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Ebola primer: Facts for pharmacists

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As the first point of care for many patients, pharmacists can help contain outbreak

As cases of Ebola virus disease (EVD) continue to climb in Guinea, Sierra Leone, Liberia, and Nigeria, two American aid workers who contracted the disease are now here in the United States for treatment.

“This is the biggest and most complex Ebola outbreak in history,” said CDC Director Tom Frieden, MD, MPH, in a news release on July 31st. “It will take many months, and it won’t be easy, but Ebola can be stopped. We know what needs to be done.”

EVD first appeared in 1976 in two simultaneous outbreaks in Sudan and the Democratic Republic of Congo, and since that time, there have been numerous small outbreaks, most of them in Central and East Africa near tropical rainforests. The early symptoms of EVD include flu-like symptoms such as fever, weakness, and muscle pain. However, the disease quickly progresses to vomiting, diarrhea, organ failure, and internal and external bleeding.

According to WHO, EVD outbreaks have a case fatality rate of up to 90%. The virus is transmitted to people from wild animals such as infected chimpanzees, gorillas, fruit bats, and monkeys that were found ill or dead in the rainforest. The virus spreads in the human population by direct contact with blood, secretions, or other bodily fluids of infected people.

Last week CDC issued a warning to avoid nonessential travel to the West African nations of Guinea, Liberia, and Sierra Leone. CDC is also assisting with active screening and education efforts on the ground in West Africa to prevent the spread of the disease.

Ebola virus infections can be diagnosed by several laboratory tests, according to CDC. Although there is no vaccine currently available, several vaccine candidates are currently undergoing testing.

Missionary and physician Ken Brantly, MD, contracted EVD in Liberia and was flown to Emory University Hospital in Atlanta after being evacuated to the United States last week. According to media reports, Brantly received an experimental drug called ZMapp developed by San Diego-based biotech firm Mapp Biopharmaceutical Inc. Nancy Writebol is another American aid worker who contracted EVD in Liberia and also received the experimental drug. On Tuesday Writebol arrived in Atlanta for treatment at Emory University Hospital, which is located near CDC.

According to the Mapp Biopharmaceutical website, the agent is made up of three humanized monoclonal antibodies. It was first identified as a drug candidate in January and has not been evaluated in humans.

Pharmacists in Africa are doing their part to help contain the outbreak. According to GhanaWeb, the Pharmaceutical Society of Ghana released a statement asking its members to refer suspected cases of EVD to the nearest hospital since people often use community pharmacies as their first point of health care when they have symptoms. The Pharmacists Society of Sierra Leone organized a workshop for its members on the prevention and sensitization of EVD, according to Awoko.org.

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