Skip to Content
by HealthDay staff

Biggest Ever Weekly Rise in Ebola Cases, U.N. Agency Says

About 500 new infections reported across West Africa, including first case in Senegal
FRIDAY, Aug. 29, 2014 (HealthDay News) -- The West African Ebola outbreak took a more deadly turn Friday with the World Health Organization announcing an estimated 500 new cases this week -- the biggest jump in infections so far.
Most of the new cases arose in Liberia, the U.N. health agency said, but cases in Guinea and Sierra Leone also rose sharply, the Associated Press reported.
"There are serious problems with case management and infection prevention and control," according to the WHO report. "The situation is worsening in Liberia and Sierra Leone."
Senegal -- a prime tourist destination in the region -- has also now recorded its first case, an infected university student from Guinea who sought treatment at a hospital in Senegal's capital city, Dakar, the AP reported.
According to Senegal's Health Minister, Awa Marie Coll Seck, the young man had had contact with Ebola patients in Guinea and has now been placed under quarantine. Tests have confirmed he is infected with Ebola virus, the AP said.
The news follows a WHO update released on Thursday that warned that the deadly Ebola outbreak hitting five West African nations could eventually infect more than 20,000 people.
Already the largest Ebola outbreak ever, the viral infection has produced 3,069 cases so far and killed 1,552 people in Guinea, Liberia, Nigeria and Sierra Leone, with Senegal now added to that list.
Nearly 40 percent of the total number of reported cases have occurred in the past three weeks, the health agency said.
"This far outstrips any historic Ebola outbreak in numbers. The largest outbreak in the past was about 400 cases," Dr. Bruce Aylward, WHO's assistant director-general for emergency operations, said at a news conference, the AP reported.
In the meantime, many American universities say they plan to run extra health checks on college students arriving from the affected region.
According to the AP, about 30 students from Nigeria are expected to arrive this semester at the University of Illinois. According to Dr. Robert Palinkas, director of the university's health center, the Nigerian students will be asked to undergo a temperature check for signs of fever and to have a private discussion about Ebola when they arrive at the university health center for required immunization paperwork and tuberculosis testing.
Health experts stress that the threat to U.S. college students remains very small, but Palinkas told the AP that the added precautions should reassure parents.
"Parents are comforted to know that there is a screening process, that we are alert for it, that we are prepared for it," he said, "and that we're doing everything we can without infringing on the rights of anybody to make sure their son or daughter is going to have the lowest risk possible."
Similar precautions are being conducted at the University at Buffalo in New York, Mercer University in Georgia, Liberty University in Lynchburg, Va., and the University of Akron in Ohio, the AP said.
In response to the crisis, WHO unveiled a battle plan Thursday that calls for stopping Ebola transmissions within six to nine months, while "rapidly managing the consequences of any further international spread," the WHO said in a news release.
The plan calls for spending $489 million over the next nine months and enlisting 750 international workers and 12,000 national workers, the AP reported.
Also Thursday, the U.S. National Institutes of Health (NIH) said it would begin testing an experimental Ebola vaccine in humans next week. It will be tested in 20 healthy adults in Maryland to see if it's safe and able to produce an appropriate immune system response.
The vaccine was developed by the U.S. National Institute of Allergy and Infectious Diseases and drug maker GlaxoSmithKline. It will also be tested on healthy volunteers in Great Britain and the West African nations of Gambia and Mali, the NIH said.
Unlike diseases such as tuberculosis or flu, Ebola isn't spread by breathing air from an infected person. Transmission requires direct contact with blood, secretions, organs or other body fluids of infected living or dead persons or animals, according to the WHO.
Ebola, one of the world's most virulent diseases, kills up to 90 percent of people it infects. Symptoms include a sudden fever, intense weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhea, rash, poor kidney and liver function and, in some cases, both internal and external bleeding.
Many of those killed during the current Ebola outbreak have been health care workers.
According to the CDC, health care workers must be able to recognize a case of Ebola and be ready to use "isolation precautions or barrier nursing techniques." Barrier nursing techniques include:
wearing protective clothing, such as masks, gloves, gowns, and goggles; using infection-control measures, including complete equipment sterilization and routine use of disinfectant; isolating patients with Ebola from contact with unprotected persons.
The aim of these techniques is to avoid contact with the blood or secretions of an infected patient, the CDC said.
More information
For more on Ebola virus, visit the U.S. Centers for Disease Control and Prevention (http://www.cdc.gov/vhf/ebola/ ).
SOURCES: U.S. National Institutes of Health, news release, Aug. 28, 2014; World Health Organization, news release, Aug. 28, 2014; Associated Press
by HealthDay staff

Monkey Trial Supports Ebola Drug That May Have Helped 2 Stricken Americans

All 18 rhesus monkeys infected with the virus survived after getting the experimental medication, researchers report
FRIDAY, Aug. 29, 2014 (HealthDay News) -- An experimental Ebola drug previously given to two American aid workers successfully cured a group of monkeys infected with the deadly virus in laboratory tests, researchers report.
The drug, ZMapp, prompted recovery in all 18 monkeys who received it, even if they didn't get the medication until five days after infection.
ZMapp even cured monkeys with advanced cases of Ebola who were days or even hours away from death, said study senior author Gary Kobinger, chief of special pathogens for the Public Health Agency of Canada.
"The level of improvement was beyond my own expectations," Kobinger said, noting that the drug cleared the liver damage, excessive bleeding and horrible rashes that are the hallmarks of Ebola infection.
This study provides some scientific evidence for the effectiveness of ZMapp, which aid workers Dr. Kent Brantly and Nancy Writebol both received under "compassionate use" guidelines after contracting Ebola while in Liberia fighting the current outbreak in West Africa.
Brantly and Writebol successfully fended off the virus. They were flown home for treatment in the United States, and last week were released from hospital care in Atlanta.
The results of the monkey trial were published Aug. 29 in the journal Nature.
Because Brantly and Writebol were given ZMapp outside of a clinical trial, physicians and public health officials have been reluctant to fully credit the drug with their recovery. Further clouding the picture, a Liberian doctor and a Spanish priest subsequently died from Ebola despite receiving the drug.
"We hope that initial safety testing in humans will be undertaken soon, preferably within the next few months, to enable the compassionate use of ZMapp as soon as possible," the researchers concluded in their paper.
The West Africa outbreak is the largest ever for Ebola, with 3,069 infected and 1,552 dead. The World Health Organization (WHO) estimates that more than 20,000 people could become infected before the end of the outbreak.
In the face of this health-care crisis, a WHO expert panel ruled earlier this month that it would be ethical to treat Ebola patients with experimental medications like ZMapp.
"Given the severity of this condition and the fact that there's nothing else available, this is as good as it gets," Dr. Ambreen Khalil, an infectious disease specialist with Staten Island University Hospital in New York City, said of the results from the ZMapp monkey trial. "Our focus should be now on the people who are rapidly dying in Africa. In those patients, ZMapp should be used, based on this study."
ZMapp is a cocktail of three laboratory-produced antibodies, which have been derived from two previous antibody cocktails for Ebola, Kobinger said.
In the study, researchers infected 21 rhesus monkeys with an Ebola strain similar to the one raging through West Africa. Then they administered ZMapp to 18 of the monkeys starting on days three, four or five after infection. The monkeys received three doses of the drug at three-day intervals.
All 18 animals treated with ZMapp survived, regardless of how sick they had become. The three monkeys not treated with ZMapp all died by day eight.
Because the Ebola virus strain used to infect monkeys in this experiment is different to the strain in the current West African outbreak, the researchers also performed lab tests that showed that ZMapp does bind to the new virus strain and would likely be as effective against it, Kobinger said.
ZMapp is the only experimental treatment that has been deployed against Ebola during this outbreak, but others could be on the way.
The U.S. National Institutes of Health and drug manufacturer GlaxoSmithKline are expected to announce that they are starting the first human trials of a potential Ebola vaccine, NBC News reported Wednesday.
More information
For more on the Ebola virus, visit the U.S. Centers for Disease Control and Prevention (http://www.cdc.gov/vhf/ebola/ ).
SOURCES: Gary Kobinger, Ph.D., chief, special pathogens, Public Health Agency of Canada; Ambreen Khalil, M.D., infectious disease specialist, Staten Island University Hospital, New York City; Aug. 29, 2014, Nature, online
by HealthDay staff

'Doctor-Shopping' for Painkillers Common After Broken-Bone Surgery, Study Finds

1 in 5 patients sought narcotics from multiple physicians
FRIDAY, Aug. 29, 2014 (HealthDay News) -- About one in five patients operated on for broken bones or other orthopedic trauma shops around for additional painkillers after surgery, a new study finds.
Less-educated patients and patients who had used narcotic painkillers previously were several times more likely to be "doctor shoppers," said study lead author Dr. Brent Morris, a shoulder and neck surgeon in Lexington, Ky. Overall, he said, the study suggests that doctors aren't talking to one another about the painkiller needs of their patients.
"There needs to be coordination if additional pain medications are needed," he said. "Patients should not be receiving multiple narcotic pain medication prescriptions from multiple providers without coordinating with their treating surgeon."
Use of narcotic painkillers for nonmedical purposes is a serious concern in the United States. Unintentional overdose deaths increased 124 percent from 1999 to 2007 largely because of prescription narcotics, according to background information in the study.
Doctor shoppers go to multiple physicians in search of prescription medications, often narcotic painkillers, anti-anxiety drugs such as Xanax, or medications to treat attention deficit hyperactivity disorder (ADHD), said Julie Worley, an assistant professor of nursing at Rush University in Chicago, who has studied the trend.
Patients who doctor-shop are often addicted to painkillers or looking to get drugs they can sell, Worley said. Most states track prescriptions of narcotic painkillers to prevent abuse, but the systems "have many issues and aren't foolproof," she said. In addition, she said, physicians are often wary of confronting their patients.
In the new study, published in the August issue of the Journal of Bone & Joint Surgery, researchers examined the medical and pharmacy records of 130 patients ages 18 to 64 who sought treatment at Nashville's Vanderbilt University Medical Center in 2011.
They looked at painkiller prescriptions for three months before admission and six months after discharge. All of the patients suffered from single orthopedic injuries such as broken legs, ankles and arms.
"The surgeon that performed the operation is typically responsible for pain control immediately after surgery," Morris said. "Pain control after this type of surgery often requires narcotic pain medications for the first several weeks."
Overall, 21 percent of the patients tried to get narcotic painkillers from more than just the surgeon who treated them. Patients who weren't college-educated were 3.2 times more likely to try to get the drugs from more than one doctor, and those who had used narcotic painkillers before were 4.5 times more likely.
The doctor shoppers -- who were mostly white males -- used narcotics for about 3.5 months after surgery whereas single-provider painkiller users took them for four weeks on average, the study found. Many obtained seven or more narcotic prescriptions compared to two prescriptions for single-provider patients.
Whether the doctor shoppers had legitimate pain needs isn't clear from the study. "The ER is definitely an area where people doctor-shop. But I don't know that they're going to be having an orthopedic trauma to get drugs," said Worley.
It's possible, she said, that some of the patients went to other doctors, perhaps their own physicians, in search of painkillers.
Whatever the reasons, Morris and Worley called for more reliable systems to prevent patients from abusing narcotic painkillers.
Worley said physicians should be wary of patients who pay with cash since doctor-shoppers with insurance are more easily detected. It's also helpful to check patients for needle marks and to use more extensive drug test procedures to make sure patients aren't sneaking in someone else's urine, she said.
Morris added that one important way to help identify patients who are doctor-shopping is by using a prescription drug-monitoring program. Nearly all states have an active prescription drug-monitoring program, "but only seven states actually mandate use of these programs," he said.
"Physicians and patients have to work together," he added, "to establish reasonable expectations for pain control and to identify at-risk patients early on to allow appropriate interventions."
More information
For more about painkiller abuse, see the U.S. National Institute on Drug Abuse (http://www.easyread.drugabuse.gov/painkiller-addiction-signs.php ).
SOURCES: Brent Morris, M.D., shoulder and neck surgeon, Lexington, Ky.; Julie Worley, Ph.D., psychiatric and family nurse practitioner and assistant professor of nursing, Rush University, Chicago, Ill.; August 2014, Journal of Bone & Joint Surgery
by HealthDay staff

Could Too Much Salt Harm MS Patients?

Researchers find a link but say it's too soon to recommend reducing sodium intake
THURSDAY, Aug. 28, 2014 (HealthDay News) -- Too much salt in the diet may worsen symptoms of multiple sclerosis (MS), a new study from Argentina suggests.
"Many environmental factors affect MS, such as vitamin D, smoking and Epstein Barr virus infection. Our study shows that high salt intake may be another environmental factor affecting MS patients," said lead researcher Dr. Mauricio Farez, of the Raul Carrea Institute for Neurological Research in Buenos Aires.
Multiple sclerosis is a disease of the nervous system that causes weakness, visual disturbances, trouble with balance, numbness and thinking and memory problems. The most common form is called relapsing-remitting MS, meaning symptoms subside and then become worsen.
Earlier research found that salt may alter autoimmune response, which is involved in the development of MS.
Farez cautioned that this study does not show that salt causes MS to worsen, but there does seem to be an association.
"This is a small observational study showing a relationship between salt intake and MS disease activity, and these data need to be further validated in larger studies, including different populations," he said.
For the study, Farez's team measured the levels of sodium (the main component of salt), creatinine and vitamin D in the blood and urine of 70 patients with the relapsing-remitting form of MS. Creatinine is a marker of inflammation, and low levels of vitamin D have been associated with MS.
Sodium intake was divided into three levels: less than 2 grams daily, between 2 and 4.8 grams a day, and more than 4.8 grams daily. Current guidelines for heart disease prevention recommend a maximum sodium intake of 1.5 grams to 2.4 grams per day. At the upper end, that's just under half a teaspoon of table salt a day.
Farez's group found that people with daily sodium intake of between 2 and 4.8 grams and those who consume more than 4.8 grams -- a little less than a teaspoon of salt -- were up to four times more likely to have more episodes of worsening MS symptoms as those who consumed the least salt.
To check the progression of the disease in patients' brains, the researchers analyzed X-rays and scans. They found that patients who had the highest salt intake were about 3.4 times more likely to have their disease worsen, compared with those with the lowest salt intake.
Similar results were found in a second group of 52 MS patients, the researchers added.
"It is too soon to say that MS patients should cut their salt intake," Farez said. "Our findings could serve as a basis for clinical trials with salt restriction in MS patients," he said.
The report was published Aug. 28 in the Journal of Neurology, Neurosurgery and Psychiatry.
Salt's influence on MS is a subject of increasing interest, said Nicholas LaRocca, vice president of health care delivery and policy research at the National Multiple Sclerosis Society.
"At this stage you really can't assign cause and effect, but it's beginning to look like there is a significant role of salt in MS disease activity and progression," he said.
The mechanism for this association isn't known, LaRocca said. Salt may make the immune system more prone to the disease, he suggested.
He agreed that there isn't enough evidence to recommend that MS patients reduce salt in their diet.
"However, in a more general sense, we should all be watching our salt intake. We should all be careful about consuming excessive amounts of salt," he said.
For the study, salt intake was estimated from sodium excreted in urine samples the participants provided three times over nine months. In addition, the researchers tracked the course of the patients' MS from 2010 to 2012.
After accounting for factors such as smoking, age, gender, length of time after diagnosis, weight, treatment and vitamin D, the link between more salt and worsening MS remained, the researchers said.
More information
For more on MS, visit the National Multiple Sclerosis Society (http://www.nationalmssociety.org/ ).
SOURCES: Mauricio Farez, M.D., department of neurology, Raul Carrea Institute for Neurological Research, Buenos Aires, Argentina; Nicholas LaRocca, Ph.D., vice president, health care delivery and policy research, National Multiple Sclerosis Society, New York City; Aug. 28, 2014, Journal of Neurology, Neurosurgery and Psychiatry
by HealthDay staff

Encouraging Your Baby's Babbling May Speed Language Development

Researchers found that when parents responded, infants began to form more complex sounds
FRIDAY, Aug. 29, 2014 (HealthDay News) -- The way that parents respond to their infant's babbling might affect the baby's language development, a new study suggests.
Over six months, researchers observed the interactions between 12 mothers and their infants during free play. The sessions were 30 minutes long and happened twice a month. The infants were 8 months old at the start of the study.
When parents listened and responded to a baby's babbling, infants began to form complex sounds. The babies whose parents responded to babbling also started using language more quickly, according to the study published recently in the journal Infancy.
Language skills developed more slowly in babies whose mothers didn't make as much effort to understand their babbling, and instead sometimes directed their infants' attention to something else.
The results show that parents who actively interact with their babbling baby can hasten the child's language development, according to the researchers.
"It's not that we found responsiveness matters. It's how a mother responds that matters," study corresponding author Julie Gros-Louis, an assistant professor of psychology at the University of Iowa, said in a university news release.
The study shows that "social stimulation shapes at a very early age what children attend to. And if you can show the parent can shape what an infant attends to, there is the possibility to shape what the child is sensitive to. They are learning how to learn," study co-author Andrew King, a senior scientist in psychology at Indiana University, said in the news release.
More information
The American Speech-Language-Hearing Association has more about speech and language development (http://www.asha.org/public/speech/development/ ).
SOURCE: University of Iowa, news release, Aug. 27, 2014
by HealthDay staff

Health Highlights: Aug. 29, 2014

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:
Many Foods' 'Trans-Fat-Free' Claims False: Study
Many processed foods contain more trans-fats than you might suspect, according to a New York City health department study.
That's because many of the products that claim to be trans-fat-free actually contain some of the unhealthy fats. The researchers examined 4,340 top-selling packaged foods and found that nine percent had trans-fats, NBC News reported.
Of the foods found to have trans-fats, 84 percent said they had 0 grams of the artery-clogging substance, according to the study in the journal Preventing Chronic Disease.
"This labeling is cause for concern because consumers, seeing the 0 g trans-fat on the Nutrition Facts label, are probably unaware that they are consuming trans-fat," wrote Jenifer Clapp, of the New York City Department of Health and Mental Hygiene, and colleagues, NBC News reported.
Joan Rivers 'Resting Comfortably,' Daughter Says
Joan Rivers' daughter says the 81-year-old comedian is resting comfortably in Mount Sinai Hospital in New York City after being rushed there Thursday.
"I want to thank everyone for the overwhelming love and support for my mother," Melissa Rivers said in a statement released by the hosptial. "She is resting comfortably and is with our family. We ask that you continue to keep her in your thoughts and prayers."
Rivers was taken to the hospital after an emergency call that she was in cardiac arrest, a law enforcement official told ABC News.
The incident occurred while Rivers was having surgery on her vocal cords at an Upper East Side clinic called Yorkville Endoscopy, according to TMZ.
by HealthDay staff

Health Tip: Teach Your Child to Read Food Labels

Have the child check each snack's nutrition
(HealthDay News) -- Teaching a child to make healthy food choices empowers the child to lead a healthier lifestyle when he or she is grown.
The Academy of Nutrition and Dietetics offers these tips about children and food labels:
Before choosing a snack, encourage your child to check its label for calories and fat. Have your child measure what he or she considers an appropriate serving size, then show the actual serving size. Pre-portion your child's snack to the label's serving size. In a supermarket, send your child to find healthy groceries by scanning nutrition labels. Have your child pack his or her own lunch, keeping it under 600 calories. Offer your child praise when the child reads food labels.
by HealthDay staff

Take Steps to Control Bunions

Ignoring these painful bumps will only make them worse, foot doctor says
FRIDAY, Aug. 29, 2014 (HealthDay News) -- If you have bunions, taking care of them now can help you avoid more serious treatment later, an expert says.
A bunion is a bump that forms on the joint of the big toe when bone or tissue moves out of place and extends beyond the normal anatomy of the toe. Left untreated, bunions can cause debilitating pain and may require surgery to correct, said Brent Rosenthal, a podiatrist and podiatric surgeon at CentraState Medical Center in Freehold, N.J.
To prevent bunions, avoid wearing shoes with pointed triangular tips and don't wear high heels for long periods of time each day, Rosenthal said. You should know your correct shoe size, which can increase with age, weight gain and pregnancy, he added.
If you do develop a bunion, start wearing shoes with a wide and deep toe box. Shoe inserts may reduce symptoms and prevent the bunion from getting worse, according to Rosenthal.
He also suggested using over-the-counter, non-medicated bunion pads whenever you wear shoes. If the bunion is inflamed and sore, apply ice packs several times a day, he said.
If these initial treatments don't help, see a podiatrist, a doctor who specializes in conditions of the feet and ankle. The doctor might prescribe an anti-inflammatory drug and/or cortisone injection to ease pain and inflammation. Ultrasound therapy is widely used to treat bunion-related soft tissue damage.
If these therapies fail, surgery may be required to relieve pressure and repair the toe joint, said Rosenthal, who noted that recovery from the surgery takes time and discomfort can last weeks.
More information
The U.S. National Library of Medicine has more about bunions (http://www.nlm.nih.gov/medlineplus/ency/article/001231.htm ).
SOURCE: CentraState Medical Center, news release
by HealthDay staff

Ebola Outbreak Could Infect 20,000 People, U.N. Says

World Health Organization unveils $489 million plan to combat the outbreak in West Africa
THURSDAY, Aug. 28, 2014 (HealthDay News) -- The deadly Ebola outbreak hitting four West African nations could eventually infect more than 20,000 people, the World Health Organization announced Thursday.
Already the largest Ebola outbreak ever, the viral infection has produced 3,069 cases so far and killed 1,552 people in Guinea, Liberia, Nigeria and Sierra Leone.
Nearly 40 percent of the total number of reported cases have occurred in the past three weeks, the health agency said.
"This far outstrips any historic Ebola outbreak in numbers. The largest outbreak in the past was about 400 cases," Dr. Bruce Aylward, WHO's assistant director-general for emergency operations, said at a news conference, the Associated Press reported.
Part of the problem, he said, is that the outbreak is occurring in large cities and broad sections of the affected countries.
"What we are seeing today, in contrast to previous Ebola outbreaks: multiple hotspots within these countries -- not a single, remote forested area, the kind of environments that have been tackled in the past. And then not multiple hotspots within one country, but international disease," Aylward said.
In response to the crisis, the U.N. health agency unveiled a battle plan Thursday that calls for stopping Ebola transmissions within six to nine months, while "rapidly managing the consequences of any further international spread," the WHO said in a news release.
The plan calls for spending $489 million over the next nine months and enlisting 750 international workers and 12,000 national workers, the AP reported.
Also Thursday, the U.S. National Institutes of Health (NIH) said it would begin testing an experimental Ebola vaccine in humans next week. It will be tested in 20 healthy adults in Maryland to see if it's safe and able to produce an appropriate immune system response.
The vaccine was developed by the U.S. National Institute of Allergy and Infectious Diseases and drug maker GlaxoSmithKline. It will also be tested on healthy volunteers in Great Britain and the West African nations of Gambia and Mali, the NIH said.
Earlier this week, Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, visited Guinea, Liberia and Sierra Leone, where he acknowledged that the virus currently has the "upper hand" in the outbreak.
"Lots of hard work is happening, lots of good things are happening," Frieden said during a meeting in Liberia, the AP reported. "But the virus still has the upper hand."
"Ebola doesn't spread by mysterious means, we know how it spreads," he said. "So we have the means to stop it from spreading, but it requires tremendous attention to every detail."
Unlike diseases such as tuberculosis or flu, Ebola isn't spread by breathing air from an infected person. Transmission requires direct contact with blood, secretions, organs or other body fluids of infected living or dead persons or animals, according to the WHO.
Ebola, one of the world's most virulent diseases, kills up to 90 percent of people it infects. Symptoms include a sudden fever, intense weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhea, rash, poor kidney and liver function and, in some cases, both internal and external bleeding.
Many of those killed during the current Ebola outbreak have been health care workers.
According to the CDC, health care workers must be able to recognize a case of Ebola and be ready to use "isolation precautions or barrier nursing techniques." Barrier nursing techniques include:
wearing protective clothing, such as masks, gloves, gowns, and goggles; using infection-control measures, including complete equipment sterilization and routine use of disinfectant; isolating patients with Ebola from contact with unprotected persons.
The aim of these techniques is to avoid contact with the blood or secretions of an infected patient, the CDC said.
More information
For more on Ebola virus, visit the U.S. Centers for Disease Control and Prevention (http://www.cdc.gov/vhf/ebola/ ).
SOURCES: U.S. National Institutes of Health, news release, Aug. 28, 2014; World Health Organization, news release, Aug. 28, 2014; Associated Press
by HealthDay staff

Gene Research Yields Insights Into Ebola Virus

Strain tied to West Africa outbreak has mutated hundreds of times, and only spreads among humans
THURSDAY, Aug. 28, 2014 (HealthDay News) -- Genetic research performed during the early days of the Ebola outbreak in West Africa has given scientists unprecedented insight into how the virus mutates and spreads.
Researchers report in the Aug. 28 online issue of Science that they have now determined the following:
The Ebola strains responsible for the current outbreak likely have a common ancestor, dating back to the very first recorded outbreak of Ebola in central Africa in 1976. The virus is spreading from person-to-person, an insight that will help guide public health efforts to quell the outbreak. Ebola has mutated often during the current crisis, undergoing hundreds of genetic changes that separate the current virus from strains detected in previous outbreaks.
The researchers' efforts have quadrupled the amount of genetic data available on Ebola, creating mounds of new and publicly available information about the DNA structure of the deadly virus, said senior study author Dr. Pardis Sabeti.
Sabeti is a senior associate member at the Broad Institute of MIT and Harvard and an associate professor at Harvard University.
The ongoing Ebola outbreak has infected 3,069 people and claimed the lives of 1,552, according to the World Health Organization.
The genetic researchers rapidly sequenced and analyzed more than 99 Ebola viruses from 78 patients in Sierra Leone during the first 24 days of the outbreak there.
Government health officials traced the entrance of Ebola into Sierra Leone to the burial of a traditional healer who had treated patients in neighboring Guinea. Thirteen women who attended the burial contracted Ebola, and researchers drew viral samples from these women to begin genetic sequencing.
Such genetic data is comparable to "fingerprints at the scene of the crime," said Dr. Lee Norman, chief medical officer of the University of Kansas Hospital.
"It tells you so much about how and where the virus came from, and what we can do about it," Norman said.
The team has found more than 300 genetic changes that make the 2014 Ebola virus distinct from the strains tied to previous Ebola outbreaks.
They also have found evidence that the Ebola outbreak started from a single introduction into humans, and has subsequently spread from person to person over many months. Animals are not helping spread Ebola.
"This is very important, because if you're trying to contain an outbreak that's coming in through an animal population, you have to do something about human contact with those animals," said Dr. Robert Amler, dean of the School of Health Sciences and Practice and dean of the Institute of Public Health at New York Medical College.
Knowing that the virus is only spreading from human-to-human will help public health workers use time-tested isolation and quarantine procedures to protect people against further spread, Amler said.
"The basic principles of disease control in a population still hold," he said. "That's reassuring, because we have a lot of experience in controlling disease outbreaks in densely populated areas, and those principles hold."
The researchers involved in this effort have publicly released all of the Ebola genetic information they've gathered, making it available through a U.S. National Institutes of Health database starting in June, Sabeti said.
This huge amount of genetic information regarding the virus hopefully will help spur and direct new research into therapies, vaccines and treatments for Ebola, Sabeti said.
"A lot of important findings that will come out of data will not come from us, but from others," Sabeti said, noting that some of the world's leading epidemic specialists are now working with the data they gathered.
Norman hailed the "integrity" behind making the genetic data available to the global health community.
"Releasing the DNA sequence into the public domain is just the right thing to do," he said. "That shows an altruistic intent, which is perfect for something as heart-rending as this outbreak has been."
The researchers involved in this effort have been tracking lethal viruses in West Africa since the middle of the last decade, initially focusing on the Lassa virus, Sabeti said.
When the ongoing Ebola outbreak began in Guinea, they were perfectly positioned to set up shop in Sierra Leone and start watching for the first cases there.
"We've built a lot of capacity to work with these deadly viruses in these rural areas," Sabeti said. "We had surveillance going for months before the first case came in, and of course that first case led to a devastating cascade."
More information
For more about Ebola virus, visit the U.S. Centers for Disease Control and Prevention (http://www.cdc.gov/vhf/ebola/ ).
SOURCES: Pardis Sabeti, M.D., senior associate member, Broad Institute of MIT and Harvard, and associate professor, Harvard University, Boston; Lee Norman, M.D., chief medical officer, University of Kansas Hospital, Kansas City; Robert Amler, M.D., dean, School of Health Sciences and Practice, and dean, Institute of Public Health, New York Medical College, Valhalla, N.Y.; Aug. 28, 2014, Science, online

My Health Patient Portal