Ebola: 'Dress Rehearsal' or Show Closer?
Rapid biomedical progress will soon make epidemics ancient history
Don't panic. Ebola may be "just a plane ride away," but it is highly unlikely to become an epidemic threat in the United States and other rich countries. The virus is transmitted by close contact with the body fluids of infected people, making transmission much more difficult with Ebola than with a respiratory virus like influenza. This intimate mode of transmission makes it much easier for public health officials to trace people who come in contact with those infected by the virus, to monitor them, and to isolate them from the public.
The spread of the disease in West Africa is occurring largely because that region lacks adequate systems for this tracing, tracking, monitoring, and isolating. In Sierra Leone, the current epicenter of the outbreak, people who are supposed to be quarantined in their houses and monitored by police still receive visitors and go shopping. Many are also refusing to go to hospitals for treatment because they regard them as death traps. The government is now calling out soldiers to enforce the quarantines.
David Quammen, author of Spillover: Animal Infections and the Next Human Pandemic, told NPR this week that the current Ebola outbreak is "a dress rehearsal for the next big one." By the "next big one," Quammen means an epidemic caused by a respiratory disease microbe jumping from an animal species into the human population. Researchers worry that a deadly epidemic could result from the respiratory transmission of a mutated bird flu virus, or a coronavirus like the ones responsible for Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS). Yet the SARS example shows how prompt isolation and quarantine measures can stop a nascent respiratory disease outbreak. Since 2004, there have been no cases of SARS reported anywhere in the world.
If Ebola is a dress rehearsal, the good news is that biomedical researchers are developing a variety of show closers. The "secret serum" from Mapp Biopharmaceuticals injected into infected American aid workers Kent Brantly and Nancy Writebol is an example of a whole suite of new biotechnologies being developed to treat and prevent infectious diseases. The serum, called ZMapp, combines three monoclonal antibodies. One makes the virus visible to a patient's immune system, which then attacks it, while the other two neutralize it so that it can't infect human cells. ZMapp is not a vaccine; instead it confers passive immunity. (Cautionary note: The treatment's true effectiveness cannot be determined based on what amounts to a clinical trial of two people.)
Mapp Biopharmaceuticals produced the antibodies by injecting mice with a protein from the virus. This provoked the mouse immune systems to create cells that produce antibodies against the protein. The researchers fused the antibody-producing cells with cancer cells in order to have a steady supply of them. They then identified the genes for the specific three antibodies and genetically engineered them into tobacco plants to produce greater quantities. Identifying and producing monoclonal antibodies as treatments against infectious diseases is now slow and expensive, but new techniques are being developed to speed up the process. (Interestingly, the biotech company Crucell has identified a monoclonal antibody that confers near-universal immunity to influenza virus strains.)
It is impossible to survey all of the new biomedical techniques that are being developed to fight infectious diseases, but we can take a look at few of the more promising projects.
The fall in the price and availability of genetic sequencing systems is opening up a new field of "genomicepidemiology" by making it easier to quickly identify disease microbes. Next comes reverse vaccinology, which uses the genomic information to identify genes that produce targets, usually microbial proteins, for vaccine development.
In 2013, researchers at the J. Craig Venter Institute used synthetic biology to pinpoint the genes for target proteins in particular influenza virus types. Before this, the time required to create the seed strains needed for producing vaccines was 4 to 6 weeks; now it's less than a week. It takes six to nine months to make flu vaccines the conventional way, using eggs. But a new recombinant seasonal flu vaccine that the Food and Drug Administration approved last year—produced using insect cells—can be formulated in only two months.
Researchers at Arizona State University have devised a clever way to deliver DNA from pathogenic microbes as a vaccine. They have created a weakened version of Salmonella bacteria that have been genetically modified to live on a non-natural sugar. The DNA from the pathogens is inserted into the Salmonella bacteria, which are then swallowed and quickly invade host cells. Without access to their non-natural sugar supplies, the Salmonella explode, releasing the pathogenic DNA, to which the host cells develop an immune response.
"The universal DNA vaccine platform technology represents an important advance in the ability to rapidly engineer and scale up effective vaccines for influenza and other potentially lethal pathogens for biodefense," notes Global Biodefense. "The technique also permits large quantities of DNA vaccine to be produced rapidly at low cost, freeze-dried and stockpiled to be used when needed."
Given how much progress has been made toward rapidly devising new treatments for dangerous infectious diseases, you may wonder why only a handful of ZMapp serum doses are available? Ebola outbreaks are rare, and they mostly affect people in poor countries. This small, penurious market, combined with the protracted and costly drug approval system, provide pharmaceutical companies with little financial incentive to develop therapies aimed at Ebola. The development of ZMapp was largely funded by government agencies as biodefense research. There are also a number of Ebola vaccine candidates in the pipeline, all of which have also been largely supported by government biodefense funding.
What about the future? Advances in fields like genomics, proteomics, reverse vaccinology, synthetic biotechnology, and bioinformatics are exponentially improving the knowledge of researchers about how pathogens and the human immune system interact. All of the tools involved with identifying pathogens and producing treatments like monoclonal antibodies and vaccines will continue to fall in price and become more ubiquitous. Thus will compounding therapies become ever faster and cheaper. Long, complicated, and expensive clinical trials overseen by hypercautious regulators will no longer be required for validating the safety and effectiveness of targeted, rationally designed therapies. A couple of decades hence, infectious diseases will still strike, but any patient with a fever will be tested, her infection immediately identified, and a personalized treatment regimen crafted just for her will be administered. We may reach a time when epidemics and pandemics are ancient history.
Editor's Note: As of February 29, 2024, commenting privileges on reason.com posts are limited to Reason Plus subscribers. Past commenters are grandfathered in for a temporary period. Subscribe here to preserve your ability to comment. Your Reason Plus subscription also gives you an ad-free version of reason.com, along with full access to the digital edition and archives of Reason magazine. We request that comments be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of reason.com or Reason Foundation. We reserve the right to delete any comment and ban commenters for any reason at any time. Comments may only be edited within 5 minutes of posting. Report abuses.
Please
to post comments
And a cure for cancer has been 20 years away for the last 50 years or so.
It exists, it’s just hiding inside successful fusion reactors.
Cold fusion reactors?
I think I saw one of those near my jackalope ranch.
I saw one hiding behind a practical electric car.
Phooey! No such thing and we don’t need it.
I just patented the 100MPG carbur…
Wait! Who are you guys? You’re from wh NOOOO! AAARGH!
“Look, if he was dying, he wouldn’t have bothered to carve ‘Aaaarrrggghhhh’. He’d just say it. “
“AHHHHHHHHHHHHHH!!!!”
“No no it’s Aaaaarrrrggghhhhh, not AHHHHHH”
I had one once! But then I turned off my heater and it stopped working for some reason…
And a cure for cancer has been 20 years away for the last 50 years or so.
Cancer has been cured.
My grandma had cancer and then she was treated and it went away.
That is a cure.
Offered with no comment:
New strain of ebola
Ron, out shilling for Big Virus…
Don’t strain yourself Ron.
*narrows gaze*
Have they blamed global warming for this yet?
Of course it’s global warming. No need to even discuss it.
The science is settled. Why would you question it? I mean do you think the earth is flat? If the earth is round that proves that there is global warming.
Yum, like a panini!
Washington Post links ebola to climate change.
Oh my fucking god.
Is Peak Retard really a worthy goal?
Peak Retard is truly unattainable.
Tony rejects the idea that Peak Derp is not attainable.
That dude is a fucking idiot. “One can imagine”? Yeah, I can imagine satan doing black magic but that doesn’t make it true. Wow. Just wow.
…I can imagine satan doing black magic…
Raaaaaciiiist!!!
Needz moar scary boogeymen. Ebola = really scary.
Get back to me when you know how Ebola is polling with millennials.
They were against it until they heard it was the hot new infection they hadn’t heard of before.
47% are opposed; 53% think it’s a legitimate dialect.
So long as it doesn’t cost too much.
…but it is highly unlikely to become an epidemic threat in the United States and other rich countries.
They said the same thing about zombies, but look at World War Z.
“look at World War Z”
Meh. I’d rather not. The book was bad enough.
Ok, “The Stand” then.
M-O-O-N
That spells Ebola.
Ok, “The Stand” then.
Does Ebola have its own trans-dimensional elf wizard like the Stand had Flag?
I watched it on cable. It wasn’t a terrible movie, though I won’t watch it a second time.
Would have been better if the virus would have made monkeys super intelligent. Zombies are like, so last week.
Viruses mostly cause diarrhea, but nobody wants to watch a film called “Planet of the Diarrheas”.
I thought they mostly cause the sniffles. Planet of the Sniffles? Sounds like Day of the Triffids, but slightly better.
Planet of the Vomits.
I am so goddamn bored with zombies. It’s a shame, I like a good zombie movie, but it gets tiresome. I’ve seen zombie themed shotgun shells for sale, for fuck’s sake.
I watch The Walking Dead only because the wife likes it. So I watch it with her so she can have someone to talk about it with. Otherwise, meh.
The take away from this is : Africa sucks. All four horsemen of the Apocalypse hang out there.
. We may reach a time when epidemics and pandemics are ancient history.
Dream on, Ron. As long as the Treasury department still has access to a printing press, the number of alarums about epidemics and pandemics raised by the likes of the CDC and the WHO are going to increase year-over-year. We already have an obesity epidemic and a gun violence epidemic, we’re on course for a my shoes are too tight epidemic and an I don’t like my haircut epidemic and a there’s nothing good on TV epidemic. All of which will require massive injections of cash into the CDC budget to combat.
Is Gay Marriage To Blame for the Ebola Virus Outbreak?
Obama is Infecting Christians with Ebola To Destroy Jesus and Start A New Age of Liberal Darkness
I’m not clicking on either one of those links, the stupid hurts enough just reading them.
Wait to you hear what they have to say about The Golden Girls.
Christwire.org is satire. At least I hope it is.
OK, that site has to be parody.
It is. And not a very funny one.
Just for fun
Start with ebola. Add some cancer. Mix with tobacco. Save lives.
I fucking love this shit.
Long, complicated, and expensive clinical trials overseen by hypercautious regulators will no longer be required for validating the safety and effectiveness of targeted, rationally designed therapies.
I have no problem you can deliver vaccines by eating genetically engineered salmonella. But believing that regulators are going to stop regulating? That’s a bridge too far.
Ebola is going to be a tough one to make much biomedical progress on, for this reason:
Experimental drugs have to be tested on somebody. We can’t give them to Africans infected with Ebola, because it would be racist to use blacks as guinea pigs. And we can’t give them to whites infected with ebola, because it would be racist to give our newest and best drugs only to whites.
I’m sorry but what? Are you trying to come up with the stupidest “libertard” argument against medical research possible? Well, you succeeded… I guess.
Have you heard the other retard argument for ending medical research? It goes like this: IP is an “arbitrary monopoly”.
Nope, nobody has to actually invest millions and billions in time, effort and money to develop medicines (or anything else, for that matter); ideas just kind of float around in the ether somewhere, and an inventor is just a guy who just happened to snag an idea and become an “arbitrary monopolist” via the agency of IP.
/sarc?
bassjoe: WHOOSH!
Good, all these rapid advancements of biomedical technology will let me invent my very own T virus.
I’ll relax more when they figure out a cure for viruses and not just perpetual treatment.
I’ll relax when they take off the space suits around people infected.
A couple of decades hence, infectious diseases will still strike, but any patient with a fever will be tested, her infection immediately identified, and a personalized treatment regimen crafted just for her will be administered
Science, Ron, really? Rewarding butt-hurt “feminists” by changing the English language will only encourage more butt-hurt. They can never be appeased. Today it is “only” changing “him or he or his” to “her or she or hers”. Tomorrow, once they have their victim hood momentarily appeased, it will be something else. Incrementalism is the name of the game.
Maybe Ron was trying to sat that WOMENZ are responsible for the spread of this disease. TWTANLW
Ebola? Hey, no worries – we now have Obamacare healthcare insurance in this country. Isn’t that reassuring?