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Race, Ethnicity, Research, and the Ebola Virus: An Analysis

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Erica Janz

on 8 May 2015

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Transcript of Race, Ethnicity, Research, and the Ebola Virus: An Analysis

Ebolavirus
Introduction
Social Injustices
Large gaps between rich and poor within African countries
Poor living conditions*
Weak health care system*
Rich receive best care; poor receive little to none care
Vaccine Outlook
Few candidate vaccines that are going through testing

Since discovery
, cumulative total of approximately
885,343
suspected and confirmed clinical cases and
7,718
confirmed deaths
Highly virulent (
50% to 90%
) virus
Belongs to the viral family
Filoviridae
Reservoir = unknown, but potentially fruit bats
Enters through mucous membranes, breaks in the skin, or parenterally via blood and body fluids from other infected people
5 different strains:
Zaire
ebolavirus
(ZEBOV)*
Sudan
ebolavirus
(SEBOV)*
Côte d’Ivoire
ebolavirus
Bundibugyo
ebolavirus
(BDBV)*
Reston
ebolavirus
(REBOV)
Race, Ethnicity, Research, and Ebola: An Analysis of Why There is Still No Vaccine
History of Ebola Outbreaks
Clinical Signs
Appear 2-21 days
Average time =
8-10 days
Early signs (non-specific):
Fever
Chills
Myalgias
Malaise
So why is there no vaccine or therapeutic drug against this highly lethal disease?
Pharmaceutical
Profitability
Lengthy Process and its consequences
The Good, the Bad,
& the Unjust
Questions?
References
Later signs (approximately 5 days after onset):
Severe watery diarrhea (+/- blood)
Nausea
Vomiting (+/- blood)
Abdominal Pain
Late signs:
Multi-organ failure
Shock
Death
Current Ebola Outbreak
As of April 30th, there were
26, 333
reported cases and
10,907
deaths
*
Social Injustices
Now imagine these countries dealing with a virus that can spread like wild fire
The result is the 2014 Ebola outbreak
However, prior to 2014...
Outbreaks only occurred in remote, small villages in Africa
Never spread to large cities or to another continent
The scientific community and world has short-attention span with their concern
Until current outbreak, they were actively ignoring the Ebola-related deaths
Base their decisions on which drugs will be the most profitable
Hypertension, cancer, and AIDS research =
profitable
Ebolavirus
research and its associated vaccine or drug profitable
Pharmaceutical companies hold power
Decide which research will receive grant money
Decides which drugs will be made
Only affects a
small population
in
Africa
- mainly
developing
countries
Vaccine only
used once
Average time from research to distribution =
10-15 years
Therefore, even if a vaccine or drug that was found to be successful, it would not even be FDA approved for another 10 years minimum
However, some drugs can be fast tracked (10 months)
Is it safe to fast track a drug?
Not enough time to test for toxicity or efficacy
Hoping for the best despite deathly side effects
Many experimental drugs are being used in current Ebola outbreak
Understandable, but...
Again, hoping for the best despite deathly side effects
Preferentially being given out*
Select few white Americans
NOT the many Africans suffering
Only the most successful so far are being fast-tracked by FDA
Hopefully approved by the end of 2015

Two most successful candidate vaccines =
ChAd3-ZEBOV
and
rVSV-ZEBOV
ChAd3-ZEBOV
Killed version of a chimpanzee adenovirus, which contains the gene for EVD surface protein
rVSV-ZEBOV
Attenuated form of an animal virus (
V
esicular
S
tomatitis
V
irus), which carries a non-infectious segment of the Ebola virus genome
Vaccine Outlook
1. Ebola Outbreak: Ebola’s Patient Zero. Prod. PBS. New York Times Company. N.p., 28 Dec. 2014. Web. 28 Apr. 2015.
2. Goeijenbier, M., et al. "Ebola Virus Disease: A Review on Epidemiology, Symptoms, Treatment and Pathogenesis." The Netherlands Journal Of Medicine 72.9 (2014): 442-48. Print.
3. Peters, C. J., and J. W. Peters. "An Introduction to Ebola: The Virus and the Disease." Journal of Infectious Diseases 179.Supplement 1 (1999): ix-xvi. Print.
4. Rajak, Harish, et al. "Ebola Virus Disease: Past, Present and Future." Asian Pacific Journal of Tropical Biomedicine 5.5 (2015): 337-43. Print.
5. Shears, P., and T. J. D. O'Dempsey. "Ebola Virus Disease in Africa: Epidemiology and Nosocomial Transmission." Journal of Hospital Infection 90.1 (2015): 1-9. Print.
6. Centers for Disease Control and Prevention. "Ebola Virus Disease (EVD) Information for Clinicians in U.S. Healthcare Settings." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 01 Apr. 2015. Web. 28 Apr. 2015.
7.Centers for Disease Control and Prevention. "Signs and Symptoms." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 02 Nov. 2014. Web. 28 Apr. 2015.
8. Public Health Agency of Canada. "Ebolavirus." Public Health Agency of Canada. Public Health Agency of Canada, 22 Aug. 2014. Web. 28 Apr. 2015.
9. H Feldmann, TW Geisbert, PB Jahrling, HD Klenk, SV Netesov, CJ Peters, et al. Filoviridae. C Fauquet, MA Mayo, M Maniloff, U Desselberger, LA Ball (Eds.), Virus taxonomy: VIIIth report of the international committee on taxonomy of viruses, Elsevier/Academic Press, London (2004), pp. 645–653
10. Groseth, A., H. Feldmann, and J. E. Strong. "The Ecology of Ebola Virus." Trends Microbiol 15.9 (2007): 408-16. Print.
11. Towner, Jonathan S. et al. “Newly Discovered Ebola Virus Associated with Hemorrhagic Fever Outbreak in Uganda.” Ed. Christopher F. Basler. PLoS Pathogens 4.11 (2008): e1000212. PMC. Web. 7 May 2015.
12. Mohajan, Haradhan Kumar. "The Most Fatal 2014 Outbreak of Ebolavirus Disease in Western Africa." American Journal of Epidemiology and Infectious Disease 2.4 (2014): 101-08. Print.
13. Centers for Disease Control and Prevention. "2014 Ebola Outbreak in West Africa - Outbreak Distribution Map." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 04 May 2015. Web. 29 Apr. 2015.
14. Baize, Sylvain, et al. "Emergence of Zaire Ebola Virus Disease in Guinea." New England Journal of Medicine 371.15 (2014): 1418-25. Print.
15. Schwartz, Daniel. "Worst-ever Ebola Outbreak, by the Numbers." CBC News. The CBC, 16 Sept. 2014. Web. 29 Apr. 2015.
16. Centers for Disease Control and Prevention. "2014 Ebola Outbreak in West Africa." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 21 Apr. 2015. Web. 29 Apr. 2015.
17. Chothia, Farouk. "Ebola Drains Already Weak West African Health Systems."BBC. BBC, 24 Sept. 2014. Web. 29 Apr. 2015.
18. Hongoltz-Hetling, Matt. "When Science, Faith Clash: In Sierra Leone, a Deadly Gap Between Ritual and Medical Practices." Pulitzer Center on Crisis Reporting. N.p., 26 Apr. 2015. Web. 30 Apr. 2015.
19. Horowitz, Evan. "How the Ebola Outbreak Spun out of Control." The Boston Globe. N.p., 08 Oct. 2014. Web. 30 Apr. 2014.
20. World Health Organization. "Ebola Virus Disease." World Health Organization. N.p., Apr. 2015. Web. 06 May 2015.
21. Surowiecki, James. "Ebolanomics." The New Yorker. N.p., 25 Aug. 2014. Web. 01 May 2015.
22. Tambo, Ernest, Emmanuel Chidiebere Ugwu, and Jeane Yonkeu Ngogang. "Need of Surveillance Response Systems to Combat Ebola Outbreaks and Other Emerging Infectious Diseases in African Countries." Infectious Diseases Of Poverty 3 (2014): 1-7. Print.
23. U.S. Food and Drug Administration. "The FDA's Drug Review Process: Ensuring Drugs Are Safe and Effective." U.S. Food and Drug Administration. N.p., 06 Nov. 2014. Web. 04 May 2015.
24. California Biomedical Research Association. New Drug Development Process. N.p.: California Biomedical Research Association, 2015. Print.
25. Gupta, Sanjay, MD, and Danielle Dellorto. "Experimental Drug Likely Saved Ebola Patients." CNN. CNN, 05 Aug. 2014. Web. 4 May 2015.
26. Mapp Bio. ZMAPP™ FAQ. N.p.: Mapp Bio, 2014. Print.
27. Wikipedia. "List of Ebola Patients." Wikipedia. Wikimedia Foundation, 17 Apr. 2015. Web. 07 May 2015.
28. Institute of Medicine (US) Forum on Microbial Threats. "Toward Preparedness: Opportunities and Obstacles." The Threat of Pandemic Influenza: Are We Ready? Workshop Summary (2005): n. pag. Toward Preparedness: Opportunities and Obstacles. U.S. National Library of Medicine, 2005. Web. 04 May 2015. <http://www.ncbi.nlm.nih.gov/books/NBK22157/>.
29. World Health Organization. "Ebola Vaccines, Therapies, and Diagnostics."World Health Organization. N.p., 17 Mar. 2015. Web. 04 May 2015.
30. Kieny, Marie-Paule, MD. From Research to Large-scale Use. N.p.: World Health Organization, 2014. Print.
31. World Health Organization. "Ebola Vaccine Chosen for Planned Guinea Clinical Trial." World Health Organization. N.p., Mar. 2015. Web. 04 May 2015.
References
Other candidate vaccines that are going through Phase I and II clinical trials*
Ad26-EBOV & MVA-EBOV
Recombinant influenza candidate Ebola vaccine
Oral adenovirus platform
Alternative vesicular stomatitis virus candidate
Alternative recombinant protein
DNA vaccine
Recombinant rabies vaccine
*
**
Full transcript