Researchers hopeful experimental antiviral treatment stops Ebola
pharmafile | August 26, 2015 | News story | Research and Development | Ebola, Ebola virus, Ebola virus disease, Toyama Chemical, VSV-ZEBOV, favipiravir, zmapp
An experimental antiviral therapy may have prevented British healthcare workers from contracting Ebola after exposure to the disease in West Africa.
A report, published in The Lancet Infectious Diseases journal, describes a case study of eight British healthcare workers who were evacuated to London’s Royal Free Hospital after possible accidental exposure to Ebola virus in Sierra Leone between January and March 2015.
Four of the healthcare workers had suffered accidental needlestick injuries, putting them at significant risk of exposure to Ebola. These patients were given post-exposure prophylaxis (PEP) with Toyama Chemical’s antiviral drug favipiravir, with or without monoclonal antibodies (like the existing experimental Ebola therapy ZMapp).
The other four workers had exposure that was not the result of a sharps injury, and were judged to be at lower risk. They were not given PEP, and were managed by watchful waiting.
None of the healthcare workers went on to develop Ebola, and all eight remained healthy throughout the 42 day follow-up period, with no signs of disease or detectable levels of the virus in their blood. The treatment regimen was well tolerated, and no serious adverse events were reported.
Despite this positive outcome, it has not proven the efficacy of favipiravir, as the report’s lead author Dr Michael Jacobs, from the Royal Free NHS Foundation Trust, London, explains: “It is possible that none of these health-care workers were infected with Ebola virus. Therefore, we cannot know for sure whether or not post-exposure prophylaxis prevented the onset of Ebola-virus disease. However, two of the workers had needlestick injuries contaminated with fresh blood from patients with Ebola virus disease, putting them at very high risk of transmission.”
Healthcare workers in West Africa face a high risk of exposure to Ebola, which is highly contagious. As of 5 August 2015, 880 out of 27,862 cases of Ebola were reported in healthcare workers, and similar needlestick injuries had always previously resulted in infection.
The 2013/14 Ebola outbreak resulted in a huge push for treatments and vaccinations. Most encouraging so far is Merck’s experimental vaccine VSV-ZEBOV, which proved 100% effective in a recent trial in Guinea.
Despite this progress and the decline in new cases, further Ebola outbreaks remain a concern, and doctors and nurses caring for patients still have no guidelines to quantify exposure risk.
The Lancet report’s authors conclude by calling for standardised guidelines about transmission risk and management after potential Ebola exposure to be urgently developed and adopted, as they have been for many other infections, such as HIV and hepatitis B.
Joel Levy
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