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观点 传染病

Can the rush for vaccines slow the latest Ebola outbreak?

The Bundibugyo strain is a reminder that serious health threats can escalate from under-the-radar pathogens
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{"text":[[{"start":7.45,"text":"The writer is a science commentator"}],[{"start":10.1,"text":"The happiest ending, if that is the right phrase, for any disease outbreak is that it naturally burns itself out or is snuffed out by countermeasures, such as vaccines and drugs. For a new Ebola outbreak currently spreading inside and beyond the Democratic Republic of Congo, neither finale looks imminent."}],[{"start":29.4,"text":"Last week, the World Health Organization said there were more than 1,000 suspected cases of Bundibugyo virus disease, caused by a rare virus for which there is no vaccine or targeted treatment. Most of the 1,000-plus suspected cases are in DR Congo, with some in neighbouring Uganda, including the capital Kampala. The true toll, though, is thought to be higher. The virus is circulating in a border area characterised by conflict, poverty and displacement, making testing and contact tracing difficult. The WHO declared it a public health emergency of international concern on May 17, though not a pandemic, with it posing the highest risk to those in the region."}],[{"start":71.9,"text":"Now scientists are marshalling knowledge culled from previous epidemics, including Covid, to tackle this unfamiliar foe. The non-profit Coalition for Epidemic Preparedness Innovations (Cepi) announced on Monday that it would fast-track three experimental Bundibugyo vaccines into clinical testing and called for more vaccine candidates. The WHO will test potential treatments using the same no-frills protocol that showed remdesivir, an antiviral medication, could speed up recovery from Covid."}],[{"start":103,"text":"The outbreak also offers frustratingly familiar lessons in our poly-plague world: that serious health threats can escalate from under-the-radar pathogens, and preparedness matters; that aid cuts weaken the local networks that can spot outbreaks early; and that, with the US embroiled in a dispute over plans to quarantine its own returning citizens in Kenya, dropping the ball on infectious diseases is a losing strategy for global security and international relations."}],[{"start":130.25,"text":"Bundibugyo, named after a town in Uganda, is one of six species of Orthoebolavirus, four of which cause illness in humans. Outbreaks, which start with zoonotic spillovers, are most often linked to its sibling, Zaire, which drove the record 2014-16 epidemic in west Africa that killed more than 11,000, and the 2018 outbreak in DR Congo that killed nearly 2,300. There is an Ebola vaccine, Ervebo, that targets Zaire but, the WHO cautions, there is “limited and inconclusive” evidence that it can cross-protect against other Orthoebolaviruses. "}],[{"start":166.15,"text":"Meanwhile, scientists are sceptical that the Bundibugyo outbreak will fizzle out on its own. At a briefing last week, Christophe Fraser, from the Pandemic Sciences Institute at Oxford university, said epidemiological analysis suggested it had been spreading for about three months and was already outpacing the 2018 DR Congo outbreak. One bright spot: data from Uganda suggests a case fatality rate of 14 per cent, lower than for Zaire, which without medical care typically kills half or more of those infected; one nurse sickened by Bundibugyo is reported to have fully recovered."}],[{"start":203.55,"text":"Cepi head Richard Hatchett told the briefing it was “hard to fathom” how this outbreak would end without vaccines and treatments, given the affected area contains 15mn people and armed groups suspicious of outsiders. Clinics have been targeted by arsonists and burials disrupted by grieving relatives trying to reclaim the bodies of loved ones. Local customs, such as washing bodies before burial, are known to spread the disease. "}],[{"start":231.60000000000002,"text":"One of the fast-tracked experimental vaccines, developed by the International Aids Vaccine Initiative, uses the same technology as Ervebo; Cepi is giving IAVI around $3mn to produce a “master virus seed” stock, the starting material for a vaccine. About $50mn is earmarked for early testing of Moderna’s mRNA Bundibugyo vaccine candidate. Nearly $9mn will go to the team behind the Oxford/AstraZeneca Covid jab, with the Serum Institute of India again partnering to make doses of ChAdOx1 Bundibugyo — designed to boost antibodies and T-cells — hopefully ready for human testing in two to three months."}],[{"start":270.6,"text":"Oxford university scientists will also play a leading role in the therapeutics trial, testing remdesivir and a monoclonal antibody known as MBP134. Close contacts of confirmed cases may be given the antiviral medication obeldesivir, experimentally, to test whether post-exposure prophylaxis can prevent disease developing."}],[{"start":291.75,"text":"Bundibugyo might be a viral stranger but the sense of foreboding it has stirred, and the desperate race for effective vaccines and treatments, looks grimly familiar."}],[{"start":309.29999999999995,"text":""}]],"url":"https://audio.ftcn.net.cn/album/a_1780472017_6696.mp3"}

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