The epidemic of Ebola virus in West Africa has a current mortality rate of 70%.1 As of October 2014, there have been 13,703 confirmed and probable cases in West Africa, with 4,920 deaths due to Ebola virus.1 Recently, there have been a small number of travel and health-care related transmissions in the United States and Spain. The virus causing Ebola hemorrhagic fever is known as filovirus Ebola, a single- stranded ribonucleic acid (RNA) virus.2 Viral transmission occurs through person- to-person direct contact of broken skin or unprotected mucus membranes with body fluids (blood, feces, vomit, semen, urine and breast milk) of a patient infected with Ebola virus. Symptoms usually occur between 2-21 days (typically 8 to 10 days) after exposure.3
Early symptoms include the occurrence of nonspecific flu-like symptoms with a nonproductive cough. Diarrhea, nausea, vomiting, and abdominal pain may also occur. In addition, manifestations including a diffuse erythematous, non- pruritic maculopapular may also develop 5 to 7 days after presentation.3 Finally, late in the presentation, patients might complain of mucosal hemorrhage, melena and hemoptysis. Patients typically improve between days 6-11 in nonfatal cases of Ebola virus. However, fatal disease is characterized by a rapid progression to multi-organ failure and septic shock. Death in this case occurs between days 6 to 16 after onset of symptoms.3 Testing of the Ebola virus is conducted at specialty laboratories such as at the Centers for Disease Control. It is usually made by detection of virus antigens or RNA in blood by means of reverse transcription polymerase chain reaction (PCR) or by enzyme-linked immunosorbent assay.
Although no approved treatment for Ebola exists, current investigational treatments have shown some promise. Those include the use of monoclonal antibodies, plasma transfusions from recovering patients, novel small-molecule antiviral agents, vaccines and several other medications not known as antivirals. The procurement of such medications can be through filling the new drug application.
The author of this review article “BB” performed a PubMed literature search from 1976 through October 20, 2014 using the search term Ebola. All animal and human studies published in English were selected and the common experimental and non-experimental therapies available were summarized.4 First, the Antibody Therapy (ZMapp 50 mg/kg every 3 days for 3 doses), a cocktail of 3 “humanized” monoclonal antibodies manufactured in tobacco plants, targets Ebola virus glycoprotein. Currently, ZMapp has been used to treat 7 patients, with 5 of those patients surviving.5 The United States Department of Health and Human Services has signed a contract with the manufacturer of ZMapp to accelerate production time and clinical trial progression.
The second treatment option available include the use of Transfusion Therapy. Eight patients infected with Ebola virus were treated with blood transfusions from 5 recovering patients.6 The blood transfusions were positive for IgG Ebola virus antibodies and negative for Ebola virus antigen. Only 1 patient ...