An­ti­dote to Ebola could lie in re­cov­ered suf­fer­ers

CityPress - - News -

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

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