Tue July 29, 2014
In Treating Ebola, Doctors Have Only Containment, Not Yet A Cure
Originally published on Tue July 29, 2014 5:31 pm
AUDIE CORNISH, HOST:
For more on the current Ebola outbreak, we turn now to Doctor Thomas Geisbert. He's a virologist with the University of Texas medical branch in Galveston, Texas, and has spent decades studying Ebola and other hemorrhagic fevers. Thank you for joining us.
THOMAS GEISBERT: Thank you - good to be here.
CORNISH: Now, it seems like we're hearing more and more about health workers like Doctor Brantly falling sick with the Ebola. How alarming is this to you, and what does it tell you about this particular outbreak or strain of Ebola?
GEISBERT: I think it's very concerning. This outbreak has had a higher proportion of healthcare workers that have been infected than what we're used to dealing with. I really don't think we know the answer of why yet, quite honestly.
CORNISH: How have past Ebola outbreaks ended, and what do you think needs to be done to end this particular outbreak?
GEISBERT: Outbreaks usually end when the public health agencies are able to come in and quarantine the affected individuals, and, you know, eventually the outbreak runs its course, and it's over. You know, in central Africa these outbreaks have tended to occur in a very defined geographic area - for example, a village. And the public health agencies, like the World Health Organization and humanitarian aid organizations like Medecins Sans Frontieres, have come in, quarantined that area, and the outbreak has been contained. I think what's been difficult with West Africa is that it's so widespread, and it's occurring simultaneously in so many different areas, that you really stretch that experienced resource thin, and so that's a huge problem.
CORNISH: As we've mentioned, most of the cases have been in Guinea, Sierra Leone and Liberia, but Nigeria has also reported its first case - a man who flew into Nigeria from Liberia and died several days later. How worrying is it to hear that someone was traveling by plane while apparently ill?
GEISBERT: I mean, I think it's concerning. I think it's something that you have to take seriously and look at. I don't want to, you know, instill panic or fear. The virus is not transmitted like influenza. It's not airborne, at least we don't have any evidence to this point that suggests that. It's mainly transmitted by close contact - so contact with body fluids, things like that. So I don't want to say that the risk is zero because there's always a risk, and certainly, the people on that plane would need to be monitored and followed. But I think, you know, historically, this has not really been a large problem.
CORNISH: What treatments can be offered to those who are sick currently?
GEISBERT: Right now the main care is just general supportive care, so replacement of fluids, things like that. There are experimental drugs that potentially could be available. That's one of the things that we work on here at the University of Texas medical branch. We just received a very large grant from NIH to take what we think are the three most promising treatments against Ebola and advance those for further development. And also, kind of like what you've seen with HIV where different antiviral drugs are combined for a synergistic effect, we're actually looking at combining some of these promising treatments to see if we can get an added benefit. So it's possible that some of these treatments could be used for compassionate use. I think that's a very challenging situation to try to do that in an outbreak in West Africa.
GEISBERT: I think there's just a lot of political issues at play. A lot of the treatments that we work on - in fact all of them - none of them are approved for use on humans at this time, so you have safety concerns - things like that.
CORNISH: Your research focuses on vaccines, and while there are vaccines that have been used in animals, they're not approved for use in humans. But how far away is a vaccine that could be?
GEISBERT: I think as soon as maybe two years and as long as five or six - I mean, somewhere in that window. I think one of the main obstacles is really a financial obstacle. Most of the companies that would develop these vaccines are small biotech companies, and there's a very small global market for an Ebola vaccine. It's not like something like malaria that's prevalent. So the companies really - it comes down to money. They just can't really afford to do it. So it's going to take the financial backing of a government like the U.S. government. So that's really the limiting factor right now.
CORNISH: Doctor Thomas Geisbert is a professor of microbiology and immunology at the University of Texas medical branch. He spoke with us from Galveston, Texas. Doctor Geisbert, thanks so much.
GEISBERT: Thank you. Have a great day. Transcript provided by NPR, Copyright NPR.