FOR A CURE
Antidote to Ebola could lie in recovered sufferers
With no proven drugs to treat Ebola and experimental ones in short supply, health authorities are planning to turn to a treatment walking around in the outbreak zone in west Africa. This would be the blood of people who have recovered from Ebola. Their blood should contain antibodies that might help other patients fight off the infection.
The World Health Organisation (WHO) is prioritising trials of such convalescent blood, or plasma, and is talking to the affected countries about how to do it.
This week, the organisation issued guidance on how to collect the blood and administer transfusions.
But plausibility is not proof that such treatments would work and some virologists doubt it will. They note that the results of studies in monkeys were discouraging.
There will also be logistical problems doing this in west Africa, where blood banks are not well developed. One challenge will be to ensure the donated blood, even if it helps patients recover from Ebola, does not give them HIV or hepatitis.
“Major questions need to be answered about the safety and efficacy of convalescent therapies, and the feasibility of implementation in countries with shattered health systems and an acute shortage of medical staff,” said the WHO.
Still, with the epidemic spiralling out of control, there is a sense that some treatment needs to be offered, even if only to give sick people hope and a reason to go to medical centres, where they can be stopped from spreading the disease to others. There really are no other good options. “The attraction, at least on the surface, is it is something that could be implemented readily,” said Dr Daniel Bausch, an expert on Ebola at Tulane University. The Bill & Melinda Gates Foundation and the Wellcome Trust are among the organisations championing convalescent plasma and working on how to put it into effect.
“Blood is donated in west Africa every day of the week for surgery and other things, and could be safely tested for viruses,” said Dr Jeremy Farrar, the director of the Wellcome Trust.
Such therapies have already been used in the outbreak. Dr Kent Brantly, a US aid worker who contracted Ebola in Liberia, received a blood transfusion from a boy who had recovered.
After Brantly survived his bout with the disease, some of his plasma was given to another US aid worker, Dr Rick Sacra, who also recovered.
But it is not known if the transfusions helped in those cases since both men also received experimental drugs and excellent supportive care in US hospitals.
Authorities say transfusions have been used in Africa, but to a limited extent. There have even been rumours of a black market for the blood of survivors.
The use of blood or plasma dates from the late 1800s and for decades was a mainstay of treatment for infectious diseases.
Such treatments are still used for rabies, snakebite, hepatitis A and B, and other diseases. But for some viral diseases, like hepatitis C and HIV, it has not been shown to work.
Many treatments used today are made by pooling the plasma of donors and processing it to get high concentrations of the antibodies. This is probably not going to be feasible in Africa because of a lack of technology and the large-scale facilities requires to do it, say executives in the plasma products industry.
The simplest approach would be to use whole blood donated by one person and transfused into another. That has some risk of side effects although not much if the blood types of the donor and recipient match.
– The New York Times
EVIDENCE A copy of the end user certificate signed by Nigeria’s national