Updated: Jan 17
By Harrison York
The second-largest outbreak of the Ebola virus began in the Congo in 2018. Spread through body fluids, Ebola is not particularly contagious except in densely-packed urban areas. The virus has had an extremely high mortality rate, which at one point was above 90%, when no medical treatments were available.
Because of the high chance of death in patients who have contracted the virus, doctors and scientists have been racing to create vaccines and treatments that can be mass-produced and distributed to impacted regions in order to reduce mortality.
On October 14, the Food and Drug Administration approved an Ebola treatment created by Regeneron, called REGN-EB3. The antibody cocktail is able to treat Zaire Ebola—the deadliest form of the Ebola virus—in patients both young and old. The announcement follows the recent outbreak of Ebola in the Congo in 2018, which was finally contained this summer. Of the estimated 3,500 infected, at least 2,287 people died.
REGN-EB3 (also known and marketed as Inmazeb) has been proven to decrease mortality rates from well over 50% to ~33.5%. Coupled with an effective vaccine approved last December, these two developments will help to prevent outbreaks and cure those who become infected.
“Now there’s hope,” said Dr. Scott Lillibridge, Chief Epidemiologist of the International Medical Corps, in reference to the previously dismal chances of survival upon being infected. In Liberia, for example, death rates were as high as 80%. In his role with the Medical Corps Dr. Lilibridge has worked to combat African Ebola virus outbreaks since the 1990s.
Production of REGEN-EB3 was boosted by BARDA, a department of the U.S. Department of Health and Human Services, allowing the Congo government to receive free supplies. Advocates are calling for increased manufacturing of both the vaccine and Ebola treatments to create an international stockpile that can be quickly distributed to countries as outbreaks arise.
Viruses like Ebola operate with the single goal of self-replicating. This replication of the virus usually takes the shape of an infectious disease. The virus enters the human body and attaches itself to a healthy cell. Once attached to the cell, the virus enters through the cell membrane and hijacks the cell by placing its viral DNA into the cell's genetic material. The viral DNA is duplicated by the cell, which allows it to replicate and send out more individual viruses to continue the process. The genetic material the virus inserts into the cell can be as little as two to ten genes, but these small changes can have a large effect on the host if the virus infects enough cells.
The REGN-EB3 treatment is a combination of three genetically-engineered antibodies that work to stop the virus’ glycoprotein from attaching to a healthy cell. The three antibodies in the treatment, atoltivimab, maftivimab, and odesivimab-ebgn, showed success in multiple trials among patients that gave it the edge to gain approval over several other contenders. This success was seen as the treatment that prevented the virus from breaking through the cell membrane and infecting the cell.
Implications for COVID-19
The process of using antibodies to stop viruses from entering a cell is exactly the mechanism of treatment that scientists are trying to develop for COVID-19. Although the REGN-EB3 treatment is much different from what a coronavirus cure would look like, the concept—given the similarities between how viruses like Ebola and Covid operate—remains the same.
In fact, Regeneron, the very same pharmaceutical company, is working towards a cure for the coronavirus. Their antibody infusion treatment was even administered to President Trump during his brief battle with the virus. The company gained public notoriety from this news, which will hopefully bring more attention to research into cures for both Ebola and COVID-19.
"I think that should give us hope of what we can achieve together in COVID," Head of Emergencies at the World Health Organization, Mike Ryan, said later. "We have a living example [with REGN-EB3] of what can be achieved when science, industry, compassion and humanity come together."
Regardless of the inability for the treatment to cross over into Covid-19, the approval of Regeneron’s Ebola treatment is a reassuring sign of medicinal and scientific progress in an age when good news is rare.
Q: How does a virus work?
A: A virus works by taking control of an organism’s healthy cells. The virus injects its own genetic material into the cell, which then replicates the viral genes along with its own, to allow the virus to continue spreading. While this infection takes the form of a disease, if the mortality rate is too high, a deadly disease may hinder its own spread as the death of the host prevents further transmission.
Q: What are the effects of REGEN-EB3’s approval on COVID-19?
A: The actual treatment has very little crossover to the current global pandemic, but the process of engineering antibodies to prevent the virus from entering healthy cells is similar. Progress in the medical field is taking place rapidly, and this development gives hope that scientists may find a cure for the coronavirus soon.
No changes were made to the following image, flickr @ CDC_Global, License: https://creativecommons.org/licenses/by/2.0/legalcode
Public Domain, https://pixabay.com/illustrations/corona-coronavirus-virus-blood-5174671/