Auburn professor speaks on the Ebola outbreak in the Democratic Republic of the Congo

Stewart Schneller, a chemistry and biochemistry professor in Auburn University’s College of Sciences and Mathematics, has for many years studied the Ebola virus and has even worked with a research team at Auburn to design compounds to fight the compromising effects on the immune system that viral infections such as Ebola can cause. Schneller offers a commentary below involving the Ebola virus, including recent news of more Ebola outbreaks in the Democratic Republic of the Congo. He points to data that so far suggests  tracing patient contact with non-infected people and vaccination have not proven to prevent transmission. 

Since its discovery in 1976, Ebola, an infectious virus (EBOV, named for the Ebola River), has caused horrific outbreaks.  Except for the major outbreak in west Africa in the 2014-2016 period and in 2000 in Uganda, it has been contained preventing other extensive flareups.  However, the recent (beginning in August 2018) EBOV outbreak in the North Kivu province of the Democratic Republic of the Congo (DRC), has been designated as the second largest (and deadliest) outbreak in history and serves as a reminder that outbreaks will continue (EBOV is endemic to DRC and can spread beyond).  The severity of the EBOV pathogen resides in its ability to circumvent its host (humans) immune system to allow for its almost uncontrollable replication. 

Certainly, the numbers of infected individuals in the current outbreak is far less than the west Africa situation, containment is a challenge that must be overcome to prevent spread.  As an outgrowth of the West Africa epidemic, our lab and others have been motivated to seek means to curtail the spread and effects of Ebola.  From those efforts, several methods developed by pharmaceutical companies and the National Institutes of Health have been fast-tracked for deployment by: (1) monoclonal antibodies ZMapp, REGN and mAb and Remdesivir, small molecule agent. 

While none of these therapeutic approaches have received governmental approval for broad application, the World Health Organization has authorized their use outside of the parameters of a thorough clinical trial (in a sense, their use in the DRC is serving as a clinical trial) under the compassionate use protocol.

The 2014-2016 epidemic also provided the impetus for the creation of a vaccine by Merck/New Links Genetics that Is foreseen as being useful for responders and for application of the ring method for controlling viral spread (similar to what was used in the elimination on smallpox).  

There are, of course, challenges, with all of these methods:  (1) the ceaseless violent unrest in  in the region of infectivity; (2) patient monitoring issues; (3) antibody  therapy requiring multiple infusions; (4) the need to monitor the patient's liver with the use of Remdesivir; (5) with vaccines, an unresponsive immune systems and/or debilitating side effects; and, (6) the burial rituals of the local people that include touching the body of the deceased (EBOV is spread by bodily fluids).  Furthermore, data is beginning to accumulate that suggests tracing patient contact with non-infected people and vaccination have not prevented transmission.  Also, significantly, is an increase of recalcitrant malaria (a parasite) in the region effected by EBOV.

While the therapeutic progress towards managing EBOV has been remarkable since the 2014-2016 epidemic and offers optimism, the search for new or modified approaches must be ongoing to deal with the setbacks of current procedures, with the certain mutations under which EBOV will evolve to survive, and its ese of spread. .