U.S. official: Ebola outbreak is “spiraling out of control”
(CNN) — The Ebola outbreak is much worse than official figures show and is “spiraling out of control,” a leading U.S. official said Tuesday — due in part, he said, to some countries that inadvertently have made it harder to corral the deadly disease.
Centers for Disease Control and Prevention Director Dr. Tom Frieden offered his stark commentary to CNN a day after Ellen Johnson Sirleaf, the president of Liberia, voiced dissatisfaction with the world response so far.
“In a way, we feel saddened by the response,” President Sirleaf said.
More than 3,000 people have been infected by Ebola in Liberia, Guinea, Sierra Leone and Nigeria since the first documented cases in December, according to the World Health Organization. At least 1,552 have died.
Making it worse, Frieden said, is how other countries have turned their backs on those coming from countries where the outbreak is strongest, even if they don’t realize it.
Measures to restrict flights and border crossings into the countries facing the outbreak were designed to contain the spread, but are having a paradoxical effect, he explained.
“This is making it really hard to get help in and to respond effectively to the outbreak,” he said on CNN’s “New Day.”
“What we’re seeing is a … hugely fast increase in cases that’s harder and harder to manage,” he said. “The more we can get in there and tamp that down, the fewer cases we’ll have in the weeks and months to come.”
The president of Doctors Without Borders sharply criticized what she called the “global coalition of inaction” for focusing on insulating their nations instead of helping those in Africa who need it most. Dr. Joanne Liu said centers run by her group have turned away sick because they are too full, as an ever-increasing number of people develop symptoms of Ebola.
“States with the required capacity have a political and humanitarian responsibility to come forward and offer a desperately needed, concrete response to the disaster unfolding in front of the world’s eyes … rather than limit their response to the potential arrival of an infected patient in their countries,” Liu said.
In her CNN interview, President Sirleaf of Liberia appealed for other nations to “please work as partners with us” by offering monetary, health care, logistical and other assistance, yes, but also by giving moral and personal support to a problem that’s affected millions already.
“Give us hope by joining us in this fight,” Sirleaf said. “Don’t instill fear. We need that hope, we need that assistance, we need for Liberians to know that this war can be won.”
Obama sends message to people of West Africa
The U.S. government tried to get front-and-center on the issue Tuesday, led by President Barack Obama.
Speaking “directly to … the people of West Africa” in a video message, Obama said America’s prayers are with those impacted by the disease and reiterated basic facts to educate locals on how Ebola spreads.
“Stopping this disease won’t be easy, but we know how to do it,” Obama said. “You are not alone. Together, we can treat those who are sick with respect and dignity, we can save lives, and our countries can work together to improve public health so this kind of outbreak doesn’t happen again.”
Obama insisted his government is working those in Africa to make a difference: To this point, White House spokesman Josh Earnest said more than 500 staff members from the CDC — the U.S. health agency focused on infectious diseases, including Ebola — are on the case, including 70 of the roughly 100 U.S. government personnel that are on the ground in hard-hit areas.
These government workers in Guinea, Liberia, Nigeria and Sierra Leone are doing things like “surveillance, contact tracing, database management and health education,” Earnest said.
But they aren’t the only Americans on the ground, putting themselves in harm’s way to help others.
Many are there as part of humanitarian groups, like two who contracted Ebola earlier this summer. They were sent to Atlanta’s Emory University Hospital, where they were treated and later released.
On Tuesday, a group called Serving in Mission announced that another American — a doctor working in Liberia’s capital — had tested positive for Ebola.
The doctor, whose name was not released, was not treating Ebola patients and it’s not known how he contracted the disease, SIM USA said. One of the other Americans infected with Ebola, Nancy Writebol, also was working on a SIM USA mission.
The unnamed American doctor immediately isolated himself upon the onset of symptoms, and is currently in an Ebola isolation unit, the group said.
“The doctor is doing well and is in good spirits,” SIM USA said in a statement.
Sirleaf: ‘We have no option but to succeed’
The prognosis for all of West Africa, though, isn’t good.
Frieden, the CDC director, says what’s happening now is worse that past Ebola outbreaks.
“This is the first epidemic spreading widely through many countries, and it is spiraling out of control,” said Frieden, who recently returned from a trip to the region. “It’s bad now, much worse than the numbers show. It’s going to get even worse in the very near future.”
That’s bad news for places like Liberia, where President Sirleaf notes “primary … hospitals have had to close because they became incubators for the disease and … Ebola has been spreading quite rapidly.”
The crisis is threatening already fragile economies.
Vincent Martin, head of the U.N.’s Food and Agriculture Organization’s Dakar-based Resilience Hub, noted that some households in affected areas were spending up to 80% of their income on food before the outbreak — and now prices are rising as people stock up on food, fearing it will run out.
Plus, restricted movement between countries has created labor shortages on farms, the FAO reports. The main harvest season for crops such as rice and maize is weeks away, and what was predicted to be a favorable harvest is now at risk, the agency said.
Then there’s the matter of locals who can’t work because they or loved ones are infected, who aren’t going out and spending as much due to fears tied to the crisis, or whose livelihoods are threatened because economies have become more insulated.
Sirleaf says “the great progress” the economy of Liberia, at least, is now “under question because of the Ebola crisis.”
That said, she stressed that there’s only one path forward — to defeat the disease and return to some semblance of normal.
“I’m very hopeful that we will beat this,” the Liberian President said. “We have to. We have no option but to succeed in this.”
A highly anticipated test of an experimental Ebola vaccine will begin this week at the National Institutes of Health, amid mounting anxiety about the spread of the deadly virus in West Africa.
After an expedited review by the U.S. Food and Drug Administration, researchers were given the green light to begin what’s called a human safety trial, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID).
It will be the first test of this type of Ebola vaccine in humans.
The experimental vaccine, developed by the pharmaceutical company GlaxoSmithKline and the NIAID, will first be given to three healthy human volunteers to see if they suffer any adverse effects. If deemed safe, it will then be given to another small group of volunteers, aged 18 to 50, to see if it produces a strong immune response to the virus. All will be monitored closely for side effects.
The vaccine will be administered to volunteers by an injection in the deltoid muscle of their arm, first in a lower dose, then later in a higher dose after the safety of the vaccine has been determined.
Some of the preclinical studies that are normally done on these types of vaccines were waived by the FDA during the expedited review, Fauci said, so “we want to take extra special care that we go slowly with the dosing.”
The vaccine did extremely well in earlier trials with chimpanzees, Fauci said. He noted that the method being used to prompt an immune response to Ebola cannot cause a healthy individual to become infected with the virus.
Still, he said, “I have been fooled enough in my many years of experience… you really can’t predict what you will see (in humans).”
According to the NIH, the vaccine will also be tested on healthy volunteers in the United Kingdom, Gambia and Mali, once details are finalized with health officials in those countries.
Trials cannot currently be done in the four countries affected by the recent outbreak — Guinea, Sierra Leone, Liberia and Nigeria — because the existing health care infrastructure wouldn’t support them, Fauci said. Gambia and Mali were selected because the NIH has “long-standing collaborative relationships” with researchers in those countries.
According to the NIH, officials from the Centers for Disease Control and Prevention are also in talks with health officials from Nigeria about conducting part of the safety trial there.
Funding from an international consortium formed to fight Ebola will enable GlaxoSmithKline to begin manufacturing up to 10,000 additional doses of the vaccine while clinical trials are ongoing, the pharmaceutical company said in a statement. These doses would be made available if the World Health Organization decides to allow emergency immunizations in high-risk communities.
The GSK/NIAID vaccine is one of two leading candidate vaccines. The other was developed by the Public Health Agency of Canada and licensed this month to NewLink Genetics, a company based in Iowa.
According to the NIH, safety trials of that vaccine will start this fall.
Earlier this month, the Canadian government shipped what it said was “800 to 1,000” doses of that vaccine to Liberia, at the government’s request. It’s not clear whether it has been given to health workers or anyone else there.
Worth noting: In 2009, an earlier version of the vaccine was given to a lab worker in Germany after he thought he had pricked himself with a needle tainted with Ebola. He did not develop the disease.
While there currently is no proven treatment for Ebola beyond supportive care, government agencies and small biotech firms have been scrambling to speed up development of several potential therapies and vaccines.
A third vaccine, also developed by the NIH, was recently tested in primates and found to protect them from infection; it was given in combination with Depovax, an adjuvant that has been used with other vaccines and cancer therapies to boost the body’s immune response.
While vaccines might be given to prevent infection among health workers or other people thought to be at high risk, development has also been sped up on drugs that might potentially be given to patients who already have the disease.
The drug that’s received the most attention is ZMapp, which has been given to at least seven individuals in the current outbreak, including two American missionary medical workers, Nancy Writebol and Dr. Kent Brantly.
The drug has never been formally tested in humans, and while the results in human patients are encouraging — five of the seven known to have received it are still alive — experts say there is too little data to say whether it played a role in their recoveries.
Earlier versions of ZMapp, which received backing from the U.S. and Canadian governments as well as from biotech firms, have shown some ability to protect rhesus macaque monkeys more than two days after they were infected with the virus.
The U.S. Department of Health and Human Services announced on Tuesday a $24.9 million, 18-month contract with ZMapp’s manufacturer, Mapp Biopharmaceutical, to accelerate the development of the medication.
Mapp will make “a small amount of the drug for early stage clinical safety studies and nonclinical studies” to gauge how the drug works on people, the HHS department said in a news release. The various new steps “will contribute to increasing the amount of product potentially available to treat patients with Ebola.”
Another drug, TKM-Ebola, has been tested for safety in a small number of humans. That trial was put on hold in January, after one volunteer developed moderate gastrointestinal side effects after receiving a high dose of the medication.
Last month, the FDA modified the hold to a “partial clinical hold.” In effect, this means that Tekmira could potentially be allowed to give the drug to doctors or hospitals who request it, on an emergency basis. There’s no indication that the company has received any such requests.
The vaccine going into trials this week is based on an adenovirus — a type of cold virus — that’s found in chimpanzees. The virus delivers genetic material derived from two species of Ebola virus, including the Zaire strain that’s responsible for the current outbreak. Those genes are meant to trigger the development of antibodies in the person who receives the vaccine, antibodies that can specifically defend against Ebola.
Another trial, using a version of the GSK/NIAID vaccine that uses only the Zaire strain of Ebola, will be launched in October, according to the NIH.
All participants in the trial will be evaluated nine times over a 48-week period. NIH expects to reveal the results of the trial by the end of the year.
If it’s approved for widespread use, the first priority will be to give the vaccine to health care workers or lab workers who are fighting the spread of the virus, Fauci said. It will then be considered for people in the communities where outbreaks occur.