Researchers Experiment with Treatments for Marburg Virus
JENNIFER LUDDEN, host:
This week, the World Health Organization declared an official end to an epidemic of the Marburg virus in Angola. It was the largest outbreak of Marburg ever and claimed as many as 329 lives. Its victims died horrific deaths, suffering high fever, massive bleeding and multiple organ failure. International health workers quickly learned the local culture made it hard to contain the outbreak. Julienne Anoko is an anthropologist living in Angola. She worked with the WHO and says traditional mourning rituals require that a dead body be laid out and washed by loved ones.
Ms. JULIENNE ANOKO (Anthropologist, WHO): They wash the body and the family's members and the friends have to embrace him, kiss him. They wash and kiss and cry and dance and so on. And you know that the most important way of contamination is contact.
LUDDEN: At the same time, Angolans became suspicious of hospitals. Sick people would go there and die rather than return home well.
Ms. ANOKO: When they saw that the doctors doesn't have any solution, they went back to the traditional healers. They went back through the local system, through the traditional system to look for a solution because the situation was very difficult for everyone.
LUDDEN: As the outbreak raged, scientists looked for something they could offer frightened people. They launched a crash experiment at the US Army's Infectious Disease Laboratories in Ft. Detrick, Maryland. They wanted to see if they could rescue monkeys from Marburg with an experimental drug. If the results looked good, the WHO planned to fly the drug to Angola and give it to people. NPR's Richard Knox followed that unpublicized experiment and reports now on its outcome.
RICHARD KNOX reporting:
Dr. Tom Geisbert zips himself into a space suit of blue rubberized plastic.
(Soundbite rustling plastic and zipping sounds)
KNOX: It's May 15th. More than 6,000 miles away, the Marburg virus is killing 20 Angolans a week. Here in a so-called level four maximum containment lab, Geisbert is about to have his own face-off with the virus.
Dr. TOM GEISBERT: Now I'm opening the door to actually enter the level four lab where we're going to perform the study today.
(Soundbite of pressurized air)
KNOX: The whoosh sound is pressurized air filling Geisbert's space suit. In his pocket is a tape-recorder. He agrees to carry it into the lab to document what could be an historic experiment.
Dr. GEISBERT: Katie, what animal are we on? OK.
KNOX: They're injecting Marburg virus into eight rhesus monkeys. There's no other way to test an experimental drug called recombinant napsi two(ph). Earlier tests showed the drug saved monkeys from Ebola virus, a cousin of Marburg, but no one's every tried it against Marburg. There's a sense that real lives depend on this experiment. Six monkeys get injections of the test drug every day, two monkeys get saltwater shots. A week into the experiment, Geisbert gives a progress report.
Dr. GEISBERT: The second control animal has just expired, so we now have a situation where both of the control animals have succumbed to the Marburg virus. It seems to be progressing a little faster than we thought.
KNOX: By day nine, the situation is grim.
Dr. GEISBERT: Unfortunately, this afternoon we've lost five of the six animals that were treated with the arnapsi two two(ph), the Angolan Marburg infection. So it looks like the treatment resulted in a two-day delay.
KNOX: Geisbert's disappointed the drug failed to save most of the treated monkeys, but it's significant they died two days later than the untreated animals. It suggests the drug is doing something. In humans who get supportive care the monkeys didn't, the drug might get them over the hump, but the best news is what happens to the sixth monkey.
(Soundbite of zipping sounds)
Dr. GEISBERT: Fifteen days after we began, we have one surviving animal that's treated with arnapsi two. So we're pretty confident at this point that this animal will most definitely survive the Marburg infection.
(Soundbite of zipping sounds)
KNOX: The results weren't as clear-cut as WHO officials hoped. Still, they decided there was enough evidence to justify using napsi two in Angola where Marburg was killing 90 percent of its victims. But Angolan authorities were reluctant. As negotiations dragged on, weeks passed. The epidemic petered out. The chance was gone. There's a good possibility Marburg could flare up in Africa again in the next few months, but Dr. Pierre Formenty of WHO says despite the Ft. Detrick results, the drug won't be used.
Dr. PIERRE FORMENTY (WHO): I cannot pretend that next month we will be using arnapsi two. We are not ready. It's a long process, much longer than I was expecting.
KNOX: The company that makes the drug now has legal concerns. Nevertheless, the Angolan outbreak and the spark of hope the Ft. Detrick experiment ignited have convinced WHO officials they have to rethink their strategy for fighting Marburg and Ebola. The classic method of isolating patients to cut the chains of transmission just isn't working.
Dr. FORMENTY: There is a ...(unintelligible) one in those fatalities not seen as the safe place to go if you want if you want to survive Ebola or Marburg, but it's the sort of morgue where you will not see your parents, where you will have the worst death that somebody can dream of.
KNOX: If that's going to change and people are going to trust public health workers, researchers will just have to come up with effective treatments. At Ft. Detrick, the work continues because everybody knows that Marburg will be back.
Richard Knox, NPR News.
LUDDEN: This is NPR News.