Ebola Virus Medication

  • Author: John W King, MD; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Apr 20, 2010
 
 

Medication Summary

Presently, no specific anti-Ebola viral agents are available. The nucleoside analogue inhibitors of S-adenosylhomocysteine hydrolase (SAH) have been shown to inhibit EBO-Z viral replication in adult BALB/c mice infected with mouse-adapted Ebola virus. The treatment response was dose-dependent, and, when doses of 0.7 mg/kg or more every 8 hours were begun on day 0 or 1 of infection, mortality was completely prevented. Even when the drug was given on day 2, 90% of mice survived the infection.[12] SAH is a cell-encoded enzyme that, when inhibited, indirectly inhibits transmethylation reactions required for viral replication.

Passive immunity has been attempted using equine-derived hyperimmune globulins and human-derived convalescent immune globulin preparations. Although these preparations are not proven to prevent or modify human Ebola hemorrhagic fever, some patients have survived clinical Ebola disease following their use. The survival of these patients suggests that passive immunity may be of benefit in some patients.

There are no commercially available Ebola vaccines. However, a recombinant human monoclonal antibody directed against the envelope GP of Ebola has been demonstrated to possess neutralizing activity. This Ebola neutralizing antibody may be useful in vaccine development or as a passive prophylactic agent.

Another approach has been evaluated in the rhesus macaque model of Ebola hemorrhagic fever, which carries a mortality rate that approaches 100%. Geisbert et al administered recombinant nematode anticoagulant protein, a potent inhibitor of tissue factor-initiated coagulation.[13] One third of the monkeys given the nematode anticoagulant protein survived a lethal dose of Ebola virus, whereas 16 of the 17 (94%) control animals died. This approach targeted the hemorrhagic disease component of the infection rather than the virus itself.

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Contributor Information and Disclosures
Author

John W King, MD  Professor of Medicine, Chief, Section of Infectious Diseases, Director, Viral Therapeutics Clinics for Hepatitis, Louisiana State University Health Sciences Center; Consultant in Infectious Diseases, Overton Brooks Veterans Affairs Medical Center

John W King, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Federation for Medical Research, American Society for Microbiology, Association of Subspecialty Professors, Infectious Diseases Society of America, and Sigma Xi

Disclosure: emedicine $50.00 author of chapter

Coauthor(s)

Rushdah Malik, MD  Fellow, Department of Infectious Diseases, Louisiana State University Health Science Center

Rushdah Malik, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Martin J Wood, MD †  Former Consulting Staff, Department of Infection and Tropical Medicine, Birmingham Heartlands Hospital, UK

Martin J Wood, MD † is a member of the following medical societies: Alliance for the Prudent Use of Antibiotics, American Society for Microbiology, Infectious Diseases Society of America, International Society for Infectious Diseases, and Royal College of Physicians

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Thomas M Kerkering, MD  Chief of Infectious Diseases, Virginia Tech, Carilion School of Medicine, Roanoke, Virginia

Thomas M Kerkering, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Public Health Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Medical Society of Virginia, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

References

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Ebola virus. Courtesy of the US Centers for Disease Control and Prevention.
Table 1. History of Ebola Virus Sudan Outbreaksa
YearLocationReported Cases, No.Deaths, No. (%)
1976Sudan284151 (53)
1976Englandb10 (0)
1979Sudan3422 (65)
2000-2001Uganda425224 (53)
2004Sudan1717 (41)
Total761414 (54.4)
Table 2. History of Ebola Virus Zaire Outbreaksa
YearLocationReported Cases, No.Deaths, No. (%)
1976Zaire318280 (88)
1977Zaire11 (100)
1994Gabon5231 (60)
1995DRC315250 (81)
Jan 1996 to Apr 1996Gabon3721 (57)
Jul 1996 to Jan 1997Gabon6045 (74)
1996South Africa (acquired in Gabon)11 (100)
Oct 2001 to Mar 2002Gabon6553 (82)
Oct 2001 to Mar 2002DRC5944 (75)
Dec 2002 to Apr 2003DRC143128 (89)
Nov 2003 to Dec 2004DRC3529 (83)
2007DRC264187 (71)
Total1,3501,070 (79.3)
Table 3. History of Ebola Virus Côte-d’Ivoire Outbreaks (No Deaths Reported)a
YearLocationReported Cases, No.
1994Côte-d’Ivoire1
1995Liberia1
Total2
Table 4. History of Ebola Virus Reston Outbreaks (No Deaths Reported)a
YearLocationProven bCases Reported, No.
1989Virginia, Texas, Pennsylvania0
1990Virginia and Texas4
1989 -1990Philippines3
1992Italy0
1990Alice, Tex0
1996Philippines0
Nov 2008Philippinesc6
Total13
Table 5. History of Ebola Virus Bundibugyo Outbreaka
YearLocationReported Cases, No.Deaths, No. (%)
Dec 2007 to Jan 2008Uganda14937 (25)
Total14937 (25)
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