It seems like the treatment that is working best is early serum/blood transfusions.

[Anonymous]

OP here. this thread is not meant to be a compare and contrast HIV vs Ebola.
Anyway, 99% of Liberians are HIV NEGATIVE.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Well keep in mind that people survive without any of this if they have fluid support. In Africa the survival rate is 30% and most of those 30% didn't receive transfusions or anything else. People have always survived Ebola, even before these interventions.

But this does seem like a promising avenue.

Yes, and the 30% got poor care too. Duncan had relatively better care and still died. My sense is that the reason they aren't rushing for more ZMAPP is that they suspect that the transfusions work better and are more readily available in the US.

Don't know about this, heard ZMAPP just takes a really long time to produce.

ZMapp is grown in plants -- they can't really speed that along.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Well keep in mind that people survive without any of this if they have fluid support. In Africa the survival rate is 30% and most of those 30% didn't receive transfusions or anything else. People have always survived Ebola, even before these interventions.

But this does seem like a promising avenue.

Yes, and the 30% got poor care too. Duncan had relatively better care and still died. My sense is that the reason they aren't rushing for more ZMAPP is that they suspect that the transfusions work better and are more readily available in the US.

Don't know about this, heard ZMAPP just takes a really long time to produce.

ZMapp is grown in plants -- they can't really speed that along.

Tobacco plants, actually. Not fast and not (at present) scalable to mass production. It just does not work that way today. The next batch may save a few folks. It won't be enough to treat/save every infected African, sadly.

I believe the vaccine may prove more effective if it turns out to actually work.

God I hope something works; those poor people!

[Anonymous]

It does seem the blood transfusions have a big impact on recovering. I was listening to the press conference with the dr.s from NIH treating Nina Pham and they were asked if her transfusion from Dr. Brantley is why she's doing so well. Her dr. answered they can't yet scientifically say that's the reason -but yes, it appears it's a huge positive factor.

I wonder if Dr. Brantley is a universal donor (type O-)? He's given blood to so many of the ebola patients here, and to West Africa, etc. Would there be any reason Duncan would have not wanted a blood transfusion (i.e, some religions will refuse blood transfusions no matter how ill)? Brantley apparently called the hospital to offer his blood, and the hospital eventually said they weren't a match. But there's no way Brantley has matched with every single other US patient, is there?

Just curious, don't mean to derail..

[Anonymous]

I think I read he's A+.

[Anonymous]

Which is the most common blood type in the US, so yes, it makes sense he matched a few.

[Anonymous]

Anonymous wrote:

Anonymous wrote:You can't risk giving people HIV with blood transfusions, even if it cures their Ebola. Those people (now HIV positive who weren't before) would go on to infect other people with HIV, and you've just replaced one problem with another. In any case, Liberia doesn't have the capacity to get everyone suffering from Ebola a bed and Tylenol, so getting them all serum isn't going to happen, either, unfortunately.

For crying out loud. Many Africans are encouraged to breastfeed even with HIV, because it's less risky than feeding infants formula made with contaminated water. HIV is a terrible disease, but there are worse things (well, more rapidly fatal things) out there.

Many Africans are encouraged to breastfeed with HIV because breastfeeding under certain specific circumstances reduces rather than increases the rate of transmission of the virus.

[Anonymous]

Anonymous wrote:It does seem the blood transfusions have a big impact on recovering. I was listening to the press conference with the dr.s from NIH treating Nina Pham and they were asked if her transfusion from Dr. Brantley is why she's doing so well. Her dr. answered they can't yet scientifically say that's the reason -but yes, it appears it's a huge positive factor.

I wonder if Dr. Brantley is a universal donor (type O-)? He's given blood to so many of the ebola patients here, and to West Africa, etc. Would there be any reason Duncan would have not wanted a blood transfusion (i.e, some religions will refuse blood transfusions no matter how ill)? Brantley apparently called the hospital to offer his blood, and the hospital eventually said they weren't a match. But there's no way Brantley has matched with every single other US patient, is there?

Just curious, don't mean to derail..

The universal donor type for plasma is AB+, Brantley is A+, which means he can donate to anyone who doesn't have B. Since B is pretty rare that's the majority of people.

[Anonymous]

Anonymous wrote:

Anonymous wrote:It does seem the blood transfusions have a big impact on recovering. I was listening to the press conference with the dr.s from NIH treating Nina Pham and they were asked if her transfusion from Dr. Brantley is why she's doing so well. Her dr. answered they can't yet scientifically say that's the reason -but yes, it appears it's a huge positive factor.

I wonder if Dr. Brantley is a universal donor (type O-)? He's given blood to so many of the ebola patients here, and to West Africa, etc. Would there be any reason Duncan would have not wanted a blood transfusion (i.e, some religions will refuse blood transfusions no matter how ill)? Brantley apparently called the hospital to offer his blood, and the hospital eventually said they weren't a match. But there's no way Brantley has matched with every single other US patient, is there?

Just curious, don't mean to derail..

The universal donor type for plasma is AB+, Brantley is A+, which means he can donate to anyone who doesn't have B. Since B is pretty rare that's the majority of people.

Not to derail but I didn't realize that universal donor blood type for plasma is different from regular blood universal donor - O-. Is there any idea why that is?

[Anonymous]

Anonymous wrote:I think I read he's A+.

I've also heard he's A+ and was a match with everyone besides Duncan (don't know about Amber though -- they haven't said that she's receiving his plasma). If there are any medical professionals reading -- how many times can he give plasma? Seems like he must still be recovering himself, and while is blood/plasma is useful -- is it dangerous to him to be donating or is it regenerated pretty quick? I've read that Whitebold is a rare blood type and hasn't matched with anyone, and I haven't heard anything about Rick Sacra -- the dr. who was treated at Nebraska, though I'm guessing he's also A+ because he got blood from Brantley.

[Anonymous]

Anonymous wrote:

Anonymous wrote:It does seem the blood transfusions have a big impact on recovering. I was listening to the press conference with the dr.s from NIH treating Nina Pham and they were asked if her transfusion from Dr. Brantley is why she's doing so well. Her dr. answered they can't yet scientifically say that's the reason -but yes, it appears it's a huge positive factor.

I wonder if Dr. Brantley is a universal donor (type O-)? He's given blood to so many of the ebola patients here, and to West Africa, etc. Would there be any reason Duncan would have not wanted a blood transfusion (i.e, some religions will refuse blood transfusions no matter how ill)? Brantley apparently called the hospital to offer his blood, and the hospital eventually said they weren't a match. But there's no way Brantley has matched with every single other US patient, is there?

Just curious, don't mean to derail..

The universal donor type for plasma is AB+, Brantley is A+, which means he can donate to anyone who doesn't have B. Since B is pretty rare that's the majority of people.

PP here. Oh! Interesting - I didn't know that. Makes much more sense. Thank you!

[Anonymous]

Brantly is not the only survivor out there. There are tons in Liberia. He got a transfusion from a Liberian teenager before coming to the US (he did not give any blood to Liberians). We might need to consider flying some African survivors who are AB+ or just a variety of blood types to make plasma available.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I think I read he's A+.

I've also heard he's A+ and was a match with everyone besides Duncan (don't know about Amber though -- they haven't said that she's receiving his plasma). If there are any medical professionals reading -- how many times can he give plasma? Seems like he must still be recovering himself, and while is blood/plasma is useful -- is it dangerous to him to be donating or is it regenerated pretty quick? I've read that Whitebold is a rare blood type and hasn't matched with anyone, and I haven't heard anything about Rick Sacra -- the dr. who was treated at Nebraska, though I'm guessing he's also A+ because he got blood from Brantley.

Not sure how much blood they took off, and whether they retransfused his red cells back into him. Either way, he is probably quite anemic, though I am sure he is taking iron, vitamins, and maybe EPO. I heard that they need lots of plasma, something like over a liter (?). The plasma cells make the antibodies, but over time, his supply of antibodies will drop only to spike again with another exposure to Ebola. So, they will have to find new donors.
The problem with Ebola is that it kills you before your body can make the antibodies to fight it. It takes two weeks for the body to produce a good amount of antibody. The transfusions are buying time.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think I read he's A+.

I've also heard he's A+ and was a match with everyone besides Duncan (don't know about Amber though -- they haven't said that she's receiving his plasma). If there are any medical professionals reading -- how many times can he give plasma? Seems like he must still be recovering himself, and while is blood/plasma is useful -- is it dangerous to him to be donating or is it regenerated pretty quick? I've read that Whitebold is a rare blood type and hasn't matched with anyone, and I haven't heard anything about Rick Sacra -- the dr. who was treated at Nebraska, though I'm guessing he's also A+ because he got blood from Brantley.

Not sure how much blood they took off, and whether they retransfused his red cells back into him. Either way, he is probably quite anemic, though I am sure he is taking iron, vitamins, and maybe EPO. I heard that they need lots of plasma, something like over a liter (?). The plasma cells make the antibodies, but over time, his supply of antibodies will drop only to spike again with another exposure to Ebola. So, they will have to find new donors.
The problem with Ebola is that it kills you before your body can make the antibodies to fight it. It takes two weeks for the body to produce a good amount of antibody. The transfusions are buying time.

I read somewhere that they are possibly transfusing him with plasma (from regular non-Ebola related people) to make up for what they take. I have no idea if this is true, but it's kind of interesting to think how it might work.