What Is The Best Treatment For Ebola?

The best current treatment for Ebola that we currently have is a blood transfusion from someone who has gotten better from the disease.

Dr. Kent Bradley, the first person to be flown back to the U.S. and a survivor, has donated blood to both Dr. Richard Sakra and cameraman Ashoka Mukpo. Both of them are being treated at Nebraska Medical Center.

Dr. Bradley has plans to donate to the infected nurses in Dallas as well.

Of the  thirty-four outbreaks of Ebola-like virus since 1967, most have been very poorly studied. Our current lack of knowledge about how to treat Ebola is a direct result of our largely ignoring previous outbreaks. Very little follow-up has been done with patients.

What we do have is some very good results for blood transfusion: “Transfusion of blood from convalescent patients was highlighted as potentially useful in Kikwit, Zaire when only one of eight patients receiving a transfusion died.” That’s a really good number compared to our current death rate worldwide of 50-70%.

In comparison, only two of five patients receiving heparin (an anticoagulant) survived. I wonder at this treatment, as the Ebola virus itself seems to act as an anti-coagulant. (here) I would argue that Vitamin K (which aids coagulation) would have a better outcome, but we have no data on whether it would or not.

On autopsy, what actually causes death in a person with Ebola is unclear. But patients exhibit signs that ” resemble that of severe sepsis and septic shock.” So what causes death may be a breakdown of the gut or lungs, allowing bacterial entrance into the blood stream.

In the 2012 review article, Daniel Clark et al. argue for the use of septic shock prevention and supportive measures as a starting point for supportive treatment. (here)

As researchers note, we simply have not bothered to follow-up on Ebola cases in West Africa. So now we have the tragedy of needing to do the research on our own citizens.

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