Uganda Authorizes Use of 3 Experimental Ebola Therapeutics

The Uganda National Council for Science and Technology and the National Drug Authority have granted authorization for health workers in the African nation to use 3 of the experimental Ebola treatments in response to the 3 confirmed cases of the disease in the nation.

It was reported last week that the first Ebola case outside of the outbreak zone in the Democratic Republic of the Congo (DRC) had been detected in the neighboring nation of Uganda. The case was confirmed in a 5-year-old boy who had traveled from the DRC into Uganda on June 9, 2019.

The young boy died shortly after the World Health Organization (WHO) Uganda’s announcement; however, it was later announced that his 3-year-old brother and his grandmother both tested positive for the blood-borne virus. Both have since died. The Ministry of Health notes that all 3 confirmed cases were travel-associated cases and thus far there is no known transmission of Ebola virus within Uganda.

According to a situation report issued by the WHO, there are 2 suspected cases that are currently isolated in an Ebola Treatment Unit in Uganda.

Reuters reported that the treatments approved for shipment to Uganda were remdesivir (also known as GS-5734), an antiviral drug developed by Gilead Sciences, Inc; and a monoclonal antibody cocktail treatment ZMapp, developed by Mapp Biopharmaceutical Inc; and REGN-EB3 (also known as REGN3470-3471-3479), a monoclonal antibody cocktail developed by Regeneron Pharmaceuticals, Inc.

In November, the WHO announced that a clinical trial was being launched in the outbreak zone of the DRC to evaluate the effectiveness and safety of remdesivir and ZMapp, with plans to amend the trial to include REGN-EB3. In the randomized controlled trial, the participants will recover from Ebola as onsite clinicians monitor their symptoms and collect blood samples. Once they have fully recovered, participants will be permitted to leave the treatment center but will be asked to return 2 months later for follow-up and additional bloodwork.

ZMapp is the only investigational therapeutic that was tested in an efficacy trial—during the 2014-2016 Ebola outbreak in West Africa—however, efficacy could not be definitively established at that time due to a small number of trial participants.

In Uganda, Jane Ruth Aceng, MD, Minister of Health, announced in a tweet that ring vaccination of non-vaccinated frontline health workers and contacts of confirmed Ebola virus cases was initiated on June 15, 2019.

Ring vaccination against Ebola Virus Disease has started in Kasese District. Contacts of the confirmed #Ebola cases and non-vaccinated frontline health and other workers will be vaccinated.

This is one of the moves aimed to contain the Ebola outbreak in #Uganda. pic.twitter.com/1EQRTXEl5u

— Dr. Jane Ruth Aceng (@JaneRuth_Aceng) June 15, 2019

According to a Situation Report issued on June 17, 2019, the vaccination team has identified 128 contacts of the Ebola patients and has administered 59 vaccines.

The DRC Ebola outbreak has accumulated 2087 confirmed cases of the virus since August 2018, with 1365 confirmed deaths, as of June 17.

On Friday, a WHO International Health Regulations Emergency Committee met to discuss the DRC outbreak noting that there is a severe lack of funding for the outbreak response. “Operational scale-up was reviewed and a serious need for funding, both for the response and for preparedness, was underscored. Less than one-third of the resources needed are available; presently there is a funding shortfall of USD $54 million against $98 million needed for the response through July 2019.”

Although the committee expressed “deep concern” about the outbreak, they ultimately decided against declaring it a Public Health Emergency of International Concern.

For the most recent case counts in the Ebola outbreak in the DRC, check out the Contagion® Outbreak Monitor.