Ebola: What US Clinicians Need to Know

Robert Glatter, MD

Disclosures

August 04, 2014

In This Article

Limited Treatments for Ebola

At this time, only supportive care is available (intravenous fluids; blood and platelet transfusions), although upcoming human vaccine trials may be promising.

The National Institutes of Health will begin a human vaccine trial in September 2014, according to recent statements from Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID). Previous attempts at a human vaccine in the early 2000s were not successful.[3]

The current vaccine, developed by the NIAID Vaccine Research Center, contains no infectious Ebola virus material. It is actually a chimpanzee adenovirus vector vaccine that has incorporated 2 Ebola virus genes. Adenovirus vectors are useful delivery models as vaccines because the virus can be easily manipulated. As a nonreplicating viral vector, the vaccine works by entering a cell and delivering the new genetic material. The new genes that are inserted cause a protein to become expressed, which in turn produces an immune response in the body. According to NIAID, the vaccine has shown early promise in a primate model.

Another approach to help infected patients involves transfusing blood or plasma from those patients who have recently recovered from Ebola virus infection. This approach is based on the premise that the plasma from recovered patients contains life-saving antibodies. This is an experimental treatment that has been used, according to recent reports during this epidemic, although results of such treatment have not been formally reported.

Use of an experimental compound, referred to as BCX4430, was reported in the journal Nature in April 2014.[4] The compound, an RNA-dependent RNA polymerase inhibitor, has proven successful in a nonhuman primate model, whereby postexposure prophylaxis to BCX4430 prevented death in 17 of 18 macaques studied. No human trials have yet been reported.

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