RESUMO
In the recent years, Ebola virus has been responsible for several major epidemics. Research efforts have allowed the development and evaluation in the field of several vaccine candidates. At present, two of them are already approved and used in the fight against the virus in the Democratic Republic of Congo. This review aims to describe the different candidates, the clinical trials that have been conducted as well as the first results in the field.
TITLE: Ebola, des premiers vaccins disponibles. ABSTRACT: Ces dernières années, le virus Ebola a été responsable d'épidémies de grande ampleur. Les efforts de recherche ont permis la mise au point et l'évaluation sur le terrain de plusieurs candidats vaccins. À l'heure actuelle, deux sont déjà homologués et utilisés dans la lutte contre le virus en République démocratique du Congo. Cette revue se propose de faire le point sur les différents candidats vaccins, les essais cliniques qui ont été menés et les premiers résultats de terrain.
Assuntos
Vacinas contra Ebola/uso terapêutico , Ebolavirus/imunologia , Doença pelo Vírus Ebola/terapia , Surtos de Doenças , Epidemias , Necessidades e Demandas de Serviços de Saúde , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/imunologia , Humanos , Vacinação em Massa/organização & administração , Vacinação em Massa/estatística & dados numéricos , Fatores SocioeconômicosAssuntos
Surtos de Doenças , Vacinas contra Ebola/uso terapêutico , Doença pelo Vírus Ebola , Financiamento de Capital , Busca de Comunicante , República Democrática do Congo/epidemiologia , Surtos de Doenças/prevenção & controle , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/prevenção & controle , Humanos , Organização Mundial da SaúdeRESUMO
Millions of volunteers take part in clinical trials every year. This is unsurprising, given that clinical trials are often much more lucrative than other types of unskilled work. When clinical trials offer very high pay, however, some people consider them repugnant. To understand why, we asked 1,428 respondents to evaluate a hypothetical medical trial for a new Ebola vaccine offering three different payment amounts. Some respondents (27%) used very high pay (£10,000) as a cue to infer the potential risks the clinical trial posed. These respondents were also concerned that offering £10,000 was coercive- simply too profitable to pass up. Both perceived risk and coercion in high-paying clinical trials shape how people evaluate these trials. This result was robust within and between respondents. The link between risk and repugnance may generalize to other markets in which parties are partially remunerated for the risk they take and contributes to a more complete understanding of why some market transactions appear repugnant.
Assuntos
Ensaios Clínicos como Assunto/psicologia , Doença pelo Vírus Ebola/epidemiologia , Voluntários/psicologia , Ensaios Clínicos como Assunto/economia , Vacinas contra Ebola/economia , Vacinas contra Ebola/uso terapêutico , Feminino , Doença pelo Vírus Ebola/prevenção & controle , Doença pelo Vírus Ebola/psicologia , Humanos , Masculino , Medição de Risco , Salários e Benefícios/economiaAssuntos
Surtos de Doenças/prevenção & controle , Vacinas contra Ebola/administração & dosagem , Doença pelo Vírus Ebola/epidemiologia , Congo/epidemiologia , Surtos de Doenças/economia , Vacinas contra Ebola/uso terapêutico , Doença pelo Vírus Ebola/economia , Doença pelo Vírus Ebola/prevenção & controle , Humanos , Vacinação em Massa/economia , Organização Mundial da SaúdeRESUMO
BACKGROUND: The real-time generation of information about pathogen genomes has become a vital goal for transmission analysis and characterisation in rapid outbreak responses. In response to the recently established genomic capacity in the Democratic Republic of the Congo, we explored the real-time generation of genomic information at the start of the 2018 Ebola virus disease (EVD) outbreak in North Kivu Province. METHODS: We used targeted-enrichment sequencing to produce two coding-complete Ebola virus genomes 5 days after declaration of the EVD outbreak in North Kivu. Subsequent sequencing efforts yielded an additional 46 genomes. Genomic information was used to assess early transmission, medical countermeasures, and evolution of Ebola virus. FINDINGS: The genomic information demonstrated that the EVD outbreak in the North Kivu and Ituri Provinces was distinct from the 2018 EVD outbreak in Équateur Province of the Democratic Republic of the Congo. Primer and probe mismatches to Ebola virus were identified in silico for all deployed diagnostic PCR assays, with the exception of the Cepheid GeneXpert GP assay. INTERPRETATION: The first two coding-complete genomes provided actionable information in real-time for the deployment of the rVSVΔG-ZEBOV-GP Ebola virus envelope glycoprotein vaccine, available therapeutics, and sequence-based diagnostic assays. Based on the mutations identified in the Ebola virus surface glycoprotein (GP12) observed in all 48 genomes, deployed monoclonal antibody therapeutics (mAb114 and ZMapp) should be efficacious against the circulating Ebola virus variant. Rapid Ebola virus genomic characterisation should be included in routine EVD outbreak response procedures to ascertain efficacy of medical countermeasures. FUNDING: Defense Biological Product Assurance Office.
Assuntos
Anticorpos Monoclonais/genética , Antivirais/uso terapêutico , Vacinas contra Ebola/uso terapêutico , Ebolavirus/genética , Genômica , Doença pelo Vírus Ebola/tratamento farmacológico , Doença pelo Vírus Ebola/epidemiologia , República Democrática do Congo/epidemiologia , Surtos de Doenças , Humanos , Contramedidas Médicas , Estudos RetrospectivosAssuntos
Pesquisa Biomédica/legislação & jurisprudência , Surtos de Doenças/prevenção & controle , Descoberta de Drogas/legislação & jurisprudência , Vacinas contra Ebola/uso terapêutico , Política de Saúde/legislação & jurisprudência , Doença pelo Vírus Ebola/prevenção & controle , Formulação de Políticas , Saúde Pública/legislação & jurisprudência , Vacinação/legislação & jurisprudência , Ensaios Clínicos como Assunto/legislação & jurisprudência , Vacinas contra Ebola/efeitos adversos , Vacinas contra Ebola/imunologia , Emergências , Comitês de Ética em Pesquisa/legislação & jurisprudência , Regulamentação Governamental , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/imunologia , Doença pelo Vírus Ebola/transmissão , Humanos , Vacinação/efeitos adversosRESUMO
Nature has us wired instinctively to be cautious of things that are unknown or unfamiliar. Children may fear the dark, but even as adults we remain afraid of things that go bump in the night.
Assuntos
Atitude do Pessoal de Saúde , Controle de Doenças Transmissíveis/métodos , Surtos de Doenças/prevenção & controle , Vacinas contra Ebola/uso terapêutico , Medo , Conhecimentos, Atitudes e Prática em Saúde , Doença pelo Vírus Ebola/prevenção & controle , Opinião Pública , Controle de Doenças Transmissíveis/economia , Efeitos Psicossociais da Doença , Surtos de Doenças/economia , Transmissão de Doença Infecciosa , Vacinas contra Ebola/economia , Saúde Global , Custos de Cuidados de Saúde , Doença pelo Vírus Ebola/economia , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/psicologia , Doença pelo Vírus Ebola/transmissão , Humanos , Fatores de Risco , Resultado do TratamentoRESUMO
We present a stochastic transmission chain simulation model for Ebola viral disease (EVD) in West Africa, with the salutary result that the virus may be more controllable than previously suspected. The ongoing tactics to detect cases as rapidly as possible and isolate individuals as safely as practicable is essential to saving lives in the current outbreaks in Guinea, Liberia, and Sierra Leone. Equally important are educational campaigns that reduce contact rates between susceptible and infectious individuals in the community once an outbreak occurs. However, due to the relatively low R 0 of Ebola (around 1.5 to 2.5 next generation cases are produced per current generation case in naïve populations), rapid isolation of infectious individuals proves to be highly efficacious in containing outbreaks in new areas, while vaccination programs, even with low efficacy vaccines, can be decisive in curbing future outbreaks in areas where the Ebola virus is maintained in reservoir populations.
Assuntos
Controle de Doenças Transmissíveis/métodos , Surtos de Doenças/prevenção & controle , Doença pelo Vírus Ebola/prevenção & controle , Doença pelo Vírus Ebola/terapia , Doença pelo Vírus Ebola/transmissão , Programas de Imunização/métodos , Algoritmos , Simulação por Computador , Vacinas contra Ebola/uso terapêutico , Ebolavirus , Epidemias , Guiné , Doença pelo Vírus Ebola/epidemiologia , Humanos , Libéria , Cadeias de Markov , Modelos Teóricos , Isolamento de Pacientes , Serra Leoa , Software , Processos Estocásticos , VacinaçãoAssuntos
Antivirais/uso terapêutico , Ensaios de Uso Compassivo/ética , Vacinas contra Ebola/uso terapêutico , Epidemias/prevenção & controle , Doença pelo Vírus Ebola/tratamento farmacológico , África Ocidental/epidemiologia , Antivirais/efeitos adversos , Pesquisa Biomédica/ética , Drogas em Investigação/uso terapêutico , Vacinas contra Ebola/efeitos adversos , Pessoal de Saúde/ética , Doença pelo Vírus Ebola/prevenção & controle , Humanos , Alocação de Recursos/éticaRESUMO
A universal model intended primarily for predicting dynamics of the mass epidemics (outbreaks) caused by special pathogens is being developed at the State Research Center of Virology and Biotechnology Vector. The model includes the range of major countermeasures: preventive and emergency mass vaccination, vaccination of risk groups as well as search for and isolation/observation of infected cases, contacts, and suspects, and quarantine. The intensity of interventions depends on the availability of the relevant resources. The effect of resource limitations on the development of a putative epidemic of Ebola hemorrhagic fever is demonstrated. The modeling results allow for estimation of the material and human resources necessary for eradication of an epidemic.