Ebola Epidemic Deemed the Most Severe Public Health Emergency of Modern Times

As the Ebola outbreak worsens, interest in therapies using recovered victims' blood grows.

Researchers are scrambling to develop experimental therapies to combat the escalating Ebola epidemic in West Africa and stem a global health emergency.

With more than 3000 related deaths and 6500 confirmed and suspected cases, the figures from the current Ebola outbreak are far greater than all previous outbreaks combined. The World Health Organization (WHO) said the epidemic is still vastly underestimated by the international community.

“The Ebola epidemic ravaging parts of West Africa is the most severe acute public health emergency seen in modern times,” the WHO said in a press release. “Never before in recorded history has a biosafety level 4 pathogen infected so many people so quickly, over such a broad geographical area, for so long.”

In response to the outbreak, the WHO determined there is a moral obligation to explore any possible intervention after conducting an ethical review on the use of untested experimental treatments in infected patients.

In addition to a number of promising experimental therapies currently in development, the WHO recently convened a panel of experts who agreed to prioritize convalescent blood and plasma therapies. Convalescent therapy was first used in 1976 to treat a patient in the Democratic Republic of Congo after the virus appeared.

During an outbreak in 1995, whole blood from recovered patients was used to treat 8 Ebola victims, 7 of whom recovered. The treatment has been utilized sporadically during the current outbreak, including in American doctor Kent Brantly, who the US Centers for Disease Control and Prevention declared to be virus-free last week.

The WHO called the need to expand the arsenal of treatments for the virus self-evident.

“Major questions need to be answered about the safety and efficacy of convalescent therapies, and the feasibility of implementation in countries with shattered health systems and an acute shortage of medical staff,” the organization noted in a statement. “WHO is also being asked to assess whether rapid scaling up of convalescent therapy is feasible to an extent that could begin to reduce the estimated 70.8% case fatality rate seen consistently across the 3 outbreak sites.”

Other promising therapies in development include an experimental treatment co-developed by the National Institutes of Health and GlaxoSmithKline that recently began human testing; a drug in development by Johnson & Johnson that is projected to begin clinical testing in early 2015; Tekmira Pharmaceuticals’ RNA interference treatment called TKM-Ebola; and the highly publicized ZMapp, which reversed Ebola infection in 100% of subjects during animal testing.

Apart from those drugs, convalescent therapies hold an additional appeal due to the subsequent work that would accompany their introduction. WHO officials said a significant benefit in utilizing convalescent therapies is the strengthening of basic public health infrastructures through the development of quality blood services in affected countries.

“The list of common and severe health problems that could benefit from safe and well-functioning blood services is long—ranging from malaria, dengue, Lassa fever, and yellow fever, to complications of childbirth and injuries following accidents and traffic crashes,” the WHO said. “The current situation is so dire that, in several areas that include capital cities, many of these common diseases and health conditions are barely being managed at all.”

The deteriorating public health landscape in the affected region only serves to exacerbate the growing epidemic, according to Peter Piot, MD, who has been credited with discovering the original Ebola outbreak in 1976.

“I think this is a result of a perfect storm of a lack of trust in authorities, in Western medicine, dysfunctional health services, a belief in witchcraft as cause of disease and not viruses, traditional funeral rites, and a very slow response both nationally and internationally,” Dr. Piot said in an interview with Vox. “The longer we wait, the longer there is an insufficient response. The worse it will get, (and) the more difficult it will be to control this epidemic through quarantine and isolation and all the methods that worked in the past.”