I am presently at the XX Encontro Nacional de Virologia (2oth National Congress of Virology) in Brasilia: this is just winding down – it´s the last afternoon – and it has been an amazing conference. I will be reporting on this in detail when I get home; suffice it to say that any meeting that can attract over 600 virologists in one country HAS to be quite something!
Archive for the ‘Uncategorized’ Category
Virology in Brazil
4 November, 2009Plant therapy creeping in….
8 September, 2009The August issue of Nature Biotechnology has a very interesting snippet of news – from two points of view. From a strict virology point of view, it is interesting that commercial production of a therapeutic enzyme in an industrial plant can be shut down because of infection of their mammalian cell line with a contaminating mammalian virus.
From the second point of view…well, our lab has a very strong interest in producing recombinant proteins (and especially candidate vaccine proteins) in plants – and here is a story showing just why plants may be a really good alternative means of production for pharmaceuticals. First, the story:
Nature Biotechnology 27, 681 (2009) doi:10.1038/nbt0809-681a
Virus stalls Genzyme plant by Victor BethencourtGenzyme of Cambridge, Massachusetts, faces millions in lost revenue from its top-selling specialty drugs Cerezyme and Fabrazyme as result of a viral contamination at its Allston, Massachusetts plant. The company has announced that it will temporarily shut down the facility owing to a bioreactor contamination with Vesivirus 2117 [my emphasis – Ed], which does not cause human infections, but impairs growth of the biologics-producing Chinese hamster ovary (CHO) cells. It reportedly originated from tainted nutrient medium and belongs to the same strain that caused delays at the Allston site and its European biologics plant in Belgium last year. Genzyme anticipates supply constraints of Cerezyme (imiglucerase), a treatment for Gaucher disease, and Fabrazyme (agalsidase beta), used to treat Fabry disease, while the facility shuts down for 6 to 8 weeks to allow decontamination.
OK, really interesting, that: a vesivirus – genus Vesivirus, family Caliciviridae, nice link here for structure, and here for Genzyme’s press release – that is being transmitted around via cell culture media, between manufacturing plants. One of the perils of using mammalian cells to make things…!
The article goes on:
…With sales of $1.2 billion for Cerezyme and $494 million for Fabryzyme in 2008, analysts estimate the manufacturing crisis will result in $100–300 million in lost sales. The US Food and Drug Administration (FDA) has contacted rival manufacturers Shire of Basingstoke, UK, and Carmiel, Israel–based Protalix, who have enzyme replacement therapies for Gaucher disease in clinical trials, to file treatment protocols, which would allow physicians to use their drugs ahead of approval.
And of course, Protalix makes its glucocerebrocidase in cultured carrot cells, in disposable “bioreactor bags”…. In completely defined chemical media, with no risk of plant virus contamination – not that plant viruses can infect cultured plants cells, by any means short of being shot in on gold beads! Their web site Press Room page had this to say as of 25th August:
Aug. 25, 2009 (Business Wire) — Protalix BioTherapeutics, Inc. (NYSE-Amex:PLX), announced today that it has received Fast Track Designation from the U.S. Food and Drug Administration (FDA) for prGCD, the Company’s proprietary plant-cell expressed recombinant form of glucocerebrosidase (GCD) for the treatment of Gaucher disease.
I wrote the following about Protalix after attending the Plant-Based Vaccines and Antibodies Conference in Verona in June this year (September issue of Expert Rev Vaccines, 8: 1151-1155, 2009):
“Einat Almon-Brill (Protalix Biotherapeutics, Israel) described their production of recombinant human glucocerebrosidase (rGCD) as a therapy for Gaucher disease, caused by a hereditary mitochondrial defect. They used a contained disposable bioreactor system with suspension-cultured carrot or tobacco cells, and claimed there were no mammalian cell culture risk factors; they obtained uniform glycosylation, and the exposed mannose allowed rapid macrophage uptake. The rGCD half-life was twice as long as commercial product, and had been trialled in Europe, Israel, South Africa, and North and South America.”
I wish I’d bought stock…or had the money to, or knew how to! The time of plant-made pharmaceuticals – PMPs – is coming.
Be ready…B-)
H1N1 – view on a pandemic
26 August, 2009Well, “The Big One” that we have all been waiting for since 1968 – or 1977, if you count the accidental re-release of the original humanised H1N1 as a pandemic – is well and truly here. A nice little animated graphic for depicting how it arose, while a bit simplistic, is available here.
And what have we learned? Has civilisation fallen; have populations been decimated?
Well, quite a lot; no, and no, in answer. Explanations for some of this are contained in a survey just released. Here from the News24 report published today, sourced from SAPA:
Paris – More than half the fatalities from H1N1 swine flu have been among young adults, according to one of the first surveys to gather mortality data from across the globe for the new A(H1N1) virus.
The analysis of 574 pandemic deaths from 28 countries through mid-July, released this week, also found that being diabetic or obese significantly boosted the risk of dying.
Neither children nor the elderly are as vulnerable as initial reports indicated, found the study, published by Eurosurveillance, the monitoring arm of the European Centre for Disease Prevention and Control.
“Most deaths (51%) occurred in the age group of 20-to-49 year-olds, but there is considerable variation depending on country or continent,” the researchers reported.
Only 12% of those who died were 60 or older.
All of these features – high mortality among young adults and the obese, but not the very young or elderly – are sharply different than for the seasonal flu.
More than 90% of deaths from seasonal flu – which claims 250 000 to 500 000 lives annually according to the WHO – are in people over 65.
By contrast, with the pandemic H1N1, “the elderly seem to be protected from infection to some extent, perhaps due to previous exposure to similar strains”, the study conjectured.
Persons born before 1957, other studies have suggested, were almost certainly exposed to the milder seasonal A(H1N1) viruses that evolved from the terrible pandemic of 1918, which left some 40 million dead.
With the 2009 strain, “when infection does occur, however, the percentage of deaths in elderly cases seems to be higher that in others”.
One common target across both pandemic and season strains is pregnant women, according to the study, led by Philippe Barboza of the French Institute for Public Health Surveillance….
And that’s the sinister part…here in South Africa, of 18 fatalities known to have been associated with pandemic AH1N1 infection, NINE were pregnant women, mostly in the third trimester of pregnancy. In a report published yesterday, SA’s Minister of Health Dr Aaron Motsoaledi said the following:
“We find it very worrying that there is an increasing number of pregnant women who are succumbing to this pandemic,” Motsoaledi said.
“The directive to all health care workers… is to put pregnant women with flu-like symptoms (even if they are mild) on Tamiflu treatment.
“Doctors should not wait for any tests before such treatment is administered.”
Further on in the same report:
On Monday, the National Institute for Communicable Diseases [NICD] also said pregnancy had been identified as a particular risk factor for severe H1N1 flu.
It said that in the second and especially the third trimester, urgent treatment with antiviral drugs should be considered even before any laboratory results were received.
The institute added however that most H1N1 flu cases in South Africa remained mild and “self-limiting”.
Routine H1N1 testing for everyone with flu-like illness was still not recommended.
Nationwide, there had been 5 118 laboratory-confirmed cases of H1N1 flu, it said.
The figure is essentially meaningless, given that most suspected flu cases are not laboratory-diagnosed (it costs R700, or ~US$70, for a single test) and the pandemic flu is pretty much indistinguishable from seasonal, and may in fact have supplanted the normal flu. It certainly has in Australia and Argentina, which remain the two worst-hit southern hemisphere countries, and probably has in South Africa too: the CDC has a very useful map illustrating this, accessible here.
International news, via the CDC site, is the following:
As of August 13, the World Health Organization (WHO) regions have reported over 182,166 laboratory-confirmed cases of 2009 H1N1 influenza virus (2009 H1N1) with 1,799 deaths. The laboratory-confirmed cases represent an underestimation of total cases in the world as many countries now focus surveillance and laboratory testing only in persons with severe illness. The 2009 H1N1 influenza virus continues to be the dominant influenza virus in circulation in the world.
One very important piece of information further down this report is the following:
There have been no significant changes detected in the 2009 H1N1 influenza virus isolated from persons in the Southern Hemisphere as compared to viruses isolated from persons in the Northern Hemisphere.
This is important because the frantic rush to make vaccines to combat the expected northern hemisphere upsurge in infections in their autumn season – October or so – depends upon the virus not having changed much from the seed material which was derived from virus isolated earlier this year. This could negate some of theh fears that the much-anticipated “second wave” of virus infections could be a lot worse than the first.
Good news on the vaccine front – for Australians at least – is that an Australian company, CSL Ltd, has the world’s first data from human trials of a pandemic strain vaccine, and looks set to be able to provide Australia with 21 million doses of vaccine – and 2 million doses of the vaccine at the end of the month.
Other vaccine news is also fairly encouraging, notwithstanding a rather alarming report in New Scientist recently about the new strain growing only half as well in eggs as seasonal flu types: while this remains a worry, newer, faster-growing variants have been derived and distributed – though possibly not in time for a northern hemisphere autumn roll-out.
Mind you, all of this production relies on the well-proven-but-seriously-archaic 1930s technology of growing live virus in hen’s eggs: we are still trapped, in the 21st century, into having to use early 20th century methods to produce vaccines for fast-adapting pathogens. Things ARE changing: various pharma companies are diversifying into mammalian and insect cell culture; people (including us!) are investigating making recombinant subunit vaccines in plants (see here) – and there is at least the tantalising possibility that “universal vaccines” may become available in the not-too-distant future. These will exploit all or part of the highly conserved M2 “ion channel” protein of influenza viruses as recombinant subunit vaccines.
However, all of this is at least six months in the future for conventional vaccines, and many years hence for newer offerings. Meantime – there is disturbing news concerning trans-species transmissions of pandemic AH1N1 viruses.
ProMED Mail (ProMED Digest V2009 #394) reports that “Chile finds H1N1 swine flu in turkeys“:
Chilean health authorities announced on Thursday night [20 Aug 2009] that they had detected and controlled an outbreak of swine flu in 2 turkey farms, according to a communication from the Agricultural and Livestock Service (SAG).
“The presence of an influenza type A virus was detected in 2 farms in the Valparaiso Region, and immediate precautionary measures were adopted to prevent the dissemination of the disease and to protect the population’s health,” said the text.
And again from ProMED on 20th August, quoting The Straits Times and AFP:
A 2nd Australian piggery was placed in quarantine due to swine flu on Wednesday [19 Aug 2009] as the number of human deaths from the virus reached 121.
Authorities ordered a biosecurity lockdown at the piggery in Victoria state amid concerns the virus could mutate and return to humans in a more deadly form.
Another piggery in New South Wales state has been quarantined since late July [2009], although the state government said most of the animals had recovered from the disease.
Victoria Agriculture Minister Joe Helper said tests confirmed the presence of influenza at the piggery after its owners reported earlier this week that the animals were not eating.
‘It is important to stress that this is not a human health issue and that national and international food authorities continue to advise that pork and pork products are safe to eat,’ he said.
Media reports said the pigs were believed to have contracted the virus from workers at the property who were suffering the human form of the disease.
Health experts fear swine flu in humans, which is easily spread but has a relatively low fatality rate, could mutate in other animals and emerge in a more virulent form. [my emphasis]
So: two independent incidents, on different continents, of pandemic AH1N1 viruses getting into different species of farmed livestock – and luckily controlled.
What would have happened if domestic fowl and/or pigs had been infected in places like Vietnam, Thailand, Indonesia, Turkey and Egypt – where highly pathogenic avian H5N1 influenza viruses appear to be endemic, and not well controlled? Given the complex origins of the current pandemic virus – from several swine, avian and human viruses – it could be a recipe for disaster, on a scale even greater than the 1918 pandemic.
The REAL Big One. Let’s all help get a vaccine, people!!
Happy Anniversary, Apollo 11!
16 July, 2009Forty years ago today
Neil Armstrong was just learning to say
A giant leap for all mankind….
Apologies to messrs. Lennon & McCartney – but given my obsessive fascinations with (a) vintage rock, (b) outer space, I just HAD to do that. One might also diffidently mention here the first decent musical commemoration of the first moon landing, which was of course “For Michael Collins, Jeffery and Me“, on Jethro Tull’s “Benefit” album.
“I’m with you, LEM
It’s just a shame that it had to be you
The mothership is just a blip
From your trip made for two…”
And, of course, added to this is the imperative from my professional obsession with inner space, and the vehicles that ferry genetic material across that: viruses, naturally!
Ten years ago, on the 30th anniversary, I included an interactive panel (called “The Virus as Spacecraft”) in my still-unfinished standalone multimedia teaching vehicle, “An Electronic Introduction to Molecular Virology”, commemmorating the date, and the fact that the Lunar Excursion Module (LEM) looked exactly like a T-even phage, and why that should be.
Great presentation, I still think; made using a depiction of T4 coliphage as a machine (packed with floppy disks); official NASA images of Apollo spacecraft, Russell Kightley’s T4 pictures, and Linda Stannard’s EMs of T4, using the legendary “Illuminatus” multimedia suite (now a “legacy product”…B-(, with “In-a-gadda-da-vida” as the opening title backing track. Ah, me…. I still use it, mind; it’s just that the Web is a much easier vehicle to use these days, and students’ access is SO much better.
But lest we forget:
Solstice competition
23 December, 2008OK, regulars: if New Scientist can have a regular summer solstice (yes, for us in the southern hemisphere it IS the summer solstice) competition, so can Viroblogy.
And it is this: name the generic affiliations of the four viruses in our header – and win a prize.
Now while the prize may be along the lines of:
- first prize: a week in wintry Glasgow
- second prize TWO weeks in wintry Glasgow!
there will still be a prize. Entries in by 25th December so the Viroblogical offspring can choose a winner.
And a happy solstice / Yule / Saturnalia to you all.
Google it
15 November, 2008In the beginning was Google, and the world thought it was good.
In the second wave, Sergei Brin and friend created Google Earth, and the world loved it and incorporated it into their PowerPoint presentations.
In the third wave, the Googlers have created an awesome engine which monitors influenza outbreaks – lo, weeks ahead of the mighty CDC.
And the world has looked on this, and said “Wow!”. Or at least, Scientific American and other science-reporting other news media have. And a good thing it is too: at a glance you can – in the USA anyway – see where flu trends are ominously increasing, and conclude “I don’t want to go there right now!”.
But has anyone stopped to think how they’re doing this?
It can only be by geographically locating every query they get about “flu and/or sniffles NOT cat”, can’t it?
So what do they do with queries like “biowar agent virus haemorrhagic fever”? Pass them on to ECHELON, maybe? I hope not – otherwise I have a file a metre thick, seeing as I have a morbid but professional interest in such things. Oops – I wrote “ECHELON”. Oh, bugger, I wrote “haemorrhagic”! Ah, FTFAGOS*, I didn’t like my career anyway.
Ah, well – let us hope they only use their powers for good….
* = involves the words “game of soldiers”, “that” and “for”, among others.
Zambia Fever Revisited
24 October, 2008Apologies for not updating more often; little things like HIV Vaccine conferences get in the way…B-) More on that later – for now, news:
From SAPA / News24.com today:
Virus: Nurse responds to meds
24/10/2008 14:31 – (SA)Johannesburg – The nursing sister fighting an arenavirus is showing signs of responding to her treatment, although she is still in a serious condition, the Morningside Medi-Clinic said on Friday.
Meanwhile, the number of people being monitored after coming into contact with patients who had developed the viral haemorrhagic fever associated with the virus, has dropped from 94 to 31, spokesperson Melinda Pelser said.
Three people are known to have died from the virus.
Paramedic Hannes Els became ill after accompanying Cecilia van Deventer from Zambia to South Africa in September when it was thought she had tick bite fever, and clinic nurse Gladys Mthembu died before the virus, which is associated with rodents, could be identified.
“Antiviral treatment continues and there are indications that she is responding to this treatment,” said Pelser of the nursing sister currently being treated.
Monitoring of the remaining 31 people is done while they are at home and at work and so far nobody has presented with the virus.
And from close to two weeks ago:
Mystery virus identified
12/10/2008 16:39 – (SA)Johannesburg – The mystery viral haemorrhagic fever which killed three people in South Africa has been provisionally identified as an arenavirus, the National Institute for Communicable diseases and the Department of Health said on Sunday.
“The causative agent of the disease… may be a rodent-borne arenavirus related to the lassa fever virus of West Africa,” said NICD’s Dr Lucille Blumberg.
She said tests done by the NICD and the Centres for Disease Control in Atlanta, US indicated that the disease seemed to be a kind of arenavirus.
Arenaviruses cause chronic infections in multimammatic mice – a kind of wild mouse – who excrete the virus in their urine which can then contaminate human food or house dust.
More tests needed
Viruses similar to the lassa fever virus have been found in rodents in Africa, but other than in West Africa, have not been found to cause diseases in humans.
Therefore further tests still need to be done to find out whether this current strain is an undiscovered member of the arenavirus and what its distribution is.
Arenaviruses are enveloped ss(-)RNA viruses with 2-component genomes. The ones affecting humans are generally rodent-associated, and are transmitted to humans by contact with rodent urine and/or faeces. Perhaps the best known example from Africa is Lassa fever, which is found in West Africa.
Lassa fever virions: from Wikipedia
From the Centers for Disease Control and Prevention:
From the WHO:
New virus from Arenaviridae family in South Africa and Zambia – Update
13 October 2008 — The results of tests conducted at the Special Pathogens Unit, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service in Johannesburg, and at the Special Pathogens and Infectious Disease Pathology branches of the Centers for Disease Control in Atlanta, USA, provide preliminary evidence that the causative agent of the disease which has resulted in the recent deaths of 3 people from Zambia and South Africa, is a virus from the Arenaviridae family.
So we have what looks like a new arenavirus, popping up out of Zambia most unexpectedly. People who knew the index case – Cecilia van Deventer – are most concerned, as they know of no risks that they are not also associated with.
Watch this space….
Zambia fever virus: latest
8 October, 2008Latest links:
“120 people under observation for killer virus” SABC, October 8th
“Killer-fever link found by luck ” Independent On-Line 08-10-08
And just as a reminder that life goes on: a Congo fever patient from here in South Africa.
Deadly Zambian fever: deja vu all over again
7 October, 2008The news media are presently fascinated by the appearance of what looks like a new and nasty virus from my old home country, Zambia: see a link to The Times article of 7th October for the official word.
Which is “Don’t Panic”, written in large, friendly letters across the face of the newspaper….
From The Times article by Sashni Pather:
“Disease transmitted via bodily fluids
THE deputy director of the National Institute for Communicable Diseases has assured the public that there is no need to panic, despite the fact that four people have been killed by an unknown, highly contagious virus.
Doctor Lucille Blumberg, who also heads up the NICD’s epidemiology unit and consults to its special pathogens unit, referred to the death of Cecilia van Deventer, 36, as an “isolated case” and said test results were not yet available.
…A paramedic, Hannes Els, 33, who treated the critically ill Van Deventer in Zambia, and brought her to the Morningside Medi-Clinic in Sandton on September 12, died last Thursday after being infected with the highly contagious disease.
On Sunday a nurse and a cleaner, who had possibly been exposed to the disease, died.
Blumberg said: “The cause of death of the cleaner is still being investigated. We are busy conducting tests on all four deceased. The cleaner might not have been killed as a result of the virus.
“This is an isolated case. There have been no other reported cases in Lusaka, Zambia. “”
OK, so no obvious panic there, then – but disturbing echoes of another incident from 1996, when a Gabonese doctor was medevacced in to South Africa, and passed on an Ebola virus infection to a theatre nurse, Marilyn Lahana. He recovered, and she died – and there was close to panic in the land, as chronicled here. And here we are again…. Incidentally, anyone who wants to see how the first Ebola outbreaks of the electronic age unfolded can see a day-by-day history here, on my original Ebola pages. Still accessible, to my surprise!
That wonderful institution that is ProMED – who were the first people to break hard news of the Kikwit Ebola outbreak back in 1995, came to the attention of the serious medical reporting world as a result – has a slightly different view of the whole thing – and some interesting details not in the general news story. In this morning’s digest:
UNDIAGNOSED FATALITIES – SOUTH AFRICA ex ZAMBIA (02)
***********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the International Society for Infectious Diseases
<http://www.isid.org>[1]
Date: Mon 6 Oct 2008
Source: South African Broadcasting Corporation News online [edited]
<http://www.sabcnews.com/south_africa/health/0,2172,177844,00.htm>A 4th person with viral haemorragic fever (VHF) symptoms has died. The virus has already claimed the lives of a Zambian national and 2 other people at the Morningside Clinic in Johannesburg. The woman was a cleaner at the clinic.
The National Health Department has issued an alert in Gauteng following these deaths. Unconfirmed tests indicate they may have died of [a] fatal viral haemorragic fever. An Outbreak Response and Tracking Team has been set up to contain any further spread. The department’s Zanele Mngadi says investigations are still underway into the cause of the deaths.
Mngadi confirmed the death of the 4th person, who was admitted at the Leratong hospital last night [5 Oct 2008]. The patient, who showed symptoms of VHF, was transferred to the Charlotte Maxeke Johannesburg
Academic Hospital, where she died. The health department says there is no need for South Africans to panic. The department’s Frew Denson says the fever is highly contagious but is only transmitted through body fluids.It is reported that the virus can kill a person within 72 hours. VHF is an extremely infectious and life-threatening disease caused by [several different] viruses, including Ebola virus. The death rate [in the case of Ebola virus] can be as high as 90 percent. Symptoms vary but include fever, vomiting, diarrhea and bleeding.
Communicated by:
Rabelani Daswa <rabedaswa@gmail.com>******
[2]
Date: Mon 6 Oct 2008
From: Amy Cantlay <inka@iwayafrica.com>I have just read the posting (Undiagnosed fatalities – South Africa ex Zambia: RFI 20081005.3139) on your site, and it appears to be rather misleading. The chronological order of events (as I can gather) is as follows (None of this information has yet been confirmed.):
4 Sep 2008 – Index Case – female South African, (living in Zambia for many years) begins to suffer from flu-like symptoms.
9 Sep 2008 – She is slowly deteriorating. She sees multiple doctors in Lusaka.
11 Sep 2008 – She is admitted to hospital and deteriorates over night.
12 Sep 2008 – Paramedic is called in to evacuate her to South Africa. He does the transfer, along with another Dr assisting.
13 Sep 2008 – Index Case dies.
14 Sep 2008 Paramedic starts to develop flu-like symptoms.
14-27 Sep 2008 – Paramedic slowly deteriorates.
27 Sep 2008 – Paramedic is diagnosed as very sick and medivaced [sic] to South Africa. Nurse who treated Index case begins to get flu-like symptoms.
30 Sep 2008 – Paramedic dies.
1 Oct 2008 – Nurse who treated Index Case is admitted to hospital.
5 Oct 2008 – Nurse who treated Index Case dies.
The information that I can gather is the following:
1. Incubation period is as little as 2 days (paramedic), but as long as 14 days (nurse).
2. Disease course is generally 4-7 days of flu-like illness with patient only becoming critically ill in 2nd week of disease.
3. Further information is that Index Case reportedly had an eschar on one of her feet, thought to be from a tick-bite. She had also been in contact with horses from Congo in the weeks preceding her illness. Transmission is hypothesized to be by 2 means: tick-borne 1st (which may have brought the disease into the human population from the animal population) followed by direct contact with bodily fluids (resulting in human to human transmission).
4. It appears further hospital staff are now critically ill in Zambia, though this has not been confirmed.
5. If the incubation period is as long as 2 weeks, then we should still be closely watching all “contact-cases” for any signs of the disease. Those in contact with the Index case should be in the clear by now, while those in contact with the paramedic and the nurse (as well as any hospital staff who are currently sick) are still at high risk. One should probably work on a 21-day incubation period/quarantine period to be safe.
6. Chances are this is a new virus (or new subtype of virus) in the [family _Filoviridae_]. The only 2 known viruses in this group are Ebola and Marburg. It looks as though [the infection] may have entered Zambia from the Democratic Republic of the Congo (DRC) through a tick (carried on a horse), but again this cannot be confirmed.
This comment assumes that labs in South Africa have already tested all known VHFs. It is unlikely to be pneumonic plague, as this would have been discovered in South Africa; however, it is still a possibility that this [putative] viral disease has been in the Southern Province of Zambia (and that the 4 reported cases seen there were not diagnosed or wrongly called pneumonic plague).
7. The important steps in control are 1. effective quarantine of sick patients, and 2. monitoring of all “in-contact” cases, with quarantine as soon as any signs of flu or fever are noted. The government should also ideally make a statement to calm the panic and prevent people from fleeing the capital (potentially carrying the disease countrywide). This disease only spreads to people who are in very close contact with sick individuals. Those family members who are potentially incubating the disease should be encouraged to stay
around Lusaka, so that signs can be picked up quickly and treatment issued rapidly….[section on use of ribavirin – effective only against Lassa fever – edited out].Communicated by:
Dr Amy Cantlay BVSc.MRCVS <inka@iwayafrica.com>
Veterinarian
Mkushi, Zambia[ProMED-mail thanks Dr. Cantlay for her commentary, which contributes some interesting detail. At this point, it would not be useful to speculate further on the identity of the infectious agent responsible for the deaths of the 4 Zambian patients. No doubt a firm diagnosis will be available shortly from a South African reference laboratory. Several different viruses cause viral hemorrhagic fever. Of these, Ebola, Marburg, Lassa or Crimean-Congo hemorrhagic fever viruses have not been recorded in Zambia up to the present. A comprehensive account of these and other viruses responsible for hemorrhagic fevers can be found at the US CDC website: <http://www.cdc.gov/ncidod/diseases/virlfvr/virlfvr.htm>.
So: an unknown fever-causing agent, possibly associated with a tick bite in the index case, but which seems definitely to be transmitted quite efficiently via exposure to (presumably) body fluids, in a hospital setting…which does not appear to be known strains / types of Marburg or Ebola viruses, or Crimean-Congo haemorrhagic fever virus.
Loose in Johannesburg…part of a greater conurbation housing some 9 million people….
Should we be worried??
And the answer would be – NO.
If Ebola didn’t spread out of Kikwit in 1995 – a city of 500 000+ with no decent infrastructure to speak of – even to get as far as Kinshasa, then why should it spread in Johannesburg, or even Lusaka, where the infrastructure is MUCH more sophisticated?
I will leave this with a couple of quotes from posts I compiled on Ebola back in August 1995 from the fondly-remembered virology group at bio.net:
“To: virology@net.bio.net
From: ED@molbiol.uct.ac.za (“Ed Rybicki”)
Subject: Re: The Ebola virus – the end of the civilized world
Date: 18 Aug 1995 05:53:07 -0700I would say you – and many others – are being unnecessarily
frightened by a concerted media campaign designed at selling lurid
books and films. Listen – for a change – to what experts tell you,
and react accordingly.That is, RELAX!!!!!”
And:
“To: virology@net.bio.net
From: york@mbcrr.harvard.edu (Ian A. York)
Subject: Re: Ebola: the greatest threat, continuedIn article <99792FA2E69@ida.ruc.dk>, wrote:
>
>Ebola is another ballgame. There is no way to protect effectively
>against this disease, and we have seen at mutation of this virus, Ebola
>Reston, that evidently was airborn (luckily it only affects monkeys).…
Ebola has killed less than 400 people in the past decade. By contrast, typhoid fever kills over 600,000 people per year; measles kills 1,000,000 (one million) people per year. If you think Ebola has the potential tokill anywhere near that many, you don’t understand the virus. The Ebola outbreak in Kikwit *was* the worst-case scenario; *everything* went wrong. 300 deaths. Not trivial. But a tiny fraction of the real killers.Lobby and try to get measles vaccine in Africa, if you want to do some good. So don’t waste your time worrying about Ebola.”
Amen to that! Pity we have to keep revisiting The Threat From Darkest Africa – maybe we can sell the rest of the world some vaccines against them sometime soon…B-)
ViroBlogy 