Liberia to give two doctors trial drug, Ebola toll at 1,013

MONROVIA/DAKAR Tue Aug 12, 2014 11:20am EDT

1 of 2. Liberian soldiers check people travelling in Bomi County August 11, 2014.

Credit: Reuters/Stringer

MONROVIA/DAKAR (Reuters) - Liberia said on Tuesday it would treat two infected doctors with the scarce experimental Ebola drug ZMapp, the first Africans to receive the treatment, while authorities in Spain said a 75-year-old priest had died of the disease.

The death toll from the worst ever outbreak of the highly contagious disease has climbed to 1,013 since it was discovered in remote southeastern Guinea in March, according to the World Health Organization (WHO).

It said ZMapp doses were very scarce, raising ethical questions of who should have priority.

Spanish authorities said a 75-year-old Spanish priest who contracted Ebola in Liberia had died. The government had announced on Sunday that Miguel Pajares, the first European infected by the strain, would also be treated with ZMapp manufactured by California-based Mapp Biopharmaceutical.

In addition to Pajares, ZMapp has already been administered to two U.S. aid workers. The U.S. citizens are now in a hospital in Atlanta, Georgia, after being medically evacuated and have shown some signs of improvement.

The virus - one of the deadliest diseases known to man - has spread to four African countries, infecting a total 1,848 people, according to the WHO, which has branded the outbreak an international health emergency.

The epidemic in one of the world's poorest regions, where crumbling healthcare systems are unable to cope, has opened an ethical debate on the use of trial drugs on humans. A WHO medical ethics committee was due to announce its findings on Tuesday, including on the sensitive issue of who should receive priority for the limited supplies of the drugs.

With medical staff lacking the equipment and training to tackle the first outbreak of Ebola in West Africa, more than 60 healthcare workers have died and dozens more been infected, severely hindering countries' ability to cope with the disease.

Information Minister Lewis Brown said the Liberian government had received written consent from the two doctors - who he identified as Zukunis Ireland and Abraham Borbor - for the treatment, which has not been fully tested in humans.

"The drug maker could not export...the drug without the approval of the FDA so our authorities approached the FDA and received specific approval for the treatment of these two doctors," Brown told Reuters by telephone.


He said the drug was expected to reach Liberia within the next 48 hours. A statement on the Liberian presidency's website had earlier said U.S. President Barack Obama had approved export of ZMapp but the minister said this was incorrect.

A spokesperson for the U.S. Health and Human Services (HHS) Department said U.S. authorities had simply assisted in connecting the Liberian government with the drug's manufacturer and followed procedures for the export of pharmaceuticals.

Mapp Biopharmaceutical said on Monday its supply of the drug has been exhausted, after the company provided doses to a West African nation, according to a report published by the Wall Street Journal.

The Liberian presidency statement said the head of the WHO, Margaret Chan, had authorized the dispatch of additional doses of the experimental drug to Liberia, but Minister Brown said it was not clear if this was true.

A WHO spokeswoman said supplies were "very scarce".

"They have less than a dozen (doses) of it," spokeswoman Fadela Chaib told a briefing. "It is very important to discuss who should get it...and if it is ethical to use it."

The WHO has said the epidemic will likely continue for months as the region's healthcare systems struggle to cope and has appealed urgently for funding and emergency medical staff.

Ivory Coast, the economic powerhouse of French-speaking West Africa, on Monday banned air travelers from the three countries worst-hit by the Ebola outbreak and ordered its flagship carrier Air Cote d'Ivoire to cease flights to and from them. Ivory Coast has not registered any cases but is seen as vulnerable given its shared borders with Guinea and Liberia.

Highly contagious, Ebola kills more than half of its victims. It is believed to have been transferred from fruit bats to humans in Guinea late last year and then spilled over in neighboring Sierra Leone and Liberia.

The virus has since spread to Nigeria via a passenger from Liberia who collapsed in the busy Lagos airport in late July and later died. Nigeria now has more than 10 confirmed Ebola cases, its health minister said on Monday.

(Additional reporting by Michele Gershberg, Tanvi Mehta in Bangalore, Editing by Ralph Boulton)

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Comments (4)
sophie11rose wrote:
In this type of emergency there should be an effort to assist this manufacturer in increasing their production of this trial drug. In addition, it is time to look seriously at a process where a terminal patient could request an unapproved drug/treatment at their own risk. Let’s face it if you are going to die anyway why not take the chance on an untested drug/treatment it just might work. Even if it doesn’t using it would provide more data.

Aug 12, 2014 9:18am EDT  --  Report as abuse
adaptor40 wrote:
The question is Why is it scarce? Is the drug made of platinum or Gold?

Aug 12, 2014 10:14am EDT  --  Report as abuse
About one year ago I was prescribed the nsaid drug Diclofenac, for an arthritic knee. I opted not to take it due to the label warning that in cases where Dengue fever was possible, this drug like ALL NSAIDS could cause severe capillary leakage (internal/ external bleeding)leading to sudden death. Living in the tropics, I reasoned it better not to take the drug or any NSAIDS for that matter as arthritis in itself does not cause death.
I emailed CDC regarding this fact wondering if there death count from a Dengue outbreak here in 2010 was accurate, since it seemed likely that the elderly could die suddenly from one mosquito bite as they are a large population that consumes NSAIDS, and nobody would be the wiser, if their death was attributed to old age.
I received no response from the CDC regarding this question which I still believe today is worthy of an answer.
Since the ebola virus may cause internal/external bleeding, I have to wonder now if there is any correlation between cases, of a possible NSAID connection that is exacerbating symptoms, which could be life threatening.
I know that is seems hard to believe, but what I have learned so often recently is that truth is stranger than fiction.
I realize that ebola and dengue are two different viruses, however
the NSAID warning I believe is so overlooked, that it is possible, that it is a potential culprit.
NSAIDS are big business, but there not to die for. I assume the CDC did not reply, due to the implications of my question, to that market. Panic. Millions take NSAIDS daily (not me). Before taking any drug I have to read all the documentation that comes with them.
I was absolutely shocked to discover this information, 4/5 of the way through the fine print.
I cannot be sure, since data is limited, however it seems likely that since ebola comes with fever, NSAIDS are used to reduce that fever, but is it causing the internal/external bleeding?
How many of the population in the ebola outbreak zone are consuming NSAIDS before onset of the virus.
It’s nice to have the internet to investigate stuff, but when ever
big business is at risk of losing money, information gets squelched.
I wonder just how many people are even aware of the NSAID side effect when exposed to dengue fever could cause sudden death, through excessive capillary leakage?

Aug 12, 2014 12:09pm EDT  --  Report as abuse
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