system. “We can teach other health care systems and physicians not only here in the United States, but throughout the world because our processes seem to be working quite well.”
The Emory team is working 24/7 to neutralise the disease in the two infected Americans, and while it’s uncomfortable to be faced with the dark consequences of our interconnectedness, it’s comforting to know that for over a decade, despite questioning, highly trained specialists have been watching our backs.
Patients in isolation recovering in Lagos
Besides, an alleged recovery of some patients from Ebola may have doused the fear that an infection with the virus ultimately condemns one to death.
A cheery account of recuperation of some patients of Ebola Virus Disease (EVD) who have been placed under quarantine at Mainland Hospital Yaba, Lagos, came from the Director of Communication and Community Mobilisation at the Nigeria’s Emergency Operations Centre on EVD, Prof. Adebayo Onajole, at the weekend.
In a telephone interview with The Guardian yesterday, he declared: “Most of them are recovering and some are getting out of quarantine.”
But the fear of the virus continues to make Nigerian officials at the nation’s gateways to be cautious in their dealings with those coming into or leaving the country.
GSK set for clinical trial
Another source of hope for Ebola patients emerged yesterday as British drug-maker, GlaxoSmithKline (GSK) is set to start a clinical trial of an experimental vaccine against the deadly Ebola virus. GSK is co-developing the product with U.S. scientists.
According to a report yesterday by Reuters, GSK’s experimental vaccine has already produced promising results in animal studies involving primates and it is now due to enter initial phase one testing in humans, pending approval from the U.S. Food and Drug Administration.
A company spokeswoman said yesterday that the trial should get underway “later this year”, while GSK’s partner the U.S. National Institute of Allergy and Infectious Diseases (NIAID) said in a statement on its website it would start “as early as fall 2014”, implying a potential September launch of testing.
Even if is fast-tracked, however, and emergency procedures are put in place, the new vaccine could not be ready for widespread deployment before 2015 - even assuming it works as well as hoped.
“It is right at the beginning of the development journey and still has a very long way to go,” the GSK official said, declining to be drawn on a possible timeline for launch.
Meanwhile, a Nigerian man, who was quarantined after he showed Ebola-like symptoms while travelling to Hong Kong has tested negative for the deadly virus.
According to a report yesterday by Agence France Presse (AFP), the southern Chinese city government said in a statement yesterday that the man, 32, had “tested negative for Ebola virus upon preliminary laboratory testing”.
“In the past one month... he had no contact history with sick persons or animals and did not visit health-care facilities. He is currently in stable condition,” a government spokesman said in the statement.
The man arrived in Hong Kong from Lagos, Nigeria’s most populous city, via Dubai on Thursday and was hospitalised yesterday after vomiting and having diarrhoea.
Onajole said although the country had done very well and better than other West African countries in containing the virus, it could have done better with stronger emergency preparedness.
He denied a rumour that the husband and children of the matron who was the first victim of the virus in the country are on the run and might be spreading the disease in the process.
According to Onajole, EVD is not a death sentence and with early report and treatment more people may survive.
Disturbed by the outbreak of the disease, the Pharmaceutical Society of Nigeria (PSN) has challenged pharmaceutical and scientific researchers to respond to this public health concern through intense research and development to identify a vaccine to prevent it.
President, PSN, Olumide Akintayo, told The Guardian yesterday that the society’s research and study group in recent reviews had discovered that some previous work had been conducted: high-titeredhyperimmune horse anti-Ebola serum has been protective in baboons experimentally challenged with the virus; monoclonal antibodies from the marrow of Ebola survivors; a potential, promising vaccine that offered considerable protection against Ebola to guinea pigs; and in mice used as a model for Ebola infections, a series of nucleoside analogue inhibitors of S-adenosylhomocysteine hydrolase provided protection against Ebola-Zaire when administered within two days of Ebola-Zaire infection.
Onajole said: “From our projection we are doing well because looking at projection from other countries like Guinea, Liberia, Sierra Leone and so on we are expected to have had many more cases that we are having and so that shows that what we are doing is good.
“Part of the problem is that our emergency preparedness has not been at its peak all along and one thing about emergency preparedness is that it is in all sectors not just the health sector. We are also trying to increase awareness among frontline health care providers because they are primarily exposed because of the fact that if they do not have an index suspicion, they did not maintain what we call the basic universal safety precaution, which under normal circumstances should have been done.”
On what the government is doing to stop the spread of the virus, Onajole said: “Currently, index cases that have been identified are already isolated, contacts are being traced and most of them have been quarantined. We have also started community awareness and part of it is what you hear on jingles, in radio, television to increase awareness. If and when there is misinformation we rapidly progress to correct such misinformation and we are working tirelessly to try and contain the explosion.”
Ebola not death sentence
On the rumour that the husband and children of the matron who died of the virus are on the run, Onajole said: “I am not aware of that, most of them have been quarantined, I can assure you, so we don’t have such cases. One of the things the press should assist us in trying to explain to the public is that even in those that are exposed we only have two deaths. But if you go and look at other countries we would have had several deaths. So if they are monitored and treated early enough that fatality rate is very low.”
Is Ebola a death sentence? Onajole said: “What I can say to you is that even those cases we have identified as contacts only very few of them have come down with the disease. So one of those things we are trying to do is that people try to put in a lot of basic preventive measures, which include personal hygiene- washing of hand with soap, the virus is very fragile. Wash your hand with detergent even if you are exposed.
“People should avoid things like getting in contact with dead bodies. People should report early enough to the surveillance team or health facility. As I told you a lot of those who are under isolation and receiving treatment are still doing very well. So it does not automatically lead to death.”
On how many Nigerians have so far died of the virus, he said: “So far it is only one Nigerian that has died of the virus and that person had direct contact with the index case,” he said.
He added that those under surveillance were doing well but that he could not offer “statistics now.”
According to Akintayo, three companies, the United States (U.S.) government and the Public Health Agency of Canada are behind the experimental drug, ZMapp.
He explained: “ZMapp was first identified as a drug candidate in January 2014 and has not yet been evaluated for safety in humans. As such, very little of the drug is currently available.
“Promoters of ZMapp and their partners are co-operating with appropriate government agencies to increase production as quickly as possible.
“ZMapp is a drug still in its experimental stage being produced by Mapp Biopharmaceuticals in collaboration with LeafBio (San Diego, CA), Defyrus Inc. (Toronto, Canada), the U.S. government and the Public Health Agency of Canada (PHAC). This drug is composed of three humanised monoclonal antibodies manufactured in plants, specifically the plant Nicotiana which is commonly used in tobacco production. Genes of the necessary antibodies are fused to the tobacco genes, infecting the tobacco with the virus. The plant then produces wanted antibodies that are subsequently separated from the plant when it is ground up. The body’s immune system can vigilantly fight off the virus once the antibodies from the serum are present in the blood system.
“The treatment offers an artificial immune response to the virus, and the lab-made antibodies then fight the infection by binding to the Ebola virus. Since it is still in the experimental stage, it has not yet been tested in humans for safety or effectiveness and more study is needed.
“ZMapp is not a vaccine and is being designed solely for treatment of the Ebola disease; however the NIH (National Institute of Health) in the U.S. is currently working on developing a vaccine. It is also supporting the Crucell biopharmaceutical company in its development of an Ebola/Marburg vaccine as well as Profectus Biosciences in its development of an Ebola vaccine.
“Additionally, NIH and the Thomas Jefferson University are collaborating to develop a candidate Ebola vaccine based on the established rabies vaccine. Zmapp has yet to enter Phase 1 testing but has shown some success in treating Dr Kent Brantley and Nancy Writebol who contracted the virus while working in Africa. Although neither patient is cured each has shown considerable improvement in their condition.
“The FDA has recently authorised the use of a diagnostic test for Ebola developed by the department of defence called the DoD EZ1 Real time RT-PCR Assay to help determine if aid workers and responders are infected. Until experimental drugs pass clinical trials and are available for human treatment the best treatment for individuals infected with the virus is supportive care. This includes providing fluids, maintaining blood pressure, providing oxygen as needed, replacing lost blood and treating other infections that develop.”
Lifestyle changes at Seme border
Visits to the Seme border and the Murtala Muhammed International Airport, Lagos, show caution on part of officers who screen immigrants on their arrival at the gateways.
Immigration officers at the Murtala Muhammed Airport are jittery over the virus. They are afraid that they might become victims since they are the first officers to have contact with immigrants.
A source at the airport said: “Honestly we are afraid of this disease. No one is safe here, we just depend on God. Our men and other officers that work here are really afraid.”
A resident of Seme who spoke to The Guardian at the weekend said: “We have not recorded any incident of Ebola here but everyone of us is afraid of the spread, so we are careful. We don’t shake people anymore, we are now more conscious about our personal hygiene. Our lifestyle here has changed because no one wants to die.”
The Immigration Controller in charge of Seme Border, Comptroller Domyil Barko told The Guardian that his officers were on the alert at the gateway to ensure it was checked.
Barko, who took over the command recently said: “On my arrival, I met an elaborate arrangement. The joint security Forces at Seme Border summoned the traditional rulers, the chiefs, members of Motorcycle Riders Association and others to enlighten them on the danger of the Ebola virus and how to prevent it. Port health team delivered a keynote address stressing the danger of the disease. So far, no case has been recorded but we are at alert.
“We have acquired hand gloves and other kits for our personnel to keep them safe. We all appealed to the Nigeria Customs to provide us with an accommodation so that any victim discovered would be quarantined there before the Federal Ministry of Health can take over. We intend to sustain the sensitisation programme. We have started by organising a campaign and we would continue to make sure that our border is safe.”
Customs Area Controller in charge of Seme border, Comptroller Willy Egbudin, who is the head of the Joint Security Forces at Seme border had hosted an enlightenment campaign attended by residents, traditional rulers and other stakeholders at the border where he urged everyone to be conscious of insecurity and the Ebola virus.
The Joint Border Security meeting is an umbrella body of all security agencies operating at the border. They comprise the Nigeria Customs Service, Nigeria Immigration Service, Nigerian Army (242 Battalion and 15 FER), Nigerian Navy, Department of State Security, Nigeria Police Border Patrol, Nigeria Immigration Service Border Patrol, National Drug Law Enforcement Agency, Federal Road Safety Corps and Standard Organization of Nigeria (SON).
Others include the Seme Division of Nigeria Police, Badagry Division of Nigeria Police, National Food and Drug Administration Control, Port Health Services and Nigeria Agricultural Quarantine Service. While each of the security agencies carries out its specific mandate, the Joint Border Security meeting provides the framework for co-operation and exchange of intelligence needed to drive the Federal Government’s transformation on security.
Egbudin said: “The global travelling and trading system has in recent times been vulnerable to criminal and terrorist attacks and if left unchecked could seriously affect nations and the global economic system. Seme border, unarguably the busiest border in West Africa and strategically located in between the two commercial cities of Lagos and Cotonou plays host to a large number of these travellers and traders.
“As the increase in legitimate trade and travel across the frontier comes with a lot of economic advantage, it is accompanied also with smuggling and other cross-border crimes. It is therefore in the light of the foregoing that the security agencies at this border have been collaborating for a co-coordinated management of Seme border security.
“To achieve this, we have been liaising also with our counterparts in the Republic of Benin to curb cross-border crimes. Investigation over time revealed that a major catalyst in these cross- border crimes could be traced to the means of transportation which in this case involves the use of motorcycles/tricycles.”
Source: The Guardian
But last week, when Emory got word that two Americans were infected with Ebola and would need to be evacuated from West Africa, health experts were all too glad the unit existed.
“I have to admit, a lot of people saw this as Noah’s Ark,” says Dr. Bruce Ribner, the infectious disease specialist at Emory University Hospital leading the care of the American patients with Ebola virus. “They thought, ‘You are not going to have any activity there, you’re just wasting your time with all that.”
Now, Ribner is fielding an average of 100 emails a day from hospitals here and abroad seeking consultations, and there’s a caravan of news vans seemingly permanently parked along the sidewalk in front of the hospital, with news crews braving the thick Georgia heat in pitched tents on the grass.
“When news of the patients finally came, we said, ‘This is what we’ve been preparing for, for 12 years,” Ribner says in an interview with TIME. Indeed, the infectious disease team caring for the patients with Ebola have been practising the process of receiving and treating patients with serious diseases—like Ebola, SARS or anthrax—about two times a year every year since 2002, when it created its programme and isolation unit with the help of the CDC.
Dr. Alexander Isakov, who helped get the patients from their landed flight to the isolation room, remembers first hearing the news and thinking: Here’s a chance to finally activate all that they had been preparing for, to help people get better. “It’s gratifying,” he says.
Treating the patients
Though Emory’s isolation unit was created with this precise type of health emergency in mind, experts stress that nearly all American hospitals are equipped and prepared to receive a patient suspected to have contracted Ebola. When both patients were moved from the ambulance into the hospital, choppers ahead captured footage of the full-body protective suits with air purifying respirators that were worn by the team. Emory says it’s trying to re-message the idea that physicians need to dress in what some are calling “moon suits” to care for a patient.
“Of course the message goes out that you have to dress like some sort of space person,” says Ribner. “Which is an unfortunate message.” The CDC recommends that anyone entering a patient with Ebola’s room wear at least gloves, a gown, eye protection and a face mask, with the acknowledgement that depending on the amount of fluids being excreted, more may be needed. The hospital agrees with this advice, and Ribner says his nurses felt more comfortable wearing the full-body suits. One of the features of Ebola virus infection is diarrhea. “One [reason from our nurses] was just pragmatic: I don’t want my shoes full of feces. The other was, ‘You know what? These are kind of comfortable,” says Ribner.
(The patients at Emory have requested privacy, but one released a statement Saturday saying he was getting “stronger every day.”)
Now that more cases of Ebola are spreading in Lagos, a highly trafficked city in Nigeria, the possibility for more patients in the U.S. is not out of the realm of possibility. “If we had to accept other Ebola patients—and we’ve been in contact about possibly doing that—we could do it,” said Dr. G. Marshall Lyon, one of the Emory physicians treating the patients with Ebola. Lyon says the unit also has a contract with the CDC to handle their employees, should any of them be exposed to serious communicable diseases.
A new age of infectious diseases
While Ebola is new in the U.S., it’s not a novel virus and health experts remain confident that the outbreak will eventually subside. Still, the current Ebola outbreak, the deadliest in history, begs the question: Is the U.S. prepared for other infectious and even unknown, emerging diseases?
“We live in a world where we are all connected by the air we breathe, the water we drink, the food we eat, and by airplanes that can bring disease from anywhere to anywhere in a day,” says CDC Director, Dr. Tom Frieden.
“That’s why it’s so important to strengthen global health security and work with countries all around the world so they can do a better job finding threats.” (In recent months, the CDC experienced two lapses in lab safety that raised skepticism about protection oversight, to which Frieden assures, “We blew the whistle on ourselves and began a comprehensive and aggressive programme to address lab-safety here.”)
In his opinion, the U.S. is facing three threats when it comes to emerging disease: new infections and organisms spreading in different places; drug-resistant bacteria; and intentionally created organisms. “Those risks require us to put in place robust systems,” he says.
Lyon says he remembers reading an article about 20 years ago stating the age of infectious disease was over. It couldn’t have been more wrong. “The bugs have evolved and kept us on our toes,” he says. “We have to deal with things like tuberculosis and measles having a resurgence.”
In 2009, H1N1 emerged as an influenza virus with little known about its transmission or how virulent it was. Ribner says, “We were really lucky” it wasn’t more lethal. “Do I foresee down the road that we could have a more virulent influenza strain? We’ve had them in the past, so yeah, we could,” he says. “Would we handle it? We would handle it as best we could.”
Learning on the job
Having two patients with Ebola under treatment in the U.S. not only gives them a better shot at life, but it grants doctors the opportunity to learn something. “We have the unique opportunity to look at a disease that we don’t usually see here,” Dr. Aneesh Mehta, the Emory physician who had what he calls the “honor” to be the first doctor to receive an Ebola patient into the isolation room. “For these two patients, if they agree to participate in research down the road, we will be able to really look in-depth at the pathogenesis and the immunological response to Ebola in ways that can’t be done in Africa.”
Mehta says the drills at Emory—as well as the attention being paid to the effectiveness of governmental responses to this pathogen—will help experts better understand how to take care of patients in the larger context of our health care system. “We can teach other health care systems and physicians not only here in the United States, but throughout the world because our processes seem to be working quite well.”
The Emory team is working 24/7 to neutralise the disease in the two infected Americans, and while it’s uncomfortable to be faced with the dark consequences of our interconnectedness, it’s comforting to know that for over a decade, despite questioning, highly trained specialists have been watching our backs.
Patients in isolation recovering in Lagos
Besides, an alleged recovery of some patients from Ebola may have doused the fear that an infection with the virus ultimately condemns one to death.
A cheery account of recuperation of some patients of Ebola Virus Disease (EVD) who have been placed under quarantine at Mainland Hospital Yaba, Lagos, came from the Director of Communication and Community Mobilisation at the Nigeria’s Emergency Operations Centre on EVD, Prof. Adebayo Onajole, at the weekend.
In a telephone interview with The Guardian yesterday, he declared: “Most of them are recovering and some are getting out of quarantine.”
But the fear of the virus continues to make Nigerian officials at the nation’s gateways to be cautious in their dealings with those coming into or leaving the country.
GSK set for clinical trial
Another source of hope for Ebola patients emerged yesterday as British drug-maker, GlaxoSmithKline (GSK) is set to start a clinical trial of an experimental vaccine against the deadly Ebola virus. GSK is co-developing the product with U.S. scientists.
According to a report yesterday by Reuters, GSK’s experimental vaccine has already produced promising results in animal studies involving primates and it is now due to enter initial phase one testing in humans, pending approval from the U.S. Food and Drug Administration.
A company spokeswoman said yesterday that the trial should get underway “later this year”, while GSK’s partner the U.S. National Institute of Allergy and Infectious Diseases (NIAID) said in a statement on its website it would start “as early as fall 2014”, implying a potential September launch of testing.
Even if is fast-tracked, however, and emergency procedures are put in place, the new vaccine could not be ready for widespread deployment before 2015 - even assuming it works as well as hoped.
“It is right at the beginning of the development journey and still has a very long way to go,” the GSK official said, declining to be drawn on a possible timeline for launch.
Meanwhile, a Nigerian man, who was quarantined after he showed Ebola-like symptoms while travelling to Hong Kong has tested negative for the deadly virus.
According to a report yesterday by Agence France Presse (AFP), the southern Chinese city government said in a statement yesterday that the man, 32, had “tested negative for Ebola virus upon preliminary laboratory testing”.
“In the past one month... he had no contact history with sick persons or animals and did not visit health-care facilities. He is currently in stable condition,” a government spokesman said in the statement.
The man arrived in Hong Kong from Lagos, Nigeria’s most populous city, via Dubai on Thursday and was hospitalised yesterday after vomiting and having diarrhoea.
Onajole said although the country had done very well and better than other West African countries in containing the virus, it could have done better with stronger emergency preparedness.
He denied a rumour that the husband and children of the matron who was the first victim of the virus in the country are on the run and might be spreading the disease in the process.
According to Onajole, EVD is not a death sentence and with early report and treatment more people may survive.
Disturbed by the outbreak of the disease, the Pharmaceutical Society of Nigeria (PSN) has challenged pharmaceutical and scientific researchers to respond to this public health concern through intense research and development to identify a vaccine to prevent it.
President, PSN, Olumide Akintayo, told The Guardian yesterday that the society’s research and study group in recent reviews had discovered that some previous work had been conducted: high-titeredhyperimmune horse anti-Ebola serum has been protective in baboons experimentally challenged with the virus; monoclonal antibodies from the marrow of Ebola survivors; a potential, promising vaccine that offered considerable protection against Ebola to guinea pigs; and in mice used as a model for Ebola infections, a series of nucleoside analogue inhibitors of S-adenosylhomocysteine hydrolase provided protection against Ebola-Zaire when administered within two days of Ebola-Zaire infection.
Onajole said: “From our projection we are doing well because looking at projection from other countries like Guinea, Liberia, Sierra Leone and so on we are expected to have had many more cases that we are having and so that shows that what we are doing is good.
“Part of the problem is that our emergency preparedness has not been at its peak all along and one thing about emergency preparedness is that it is in all sectors not just the health sector. We are also trying to increase awareness among frontline health care providers because they are primarily exposed because of the fact that if they do not have an index suspicion, they did not maintain what we call the basic universal safety precaution, which under normal circumstances should have been done.”
On what the government is doing to stop the spread of the virus, Onajole said: “Currently, index cases that have been identified are already isolated, contacts are being traced and most of them have been quarantined. We have also started community awareness and part of it is what you hear on jingles, in radio, television to increase awareness. If and when there is misinformation we rapidly progress to correct such misinformation and we are working tirelessly to try and contain the explosion.”
Ebola not death sentence
On the rumour that the husband and children of the matron who died of the virus are on the run, Onajole said: “I am not aware of that, most of them have been quarantined, I can assure you, so we don’t have such cases. One of the things the press should assist us in trying to explain to the public is that even in those that are exposed we only have two deaths. But if you go and look at other countries we would have had several deaths. So if they are monitored and treated early enough that fatality rate is very low.”
Is Ebola a death sentence? Onajole said: “What I can say to you is that even those cases we have identified as contacts only very few of them have come down with the disease. So one of those things we are trying to do is that people try to put in a lot of basic preventive measures, which include personal hygiene- washing of hand with soap, the virus is very fragile. Wash your hand with detergent even if you are exposed.
“People should avoid things like getting in contact with dead bodies. People should report early enough to the surveillance team or health facility. As I told you a lot of those who are under isolation and receiving treatment are still doing very well. So it does not automatically lead to death.”
On how many Nigerians have so far died of the virus, he said: “So far it is only one Nigerian that has died of the virus and that person had direct contact with the index case,” he said.
He added that those under surveillance were doing well but that he could not offer “statistics now.”
According to Akintayo, three companies, the United States (U.S.) government and the Public Health Agency of Canada are behind the experimental drug, ZMapp.
He explained: “ZMapp was first identified as a drug candidate in January 2014 and has not yet been evaluated for safety in humans. As such, very little of the drug is currently available.
“Promoters of ZMapp and their partners are co-operating with appropriate government agencies to increase production as quickly as possible.
“ZMapp is a drug still in its experimental stage being produced by Mapp Biopharmaceuticals in collaboration with LeafBio (San Diego, CA), Defyrus Inc. (Toronto, Canada), the U.S. government and the Public Health Agency of Canada (PHAC). This drug is composed of three humanised monoclonal antibodies manufactured in plants, specifically the plant Nicotiana which is commonly used in tobacco production. Genes of the necessary antibodies are fused to the tobacco genes, infecting the tobacco with the virus. The plant then produces wanted antibodies that are subsequently separated from the plant when it is ground up. The body’s immune system can vigilantly fight off the virus once the antibodies from the serum are present in the blood system.
“The treatment offers an artificial immune response to the virus, and the lab-made antibodies then fight the infection by binding to the Ebola virus. Since it is still in the experimental stage, it has not yet been tested in humans for safety or effectiveness and more study is needed.
“ZMapp is not a vaccine and is being designed solely for treatment of the Ebola disease; however the NIH (National Institute of Health) in the U.S. is currently working on developing a vaccine. It is also supporting the Crucell biopharmaceutical company in its development of an Ebola/Marburg vaccine as well as Profectus Biosciences in its development of an Ebola vaccine.
“Additionally, NIH and the Thomas Jefferson University are collaborating to develop a candidate Ebola vaccine based on the established rabies vaccine. Zmapp has yet to enter Phase 1 testing but has shown some success in treating Dr Kent Brantley and Nancy Writebol who contracted the virus while working in Africa. Although neither patient is cured each has shown considerable improvement in their condition.
“The FDA has recently authorised the use of a diagnostic test for Ebola developed by the department of defence called the DoD EZ1 Real time RT-PCR Assay to help determine if aid workers and responders are infected. Until experimental drugs pass clinical trials and are available for human treatment the best treatment for individuals infected with the virus is supportive care. This includes providing fluids, maintaining blood pressure, providing oxygen as needed, replacing lost blood and treating other infections that develop.”
Lifestyle changes at Seme border
Visits to the Seme border and the Murtala Muhammed International Airport, Lagos, show caution on part of officers who screen immigrants on their arrival at the gateways.
Immigration officers at the Murtala Muhammed Airport are jittery over the virus. They are afraid that they might become victims since they are the first officers to have contact with immigrants.
A source at the airport said: “Honestly we are afraid of this disease. No one is safe here, we just depend on God. Our men and other officers that work here are really afraid.”
A resident of Seme who spoke to The Guardian at the weekend said: “We have not recorded any incident of Ebola here but everyone of us is afraid of the spread, so we are careful. We don’t shake people anymore, we are now more conscious about our personal hygiene. Our lifestyle here has changed because no one wants to die.”
The Immigration Controller in charge of Seme Border, Comptroller Domyil Barko told The Guardian that his officers were on the alert at the gateway to ensure it was checked.
Barko, who took over the command recently said: “On my arrival, I met an elaborate arrangement. The joint security Forces at Seme Border summoned the traditional rulers, the chiefs, members of Motorcycle Riders Association and others to enlighten them on the danger of the Ebola virus and how to prevent it. Port health team delivered a keynote address stressing the danger of the disease. So far, no case has been recorded but we are at alert.
“We have acquired hand gloves and other kits for our personnel to keep them safe. We all appealed to the Nigeria Customs to provide us with an accommodation so that any victim discovered would be quarantined there before the Federal Ministry of Health can take over. We intend to sustain the sensitisation programme. We have started by organising a campaign and we would continue to make sure that our border is safe.”
Customs Area Controller in charge of Seme border, Comptroller Willy Egbudin, who is the head of the Joint Security Forces at Seme border had hosted an enlightenment campaign attended by residents, traditional rulers and other stakeholders at the border where he urged everyone to be conscious of insecurity and the Ebola virus.
The Joint Border Security meeting is an umbrella body of all security agencies operating at the border. They comprise the Nigeria Customs Service, Nigeria Immigration Service, Nigerian Army (242 Battalion and 15 FER), Nigerian Navy, Department of State Security, Nigeria Police Border Patrol, Nigeria Immigration Service Border Patrol, National Drug Law Enforcement Agency, Federal Road Safety Corps and Standard Organization of Nigeria (SON).
Others include the Seme Division of Nigeria Police, Badagry Division of Nigeria Police, National Food and Drug Administration Control, Port Health Services and Nigeria Agricultural Quarantine Service. While each of the security agencies carries out its specific mandate, the Joint Border Security meeting provides the framework for co-operation and exchange of intelligence needed to drive the Federal Government’s transformation on security.
Egbudin said: “The global travelling and trading system has in recent times been vulnerable to criminal and terrorist attacks and if left unchecked could seriously affect nations and the global economic system. Seme border, unarguably the busiest border in West Africa and strategically located in between the two commercial cities of Lagos and Cotonou plays host to a large number of these travellers and traders.
“As the increase in legitimate trade and travel across the frontier comes with a lot of economic advantage, it is accompanied also with smuggling and other cross-border crimes. It is therefore in the light of the foregoing that the security agencies at this border have been collaborating for a co-coordinated management of Seme border security.
“To achieve this, we have been liaising also with our counterparts in the Republic of Benin to curb cross-border crimes. Investigation over time revealed that a major catalyst in these cross- border crimes could be traced to the means of transportation which in this case involves the use of motorcycles/tricycles.”
Source: The Guardian
