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Loyola University Health System study: Groundbreaking study could lead to fast, simple test for Ebola virus

12 May

The Centers for Disease Control and Prevention described Ebola:

What is Ebola Virus Disease?
Ebola Virus Disease (EVD) is a rare and deadly disease most commonly affecting people and nonhuman primates (monkeys, gorillas, and chimpanzees). It is caused by an infection with a group of viruses within the genus Ebolavirus:
• Ebola virus (species Zaire ebolavirus)
• Sudan virus (species Sudan ebolavirus)
• Taï Forest virus (species Taï Forest ebolavirus, formerly Côte d’Ivoire ebolavirus)
• Bundibugyo virus (species Bundibugyo ebolavirus)
• Reston virus (species Reston ebolavirus)
• Bombali virus (species Bombali ebolavirus)
Of these, only four (Ebola, Sudan, Taï Forest, and Bundibugyo viruses) are known to cause disease in people. Reston virus is known to cause disease in nonhuman primates and pigs, but not in people. It is unknown if Bombali virus, which was recently identified in bats, causes disease in either animals or people.
Ebola virus was first discovered in 1976 near the Ebola River in what is now the Democratic Republic of Congo. Since then, the virus has been infecting people from time to time, leading to outbreaks in several African countries. Scientists do not know where Ebola virus comes from. However, based on the nature of similar viruses, they believe the virus is animal-borne, with bats being the most likely source. The bats carrying the virus can transmit it to other animals, like apes, monkeys, duikers and humans.
Ebola virus spreads to people through direct contact with bodily fluids of a person who is sick with or has died from EVD. This can occur when a person touches the infected body fluids (or objects that are contaminated with them), and the virus gets in through broken skin or mucous membranes in the eyes, nose, or mouth. The virus can also spread to people through direct contact with the blood, body fluids and tissues of infected fruit bats or primates. People can get the virus through sexual contact as well.
Ebola survivors may experience difficult side effects after their recovery, such as tiredness, muscle aches, eye and vision problems and stomach pain. Survivors may also experience stigma as they re-enter their communities….. https://www.cdc.gov/vhf/ebola/about.html

Ebola is a virus caused disease.

Medical News Today described the symptoms of Ebola:

Symptoms of Ebola
The time interval from infection with Ebola to the onset of symptoms is 2-21 days, although 8-10 days is most common. Signs and symptoms include:
• fever
• headache
• joint and muscle aches
• weakness
• diarrhea
• vomiting
• stomach pain
• lack of appetite
Some patients may experience:
• rash
• red eyes
• hiccups
• cough
• sore throat
• chest pain
• difficulty breathing
• difficulty swallowing
• bleeding inside and outside of the body
Laboratory tests may show low white blood cell and platelet counts and elevated liver enzymes. As long as the patient’s blood and secretions contain the virus, they are infectious. In fact, Ebola virus was isolated from the semen of an infected man 61 days after the onset of illness. https://www.medicalnewstoday.com/articles/280598.php

Those infected with Ebola or suspected of being exposed are isolated:

Ebola prevention
It is still unknown how individuals are infected with Ebola, so stopping infection is still difficult. Preventing transmission is achieved by:
• ensuring all healthcare workers wear protective clothing
• implementing infection-control measures, such as complete equipment sterilization and routine use of disinfectant
• isolation of Ebola patients from contact with unprotected persons
Thorough sterilization and proper disposal of needles in hospitals are essential in preventing further infection and halting the spread of an outbreak.
Ebola tends to spread quickly through families and among friends as they are exposed to infectious secretions when caring for an ill individual. The virus can also spread quickly within healthcare settings for the same reason, highlighting the importance of wearing appropriate protective equipment, such as masks, gowns, and gloves.
Together with the WHO, the Centers for Disease Control and Prevention (CDC) has developed a set of guidelines to help prevent and control the spread of Ebola – Infection Control for Viral Hemorrhagic Fevers In the African Healthcare Setting. https://www.medicalnewstoday.com/articles/280598.php

The World Health Organization provided statistics about Ebola. https://www.who.int/news-room/fact-sheets/detail/ebola-virus-disease

The CBC printed the Thompson Reuters article, Ebola outbreak in Congo expected to last into mid-2019, WHO says:

The Ebola outbreak in northeastern Congo, which has already killed more than 200 people, is expected to last until mid-2019, a senior World Health Organization official said on Tuesday.
“It’s very hard to predict timeframes in an outbreak as complicated as this with so many variables that are outside our control, but certainly we’re planning on at least another six months before we can declare this outbreak over,” WHO emergency response chief Peter Salama told reporters.
The outbreak in Congo’s North Kivu province has caused 333 confirmed and probable cases of the deadly virus, and is now the
The location of the disease is perhaps the most difficult the WHO has ever encountered, due to a dense and mobile local population, insecurity caused by two armed groups, and its spread by transmission in health centres, Salama said.
One of the major drivers of the spread of the disease was due to people visiting the several hundred “tradi-modern” health centres in the town of Beni, he said.
“Those facilities, we believe, are one of the major drivers of transmission,” he said.
The tradi-modern facilities were unregulated, informal, and varied from being a standalone structure to a room in someone’s house, and were not set up to spot Ebola, let alone tackle cases of the disease.
Many had no running water for handwashing, and patients — who generally opted for injectable medicine because they felt it gave them a stronger form of medicine — would reuse needles.
“With the injections come the risks,” Salama said.
There had been an epidemiological breakthrough around late October, when a change in the age distribution of Ebola patients revealed that many of them were children being treated for malaria in the tradi-modern health centres. https://www.cbc.ca/news/health/congo-ebola-outbreak-to-last-into-2019-1.4903475

Conditions present in the Congo are similar to many impoverished parts of the globe.

Science Daily reported in Groundbreaking study could lead to fast, simple test for Ebola virus:

In a breakthrough that could lead to a simple and inexpensive test for Ebola virus disease, researchers have generated two antibodies to the deadly virus.

The antibodies, which are inexpensive to produce, potentially could be used in a simple filter paper test to detect Ebola virus and the related Marburg virus. (If the filter paper turns color, the virus is present.)
Corresponding author Ravi Durvasula, MD, and colleagues report their findings in the American Journal of Tropical Medicine & Hygiene. Dr. Durvasula, a world leader in global infectious diseases research, is a professor and chair of the department of medicine of Loyola Medicine and Loyola University Chicago Stritch School of Medicine. First author Adinarayana Kunamneni, PhD, is a research assistant professor in Loyola’s department of medicine.
Ebola and Marburg viruses can cause severe bleeding and organ failure, with fatality rates reaching 90 percent in some outbreaks. The diseases spread through direct contact with bodily fluids of an infected person, monkey, gorilla, chimpanzee or bat.
Ebola and Marburg belong to a class of viruses native to Africa called filoviruses. There are four known types of Ebola virus and two known types of Marburg virus. They are textbook examples of emerging diseases that appear quickly, often in remote areas with little or no public health infrastructure. There were major Ebola outbreaks in West Africa from 2013 to 2016. There is no effective vaccine or drug to treat the diseases.
Early symptoms of Ebola and Marburg, such as fever, headache and diarrhea, mimic more common diseases, so there’s a critical need for a rapid diagnostic test. Such a test could help in efforts to limit outbreaks by quickly quarantining infected persons. But existing diagnostic tests either are inaccurate or are expensive and require extensive training to administer.
Antibodies could be key to diagnosing Ebola and Marburg viruses. An antibody is a Y-shaped protein made by the immune system. When a virus or other pathogen invades the body, antibodies mark it for the immune system to destroy.
Using a technology called cell-free ribosome display, researchers generated two synthetic antibodies that bind to all six Ebola and Marburg viruses. (The research involved the use of non-hazardous proteins that sit on the surface of Ebola and Marburg viruses. Because the actual viruses were not used in the study, there was no risk of infection to researchers or the public….) https://www.sciencedaily.com/releases/2019/05/190507145516.htm

Citation:

Groundbreaking study could lead to fast, simple test for Ebola virus
Date: May 7, 2019
Source: Loyola University Health System
Summary:
In a breakthrough that could lead to a simple and inexpensive test for Ebola virus disease, researchers have generated two antibodies to the deadly virus. The antibodies, which are inexpensive to produce, potentially could be used in a simple filter paper test to detect Ebola virus and the related Marburg virus.

Journal Reference:
Adinarayana Kunamneni, Elizabeth C. Clarke, Chunyan Ye, Steven B. Bradfute, Ravi Durvasula. Generation and Selection of a Panel of Pan-Filovirus Single-Chain Antibodies using Cell-Free Ribosome Display. The American Journal of Tropical Medicine and Hygiene, 2019; DOI: 10.4269/ajtmh.18-0658

Here is the press release from Loyola University Health System:

NEWS RELEASE 7-MAY-2019
Groundbreaking study could lead to fast, simple test for Ebola virus
LOYOLA UNIVERSITY HEALTH SYSTEM
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MAYWOOD, IL – In a breakthrough that could lead to a simple and inexpensive test for Ebola virus disease, researchers have generated two antibodies to the deadly virus.
The antibodies, which are inexpensive to produce, potentially could be used in a simple filter paper test to detect Ebola virus and the related Marburg virus. (If the filter paper turns color, the virus is present.)
Corresponding author Ravi Durvasula, MD, and colleagues report their findings in the American Journal of Tropical Medicine & Hygiene. Dr. Durvasula, a world leader in global infectious diseases research, is a professor and chair of the department of medicine of Loyola Medicine and Loyola University Chicago Stritch School of Medicine. First author Adinarayana Kunamneni, PhD, is a research assistant professor in Loyola’s department of medicine.
Ebola and Marburg viruses can cause severe bleeding and organ failure, with fatality rates reaching 90 percent in some outbreaks. The diseases spread through direct contact with bodily fluids of an infected person, monkey, gorilla, chimpanzee or bat.
Ebola and Marburg belong to a class of viruses native to Africa called filoviruses. There are four known types of Ebola virus and two known types of Marburg virus. They are textbook examples of emerging diseases that appear quickly, often in remote areas with little or no public health infrastructure. There were major Ebola outbreaks in West Africa from 2013 to 2016. There is no effective vaccine or drug to treat the diseases.
Early symptoms of Ebola and Marburg, such as fever, headache and diarrhea, mimic more common diseases, so there’s a critical need for a rapid diagnostic test. Such a test could help in efforts to limit outbreaks by quickly quarantining infected persons. But existing diagnostic tests either are inaccurate or are expensive and require extensive training to administer.
Antibodies could be key to diagnosing Ebola and Marburg viruses. An antibody is a Y-shaped protein made by the immune system. When a virus or other pathogen invades the body, antibodies mark it for the immune system to destroy.
Using a technology called cell-free ribosome display, researchers generated two synthetic antibodies that bind to all six Ebola and Marburg viruses. (The research involved the use of non-hazardous proteins that sit on the surface of Ebola and Marburg viruses. Because the actual viruses were not used in the study, there was no risk of infection to researchers or the public.)
It will take further research to validate the antibodies’ potential for diagnosing Ebola and Marburg viruses, Drs. Durvasula and Kunamneni said.
###
The study is titled, “Generation and Selection of a Panel of Pan-Filovirus Single-Chain Antibodies using Cell-Free Ribosome Display.”
In addition to Drs. Kunamneni and Durvasula, other co-authors are Elizabeth Clarke, MS, Chunyan Ye and Steven Bradfute, PhD, of the University of New Mexico.
Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

Inter Press Service reported about the difficulty in controlling a disease like Ebola in Stopping Ebola in its Tracks with Point of Entry Screening http://www.ipsnews.net/2018/08/stopping-ebola-tracks-point-entry-screening/

Researchers wrote in the abstract to Importance of diagnostics in epidemic and pandemic preparedness:

….Some challenges to diagnostic preparedness are common to all outbreak situations, as highlighted by recent outbreaks of Ebola, Zika and yellow fever. In this article, we review these overarching challenges and explore potential solutions. Challenges include fragmented and unreliable funding pathways, limited access to specimens and reagents, inadequate diagnostic testing capacity at both national and community levels of healthcare and lack of incentives for companies to develop and manufacture diagnostics for priority pathogens during non-outbreak periods. Addressing these challenges in an efficient and effective way will require multiple stakeholders—public and private—coordinated in implementing a holistic approach to diagnostics preparedness. All require strengthening of healthcare system diagnostic capacity (including surveillance and education of healthcare workers), establishment of sustainable financing and market strategies and integration of diagnostics with existing mechanisms. Identifying overlaps in diagnostic development needs across different priority pathogens would allow more timely and cost-effective use of resources than a pathogen by pathogen approach; target product profiles for diagnostics should be refined accordingly. We recommend the establishment of a global forum to bring together representatives from all key stakeholders required for the response to develop a coordinated implementation plan. In addition, we should explore if and how existing mechanisms to address challenges to the vaccines sector, such as Coalition for Epidemic Preparedness Innovations and Gavi, could be expanded to cover diagnostics. https://www.researchgate.net/publication/330758511_Importance_of_diagnostics_in_epidemic_and_pandemic_preparedness

See, New Ebola Outbreak Highlights Importance of Ongoing Preparedness Efforts http://www.hopkins-cepar.org/on-alert/new-ebola-outbreak-highlights-importance-of-ongoing-preparedness-efforts
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