Journal Club
26th September 2018
Ebola Update
Hello Everyone,
I was going to suggest reviewing the Ebola outbreak in the North West of the Democratic Republic of Congo a couple of months ago, but I bumped it to make way for other interesting topics that people were kind enough to present.
At that time it was a (fairly) good news story as the outbreak was quickly brought under control, using lessons learned from the West African epidemic (1) and by vaccinating some 3400 people, allowing the outbreak to be declared over with 53 cases and 29 deaths. (2)
Shortly afterwards, another outbreak was declared, this time in the Kivu district in the North East of the DRC, which is ongoing. The difference with this outbreak is that it takes place against the backdrop of an ongoing conflict in the area, which is near the Ugandan and Rwandan borders. The conflict has been fought since 2004 between the DRC military, Tutsi forces, a Hutu group, an Islamist militia, a group calling themselves The National Congress for the Defence of the People and a 21000 strong UN peacekeeping force. As well as the fighting a “range of conspiracy theories” concerning Ebola, the DRC government and the United Nations are being spread as propaganda. (3) The outbreak has been confirmed to be caused by the same strain as in the north-west and as of 21st September there are 116 confirmed cases, 99 deaths and 1641 contacts (DRC Ministry of Public Health).
We talked about the vaccine being used (rVSVDG-ZEBOV-GP) which, although as yet unlicensed, is the most advanced candidate. It seems to offer very good protection, but with some side effects (there is a viral arthritis associated with it, but I can’t remember where I read that and don’t know any more details). It’s proving a useful tool in breaking the chain of infection, but work is only just starting on what to measure to judge how long the protection will last. (4)
Along these lines, a signature group of five plasma proteins mediated by monocytes appears to be useful in gauging rVSVDG-ZEBOV-GP effectiveness. (5) is a link to the paper and (6) is a link to a friendlier to read article about the paper.
Jackie was kind enough to share a link (7) to a UK Public Health Rapid Support Team (UK-PHRST) whose role will be to monitor infectious diseases and other hazards globally, offering advice and help to mitigate threats in their early stages, as well as being prepared to deploy a response made up of core personnel and a reservist team, already trained to standards and protocols.
Many thanks, that was an enjoyable discussion. If you click on the list below, the links should take you to the appropriate articles.
Ade.
