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Out of Africa — Caring for Patients with Ebola

NEW ENGLAND JOURNAL OF MEDICINE                                                                  Nov. 12, 2014

Eric J. Rubin, M.D., Ph.D., and Lindsey R. Baden, M.D.

The Journal has now published detailed clinical information about three patients transferred from West Africa to the United States or Germany in the midst of their illness.

See detais of the treatment

http://www.nejm.org/doi/full/10.1056/NEJMe1412744

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Doctors Without Borders will begin Ebola drug studies by December in Africa

USA TODAY                                         Nov. 12, 2014
by Liz Sazbo

Doctors Without Borders will begin clinical trials of three experimental Ebola therapies in West Africa in December, the aid group announced Wednesday.

The studies, to be conducted at the group's treatment centers in Guinea and Liberia, will test therapies already used in some Ebola patients in the USA and Europe: the antiviral drugs brincidofovir and favipiravir, as well as blood donations from Ebola survivors.

Brincidofovir, made by Chimerix of North Carolina, was given to cameraman Ashoka Mukpo, Liberian national Thomas Eric Duncan and physician Craig Spencer. Mukpo and Spencer survived. Duncan received the drug just a couple days before he died.

Favipiravir, an anti-flu drug made by Japan's Fujifilm Holding Corp., was given to a French nurse who worked with Doctors Without Borders.

And blood donations from Ebola survivors, which contain antibodies against the virus, have been used since the first Ebola outbreak in 1976.

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http://www.usatoday.com/story/news/nation/2014/11/12/ebola-clinical-trial/18919401/

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For Ebola, don't forget lessons from the AIDS epidemic

THE HILL                                                          Nov. 12, 2014
Commentary by Claire Pomeroy, M.D., M.B.A, President of the Albert and Mary Lasker Foundation.

...Without a commitment by Congress to fund basic medical research, the lives of millions are put at risk, along with the nation’s economic and national security. Outbreaks of deadly viruses – including AIDS or Ebola – have shown us the costs of not remaining vigilant.

  So how much funding is enough? It’s time for us to have that national conversation once again. We do not know what the superbugs of tomorrow will look like. But we do know that novel pathogens will emerge or existing ones will mutate, and that as global travel and migration inexorably increase, disease knows no border. It is time for us to stop chasing at AIDS and Ebola from behind, and take stock of our capacity to commit.

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Fujifilm says tests results on Avigan as Ebola drug by end-2014

REUTERS                                                 Nov. 11, 2014
By Ayai Tomisawa and Reiji Murai

TOKYO--Fujifilm Holdings Corp said it expects its influenza drug Avigan to be approved by international government bodies to treat Ebola after it receives clinical test results as early as the end of the year.

Tablets of Avigan (generic name : Favipiravir), a drug approved as an anti-influenza drug in Japan and developed by drug maker Toyama Chemical Co, a subsidiary of Fujifilm Holdings Co. are displayed during a photo opportunity at Fujifilm's headquarters in Tokyo October 22, 2014. Credit: Reuters/Issei Kato

Fujifilm has been growing its pharmaceutical division through a series of mergers and acquisitions as its photography business wanes. In 2008, it bought Toyama Chemical Co, whose drug Avigan has been drafted to the global fight against Ebola.

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Medical Experts Look For New Ways To Test Ebola Drugs

NPR                                             Nov. 11, 2014
By Richard Harris

Medical experts are meeting today and tomorrow at the World Health Organization in Geneva to figure out how to test potential Ebola drugs in Africa. In addition to determining which experimental drugs should be the highest priority, the experts are sorting through some difficult ethical issues.

In short, they're trying to figure out how to design tests that will provide the fastest and most trustworthy answers — and yet minimize the need for comparison groups who won't be offered the experimental treatments.

Nurses assist a new patient at an Ebola center in Liberia's Lofa County. As drug trials get underway, patients may receive experimental medicines. photo by Trenchard/NPR

Practice in the United States has set an unrealistic standard. When American health care workers fell ill with Ebola in Africa, they flew home and received medical care vastly better than what Africans were getting, including experimental therapies.

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Is The Response in Liberia Succeeding? Positive indications

NEW ENGLAND COMPLEX SYSTEMS INSTITUTE                                                                        Oct. 27, 2014
ABSTRACT
By Kia Hall and Yaneer Bar-Yam
The number of cases of Ebola in West Africa has been growing exponentially, and projections assume that this dynamic will continue. However, recent case reports from Liberia indicate a change. The number of new confirmed cases reported by WHO has actually diminished for five weeks in a row.
The WHO report suggests that this may be due to underreporting under conditions of high levels of stress of the number of cases taking place.

Here we report that there appears to be a sound reason for the decreasing number of cases—a change in response strategy that is working. Understanding this dynamic is of critical importance for addressing the outbreak in Sierra Leone and Guinea. In particular the number of cases in Sierra Leone continues to grow exponentially.

Discussions with a WHO response coordinator in Liberia indicates that a change in strategy from individual reporting and contact tracing to community based screening for early detection and population wide behavior change happened in mid September.

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Harnessing artificial intelligence to search for new Ebola treatments

HOMELAND SECURITY NEWS WIRE                                                                             Nov.6, 2014

The University of Toronto, Chematria, and IBM are combining forces in a quest to find new treatments for the Ebola virus.

Using a virtual research technology invented by Chematria, a startup housed at U of T’s Impact Center, the team will use software that learns and thinks like a human chemist to search for new medicines. Running on Canada’s most powerful supercomputer, the effort will simulate and analyze the effectiveness of millions of hypothetical drugs in just a matter of weeks.

“What we are attempting would have been considered science fiction, until now,” says Abraham Heifets, a U of T graduate and the chief executive officer of Chematria. “We are going to explore the possible effectiveness of millions of drugs, something that used to take decades of physical research and tens of millions of dollars, in mere days with our technology.”

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Exclusive: U.S. Ebola researchers plead for access to virus samples

A transmission electron micrograph shows Ebola virus particles in this undated handout image released by the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) in Fredrick, Maryland. Credit: Reuters/USAMRIID/Handout

Image: A transmission electron micrograph shows Ebola virus particles in this undated handout image released by the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) in Fredrick, Maryland. Credit: Reuters/USAMRIID/Handout

reuters.com - November 5th 2014 - Julie Steenhuysen

Scientists across the United States say they cannot obtain samples of Ebola, complicating efforts to understand how the virus is mutating and develop new drugs, vaccines and diagnostics.

The problems reflect growing caution by regulators and transport companies about handling Ebola as well as the limited resources of West African countries which are struggling to help thousands of infected citizens.

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Infection Secrets of Ebola Explained

By attacking the body's first responders, the virus cripples the immune system before it can mount an effective defense

Researchers often describe the battle between the Ebola virus and the humans it occasionally infects as a race—one that people win only if their immune systems manage to pull ahead before the virus destroys too many of their internal defenses. What they may not know is that the virus is a cheat.

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US Officials Unveil Plan to Test Ebola Drugs

NEW ORLEANS --The quest for an Ebola treatment is picking up speed. Federal officials have unveiled a plan to test multiple drugs at once, in an umbrella study with a single comparison group to give fast answers on what works.

"This is novel for us" and is an approach pioneered by cancer researchers, said Dr. Luciana Borio, head of the U.S. Food and Drug Administration's Ebola response. "We need to learn what helps and what hurts" and speed treatments to patients, she said.

She outlined the plan Wednesday at an American Society of Tropical Medicine and Hygiene conference in New Orleans....

Everyone in the umbrella study would get supportive care, such as intravenous fluids, then be assigned to receive one of several drugs or be in a comparison group. That's needed because without one, there's no way to know if any problems or deaths are from the drug or the disease, Cox said....

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