Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-11 (of 11 Records) |
Query Trace: Sprecher A[original query] |
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Perspectives on advancing countermeasures for filovirus disease: Report from a multi-sector meeting
Sprecher A , Cross R , Marzi A , Martins KA , Wolfe D , Montgomery JM , Spiropoulou CF , Cihlar T , Ahuka-Mundeke S , Nyhuis T , Teicher C , Crozier I , Strong J , Kobinger G , Woolsey C , Geisbert TW , Feldmann H , Muyembe JJ . J Infect Dis 2023 228 S474-S478 Although there are now approved treatments and vaccines for Ebola virus disease (EVD), the case fatality of EVD remains unacceptably high even when treated with the newly approved therapeutics; furthermore, these countermeasures are not expected to be effective against disease caused by other filoviruses. A meeting of subject matter experts from public health, research, and countermeasure development agencies and manufacturers was held during the 10th International Filovirus Symposium to discuss strategies to address these gaps, including how newer countermeasures could be advanced for field readiness. Several investigational therapeutics, vaccine candidates, and combination strategies were presented. In all, a common theme emerged: the greatest challenge to completing development was the implementation of well-designed clinical trials of safety and efficacy during filovirus disease outbreaks. These outbreaks are usually of short duration, providing but a brief opportunity for trials to be launched, and have too few cases to allow for full enrollment during a single outbreak, so clinical trials will necessarily need to span multiple outbreaks which may occur in a number of at-risk countries. Preparing for this will require agreed-upon common protocols for trials intended to bridge multiple outbreaks across all at-risk countries. A multi-national research consortium including, and led by, at-risk countries would be an ideal mechanism to negotiate agreement on protocol design and coordinate preparation. Discussion participants recommended a follow-up meeting be held in Africa with national public health and research agencies from at-risk countries to establish such a consortium. |
Use of Ebola vaccine: Expansion of recommendations of the Advisory Committee on Immunization Practices to include two additional populations - United States, 2021
Malenfant JH , Joyce A , Choi MJ , Cossaboom CM , Whitesell AN , Harcourt BH , Atmar RL , Villanueva JM , Bell BP , Hahn C , Loehr J , Davey RT , Sprecher A , Kraft CS , Shoemaker T , Montgomery JM , Helfand R , Damon IK , Frey SE , Chen WH . MMWR Morb Mortal Wkly Rep 2022 71 (8) 290-292 On December 19, 2019, the Food and Drug Administration (FDA) approved rVSVΔG-ZEBOV-GP Ebola vaccine (ERVEBO, Merck) for the prevention of Ebola virus disease (EVD) caused by infection with Ebola virus, species Zaire ebolavirus, in adults aged ≥18 years. In February 2020, the Advisory Committee on Immunization Practices (ACIP) recommended preexposure vaccination with ERVEBO for adults aged ≥18 years in the United States who are at highest risk for potential occupational exposure to Ebola virus because they are responding to an outbreak of EVD, work as health care personnel at federally designated Ebola treatment centers in the United States, or work as laboratorians or other staff members at biosafety level 4 facilities in the United States (1). |
New filovirus disease classification and nomenclature.
Kuhn JH , Adachi T , Adhikari NKJ , Arribas JR , Bah IE , Bausch DG , Bhadelia N , Borchert M , Brantsaeter AB , Brett-Major DM , Burgess TH , Chertow DS , Chute CG , Cieslak TJ , Colebunders R , Crozier I , Davey RT , de Clerck H , Delgado R , Evans L , Fallah M , Fischer WA 2nd , Fletcher TE , Fowler RA , Grunewald T , Hall A , Hewlett A , Hoepelman AIM , Houlihan CF , Ippolito G , Jacob ST , Jacobs M , Jakob R , Jacquerioz FA , Kaiser L , Kalil AC , Kamara RF , Kapetshi J , Klenk HD , Kobinger G , Kortepeter MG , Kraft CS , Kratz T , Bosa HSK , Lado M , Lamontagne F , Lane HC , Lobel L , Lutwama J , Lyon GM 3rd , Massaquoi MBF , Massaquoi TA , Mehta AK , Makuma VM , Murthy S , Musoke TS , Muyembe-Tamfum JJ , Nakyeyune P , Nanclares C , Nanyunja M , Nsio-Mbeta J , O'Dempsey T , Paweska JT , Peters CJ , Piot P , Rapp C , Renaud B , Ribner B , Sabeti PC , Schieffelin JS , Slenczka W , Soka MJ , Sprecher A , Strong J , Swanepoel R , Uyeki TM , van Herp M , Vetter P , Wohl DA , Wolf T , Wolz A , Wurie AH , Yoti Z . Nat Rev Microbiol 2019 17 (5) 261-263 The recent large outbreak of Ebola virus disease (EVD) in Western Africa resulted in greatly increased accumulation of human genotypic, phenotypic and clinical data, and improved our understanding of the spectrum of clinical manifestations. As a result, the WHO disease classification of EVD underwent major revision. |
Clinical management of Ebola virus disease patients in low-resource settings
Sprecher A , Van Herp M , Rollin PE . Curr Top Microbiol Immunol 2017 411 93-113 The low-resource environment deprives healthcare providers caring for patients with Ebola virus disease (EVD) of many of the means employed for the critically ill that are available in better resourced settings, such as advanced therapeutic interventions and abundant staff. In addition to these limitations may be added those imposed by the remote tropical locations, where EVD outbreaks occur. In this setting, a safe environment is created where healthcare workers may care for their patients over the evolving course of their acute illness into their convalescent period. Clinical management of EVD combines supportive and symptomatic care while also addressing the patient's emotional and mental health needs. A variety of specific therapies directly targeting the virus has become available, but none of these has, as of yet, conclusively demonstrated an impact. Healthcare workers caring for EVD patients must be constantly aware that they are part of a larger epidemic control operation, and their actions have consequences that go beyond their patients to their families and the community affected by the outbreak. |
First newborn baby to receive experimental therapies survives Ebola virus disease
Dornemann J , Burzio C , Ronsse A , Sprecher A , De Clerck H , Van Herp M , Kolie MC , Yosifiva V , Caluwaerts S , McElroy AK , Antierens A . J Infect Dis 2017 215 (2) 171-174 A neonate born to an Ebola virus-positive woman was diagnosed with Ebola virus infection on her first day of life. The patient was treated with monoclonal antibodies (ZMapp), a buffy coat transfusion from an Ebola survivor, and the broad-spectrum antiviral GS-5734. On day 20, a venous blood specimen tested negative for Ebola virus by quantitative reverse-transcription polymerase chain reaction. The patient was discharged in good health on day 33 of life. Further follow-up consultations showed age-appropriate weight gain and neurodevelopment at the age of 12 months. This patient is the first neonate documented to have survived congenital infection with Ebola virus. |
Ebola virus is unlikely to become endemic in West Africa
Sprecher A , Feldmann H , Hensley LE , Kobinger G , Nichol ST , Strong J , Van Herp M . Nat Microbiol 2016 1 (3) 16007 Concern over Ebola becoming endemic in West Africa has appeared in the medical and lay media. Routes of transmission, rates of viral evolution, suitability of humans as hosts and rarity of spillover events make this very unlikely. Without evidence that endemic Ebola is likely, ending epidemics should remain the focus. |
Plasmodium Parasitemia Associated With Increased Survival in Ebola Virus-Infected Patients.
Rosenke K , Adjemian J , Munster VJ , Marzi A , Falzarano D , Onyango CO , Ochieng M , Juma B , Fischer RJ , Prescott JB , Safronetz D , Omballa V , Owuor C , Hoenen T , Groseth A , Martellaro C , van Doremalen N , Zemtsova G , Self J , Bushmaker T , McNally K , Rowe T , Emery SL , Feldmann F , Williamson BN , Best SM , Nyenswah TG , Grolla A , Strong JE , Kobinger G , Bolay FK , Zoon KC , Stassijns J , Giuliani R , de Smet M , Nichol ST , Fields B , Sprecher A , Massaquoi M , Feldmann H , de Wit E . Clin Infect Dis 2016 63 (8) 1026-33 BACKGROUND: The ongoing Ebola outbreak in West Africa has resulted in 28 646 suspected, probable, and confirmed Ebola virus infections. Nevertheless, malaria remains a large public health burden in the region affected by the outbreak. A joint Centers for Disease Control and Prevention/National Institutes of Health diagnostic laboratory was established in Monrovia, Liberia, in August 2014, to provide laboratory diagnostics for Ebola virus. METHODS: All blood samples from suspected Ebola virus-infected patients admitted to the Medecins Sans Frontieres ELWA3 Ebola treatment unit in Monrovia were tested by quantitative real-time polymerase chain reaction for the presence of Ebola virus and Plasmodium species RNA. Clinical outcome in laboratory-confirmed Ebola virus-infected patients was analyzed as a function of age, sex, Ebola viremia, and Plasmodium species parasitemia. RESULTS: The case fatality rate of 1182 patients with laboratory-confirmed Ebola virus infections was 52%. The probability of surviving decreased with increasing age and decreased with increasing Ebola viral load. Ebola virus-infected patients were 20% more likely to survive when Plasmodium species parasitemia was detected, even after controlling for Ebola viral load and age; those with the highest levels of parasitemia had a survival rate of 83%. This effect was independent of treatment with antimalarials, as this was provided to all patients. Moreover, treatment with antimalarials did not affect survival in the Ebola virus mouse model. CONCLUSIONS: Plasmodium species parasitemia is associated with an increase in the probability of surviving Ebola virus infection. More research is needed to understand the molecular mechanism underlying this remarkable phenomenon and translate it into treatment options for Ebola virus infection. |
The merits of malaria diagnostics during an Ebola virus disease outbreak
de Wit E , Falzarano D , Onyango C , Rosenke K , Marzi A , Ochieng M , Juma B , Fischer RJ , Prescott JB , Safronetz D , Omballa V , Owuor C , Hoenen T , Groseth A , van Doremalen N , Zemtsova G , Self J , Bushmaker T , McNally K , Rowe T , Emery SL , Feldmann F , Williamson B , Nyenswah TG , Grolla A , Strong JE , Kobinger G , Stroeher U , Rayfield M , Bolay FK , Zoon KC , Stassijns J , Tampellini L , de Smet M , Nichol ST , Fields B , Sprecher A , Feldmann H , Massaquoi M , Munster VJ . Emerg Infect Dis 2016 22 (2) 323-6 Malaria is a major public health concern in the countries affected by the Ebola virus disease epidemic in West Africa. We determined the feasibility of using molecular malaria diagnostics during an Ebola virus disease outbreak and report the incidence of Plasmodium spp. parasitemia in persons with suspected Ebola virus infection. |
Use of capture-recapture to estimate underreporting of Ebola virus disease, Montserrado County, Liberia
Gignoux E , Idowu R , Bawo L , Hurum L , Sprecher A , Bastard M , Porten K . Emerg Infect Dis 2015 21 (12) 2265-7 Underreporting of cases during a large outbreak of disease is not without precedent (1–5). Health systems in West Africa were ill-prepared for the arrival of Ebola virus disease (Ebola) (6). The Ebola outbreak in Liberia was declared on March 31, 2014, and peaked in September 2014. However, by mid-June, the outbreak had reached Montserrado County, where the capital, Monrovia, is located. In response, the Liberia Ministry of Health and Social Welfare (MOHSW) created a National Ebola Hotline: upon receipt of a call, a MOHSW case investigation team was dispatched to the site of the possible case. Additionally, persons could seek care at an Ebola Treatment Unit (ETU) or be referred to an ETU by another health care facility. During June 1–August 14, 2014, MOHSW, Médecins Sans Frontières, and the US nongovernment organization Samaritan’s Purse managed 3 ETUs in Montserrado County, including 2 in Monrovia operated by Eternal Love Winning Africa (ELWA). | In August 2014, to assess the extent of underreporting in the midst of the Ebola outbreak, we analyzed 2 sources of data collected during June 1–August 14. The first comprised data collected by MOHSW case investigation teams. These data were collected on MOHSW case forms and entered into a database emulating these forms using Epi Info version 7 software (Centers for Disease Control and Prevention, Atlanta, GA, USA). The second data source (designed on Excel 2003; Microsoft, Redmond, WA, USA) comprised data on all patients admitted to the 2 ELWA ETUs (ELWA1 and ELWA2). We used a capture–recapture (CRC) approach. |
Personal protective equipment for filovirus epidemics: a call for better evidence
Sprecher AG , Caluwaerts A , Draper M , Feldmann H , Frey CP , Funk RH , Kobinger G , Le Duc JW , Spiropoulou C , Williams WJ . J Infect Dis 2015 212 Suppl 2 S98-S100 Personal protective equipment (PPE) is an important part of worker protection during filovirus outbreaks. The need to protect against a highly virulent fluid-borne pathogen in the tropical environment imposes a heat stress on the wearer that is itself a safety risk. No evidence supports the choice of PPE employed in recent outbreaks, and standard testing procedures employed by the protective garment industry do not well simulate filovirus exposure. Further research is needed to determine the appropriate PPE for filoviruses and the heat stress that it imposes. |
Emerging filoviral disease in Uganda: proposed explanations and research directions
Polonsky JA , Wamala JF , de Clerck H , Van Herp M , Sprecher A , Porten K , Shoemaker T . Am J Trop Med Hyg 2014 90 (5) 790-793 Outbreaks of Ebola and Marburg virus diseases have recently increased in frequency in Uganda. This increase is probably caused by a combination of improved surveillance and laboratory capacity, increased contact between humans and the natural reservoir of the viruses, and fluctuations in viral load and prevalence in this reservoir. The roles of these proposed explanations must be investigated to guide appropriate responses to the changing epidemiological profile. Other African settings in which multiple filoviral outbreaks have occurred could also benefit from such information. |
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