Ebola Drug Therapies
Vanderbilt University researchers have partnered with Mapp Biopharmaceutical Inc. to develop their new human antibody therapies to provide short-term protection for people exposed to the deadly Ebola and Marburg viruses. These hemorrhagic filoviruses kill, in part, by causing massive bleeding.
The San Diego-based company has developed an experimental treatment, called ZMapp, which contains antibodies manufactured in plants. ZMapp has prevented lethal disease in rhesus monkeys but has not yet been tested for safety and efficacy in humans. At Vanderbilt, researchers are using a high-efficiency method to isolate and generate large quantities of human antibodies from the blood of people who have survived Ebola and Marburg infections and are now healthy. No live virus is used in the research.
“We’re the only lab in the world that has a high-efficiency human hybridoma technique for isolating human monoclonal antibodies,” explained James Crow, Jr., MD. He said Vanderbilt has been isolating antibodies to major human pathogens to better understand the basic science of immunity.
“However, with the current urgent medical need for treatments for Ebola infection, we are thrilled to be working with Mapp Biopharmaceutical to produce the antibodies we have discovered as antiviral drugs that may benefit patients and healthcare workers facing this terrible epidemic," Crowe said.
Notes from the TDH
Last month, Tennessee Department of Health Commissioner John Dreyzehner, MD, MPH, FACOEM, led a media briefing regarding the state’s level of preparedness and response to Ebola.
While stressing there had been no confirmed or suspected cases of the deadly virus in Tennessee, Dreyzehner said should the need arise, “We’re confident we can provide patient care and mitigate transmission to others.”
He added the TDH had been providing guidance to hospitals and facilities for several months … not only on Ebola but on MRSA and other contagions, as well. “In addition, we’ve been encouraging hospitals to conduct response exercises.”
Dreyzehner noted, “Fear, mistrust and stigma are really thriving with this epidemic.” For that reason, he said it was critically important that healthcare providers and media outlets help the public understand the facts about Ebola including that it can’t be spread through the air, by mosquitos, in the water and typically not through food. Instead, it is spread through bodily fluids or on items grossly contaminated by bodily fluids, such as a needle. “Ebola cannot live long outside the human body and is easily killed by common disinfectants,” he said.
Asymptomatic patients and those who have recovered from the disease are not a public health threat. However, once someone shows symptoms, Dreyzehner said the viral load increases as the person becomes sicker. While the incubation period is generally three weeks, days 8-10 are often the time when symptom onset occurs. Some individuals have taken longer than 21 days to test positive for the virus, and Dreyzehner said it appears people are capable of transmitting Ebola for about 90 days through semen.
Since bodily fluids can transmit through open wounds or through the eyes, nose, mouth and skin, it is critically important for healthcare providers to protect themselves. “The most basic thing we can do is washing our hands,” Dreyzehner said. “We touch our faces about 16 times and hour,” he added to emphasize the importance of killing germs through proper hand-washing protocols.
Equally, he said, healthcare providers need to be sure to follow the specific order of putting on and taking off personal protective equipment (PPE). “I know as a healthcare provider myself, we don’t always put as much attention as we should on putting on and taking off personal protective equipment,” Dreyzehner said. “Let he who has never snapped their glove in the trashcan cast the first aspersion,” he added wryly.
Recently, the CDC (cdc.gov) updated PPE guidelines to more closely match protocols in place by Doctors Without Borders, which has a successful history of fighting Ebola and other contagious diseases around the world.
On home soil, Dreyzehner lauded the depth and breadth of public health experience in the state. “I have great confidence in Tennessee’s ability to respond to this or any other threat,” he concluded.
HCA’s Gift
In late September, HCA made a $1 million cash donation to the CDC Foundation’s Global Disaster Response Fund to help support international Ebola response efforts involving the CDC and their work with partners on the ground in West Africa.
HCA has a long history of supporting relief efforts including those following the earthquake in Haiti, the Indonesian tsunami, Hurricane Katrina and Typhoon Haiyan in the Philippines. The donated funds will be used to provide much-needed supplies and equipment to aid workers including personal protective equipment, infection control tools, ready-to-eat meals, generators, exit screening tools and supplies at airports such as thermal scanners to detect fever.
“Ebola continues to spread rapidly in West Africa, and CDC and others have made it clear that the window of opportunity to contain the virus is closing quickly,” said R. Milton Johnson, president and CEO of HCA. “The time to act is now, and we strongly encourage other companies, particularly those in the healthcare industry, to join us in this important effort to save lives.”
Waller Launches Ebola Legal Resource Site
In late October, Waller Lansden Dortch & Davis, LLP announced the launch of a comprehensive online resource to help healthcare leaders and other organizations impacted by the Ebola virus navigate diverse issues pertaining to the arrival of the virus in the United States. The website can be accessed at EbolaLegalResource.com.
“The immediate and long-term legal implications of the Ebola virus on all facets of hospital, clinic and practice management must be seriously considered,” said Mark Peters, a partner in Waller's Labor and Employment practice who works extensively with healthcare employers. “Waller’s Ebola legal resource website comes in response to the many questions we’ve received from clients. Preparation in this situation is important, whether an Ebola patient walks through your doors or if you are simply dealing with the climate it has created.”
The site launched with a compilation of media articles, links to outside resources, and original articles from Waller attorneys including:
The Role of Healthcare Employers during the Ebola Crisis,
Patient Privacy Concerns,
FAQs on Employee Discipline, Discrimination & Harassment,
Workers' Compensation for those Contracting Ebola, and more.
The site, which will be updated as new information becomes available and is analyzed, is tailored to healthcare executives, board members, risk managers, human resources professionals and others who are asking what Ebola means, from a legal perspective, for their organization, employees and patients.
THA Statement
“With confirmed cases of Ebola in the United States, including cases among healthcare workers, hospitals across the country are on high alert. Tennessee’s hospitals are certainly no exception,” Craig Becker, president and CEO of the Tennessee Hospital Association, said in a statement last month.
“For the past several weeks, THA has worked with the Tennessee Department of Health and all hospitals in the state to ensure proper readiness should a case or cases of Ebola be identified in one of our state’s hospitals. These preparations include special exercises and drills for putting on and removing personal protective equipment, as well as identifying, diagnosing and isolating a potential Ebola patient.
“Preparations in our hospitals are focused on a single goal – ensuring patients and healthcare workers are protected and safe. High quality care is a hallmark of Tennessee’s hospitals, and the safety of hospital environments is always a top priority, not just during a public health crisis,” he said.
Becker added that citizens are understandably concerned about the evolving Ebola situation. However, he continued, “We should not succumb to fear of the unknown. THA and hospitals across the state will continue to work with healthcare professionals who have worked with this terrible disease to learn best practices and ensure these practices are in place at our state’s hospitals.”
RELATED LINKS:
AMA’s Ebola Resource Center for Clinicians
Tennessee Department of Health