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Unformatted text preview: primates. HIV inactivating protein cyanovirin-N displays potential anti-EBOV activity. CV-N binds N-linked high-mannose oligosaccharides on HIV glycoprotein gp120. Similar oligosaccharide constituents of the EBOV envelope suggest susceptibility to CV-N inhibition. Initial results show CV-N antiviral activity against Ebola-Zaire both in vitro and in vivo12 During the 1995 outbreak in Kikwit, DRC, human convalescent plasma was used to treat 8 patients with proven Ebola disease. Only 1 of these patients died. Human recombinant interferon alpha-2b used in conjunction with hyperimmune equine IgG delayed but did not prevent death in Ebola-infected cynomolgus macaques. Four laboratory workers in Russia who had possible Ebola exposure were treated with a combination of a goat-derived anti-Ebola immunoglobulin plus recombinant human alpha-2 interferon. One of these patients had a high-risk exposure and developed clinical evidence of Ebola infection. All 4 patients recovered. Equine IgG containing high-titer neutralizing antibodies to Ebola protected guinea pigs and baboons but was not effective in protecting infected rhesus monkeys. Nucleoside analogue inhibitors of S-adenosylhomocysteine hydrolase (SAH) inhibited EBO-Z viral replication.9 SAH is a cell-encoded enzyme that, when inhibited, indirectly inhibits methylation of the 5’ cap required for viral replication.10 Passive immunity Using equine-derived hyperimmune globulins and human-derived convalescent immune globulin preparations. Not proven in preventing or modifying human Ebola hemorrhagic fever Some patients have survived clinical Ebola disease following their use Supportive therapy with attention to intravascular volume, electrolytes, nutrition, and comfort care is of benefit to the patient. Stabilizing the patient’s fluids and electrolytes Maintaining oxygen status and blood pressure, Preventing shock, renal failure, and bacterial secondary infections Preventing the loss of platelet and clotting factors Treating any complicating infections. Surgical Care: Surgical intervention generally follows a mistaken diagnosis in which Ebolaassociated abdominal signs are mistaken for a surgical abdominal emergency. Such a mistake often is fatal for the patient and for any surgical team members who become contaminated with the patient's blood. Vaccines At present, there is no known cure or commercially available vaccination available for Ebola virus infection Experimental Vaccines A recombinant human monoclonal antibody in goats or horses that are specific for the GP of Ebola may be useful in both vaccine design or as a passive proph...
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This note was uploaded on 10/13/2009 for the course YIPH ln;ljhdfi taught by Professor Wanger during the Spring '09 term at Heriot-Watt.
- Spring '09