The document discusses the Ebola virus, including its origin, symptoms, transmission, prevention methods, and experimental treatments. It provides details on ZMapp, a monoclonal antibody treatment that showed promise in primate studies. ZMapp is produced using tobacco plants and was administered to some infected individuals with reported success. Several other experimental vaccines and drugs are also mentioned that are being tested in clinical trials to combat the deadly virus.

1. Pursuing Victory Over
Ebola
Kyle, Ally, Gabby

2. Background
● Exact origin, location, and natural reservoir remain unknown
● Theories: fruit bats (most likely), birds, plants
● Ebola was first identified in Zaire (now known as the Democratic Republic
of Congo [DRC])
○ Professor Peter Piot (director of the London School of Hygiene and
Tropical Medicine)
● Named after the River Ebola in the DRC
● First thought to be Yellow Fever until all patients but one died
● Zoonotic
○ Freely transferrable between animals and humans
● Animals affected: chimpanzees, gorillas, monkeys, porcupine, humans

3. Symptoms
● Fever
● Severe Headache
● Muscle Pain
● Weakness
● Fatigue
● Diarrhea
● Vomiting
● Abdominal pain
● Unexplained Hemorrhage
Symptoms appear anywhere from 2-21 days after initial exposure
Initial Symptoms thought to be signs of the flu

4. Transmission
● Spread by direct contact with body fluids from an infected individual
○ Includes saliva and sweat
● Not airborne
● Transmitted through mucous membranes or skin abrasions that come into direct
contact with blood, secretions, or organ from an infected person or animal
● Dead tissue
○ African burying rituals
○ Can be spread by handling bushmeat in Africa
■ Wild animals hunted for food
● No known insects can transmit the disease

5. Spread of ebola in highly affected countries

6. Prevention
● Practice basic hygiene practices (wash hands with soap
and water, etc)
● Do not handle objects that have been in contact with
bodily fluids
● Avoid burial rituals at all possible
● Avoid bats, nonhuman primates, or any bodily fluids
from those animals
● Upon return, monitor health for 21 days while looking for
symptoms

7. Virology ● Enveloped, negative single strand RNA virus
● Belongs to the Filoviridae virus family
○ Most similar to Cholera
○ Cuevavirus and Marburg virus
○ Characteristic filamentous or branching
convoluted shape
● Genus Ebola viruses are divided into five
subtypes
○ Each subtype has different biologic
characteristic and virulence
■ Zaire (EBOV) current West African
outbreak
■ Sudan (SUDV)
■ Bundibugyo (BDBV)
■ Tai Forest (TAFV)
■ Reston (RESTV)

8. Mortality Rates
● Two most deadly to
humans are Zaire and
Sudan strains
o Zaire has 60-90% fatality
rate
o Sudan has 40-70% fatality
rate
o They are also the most
common outbreaks

9. How It Works
● Its a virus, very very
small and must have a
host to survive
● The virus is dangerous
because it attacks our
immune systems which
would normally attack the
virus
● https://www.youtube.com/
watch?v=sRv19gkZ4E0

10. Treatment
● Current most effective
treatment is fluid and
electrolyte replacement
combined with simple care
● There were some
experiments going on in the
past but the 2014 outbreak
has drastically increased
the amount of research for
vaccines and therapies

11. Definitions
Antigen
● Any substance that causes your immune system to produce antibodies
against it
o Ex: Viruses, Bacteria, Toxins
Antibody
● A large Y-shaped protein that the immune
system uses to help identify and neutralize
the antigen
Monoclonal antibodies
● Antibodies made by identical immune cells which are all clones of an
identical parent cell
Monoconal antibodies from http://www.motifolio.com/6111172.html

12. Therapies
● ZMapp (Composed of three monoclonal antibodies developed by Mapp
biopharmaceutical and focus of presentation)
● TKM-Ebola (experimental drug developed by Tekmira Pharmaceuticals Corp.,
funded by the US gov.)
o First tested in 2010 with primates and had a 100 % success rating
o Has already passed Phase 1 clinical trial
o Created new product, TKM-Ebola-Guinea demonstrated 100% protection
from what would be a lethal dose
● VSV-EBOV is a vaccine based on the vesicular stomatitis virus
o This is the vaccine being developed by NewLink in Ames
o In Oct. 2014 multiple trials in healthy volunteers in Europe, Gabon, Kenya,
and the USA
o Temporarily halted in December but has recently resumed
o Could be deployed in West Africa and would only require a single dose

13. Therapies Cont.
● Advac/MVA-BN is a vaccine developed by Johnson &
Johnson
o Initial tests in monkeys gave complete protection from
the virus
o In September of last year a trial began involving 72
volunteers aged 18-50 and are the first humans to
receive the vaccine
o Must receive booster dose one or two months after initial
injection
 First dose primes immune system, second dose
enhances it
o Engineered to protect from the Zaire strain
o The responses will be measure over the course of a year
o Hopeful to have Phase 2 trial in Africa and Asia soon
and vaccine ready by middle of 2015

14. Therapies Cont.
● A research team at University of Texas-Austin
developed a nasal spray
o The team had been working on it for 7 years
and finally developed what they believe is a
vaccine
o In a test they had done all of the monkeys
tested were saved from the virus when given
the nasal spray but when tested as an
injection only half of the monkeys survived
o Sadly they began running out of money last
November and cannot conduct the next step
in the process, human trials

15. ZMapp Background
● Several infected patients have received ZMapp
therapy, which is a combination of 3 different
monoclonal antibodies
● Being fast-tracked into phase 1 and 2 clinical trials
● Going to be tested in the US and Liberia overseen
by independent safety monitors and Liberian leaders
who helped contain the epidemic
● The US Biomedical Advanced Research and
Development Authority (BARDA) is funding the
research and is working with pharmaceutical
companies to upscale antibody production

16. How ZMapp works
● Most antibodies work by
binding to the antigen
which then is destroyed
by the body
● ZMapp works by simply
binding to the virus and
neutralizing it so it has
minimal or no effect and
therefore cannot grow
http://www.washingtonpost.com/posttv/natio
nal/health-science/how-the-zmapp-drug-
works-to-fight-ebola/2014/08/13/e22c5a42-
230a-11e4-8b10-7db129976abb_video.html

17. ZMapp Creation
● The three antibodies that comprise
ZMapp were produced by immunizing
mice with recombinant vesicular
stomatitis virus
● The glycoprotein for that virus was
removed and Ebola’s was put in
● The antibodies that bound the ebola
virus and protected the mice were
removed and they were made to
resemble human antibodies

18. ZMapp types
● There are two types of ZMapp
substances (MB-003 and ZMAb)
● MB-003 is a cocktail of three
monoclonal antibodies
● Rhesus macaques were infected
with the EBOV, they then
received MB-003 one hour later
and all survived with little to no
symptoms following the
experiment
● When treated with MB-003 24 or
48 hours later, 67% survived and
had little to no viremia
● The other type of ZMapp, ZMAb
is also a mixture of three
monoclonal antibodies
● Rhesus monkeys again initially
survived with their dose of
ZMAb after the Ebola infection
● These surviving monkeys were
then reintroduced to the virus
10 weeks later and all of them
survived while all of the control
did not

19. ZMapp production
● BARDA is using tobacco based production to make
the antibodies
● Primate study was done with different types of
antibody production methods
● The tobacco method had produced the best results
o When Rhesus macaques were infected with the
ebola virus, the macaques who had the tobacco
production method had much higher antibody
counts
● Process takes 6 weeks to grow the plant, introduce
the gene, then have a large enough result to extract
the ZMapp
Amount of tobacco needed to produce
amount of ZMapp to cure 12 people of
ebola

20. ZMapp in action
● Dr. Kent Brantly was the first American diagnosed with Ebola
● Contracted it while caring for sick Ebola patients in Liberia
last July
● In the hospital, Brantly continued to get worse as he started
shaking and neared death
● The doctors decided to use ZMapp as a last resort
● After two doses of ZMapp his shaking stopped, an hour later
his rash disappeared, and he could get up to go to the
bathroom
● Still unsure if it was 100% ZMapp, but its promising

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