Liberian doctor who received rare Ebola drug ZMapp dies

[Shiloh]

Source: http://uk.reuters.com/article/2014/0...0GP10A20140825


Liberian doctor who received rare Ebola drug ZMapp dies
DAKAR Mon Aug 25, 2014 12:59pm BST

(Reuters) - One of three African doctors infected with Ebola and treated with the experimental drug ZMapp has died in Monrovia...doctor Abraham Borbor...

[Shiloh]

Re: Liberian doctor who received rare Ebola drug ZMapp dies

Source: http://www.winnipegfreepress.com/wor...ce=d-top-story


Liberian doctor who got experimental Ebola drug dies, says information minister
By: Jonathan Paye-Layleh, The Associated Press
Last Modified: 7:30 AM

MONROVIA, Liberia - A Liberian doctor who was among three Africans to receive an experimental Ebola drug has died, the country's information minister said Monday.

Dr. Abraham Borbor, the deputy chief medical doctor at the country's largest hospital, had been among three Liberians, and the first Africans, who received the drug, ZMapp. Two Americans received the untested drug and survived. A Spaniard infected with Ebola received the treatment but died. There was no update given on the two other Liberians who took doses of the drug.

Borbor "was showing signs of improvement but yesterday he took a turn for the worse," Information Minister Lewis Brown told The Associated Press. It wasn't clear if he died late Sunday or on Monday...

[sharon sanders]

Re: Liberian doctor who received rare Ebola drug ZMapp dies

Also please see:

Spain - Ebola surveillance 2014 - Priest treated with experimental serum - died

http://www.flutrackers.com/forum/showthread.php?t=226198

[Emily]

Re: Liberian doctor who received rare Ebola drug ZMapp dies

I think the age of the priest was 75 yrs. I can't find an age for the Liberian doctor who died.

Age was the only determinant of survival that could be statistically supported in the study below done on the 1995 DRC outbreak.

http://www.flutrackers.com/forum/sho...d.php?t=226718

[Sharky]

Re: Liberian doctor who received rare Ebola drug ZMapp dies

It's interesting that the reports about Brantly's recovery invariably mention ZMapp, while neglecting the fact that he also got a blood transfusion from a teenager he treated who later recovered -- and that he was doing better even before leaving for the US.

Regarding the Liberian doctor:

From: https://www.internationalsos.com/ebo...anguage_id=ENG

A doctor who was confirmed to be infected with Ebola has died. He was given the experimental drug ZMapp after which he showed some signs of improvement but his health deteriorated further and he died on 24 August.

[Emily]

Re: Liberian doctor who received rare Ebola drug ZMapp dies

Samaritan's Purse had a press release about the use of blood transfusion on Brantly, but that is no longer available. There is some information here:

http://www.indystar.com/story/news/2...nary/13282057/

IU grad with Ebola takes slight turn for worse
Shari Rudavsky,
7:44 p.m. EDT July 31, 2014
...
Both Brantly and Writebol are in stable but grave condition, according to Samaritan's Purse, the Christian aid organization for which Brantly was working in Liberia.

While he took a slight turn for the worse overnight, he did receive a unit of blood from a 14-year-old boy, whom Brantly had cured of Ebola. The teen said that he wanted to do what he could to help the doctor who had saved his life, said Franklin Graham, president of Samaritan's Purse in a press release.

Unclear to me what the timing of the turn for the worse and the receipt of the convalescent transfusion is, but it at least did not provide long-term improvement, which is why Brantly requested his first Zmapp treatment.

He must have relapsed again after arrival at Emory:

http://www.11alive.com/story/news/lo...ntly/13598439/

11Alive Staff, WXIA 6:49 p.m. EDT August 4, 2014
Questions remain about serum used to treat Ebola patient

...

In the meantime, a lot of questions remain about a serum has affected Brantly, who arrived at Emory University Hospital on Saturday. Dr. Brantly received a second dose of experimental treatment since his arrival at Emory and has improved, NBC News reports.

So both survivors Brantly and Writebol had at least 2 doses of Zmapp, and Brantly had the convalescent transfusion in addition.

We don't know if the deceased Zmapp recipients had only one or more doses, but a commonality is that dramatic but temporary improvement occurs after the first Zmapp treatment.

http://allafrica.com/stories/201408250629.html

25 August 2014
Liberia: JFK Loses 2nd Doctor to Ebola - Dr. Borbor Recipient of Zmapp

...
In confirming Dr. Borbor's death to FrontPageAfrica late Sunday night, Information Minister Lewis Brown, said the news came as a shock because the veteran doctor had been improving since the drug was administered.

"He was walking around yesterday and the doctors were hopeful that he would make a full recovery. "He was a classmate in high school, so this hits close to home," Brown said of Borbor, who was the only recorded internist in Liberia.

Three dosages of the ZMAPP arrived in Liberia on August 14 and administered to Dr. Borbor, along with a Nigerian doctor, Dr. Aroh Cosmos Izchukwu and a Ugandan doctor assisting the JFK Hospital.

Another prominent JFK Doctor, Dr. Phillip Zokonis Ireland who was in isolation along with Dr. Borbor, walked out of the isolation unit last week, but was not one of the recipients of the ZMAPP drug. The drug has already been administered to two American health care workers and a Spanish priest, all previously working in Liberian hospitals. The two American doctors, survived while the Spanish priest died.

Also people do survive ebola without Zmapp, as that article reports, so....

http://www.forbes.com/sites/davidkro...-drugs-worked/

David Kroll Contributor
Pharma & Healthcare 8/26/2014 @ 12:38PM 2,445 views
...
Does ZMapp work, or not?

Last week saw the release of two American missionaries from Emory University Hospital after Ebola treatment, Dr. Kent Brantly and Nancy Writebol. During the institution?s press conference, Emory infectious disease physician, Dr. Bruce Ribner, was more emphatic as to the role of strong, supportive care in their recovery rather than the ZMapp anti-Ebola antibody combination both had received in Liberia.

Ribner noted that managing electrolytes (potassium, calcium, and magnesium) and the balance of blood clotting abnormalities were two essential strategies that the Emory medical team would be communicating with their West Africa colleagues.

When asked specifically about the experimental antibodies, Ribner said that it was impossible to know if the treatment helped the patients, did nothing, or delayed their course of recovery...

If all Zmapp can do is improve a patient's condition enough to be be transferred to a hospital that can provide supportive care, that would be a benefit.

[Ronan Kelly]

Re: Liberian doctor who received rare Ebola drug ZMapp dies

REPUBLIC OF LIBERIA
MINISTRY OF HEALTH & SOCIAL WELFARE
P. O. BOX 10 ? 9009
1000 MONROVIA 10, LIBERIA
WEST AFRICA

Press Release
September 2, 2014

The Ministry of Health and Social Welfare in collaboration with NGO partners will
embark on a mass chlorination of wells and water points, and the distribution of hygiene
promotion items including soap, acquatabs, buckets, and fliers in targeted communities
in Monrovia and surrounding areas. The hygiene promotion and awareness on proper
hand washing kicks off this week in an attempt to address the issue of watery diarrhea.
About nine-thousand families have been targeted in West Point. About 450,000
aquatabs, 36,000 bars of soap, and 18,000 pieces of buckets will be distributed by 45
animators during the exercise. Mass chlorination of wells will also be done by the
Ministry of Health and Social Welfare Chlorination teams in collaboration with NGO
partners.

Meanwhile, twelve Ebola survivors were discharged yesterday from the ELWA-II Care
Center where they have been undergoing care and treatment for signs and symptoms
of Ebola. The survivors were initially tested positive but after repeated laboratory tests,
their results showed negative. This brings to 42 the number of Ebola survivors since
August 2014. Last week, ten survivors were discharged from the JFK Treatment Unit
while 31 persons were discharged from the ELWA-III Unit and 6 persons discharged
from the Foyah Center. Those discharged from the ELWA-II Center included two
clinicians who were treated with the ZMAP drugs.

In another development, the government and partners have instituted safety measures
at the Roberts International Airport and the James Spriggs Airport. Nurses and
screeners have been deployed been deployed to screen passengers while hygiene
promotion and surveillance of airport workers have been put in place to restore
confidence in the airport system.

Tolbert Nyenswah
Chair, Ebola Incident Management Committee

http://www.mohsw.gov.lr/documents/sept_2.pdf

[Graupel]

Re: Liberian doctor who received rare Ebola drug ZMapp dies

"attempt to address the issue of watery diarrhea."

So that means there's likely now a co-epidemic of cholera? horrifying.

[Gemineye]

Re: Liberian doctor who received rare Ebola drug ZMapp dies

Without more study, it's not possible to determine whether Zmapp or a convalescent blood transfusion or any other new treatment is effective. That's why it probably makes sense to bring Ebola patients to the U.S. for medical care.

[Sharky]

Re: Liberian doctor who received rare Ebola drug ZMapp dies

Without more study, it's not possible to determine whether Zmapp or a convalescent blood transfusion or any other new treatment is effective. That's why it probably makes sense to bring Ebola patients to the U.S. for medical care.

Transfusion therapy for Ebola *has* been studied. Here's a link to one such study; there are more:

Treatment of Ebola hemorrhagic fever with blood transfusions from convalescent patients

http://www.ncbi.nlm.nih.gov/pubmed/9988160