Nothing is slowing Ebola so far, says epidemiologist, but vaccines promising沒有放緩埃博拉到目前為止,流行病學家說,但疫苗有前途

 
October 16th, 2014
03:37 PM ET

By Mick Krever, CNN

Ebola is spreading as such a rate that it is outrunning all efforts to contain it, Roy Anderson, professor of infectious disease epidemiology and former chief scientist at the British Ministry of Defence, told CNN’s Christiane Amanpour on Thursday.

“Those hospitals [in West Africa] have got to be able to deal with and quarantine a very large number of patients,” he said. “So what’s feared is that the doubling time of this epidemic is going to escape the Western response at present.”

“I’m not totally convinced that these hospitals will actually slow the spread significantly.”

Because there is neither a drug to treat infected patients nor a vaccine to protect potential ones, the only option medical workers have right now to prevent the spread are efforts to quarantine people who are infected.

“Although they may slow the spread, and we need more resources to do that, longer term the solutions must be either immunotherapy, which is putting serum into infected patients, but most importantly of course in the longer term, a vaccine.”

He said that phase one human trials of potential vaccines, in the United States, United Kingdom, and Mali, have so far presented no safety concerns. Volunteers in Oxford were given a trial vaccine last month.

“So then if that continues to be good news, then the question is an international agency and regulatory authority one – it is how can we speed up the process of getting this trial vaccine, first of all manufactured on a scale, and that’s a challenge, real challenge, for the companies, and then deploy it as quickly as possible.”

Even under “the most optimistic scenario,” though, such a vaccine would not be available until the beginning or middle of 2015.

Some have suggested that reaction in the Western world to the outbreak has been out of proportion to the threat, and that attention should really be paid to Liberia, Sierra Leone, and Guinea, where medical resources are sparse.

Dr. Kent Brantly, an American who contracted and survived Ebola, told CNN’s Anderson Cooper that the fear in America is “irrational,” because the only people who have been infected in the U.S. are health care workers who were treating an Ebola patient.

Anderson agreed that the fear may be a bit much, but did not shut the door on the idea of Ebola spreading in the Western world.

“The epidemic is spreading in Liberia, Sierra Leone, Guinea at a rate which is each primary case of infection generates two secondary cases. That’s the average. In the United States, two secondary cases generated, admittedly by health care workers who were caring for the very ill patient.”

The chief of the American military, General Martin Dempsey, caused controversy this week when he suggested that the virus could mutate and become even more pernicious.

“This virus is a little bit different from the viruses that were causing sporadic epidemics way back in 2004 and the previous forty years,” Anderson said. “The number of changes in a code, which has nineteen thousand bits, is about three hundred. Relatively small.”

“So my first concern is not mutation; my first concern is getting this under control. And at the moment there is no evidence to say this is airborne droplet transmitted.”

“However, I stress that this is a very difficult infection to study, and there’s no evidence to say not. But my assumption, and the evidence at the moment, points to contact.”

沒有放緩埃博拉到目前為止,流行病學家說,但疫苗有前途

2014年10月16日
下午3時37 ET
米克Krever,美國有線電視新聞網

埃博拉病毒蔓延的它逃跑的包含了一切努力這樣的速度,羅伊·安德森,傳染病流行病學和前首席科學家在國防部英國國防部教授告訴CNN的克里斯蒂安阿曼普爾週四。

“這些醫院[西非]有必須能夠正確處理和隔離非常多的患者,”他說。“那麼,什麼是害怕的是,這個流行的倍增時間是要逃跑,目前西方的回應。”

“我不完全相信,這些醫院將實際顯著放緩的蔓延。”

因為既不是藥物治療感染的患者,也沒有疫苗,以保護潛在的人,唯一的選擇醫務人員現在所擁有的,以防止蔓延正在努力隔離誰是感染者。

“雖然他們可能放緩的蔓延,我們需要更多的資源來做到這一點,更長期的解決方案必須是免疫治療,它是把血變成感染者,但最重要的,當然從長遠來看,疫苗。”

他說,一個階段的潛在疫苗的人體試驗,在美國,英國和馬里,至今沒有提出任何安全問題。在牛津大學的志願者分別給予試驗疫苗的最後一個月。

“這樣看來,如果這仍然是個好消息,那麼問題是一個國際機構和監管機構之一 - 它是如何能夠加快獲得這項試驗疫苗的過程中,首先在規模生產的,這是一個挑戰,真正的挑戰,對於公司,然後迅速將其部署為可能的。“

即使在“最樂觀的情況下,”不過,這種疫苗將無法使用,直到年初或2015年的中間。

有些人建議的爆發在西方世界的反應是不成比例的威脅,並應注意真正支付給利比里亞,塞拉利昂,幾內亞,那裡的醫療資源是稀少。

布蘭特利肯特博士,一位美國誰承包和埃博拉病毒存活,告訴CNN的安德森·庫珀的恐懼在美國是“非理性”,因為誰已經感染在美國的唯一的人是醫護人員誰是治療埃博拉患者。

安德森認為,擔心可能有點多,但沒關上埃博拉病毒的理念在西方世界傳播的大門。

“疫情的蔓延在利比里亞,塞拉利昂,幾內亞的速度是感染每個主要情況產生兩個輔助的情況。這是平均值。在美國,兩個次級情況下產生的,誠然醫護人員誰是照顧病得很耐心。“

美軍將軍馬丁·登普西的負責人,引起了爭議,本週他認為,該病毒可能發生變異,變得更加惡劣。

“這種病毒從人造成零星疫情,早在2004年的病毒和以前40年一點點不同的,”安德森說。“變化中的一個代碼,其中有19000位,人數約為三百。比較小。“

“所以,我首先關心的是不是突變; 我首先關心的是得到這個受到控制。而此刻沒有證據說這是傳送空降滴。“

“不過,我要強調,這是一個非常困難的感染研究,而且也沒有證據說不是。但我的假設,目前的證據,指向聯繫。“

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