Maternal and Infant Death and the rVSV-ZEBOV Vaccine Through Three Recent Ebola Virus Epidemics-West Africa, DRC Équateur and DRC Kivu: 4 Years of Excluding Pregnant and Lactating Women and Their Infants from Immunization

AbstractPurpose of ReviewEbola virus infection has one of the highest overall case fatality rates of any viral disease. It has historically had an especially high case mortality rate among pregnant women and infants —greater than 90% for pregnant women in some outbreaks and close to 100 % in fetuses and newborns. The Merck recombinant vaccine against Ebola virus, termed rVSV-ZEBOV, underwent clinical trials during the 2013–2015 West Africa Ebola epidemic where it was found to be 100% efficacious. It was sub sequently used during the 2018 DRC Équateur outbreak and in the 2018 DRC Kivu Ebola which is still ongoing, where its efficacy is 97.5 %. Pregnant and lactating women and their infants have previously been excluded from the design, clinical trials, and administration of many vaccines and drugs. Thi s article critically examines the development of the rVSV-ZEBOV vaccine and its accessibility to pregnant and lactating women and infants as a life-saving form of prevention through three recent African Ebola epidemics—West Africa, DRC Équateur, and DRC Kivu.Recent FindingsPregnant and lactating women and their infants were excluded from participation in the clinical trials of rVSV-ZEBOV conducted during the West Africa epidemic. This policy of exclusion was continued with the occurrence of the DRC Équateur outbreak in 2018, in spite of calls from the public health and global maternal health communities to vaccinate this population. Followi...
Source: Current Tropical Medicine Reports - Category: Tropical Medicine Source Type: research

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AbstractPurpose of ReviewAs research efforts have advanced to understand the pathophysiology of viral hemorrhagic fevers (VHF) and other epidemic viral infections and develop medical countermeasures such as vaccines, pregnant women have remained an underexamined subgroup. To better understand the implications of future outbreaks of VHF for pregnant women amidst an evolving vaccine landscape, we examine three pathogens —yellow fever, Ebola, and Lassa fever—each with different levels of evidence and understanding of disease in pregnancy and at varying stages of vaccine development.Recent FindingsThere are very li...
Source: Current Tropical Medicine Reports - Category: Tropical Medicine Source Type: research
More than 1,500 deaths and 2,500 people sickened – that’s the recent account of the ebola outbreak in the Democratic Republic of Congo (DRC) raging in the country since last August, and recently declared a public health emergency of international concern. Experts say efforts to contain the virus are hindered by biological, public health, political, and cultural issues, but we looked around what digital health technologies could do to mitigate the spread and the devastation of the infectious disease. The Spaghetti-like virus… The lethal Ebola virus first appeared in 1976 around a river in Congo &nda...
Source: The Medical Futurist - Category: Information Technology Authors: Tags: Future of Medicine Africa AI artificial intelligence Congo digital digital health digital maps disease disease outbreak ebola epidemic Innovation technology Source Type: blogs
Pregnant women &vaccines against emerging epidemic threats: Ethics guidance for preparedness, research, and response. Vaccine. 2019 May 03;: Authors: Krubiner CB, Faden RR, Karron RA, Little MO, Lyerly AD, Abramson JS, Beigi RH, Cravioto AR, Durbin AP, Gellin BG, Gupta SB, Kaslow DC, Kochhar S, Luna F, Saenz C, Sheffield JS, Tindana PO, PREVENT Working Group Abstract Zika virus, influenza, and Ebola have called attention to the ways in which infectious disease outbreaks can severely - and at times uniquely - affect the health interests of pregnant women and their offspring. These examples also hig...
Source: Vaccine - Category: Allergy & Immunology Authors: Tags: Vaccine Source Type: research
In this study, we evaluated ATA as a potential antiviral drug against ZIKV replication. The antiviral activity of ATA against ZIKV replication in vitro showed median inhibitory concentrations (IC50) of 13.87 ± 1.09 μM and 33.33 ± 1.13 μM in Vero and A549 cells, respectively; without showing any cytotoxic effect in both cell lines (median cytotoxic concentration (CC50)> 1,000 μM). Moreover, ATA protected both cell types from ZIKV-induced cytopathic effect (CPE) and apoptosis in a time- and concentration-dependent manner. In addition, pre-treatment of Vero cells with ATA for up to 72 h also resulted...
Source: Frontiers in Microbiology - Category: Microbiology Source Type: research
Source: Wellcome Trust. Published: 9/2018. This 96-page guidance provides a roadmap for the ethically responsible, socially just, and respectful inclusion of the interests of pregnant women in the development and deployment of vaccines against emerging pathogens. It discusses how recent epidemics, including Zika virus, Lassa Fever, Ebola, and H1N1 influenza, have highlighted the ways in which infectious disease outbreaks can severely affect the health interests of pregnant women and their offspring. It specifies 22 concrete recommendations, organized around three key areas: public health preparedness, R&D, and vaccine delivery. (PDF)
Source: Disaster Lit: Resource Guide for Disaster Medicine and Public Health - Category: International Medicine & Public Health Source Type: news
Source: Center for Global Development (CGD). Published: 10/29/2018. In this one-hour, 22-minute panel discussion, speakers recount their experiences on the ground in Sierra Leone during the height of the 2014-2015 Ebola epidemic. They examine the policy and operational lessons learned that emerged from that effort; and reflect on the development and delivery of an efficacious Ebola vaccine, and how current approaches can perpetuate the exclusion of a group desperately in need of protection: pregnant women. (Video or Multimedia)
Source: Disaster Lit: Resource Guide for Disaster Medicine and Public Health - Category: International Medicine & Public Health Source Type: news
WASHINGTON ― Health and Human Services Secretary Sylvia Burwell delivered a letter to key lawmakers on Wednesday that explained exactly how their underfunded response to the Zika virus is screwing Americans over. President Barack Obama asked Congress for $1.9 billion in February to deal with the impending outbreak of Zika in the United States. Congress finally began working on the request in May, with the Senate passing a bipartisan compromise that was about $800 million short. The bill got tanked in a partisan squabble last month after Republicans decided to add in contraception restrictions, a pro-Confederate flag prov...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
Conclusion This modelling study aimed to explore the trends of the current Zika epidemic and use this data to predict the future spread of the virus. From the analysis, the main predictions were that the current epidemic will largely be over in three years, with seasonal variation based on mosquito populations. Additionally, once the current epidemic is over, there will be a delay of at least a decade before another large Zika virus epidemic. However, as the researchers acknowledge, with any modelling study the results are based on data available and some assumptions. There is a great deal of uncertainty that comes with ...
Source: NHS News Feed - Category: Consumer Health News Tags: Pregnancy/child Source Type: news
By Thomas Frieden As the world's worst Ebola epidemic fades in the rearview mirror of history, it's worth remembering what happened and the key lessons learned. Beginning in March 2014, Ebola began spreading rapidly in Sierra Leone, Liberia, and Guinea. Nearly 30,000 people were eventually afflicted with the disease, and more than 11,000 died. Ebola spread to Nigeria, Mali, the United States, and other countries. In response to the emerging epidemic, the Centers for Disease Control and Prevention activated its Emergency Operations Center to fight Ebola. This would become the CDC's largest and most intense outbreak resp...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
Congress is currently debating the level of federal funding that should be made available to fight to reduce the spread of Zika. Administration officials working with local public health agencies on the ground have recently expressed fear that the funding levels are insufficient to prevent the disease from spreading. What is one overlooked concern? State budgets. Medicaid is jointly funded by states and the federal government and serves as a key financer of health care services if Zika spreads across the country this summer. The Centers for Medicare and Medicaid Services (CMS) recently released a bulletin to state Medicaid...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Equity and Disparities Medicaid and CHIP Public Health family planning States Zika Source Type: blogs
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