ScienceMag.org is reporting that the World Health Organization (WHO) is currently contemplating using "Convalescent Serum" (blood) from Ebola survivors to treat Ebola patients.
As the Ebola outbreaks rages on in West Africa, the World Health Organization (WHO), desperate for a way to help infected people, is reconsidering a potential Ebola treatment tried as far back as 1976, after the first documented outbreak of the deadly viral disease: using the blood of people who have recovered from an infection to treat those still fighting the virus.
"Convalescent serum is high on our list of potential therapies and has been used in other outbreaks (e.g. in China during SARS)", WHO said in a written statement. "There is a long history of its use, so lots of experience of what needs to be done, what norms and standards need to be met."
The Ebola virus has sickened at least 2,127 people and killed 1,145 of them in Sierra Leone, Guinea, Liberia, and Nigeria. Those numbers may "vastly underestimate the magnitude of the outbreak", WHO warned on Thursday. It is already the largest Ebola outbreak ever recorded.
The treatment with Convalescent Serum isn't the no-brainer that some might suppose.
There have been tests in the past, after the first outbreak in 1976 (one patient who survived) and after the 1995 outbreak (8 patients, 7 survived). Subsequent analysis revealed that these patients would have likely survived anyway as they were well on their way to recovery before getting the transfusion.
Monkey studies in 2007 found no benefit from the treatment.
The ScienceNews article goes on to cover problems with the blood based treatment, from worries of HIV and Hepatitis C transmission, reluctance to donate, and uncertainty of efficacy.
The WHO's own public statement on the issue is still taking a cautious approach, and recommending prevention rather than experimental treatment except for "compassionate care" (translation: where chances of recovery are bleak).
WHO again warns about the risk of handling corpses that we discussed here on SN:
The Ebola virus is highly contagious but only under very specific conditions involving close contact with the bodily fluids of an infected person or corpse. Most infections have been linked to traditional funeral practices or the unprotected care, in homes or health facilities, of an infected person showing symptoms.
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Liberia is staggering under the plague of Ebola, with the death toll rising daily. Treating the sick and dying is risky work for medical professionals. But dealing with the dead is even more risky.
The Washington Post reports that those who bury the bodies face an even greater risk, because the bodies are more contagious than the living patients.
"When the person has just died, that is when the body is most contagious," WHO spokesperson Tarik Jasarevic told The Post on Thursday. "It's when the virus is overtaking the whole body."
In addition to physically handling the body, some of which are found lying in the streets for days, burial workers, many of them untrained in biological containment, have to wash down everything [pdf] in bleach, including the vehicles, the suites and the areas where bodies are found.
Religious burial traditions often get in the way. Some villages refuse to let doctors in, threatening them with knives and stones according to an earlier New York Times article. They continue to handle their dead with traditional Muslim manual washing, even as entire families are infected. People appear to have more confidence in witch doctors.
(Score: 1) by AnonTechie on Monday August 18 2014, @12:03PM
If there is no evidence that this works, why would anybody recommend such procedures ?
Albert Einstein - "Only two things are infinite, the universe and human stupidity, and I'm not sure about the former."
(Score: 1) by nyder on Monday August 18 2014, @12:29PM
seems better then using leeches?
(Score: 4, Interesting) by MrGuy on Monday August 18 2014, @02:36PM
Because:
a.) it is a technique that HAS worked to some degree with other analogous diseases, so it's at least plausible that this MIGHT work.
b.) there are dozens-to-hundreds of people currently dying of this disease.
c.) the death rate from this disease is such that it's unlikely a useless or even negative effect from a possible treatment is worse than doing nothing.
d.) no one has a better idea right now.
e.) the amount of time to get a proper double-blind controlled clinical trial of ANY proposed treatment to ebola renders it useless to the people dying right now.
There's a lot of bad policy made and bad medicine that's been done when "we have to do SOMETHING!" trumps "we have to use actual science, not guesswork!" There have been terrible pop-science "cures" and even counter-productive treatments utilized.
But this really feels like one of the few cases (a 90% fatal disease outbreak) where there's really not a lot of downside risk to trying something risky and unproven that MIGHT help.
(Score: 2) by dublet on Monday August 18 2014, @03:32PM
I suppose the theory is based on normal vaccine doctrine in that helping the body to cope with a weak version of the vius aids in the production of anti bodies that can kill the real thing. I'm too lazy to RFA but they probably extract the anti bodies from the donated blood, not just injecting the blood from people who are cured.
It does seem like a bit late, if you already have the virus, it's surely too late for anti bodies to be injected?
"If anyone needs me, I'm in the angry dome. [dublet.org]"
(Score: 1) by Adamsjas on Monday August 18 2014, @04:21PM
I did RTFA, and its not clear that they were extracting antibodies. Seems like whole blood. The theory isn't to help veru sick people build antibodies (too late as you said), but rather to supply blood already full of what ever is has successfully fought off the ebola. Its the natural equivelent of the MAPP drug used to tread the two americans.
(Score: 3, Informative) by Joe on Tuesday August 19 2014, @01:02AM
Serum is basically whole blood with all the cells removed. People who recently fought-off an infection will probably have plenty of antibodies directed against the pathogen that could help slow the progression of the recipient's disease.
A problem with serum is that it will still contain any viruses (HIV, HCV, etc.) that were in the donor's blood and they may be able to infect the recipient.
(Score: 1, Informative) by Anonymous Coward on Monday August 18 2014, @05:31PM
http://www.bbc.co.uk/news/world-africa-28827091 [bbc.co.uk]
Looting of an Ebola treatment center, taking away sick people because "there is no Ebola" is not going to make the situation any better. What is needed is basic education here, not "survivor blood".
(Score: 2) by MrGuy on Monday August 18 2014, @05:44PM
Why exactly can't it be the case that we can provide BOTH "basic education" AND a possible treatment vector that might be beneficial (though has yet to prove to be so)?
There's no either/or here. We need to get the epidemic under control. Both better education and better treatment are necessary to achieve that goal. Neither approach forecloses the other.
(Score: 2) by Joe on Tuesday August 19 2014, @01:14AM
I'm not sure if the best way to handle this is by using needles. There is plenty of distrust already and injecting untested (I'm assuming since it would probably be to expensive to test) serum from one person (with any viruses they have) to another may make things worse. Also, using needles would provide another opportunity for the virus to spread more easily (at least to health professionals).
Gloves, face shields, and other protective gear for those handling the sick would probably be more effective. Treating people with serum would be useful to researchers, but I'm not sure it will make things much better for those that are sick.
(Score: 2) by kaszz on Monday August 18 2014, @08:48PM
What the parent wrote about probably is the cause of many problems in Africa. Western nations didn't get advancement until we got rid of those beliefs.
Otoh, perhaps it's not a good idea to prevent Darwin evolution to do it's crude work. People with a clue deal with the disease in a rational manner, the other dies.
(Score: 2) by Joe on Tuesday August 19 2014, @01:26AM
Western nations still haven't gotten rid of all those types of beliefs.
Viruses don't care who they infect and these patients don't deserve to die from hemorrhagic fever. I'm pretty sure medical science has increased diversity (allowing people to pass on their genes when they might have died of smallpox or something else) which is actually great for the survival of a species.
P.S. Darwin's trademark on "evolution" expired long ago and the theory has progressed quite a bit since it became public domain (you don't need to give him credit every time you write the word).
(Score: 2) by kaszz on Tuesday August 19 2014, @02:51AM
The western society has got rid of most of the flawed beliefs enough. There will not be any 100% in this universe.
How much risk and future problems is it worth to support with limited resources people act in a way that threaten the existence and peace of the society at large? If a village insist on lethal burial rituals then perhaps they should be allowed to do that but also prevented from taking other villages with them.
(Score: 3, Informative) by kaszz on Monday August 18 2014, @09:18PM
"Even if the therapy works, there are challenges. One is the risk of infecting patients with other pathogens such as HIV or hepatitis C. Getting blood from recovered patients in the first place may also be a problem, Bausch says."
Blood transmitted diseases is going to be a major culprit in Africa. In Guinea where the Ebola epidemic started 1.4% is infected with HIV, Liberia 1.0%, Sierra-Leone 1.6%.[1] The Hepatitis-C infection rate is circa 3.5%. [3] So considering that Ebola kills 50 - 90% of infected people. [2] The 1.3% chance of HIV and 3.5% of Hepatitis-C is at least reasonable. If one can test quick enough for HIV and Hepatitis-C then one might actually have scored a useful treatment with reasonable side effects.
[1] http://www.unaids.org/en/regionscountries/countries/ [unaids.org]
[2] http://www.who.int/mediacentre/factsheets/fs103/en/ [who.int] http://books.google.ca/books?id=9Wy7Jgy5RWYC&pg=PA648 [google.ca]
[3] https://www.ncbi.nlm.nih.gov/pubmed/23172780 [nih.gov]