Sunday, August 5, 2012

Race for a Cure - Newsweek

With an outbreak of the deadly, untreatable Ebola virus in Uganda, it’s hard not to ask: Could an epidemic happen here? As Gwyneth Paltrow demonstrated in the 2011 movie Contagion, there’s nothing to stop a killer virus from hitching a ride on a world traveler and turning a local sneeze into a global fever.

In fact, in 2008 two women visited a bat-filled cave in Uganda and managed to bring the Marburg virus, a close and equally deadly relative of Ebola, back to both Europe and the U.S. The first, a Dutchwoman, died; the second, a woman from Colorado who recalled touching a guano-covered rock and then later covering her nose with her hand due to the ghastly smell, survived after a prolonged illness. Prior to that there was an outbreak of Ebola in a colony of laboratory monkeys in Reston, Va., a story recounted in Richard Preston’s bestseller, The Hot Zone, and exaggerated for apocalyptic effect in the 1995 movie Outbreak. The Marburg virus is named after the German lab it was discovered in, where lab workers fell ill from contact with infected monkeys in 1967. Seven died.

This is why one of the most important new developments in fighting Ebola is rapid blood testing. As the Centers for Disease Control’s Craig Manning points out, in previous outbreaks blood samples had to be shipped to the CDC’s headquarters in Atlanta for analysis, a process that, agonizingly, took three days. Now, thanks to the CDC’s collaboration with the Ugandan government, there is rapid 24-hour diagnostic testing available on the ground. Once a patient is diagnosed, epidemiologic teams can go out and isolate anyone who had contact with them. It’s a huge leap forward in epidemic containment.

This is, of course, slim comfort for those actually infected with Ebola; they have a 50 percent to 90 percent chance of dying. But even here there is hope. Until recently there was no race for a cure, because scientists didn’t even know where the starting line for such a race would be. But the National Institutes of Health has just awarded a $4.8 million grant to a team of researchers led by Kartik Chandran of Albert Einstein College of Medicine in New York, which managed to bust open Ebola’s previously elusive mechanism for entering a cell. “It’s a first step toward a therapeutic,” says Chandran. “We have a bona fide target.”

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Illustration by Ed Nacional

The interesting question we should be asking, he says, is not whether an Ebola epidemic could happen in the U.S., it’s whether the virus could ever become endemic hereâ€"that is, take up residence in our wildlife. “Since we know little about the ecology of these viruses in Africa and the Philippines, we can’t really answer this question,” he says. This is precisely what the NIH grant will allow Chandran and his team to do over the next five years.

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