d******5
发帖数: 4273 | 1 依博拉病（Ebola virus disease）：真相和热点
博客文章：
http://www.mitbbs.com/pc/pccon.php?id=14439&nid=338895
几天来，由于在德州Dalas发现美国国内首例病例，Ebola成了人们谈论的热点话题，
Ebola相关生化药股也在爆涨中。
Ebola可怕么？它如何传播？如何预防和治疗Ebola？
这里讨论了一些关于Ebola的热点问题：
（一）Ebola的真相
世界卫生组织（WHO）列举的关于Ebola的关键事实：
1. Ebola virus disease (EVD), formerly known as Ebola haemorrhagic
fever, is a severe, often fatal illness in humans.
2. The virus is transmitted to people from wild animals and
spreads in the human population through human-to-human
transmission.
3. The average EVD case fatality rate is around 50%. Case fatality
rates have varied from 25% to 90% in past outbreaks.
4. The first EVD outbreaks occurred in remote villages in Central
Africa, near tropical rainforests, but the most recent outbreak in
west Africa has involved major urban as well as rural areas.
5. Community engagement is key to successfully controlling
outbreaks. Good outbreak control relies on applying a package of
interventions, namely case management, surveillance and contact
tracing, a good laboratory service, safe burials and social
mobilisation.
6. Early supportive care with rehydration, symptomatic treatment
improves survival. There is as yet no licensed treatment proven to
neutralise the virus but a range of blood, immunological and drug
therapies are under development.
7.There are currently no licensed Ebola vaccines but 2 potential
candidates are undergoing evaluation.
要点： Ebola是一种烈性传染病，死亡率很高，但可防可控。
（二）Ebola的传播途径
美国疾病控制中心（CDC）阐述的关于Ebola传播途径，比较清晰：
When an infection does occur in humans, the virus can be spread in
several ways to others. Ebola is spread through direct contact
(through broken skin or mucous membranes in, for example, the
eyes, nose, or mouth) with：
1. blood or body fluids (including but not limited to urine,
saliva, sweat, feces, vomit, breast milk, and semen) of a person
who is sick with Ebola
2. objects (like needles and syringes) that have been contaminated
with the virus
3. infected animals
Ebola is not spread through the air or by water, or in general, by
food.
However, in Africa, Ebola may be spread as a result of handling
bushmeat (wild animals hunted for food) and contact with infected
bats. There is no evidence that mosquitos or other insects can
transmit Ebola virus. Only mammals (for example, humans, bats,
monkeys, and apes) have shown the ability to become infected with
and spread Ebola virus.
要点：Ebola通过接触传播，不通过空气与饮食传播。
（三）抗艾滋病药能否治愈Ebola？
While experts and health authorities around the world are baffled
with the task of controlling the Ebola outbreak without the
availability of a licensed Ebola treatment, a Liberian doctor has
taken matters into his own hands. Gorbee Logan, working in rural
Liberia, administered human immunodeficiency virus (HIV) drug
lamivudine to 15 Ebola patients, and surprisingly 13 of them
recovered despite the virus having a mortality rate of 70%.
This has led the National Institutes of Health (NIH) to also
explore the potential of the drug, which is marketed as Epivir by
GlaxoSmithKline plc (ADR) (GSK) for the treatment of Hepatitis B.
Liberia is one of the hardest Ebola-hit countries in Africa. Due
to the lack of Ebola drugs and the poor conditions of health
facilities, Logan has had to resort to unorthodox methods to treat
his patients. He defended his actions in an interview with CNN by
saying that, while authorities are struggling with getting through
trials and studies, the only option doctors are left with is to
utilize other approved drugs.
Logan believes that the Ebola virus is a destructive strain of the
same virus that causes the fatal liver disease HIV. He claims that
the two patients who died were given the drug after five days of
developing Ebola symptoms, compared to others who took the drug
earlier.
After the interview, the NIH took notice of Logan’s findings and
has now started testing if lamivudine can help Ebola patients.
Director of NIH’s National Institute of Allergy and Infectious
Diseases (NIAID), Dr. Anthony Fauci, has said that while the
merits of Logan’s actions are debatable, the situation is such
that any available therapies can be explored.
Fauci, who is an immunologist and has done considerable research
on HIV, also added that using lamivudine makes sense as it works
by inhibiting the replication of certain viruses. However, the
Ebola virus did not respond to the drug in a test tube study.
Fauci plans to continue testing with adjusted levels of the drug.
Clinical trials for lamivudine as an anti-Ebola treatment will be
conducted if positive results are achieved.
There are ethical dilemmas of using a drug that has not been
approved for the indication of Ebola. However, Logan argues that
while the drug may have serious side-effects, patients will die
without some sort of treatment. He added that the urgency of the
matter calls for taking risks.
Another question that remains unanswered is whether the drug will
be used as a treatment option for Thomas Duncan, the first patient
to be diagnosed with Ebola in the US. Duncan is currently admitted
in a hospital in Dallas.
Meanwhile, GSK is working on an Ebola vaccine, human trials for
which have started in the UK and US. Another leading candidate is
Tekmira Pharmaceuticals Corporation’s (TKMR) TKM-Ebola, which the
US Food and Drug Administration (FDA) recently approved for
emergency use.
要点：Lamivudine似乎可以治疗Ebola，但没有实验室依据证实。希望抗艾药物真能
治愈Ebola。
（四）Ebola的预防和治疗
预防：
There is no FDA-approved vaccine available for Ebola.
If you travel to or are in an area affected by an Ebola outbreak,
make sure to do the following:
1. Practice careful hygiene. For example, wash your hands with
soap and water or an alcohol-based hand sanitizer and avoid
contact with blood and body fluids.
2. Do not handle items that may have come in contact with an
infected person’s blood or body fluids (such as clothes, bedding,
needles, and medical equipment).
3. Avoid funeral or burial rituals that require handling the body
of someone who has died from Ebola.
4. Avoid contact with bats and nonhuman primates or blood, fluids,
and raw meat prepared from these animals.
5. Avoid hospitals where Ebola patients are being treated. The
U.S. embassy or consulate is often able to provide advice on
facilities.
6. After you return, monitor your health for 21 days and seek
medical care immediately if you develop symptoms of Ebola.
治疗：
No FDA-approved vaccine or medicine (e.g., antiviral drug) is
available for Ebola.
Symptoms of Ebola are treated as they appear. The following basic
interventions, when used early, can significantly improve the
chances of survival:
1. Providing intravenous fluids (IV)and balancing electrolytes
(body salts)
2. Maintaining oxygen status and blood pressure
Treating other infections if they occur
3. Experimental vaccines and treatments for Ebola are under
development, but they have not yet been fully tested for safety or
effectiveness.
Recovery from Ebola depends on good supportive care and the
patient’s immune response. People who recover from Ebola infection
develop antibodies that last for at least 10 years, possibly
longer. It isn't known if people who recover are immune for life
or if they can become infected with a different species of Ebola.
Some people who have recovered from Ebola have developed long-term
complications, such as joint and vision problems.
要点：Ebola的预防和控制尚没有特异性方法，但流行病学预防措施是有效可行的。
（五）Ebola疫苗：两个领先者
1、TKM-Ebola
TKM-Ebola is an experimental drug for Ebola disease.
TKM-Ebola is being developed by Tekmira Pharmaceuticals Corp., a
company located in Vancouver, Canada.The drug was formerly known
as Ebola-SNALP.
It is a combination of Small interfering RNAs targeting three of
the seven proteins in Ebola virus: Zaire Ebola L polymerase, Zaire
Ebola membrane-associated protein (VP24), and Zaire Ebola
polymerase complex protein (VP35), formulated with Tekmira's lipid
nanoparticle technology.
In January 2014, Tekmira commenced a Phase I clinical trial of
TKM-Ebola to assess its safety in healthy people. The FDA put the
trial on clinical hold in July 2014 to assess results, after some
subjects had flu-like responses. In August, the FDA changed the
status to "partial hold", allowing the drug to be used under
Expanded access in people infected with Ebola but with the Phase I
trial still suspended.
2、ZMapp
ZMapp is an experimental biopharmaceutical drug comprising three
humanized monoclonal antibodies under development as a treatment
for Ebola virus disease. The drug was first tested in humans
during the 2014 West Africa Ebola virus outbreak and was credited
as helping save lives, but it has not been subjected to a
randomized clinical trial to prove its safety or its efficacy.
Like intravenous immunoglobulin therapy, ZMapp contains
neutralizing antibodies that provide passive immunity to the virus
by directly and specifically reacting with it in a "lock and key"
fashion.
The ZMapp drug is being developed by Mapp (Leaf) Biopharmaceutical
Inc., based in San Diego.ZMapp is composed of three monoclonal
antibodies (mAbs) that have been humanized by genetic engineering.
The components are humanized monoclonal antibody c13C6 from a
previously-existing antibody cocktail called "MB-003" and two
humanized mAbs from a different antibody cocktail called "ZMab",
c2G4 and c4G7.
要点：Ebola疫苗研究有些进展，但要走的路依旧很长。 | g********d
发帖数: 19244 | 2 请讲中文
【在 d******5 的大作中提到】
: 依博拉病（Ebola virus disease）：真相和热点
: 博客文章：
: http://www.mitbbs.com/pc/pccon.php?id=14439&nid=338895
: 几天来，由于在德州Dalas发现美国国内首例病例，Ebola成了人们谈论的热点话题，
: Ebola相关生化药股也在爆涨中。
: Ebola可怕么？它如何传播？如何预防和治疗Ebola？
: 这里讨论了一些关于Ebola的热点问题：
: （一）Ebola的真相
: 世界卫生组织（WHO）列举的关于Ebola的关键事实：
: 1. Ebola virus disease (EVD), formerly known as Ebola haemorrhagic
| d******5
发帖数: 4273 | 3 外国人的病，与讲中文有何关系？！
【在 g********d 的大作中提到】
: 请讲中文
| h******x
发帖数: 10156 | | d******5
发帖数: 4273 | 5 捡里面的中文看就行啦！
纯粹科普！
估计有人看不懂，我把要点用中文总结了。
【在 h******x 的大作中提到】
: 看着费劲
| s***k
发帖数: 2117 | | d******5
发帖数: 4273 | 7 只是觉得香港离我们很远，但Ebola离我们很近。
与香港的混乱相比，我关心Ebola多些。
【在 s***k 的大作中提到】
: 谢谢科普。
| d******5
发帖数: 4273 | 8 不过，港独危害远甚于Ebola。
当然，在当今中国，港独成不了气候。 | d******5
发帖数: 4273 | 9 美国国内发现的首例Ebola病例死了，到目前还没有发现新病例。 | d******5
发帖数: 4273 | 10 Ebola在非洲的情况很严峻，人力物力不济，面临失控。 | | | h***a
发帖数: 8 | 11 你这头像分明是要跟LZ对着干
大战一百回合之后，你俩谁先变成bushmeat？
【在 h******x 的大作中提到】
: 看着费劲
| h***a
发帖数: 8 | 12 你这头像分明是要跟LZ对着干
大战一百回合之后，你俩谁先变成bushmeat？
【在 h******x 的大作中提到】
: 看着费劲
| h*********n
发帖数: 11319 | 13 现在对埃博拉传播途径的研究还很不全面，比如很多人就怀疑ebola可以通过间接接触
传播，而且至少可以在近距离内通过aerosol传播。否则无法解释埃博拉扩散如此之快
，而且大量医务人员被感染的事实
【在 d******5 的大作中提到】
: 依博拉病（Ebola virus disease）：真相和热点
: 博客文章：
: http://www.mitbbs.com/pc/pccon.php?id=14439&nid=338895
: 几天来，由于在德州Dalas发现美国国内首例病例，Ebola成了人们谈论的热点话题，
: Ebola相关生化药股也在爆涨中。
: Ebola可怕么？它如何传播？如何预防和治疗Ebola？
: 这里讨论了一些关于Ebola的热点问题：
: （一）Ebola的真相
: 世界卫生组织（WHO）列举的关于Ebola的关键事实：
: 1. Ebola virus disease (EVD), formerly known as Ebola haemorrhagic
| d******5
发帖数: 4273 | 14 nod
【在 h*********n 的大作中提到】
: 现在对埃博拉传播途径的研究还很不全面，比如很多人就怀疑ebola可以通过间接接触
: 传播，而且至少可以在近距离内通过aerosol传播。否则无法解释埃博拉扩散如此之快
: ，而且大量医务人员被感染的事实
| d******5
发帖数: 4273 | 15 Ebola Came To America Last Week. Since Then: 5,000 False Alarms. Zero New
Ebola Cases.
http://www.forbes.com/sites/dandiamond/2014/10/08/since-ebola-w
American emergency rooms prepare as Ebola fear spreads
http://www.cnn.com/2014/10/10/health/ebola-crisis/index.html | d******5
发帖数: 4273 | 16 Texas health care worker tests positive for Ebola
http://www.usatoday.com/story/news/nation/2014/10/1
2/texas-health-care-worker-ebola/17147449/
A health care worker at Texas Health Presbyterian
Hospital who provided care for the Ebola patient
who died there last week has tested positive for
the deadly virus, authorities said Sunday.
The care-giver reported having a fever Friday night
and was hospitalized, isolated and referred for
testing within 90 minutes, Clay Jenkins, Dallas
County's chief executive and its Homeland Security
director, said at a news conference.
"While this is obviously bad news, it is not news
that should bring about panic," Jenkins said. "We
knew it was a possibility that a second person
would contract the virus. We had a contingency plan
in place."
Jenkins said the preliminary test result was
received late Saturday, and that the Centers for
Disease Control and Prevention would run a
confirmation test. He said he was certain Ebola
would be confirmed. The worker, who requested
anonymity, was listed in stable condition, Jenkins
said.
Dan Varga, chief clinical officer for the hospital
group that includes Texas Health Presbyterian, said
the health care worker had worn full protective
gear when working with Thomas Eric Duncan, who died
Wednesday.
Tom Frieden, head of the CDC, told CBS's Face the
Nation that his agency will investigate how a
worker in full gear contracted the virus.
"Clearly there was a breach in protocol," Frieden
said. "We have the ability to prevent the spread of
Ebola by caring safely for patients … We'll conduct
a full investigation of what happens before health
workers go in, what happens when they're there, and
what happens in the taking out, taking off their
protective equipment because infections only occur
when there's a breach in protocol." | d******5
发帖数: 4273 | 17 从德州新病例（为医务人员）情况看，Ebola可通过飞沫传播！ | d******5
发帖数: 4273 | 18 血清治疗是有效的，但来源有限。
iRNA治疗传染病，要打个大疑问号。
小分子药物和抗体药物，可能比较现实。
抗艾滋病药物如果真有效，就是福音了。
德州死亡病例，使用CMRX的抗病毒药物brincidofovir，时机显然不对，太晚了！ |
|
