Ebola medical therapy: Difference between revisions
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*Maintaining [[oxygen]] and [[blood]] levels | *Maintaining [[oxygen]] and [[blood]] levels | ||
*Treating any complicating [[infections]]. | *Treating any complicating [[infections]]. | ||
Convalescent Plasma (factors from those who have survived Ebola infection) shows promise as a treatment for the disease. [[Ribavirin]] is ineffective. [[Interferon]] is also thought to be ineffective. In monkeys, administration of an inhibitor of coagulation (rNAPc2) has shown some benefit, protecting 33% of infected animals from a usually 100% (for monkeys) lethal infection<ref name="pmid14683653">{{cite journal| author=Geisbert TW, Hensley LE, Jahrling PB, Larsen T, Geisbert JB, Paragas J et al.| title=Treatment of Ebola virus infection with a recombinant inhibitor of factor VIIa/tissue factor: a study in rhesus monkeys. | journal=Lancet | year= 2003 | volume= 362 | issue= 9400 | pages= 1953-8 | pmid=14683653 | doi=10.1016/S0140-6736(03)15012-X | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14683653 }} </ref> (unfortunately this inoculation does not work on humans). In early 2006, scientists at [[USAMRIID]] announced a 75% recovery rate after infecting four [[rhesus monkey]]s with Ebola virus and administering [[Antisense therapy|antisense drugs]]. | Convalescent Plasma (factors from those who have survived Ebola infection) shows promise as a treatment for the disease. [[Ribavirin]] is ineffective. [[Interferon]] is also thought to be ineffective. In monkeys, administration of an inhibitor of coagulation (rNAPc2) has shown some benefit, protecting 33% of infected animals from a usually 100% (for monkeys) lethal infection<ref name="pmid14683653">{{cite journal| author=Geisbert TW, Hensley LE, Jahrling PB, Larsen T, Geisbert JB, Paragas J et al.| title=Treatment of Ebola virus infection with a recombinant inhibitor of factor VIIa/tissue factor: a study in rhesus monkeys. | journal=Lancet | year= 2003 | volume= 362 | issue= 9400 | pages= 1953-8 | pmid=14683653 | doi=10.1016/S0140-6736(03)15012-X | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14683653 }} </ref> (unfortunately this inoculation does not work on humans). In early 2006, scientists at [[USAMRIID]] announced a 75% recovery rate after infecting four [[rhesus monkey]]s with Ebola virus and administering [[Antisense therapy|antisense drugs]]<ref name="pmid16703508">{{cite journal| author=Geisbert TW, Hensley LE, Kagan E, Yu EZ, Geisbert JB, Daddario-DiCaprio K et al.| title=Postexposure protection of guinea pigs against a lethal ebola virus challenge is conferred by RNA interference. | journal=J Infect Dis | year= 2006 | volume= 193 | issue= 12 | pages= 1650-7 | pmid=16703508 | doi=10.1086/504267 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16703508 }} </ref>. Postexposure [[vaccination]] with different viruses (i.e. vesicular stomatitis virus)<ref name="pmid15113924">{{cite journal| author=Garbutt M, Liebscher R, Wahl-Jensen V, Jones S, Möller P, Wagner R et al.| title=Properties of replication-competent vesicular stomatitis virus vectors expressing glycoproteins of filoviruses and arenaviruses. | journal=J Virol | year= 2004 | volume= 78 | issue= 10 | pages= 5458-65 | pmid=15113924 | doi= | pmc=PMC400370 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15113924 }} </ref><ref name="pmid17238284">{{cite journal| author=Feldmann H, Jones SM, Daddario-DiCaprio KM, Geisbert JB, Ströher U, Grolla A et al.| title=Effective post-exposure treatment of Ebola infection. | journal=PLoS Pathog | year= 2007 | volume= 3 | issue= 1 | pages= e2 | pmid=17238284 | doi=10.1371/journal.ppat.0030002 | pmc=PMC1779298 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17238284 }} </ref> and [[passive immunization]] with [[blood]] or [[serum]]<ref name="pmid9988160">{{cite journal| author=Mupapa K, Massamba M, Kibadi K, Kuvula K, Bwaka A, Kipasa M et al.| title=Treatment of Ebola hemorrhagic fever with blood transfusions from convalescent patients. International Scientific and Technical Committee. | journal=J Infect Dis | year= 1999 | volume= 179 Suppl 1 | issue= | pages= S18-23 | pmid=9988160 | doi=10.1086/514298 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9988160 }} </ref>, or recombinant human [[monoclonal antibodies]]<ref name="pmid10364354">{{cite journal| author=Maruyama T, Rodriguez LL, Jahrling PB, Sanchez A, Khan AS, Nichol ST et al.| title=Ebola virus can be effectively neutralized by antibody produced in natural human infection. | journal=J Virol | year= 1999 | volume= 73 | issue= 7 | pages= 6024-30 | pmid=10364354 | doi= | pmc=PMC112663 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10364354 }} </ref> of human survivors have been tested with non-conclusive results. | ||
==References== | ==References== | ||
Revision as of 15:37, 18 June 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Ebola is potentially lethal and since no approved vaccine or treatment is available. Treatment is primarily supportive and includes maintaining fluids and electrolytes homeostasis, adequate oxygen and blood levels and treating any complicating infections.[1] All patients with a confirmed or suspected viral hemorrhagic fever should be put in isolation and adequate contact precautions.[2]
Medical Therapy
Treatment is primarily supportive and includes:
- Minimizing invasive procedures
- Balancing electrolytes since patients are frequently dehydrated
- Replacing lost coagulation factors to help stop bleeding
- Maintaining oxygen and blood levels
- Treating any complicating infections.
Convalescent Plasma (factors from those who have survived Ebola infection) shows promise as a treatment for the disease. Ribavirin is ineffective. Interferon is also thought to be ineffective. In monkeys, administration of an inhibitor of coagulation (rNAPc2) has shown some benefit, protecting 33% of infected animals from a usually 100% (for monkeys) lethal infection[3] (unfortunately this inoculation does not work on humans). In early 2006, scientists at USAMRIID announced a 75% recovery rate after infecting four rhesus monkeys with Ebola virus and administering antisense drugs[4]. Postexposure vaccination with different viruses (i.e. vesicular stomatitis virus)[5][6] and passive immunization with blood or serum[7], or recombinant human monoclonal antibodies[8] of human survivors have been tested with non-conclusive results.
References
- ↑ "Ebola Hemorrhagic Fever Information Packet" (PDF).
- ↑ Feldmann H, Geisbert TW (2011). "Ebola haemorrhagic fever". Lancet. 377 (9768): 849–62. doi:10.1016/S0140-6736(10)60667-8. PMC 3406178. PMID 21084112.
- ↑ Geisbert TW, Hensley LE, Jahrling PB, Larsen T, Geisbert JB, Paragas J; et al. (2003). "Treatment of Ebola virus infection with a recombinant inhibitor of factor VIIa/tissue factor: a study in rhesus monkeys". Lancet. 362 (9400): 1953–8. doi:10.1016/S0140-6736(03)15012-X. PMID 14683653.
- ↑ Geisbert TW, Hensley LE, Kagan E, Yu EZ, Geisbert JB, Daddario-DiCaprio K; et al. (2006). "Postexposure protection of guinea pigs against a lethal ebola virus challenge is conferred by RNA interference". J Infect Dis. 193 (12): 1650–7. doi:10.1086/504267. PMID 16703508.
- ↑ Garbutt M, Liebscher R, Wahl-Jensen V, Jones S, Möller P, Wagner R; et al. (2004). "Properties of replication-competent vesicular stomatitis virus vectors expressing glycoproteins of filoviruses and arenaviruses". J Virol. 78 (10): 5458–65. PMC 400370. PMID 15113924.
- ↑ Feldmann H, Jones SM, Daddario-DiCaprio KM, Geisbert JB, Ströher U, Grolla A; et al. (2007). "Effective post-exposure treatment of Ebola infection". PLoS Pathog. 3 (1): e2. doi:10.1371/journal.ppat.0030002. PMC 1779298. PMID 17238284.
- ↑ Mupapa K, Massamba M, Kibadi K, Kuvula K, Bwaka A, Kipasa M; et al. (1999). "Treatment of Ebola hemorrhagic fever with blood transfusions from convalescent patients. International Scientific and Technical Committee". J Infect Dis. 179 Suppl 1: S18–23. doi:10.1086/514298. PMID 9988160.
- ↑ Maruyama T, Rodriguez LL, Jahrling PB, Sanchez A, Khan AS, Nichol ST; et al. (1999). "Ebola virus can be effectively neutralized by antibody produced in natural human infection". J Virol. 73 (7): 6024–30. PMC 112663. PMID 10364354.