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On a path to accelerate access to Ebola vaccines: The WHO's research and development efforts during the 2014-2016 Ebola epidemic in West Africa.

ABSTRACT: During 2014 and 2015 an outbreak of Ebola deemed a Public Health Emergency of International Concern affected a number of West African countries. The outbreak underscored the need for a vaccine against Ebola. An unprecedented and to great extent collaborative effort built on the availability of a number of candidate vaccines that could enter into clinical phase evaluation. A series of international consultations and activities were led by WHO as a contribution to the unprecedented global efforts to develop and assess an Ebola vaccine. WHO consulted widely, and immediately fostered interactions with the international scientific, ethics, regulatory, vaccine development, public health partners, industry and funders' communities and participated in consortia to facilitate Ebola vaccine assessments. WHO also fostered key activities to ensure the optimal policy and deployment of Ebola vaccines, if licensed. WHO has convened a broad global coalition of experts to develop a Blueprint and a platform for accelerated R&D, in order to avert full-blown epidemics.

SUBMITTER: Henao-Restrepo AM

PROVIDER: S-EPMC5524177 | biostudies-literature | 2016 Apr

REPOSITORIES: biostudies-literature

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On a path to accelerate access to Ebola vaccines: The WHO's research and development efforts during the 2014-2016 Ebola epidemic in West Africa.

Henao-Restrepo Ana Maria AM Preziosi Marie-Pierre MP Wood David D Moorthy Vasee V Kieny Marie Paule MP

Current opinion in virology 20160401

During 2014 and 2015 an outbreak of Ebola deemed a Public Health Emergency of International Concern affected a number of West African countries. The outbreak underscored the need for a vaccine against Ebola. An unprecedented and to great extent collaborative effort built on the availability of a number of candidate vaccines that could enter into clinical phase evaluation. A series of international consultations and activities were led by WHO as a contribution to the unprecedented global efforts ...[more]

PMID: 27180074

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Project description:BackgroundHealthcare and other front-line workers are at particular risk of infection with Ebola virus (EBOV). Despite the large-scale deployment of international responders, few cases of Ebola virus disease have been diagnosed in this group. Since asymptomatic or pauci-symptomatic infection has been described, it is plausible that infections have occurred in healthcare workers but have escaped being diagnosed. We aimed to assess the prevalence of asymptomatic or pauci-symptomatic infection, and of exposure events, among returned responders to the West African Ebola epidemic 2014-2016.Methods and findingsWe used snowball sampling to identify responders who had returned to the UK or Ireland, and used an online consent and questionnaire to determine their exposure to EBOV and their experience of illness. Oral fluid collection devices were sent and returned by post, and samples were tested using an EBOV IgG capture assay that detects IgG to Ebola glycoprotein. Blood was collected from returnees with reactive samples for further testing. Unexposed UK controls were also recruited. In all, 300 individuals consented, of whom 268 (89.3%) returned an oral fluid sample (OFS). The majority had worked in Sierra Leone in clinical, laboratory, research, and other roles. Fifty-three UK controls consented and provided samples using the same method. Of the returnees, 47 (17.5%) reported that they had had a possible EBOV exposure. Based on their free-text descriptions, using a published risk assessment method, we classified 43 (16%) as having had incidents with risk of Ebola transmission, including five intermediate-risk and one high-risk exposure. Of the returnees, 57 (21%) reported a febrile or diarrhoeal illness in West Africa or within 1 mo of return, of whom 40 (70%) were not tested at the time for EBOV infection. Of the 268 OFSs, 266 were unreactive. Two returnees, who did not experience an illness in West Africa or on return, had OFSs that were reactive on the EBOV IgG capture assay, with similar results on plasma. One individual had no further positive test results; the other had a positive result on a double-antigen bridging assay but not on a competitive assay or on an indirect EBOV IgG ELISA. All 53 controls had non-reactive OFSs. While the participants were not a random sample of returnees, the number participating was high.ConclusionsThis is the first study, to our knowledge, of the prevalence of EBOV infection in international responders. More than 99% had clear negative results. Sera from two individuals had discordant results on the different assays; both were negative on the competitive assay, suggesting that prior infection was unlikely. The finding that a significant proportion experienced "near miss" exposure events, and that most of those who experienced symptoms did not get tested for EBOV at the time, suggests a need to review and standardise protocols for the management of possible exposure to EBOV, and for the management of illness, across organisations that deploy staff to outbreaks.

Dataset Information

On a path to accelerate access to Ebola vaccines: The WHO's research and development efforts during the 2014-2016 Ebola epidemic in West Africa.

Publications

On a path to accelerate access to Ebola vaccines: The WHO's research and development efforts during the 2014-2016 Ebola epidemic in West Africa.

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