Unproven serum given to two American Ebola sufferers, who show improvement

Cocktail given to two American missionaries infected with virus in Liberia with reports they showed improvement before flying to the US

PUBLISHED : Tuesday, 05 August, 2014, 10:04pm
UPDATED : Wednesday, 06 August, 2014, 10:52am

As the health of two Ebola-stricken American missionaries deteriorated late last month, an international relief organisation backing them hunted for a medical miracle. The clock was ticking, and a sobering fact remained: most people battling the disease do not survive.

Leaders at Samaritan's Purse, a North Carolina-based Christian humanitarian group, asked officials at the Centres for Disease Control and Prevention (CDC) whether any treatment existed - tested or untested - that might help save the lives of Kent Brantly and Nancy Writebol, both of whom had contracted Ebola while helping patients in Liberia.

The CDC put the group in touch with National Institutes of Health (NIH) staff in West Africa, where an employee knew about promising research the US government had funded on a serum that had been tested only on monkeys.

"Our staff in Liberia knew about the research and flagged it for the religious groups," said Anthony Fauci, director of the NIH's National Institute of Allergy and Infectious Diseases.

Within days, doses of the unproven treatment made their way in frozen vials across the ocean and were administered to Brantly and Writebol in Liberia.

"This so-called experimental serum is a cocktail of antibodies that have the capability of blocking the virus," Fauci said, adding: "The physicians in charge of the patients' care made a risk-benefit decision. The risk was less than the potential benefit."

While it is too early to say whether the treatment saved the lives of the two missionaries or slowed the disease's progression enough to allow them to return to the United States for care, some reports have suggested that Brantly and Writebol improved after getting the serum.

Both Samaritan's Purse and CDC director Tom Frieden have described Brantly's condition as "improving".

Palmer Holt, a spokesman for Service in Mission, a Christian relief group which employs Writebol and her husband, said Writebol had had good days and bad days. But he added that while her condition was worsening on July 30, the day before she first received the treatment, she seemed to stabilise in the days that followed.

Holt said Writebol had received a second dose of the serum, with encouraging results. "She's showing improvement," he said in an email. "She is walking with assistance ... strength is better ... has an appetite."

Writebol arrived at a US military base yesterday and was to be taken to Emory University Hospital in Atlanta, Georgia.

Video: What is the Ebola virus

There is no approved cure for Ebola and no proven vaccine to prevent it. Part of the problem has been a lack of interest from drug companies, given that Ebola has affected relatively few people compared with other diseases.

The drug cocktail the two Americans received, known as ZMapp, was developed by the San Diego company Mapp Biopharmaceutical. It was manufactured in Kentucky using fast-growing tobacco plants, which acted as a "photocopier" to produce proteins that were extracted from the plant and processed into the drug, said a spokeswoman for the firm that works with Mapp. It is unclear whether Brantly and Writebol will continue to receive doses of the ZMapp serum during their treatment in Atlanta. Any use of an experimental drug in the US requires Food and Drug Administration approval.

Details about the serum emerged as a New York hospital performed tests on a patient with a possible Ebola infection and the World Health Organisation said the virus had now claimed at least 887 lives in Africa, including 61 deaths in just two days.

The new WHO figures indicate the disease is picking up speed. The count of 163 new Ebola cases on July 31 and August 1 was 33 per cent higher than the 122 cases reported over the four-day period that ended on July 27.