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To Your Health: NLM update Transcript

Ebola's lost opportunities?: 03/07/2016

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Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D., senior staff, U.S. National Library of Medicine (NLM).

Here is what's new this week in To Your Health — a consumer health oriented podcast from NLM — that helps you use MedlinePlus to follow up on weekly topics.

While one clinical trial of an Ebola vaccine reported initial success, the findings from a dozen other vaccine trials have yet to be reported in leading medical journals and suggest a lost research opportunity, finds a recent story in Science.

The Ebola virus received significant global attention in winter 2015 as a few cases spread from West African nations to the U.S. and some other countries.

The Science story's two authors write (and we quote): 'To date, results from just one clinical trial have appeared in a peer-reviewed journal; a study of Merck's Ebola vaccine, organized by the World Health Organization (WHO) in Guinea' (end of quote). This study was reported in The Lancet in summer 2015.

In contrast, the authors add (and we quote): "an anticlimactic silence has set in around a dozen other Ebola studies' (end of quote), some of which began in West Africa as a result of increased international attention to the virus' spread.

Interestingly, Science suggests the reason for the dearth of findings is more related to the procedural challenges to conduct a rigorous clinical trial than the vaccine's preventive capacity.

The authors explain some Ebola trials did not enroll enough participants to achieve statistical significance (or generalize the findings to larger populations). The authors add other trials did not use a randomized controlled trial (RTC) design, which authors write (and we quote): '.... weakened results and helps explain why those researchers have had trouble publishing their data in top-tier journals' (end of quote).

Science notes the inability to learn from several vaccine studies is a lost opportunity both for research and future affected populations. A scientist from the U.S. Food and Drug Administration tells Science (and we quote): 'We're left with not knowing whether the products help, hurt, or do nothing' (end of quote).

One of the other promising trials is an ongoing study of ZMapp, an antibody cocktail that was given successfully to treat two Americans with Ebola last year. Science reports independent panels from the National Institute of Allergy and Infectious Diseases reviewed the process and recommended the trial's continuation — partially in order to provide sufficient cases for statistical significance, or at least to demonstrate a trend supporting the medication's efficacy.

On the other hand, Science reports the Ebola epidemic is weakening in West Africa. As of late December, Science reports Liberia experienced three new cases and the last Ebola cases occurred in September and October in Sierra Leone and Guinea. To backup, the WHO reported about 4,800 deaths from Ebola in Liberia in 2015, while about 4,000 and 2,500 deaths occurred in Sierra Leone and Guinea respectively.

Although the recent decline in cases is quite encouraging, the problems in developing an Ebola vaccine are a reminder that it can be challenging to conduct evidence-based clinical trials, and it is sometimes difficult to do rigorous clinical trials within the populations where they are most needed.

Meanwhile, well-written questions and answers about Ebola (from the U.S. Centers for Disease Control and Prevention — the CDC) are available in the 'start here' section of MedlinePlus.gov's Ebola health topic page.

The CDC also provides a website with questions and answers about experimental treatments and vaccines for the Ebola virus within the 'related issues' section of MedlinePlus.gov's Ebola health topic page.

MedlinePlus.gov's Ebola health topic page also provides links to the latest pertinent journal research articles, which are available in the 'journal articles' section. Links to clinical trials that may be occurring in your area are available in the 'clinical trials' section. You can sign up to receive updates about Ebola as they become available on MedlinePlus.gov.

To find MedlinePlus.gov's Ebola health topic page, please type 'Ebola' in the search box on MedlinePlus.gov's home page, then, click on 'Ebola (National Library of Medicine).'

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