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Alexander’s visit highlights efforts to confront Ebola

Sep. 24, 2014, 4:28 PM

Don’t panic over Ebola. But don’t ignore it, either.

That was the take-home message for U.S. citizens from a “mini-hearing” held by U.S. Sen. Lamar Alexander, R-Tenn., at Vanderbilt University Medical Center on Wednesday with researchers and health officials from Vanderbilt and the State of Tennessee.

“Should Ebola come here via an airplane, we can diagnose it, we can contain it and we can treat it safely and effectively,” said William Schaffner, M.D., professor of Preventive Medicine at Vanderbilt and a nationally known infectious disease expert.

U.S. Sen. Lamar Alexander, right, talks with Vanderbilt’s Thomas Talbot, M.D., MPH, right, William Schaffner, M.D., and James Crowe Jr., M.D., at Vanderbilt on Wednesday.

Yet if the often-fatal virus continues to spread in West Africa at its current rate, as many as 1.4 million people could be infected by Jan. 20, 2015, according to the U.S. Centers for Disease Control and Prevention (CDC). That could endanger “our national security interests,” Alexander said.

“I believe that we should treat the Ebola epidemic as seriously as we treat (the Islamic terrorist group) ISIS,” the senator told the group. “And I’m not given to overstatement.”

Because of that concern, Alexander asked Vanderbilt vaccine researcher James Crowe Jr., M.D., what the U.S. Congress could do to hasten development of anti-Ebola vaccines and treatments.

Historically it has taken 25 years to bring a new vaccine to market because of the safety and efficacy testing that is required. “We can’t wait that long for this,” said Crowe, Ann Scott Carell Professor and director of the Vanderbilt Vaccine Center.

“There’s this ‘Valley of Death’ people talk about in biotech where discoveries have a hard time moving into the real testing phase,” he said. Resources and regulations could be applied to rapidly move promising candidate vaccines and drugs into larger scale testing.

Crowe and his colleagues are using a high-efficiency technique they developed to isolate human monoclonal antibodies against Ebola. These antibodies, protein drugs isolated from the body’s immune cells, could be given as injections — treatments — to provide short-term protection to people, including health care workers, who are at risk of infection.

Antibody treatments differ from vaccines, which stimulate the body to produce its own longer-term immunity against viral infection.

The good news is that Ebola can only be transmitted through contact with bodily fluids. Unlike influenza, for example, it cannot be spread through the air by sneezing, said Tim Jones, M.D., state epidemiologist for the Tennessee Department of Health.

And although Ebola is mutating into different “strains,” the chance of it developing the capacity to be transmitted through the air is very low, Crowe added.

After exposure to the virus, it takes up to 21 days before an infected person begins to show symptoms including high fever. An infected person does not become contagious until symptoms occur.

And while the current outbreak of Ebola is killing as many as one in every two people it infects, the death rate can be brought down significantly with basic supportive care, even without a specific treatment, Schaffner said.

Among others who participated in the discussion were Thomas Talbot, M.D., MPH, chief hospital epidemiologist at Vanderbilt; George Nelson, M.D., associate hospital epidemiologist; Lawrence Marnett, Ph.D., associate vice chancellor for Research; and Jeff Mangrum, R.N., MHA, administrative coordinator of VUMC Emergency Preparedness.

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