Ebola
Anshupa Patel Gupta, HimaniTambde,
NCRD’s Institute of Pharmacy, Nerul, Navi Mumbai, India
Abstract: Ebola virus disease or simply Ebola is lethal viral hemorrhagic fever caused by Ebola viruses. Many outbreaks have been seen from 1976 to recent 2016, killing around 50 % of persons affected. The Ebola virus includes six species of virus out of which Zaire ebolavirus has highest mortality rate. To get protection against this virus, the vaccine was invented by scientists at the Public Health Agency of Canada (PHAC). In 2014, Merck got the licence to develop this from Newlink (which was first licensed from PHAC).Now Merck Sharp & Dohme Corp has got approval in December 2019 for manufacturing it under the trade name ERVEBO®. ERVEBO is a live recombinant viral vaccine in the form of sterile suspension for intramuscular injection. It is to be administered in single 1 ml dose. Though it has few adverse effects it will certainly be a milestone fighting against Ebola disease.
Keywords: Ebola virus, Ebola virus disease (EVD), vaccine
Introduction
Ebola Virus
The Ebola virus (family Filoviridae)[3] includes six species of virus viz. Bundibugyo ebolavirus, Restonebolavirus, Sudan ebolavirus, Taï Forest ebolavirus , Zaire ebolavirus, and Bombali ebolavirus. Zaire ebolavirus has the highest mortality rate of the Ebola viruses, and is responsible or the largest number of outbreaks including the 1976 Zaire outbreak and the outbreak with the most deaths (2014).
Ebola virus was first discovered in 1976 near the Ebola River in what is now the Democratic Republic of Congo(DRC). Since then, the virus has been infecting people from time to time, leading to outbreaks in several African countries. Scientists do not know where Ebola virus comes from. However, based on the nature of similar viruses, they believe the virus is animal-borne, with bats being the most likely source. The bats carrying the virus can transmit it to other animals like apes, monkeys, duikers and humans. [4]
Ebola Virus Disease
Ebola virus disease (EVD), also known as Ebola hemorrhagic fever (EHF) or simply Ebola, is a viral hemorrhagic fever of humans and other primates caused by Ebola viruses.[1] After entering the body, it kills cells, making some of them explode. It wrecks the immune system, causes heavy bleeding inside the body, and damages almost every organ.[2] Signs and symptoms typically start between two days and three weeks after contracting the virus with fever, sore throat, muscular pain, and headaches.[1] Vomiting, diarrhoea and rashes usually follow, along with decreased function of the liver and kidneys.[1]At this time, some people begin to bleed both internally and externally.[1] The disease has a high risk of death, killing 25% to 90% of those infected, with an average of about 50%.[1]
Outbreaks
EVD first appeared in 1976 in two simultaneous outbreaks, one in what is now Nzara, South Sudan, and the other in Yambuku, DRC. The 2014–2016 outbreak in West Africa was the largest Ebola outbreak. The outbreak started in Guinea and then moved across land borders to Sierra Leone and Liberia. The most recent 2018-2019 outbreak in eastern DRC is considered to be highly complex, with insecurity adversely affecting public health response activities.[1] Between 1976 and 2013, the World Health Organization reports 24 outbreaks involving 2,387 cases with 1,590 deaths. The largest outbreak to date was the epidemic in West Africa, which occurred from December 2013 to January 2016, with 28,646 cases and 11,323 deaths.[5]
Treatment
Since there aren’t any drugs to fight the virus, health care teams treat the person’s symptoms and offer basic support care. They include keeping the person hydrated with fluids through an IV, giving oxygen, maintaining their blood pressure and treating any other infections they have. A person’s survival depends on how well his immune system works. The sooner the patient gets medical care, the better the chances of recovery.
After Ebola
Ebola survivors have certain proteins, called antibodies, in their blood that may protect them from the same strain of the virus for 10 years or more. But no one knows if they can get sick from the other strains. It’s rare, but the Ebola virus can stay in semen for 3 months after a man recovers, so he should avoid sex or use a condom to keep from infecting others. The virus can stay in breast milk for 2 weeks after recovery, so women shouldn’t breastfeed during that time.[2]
EBOLA Vaccine
An investigational vaccine called rVSV-ZEBOV, showed to be safe and protective against the Zaire strain of the Ebola virus. This vaccine, was used under “expanded access” or what is also known as “compassionate use” in the Ebola outbreak in North Kivu.
The vaccine for ebola was created by scientists at the National Microbiology Laboratory in Winnipeg, Manitoba, Canada, which is part of the Public Health Agency of Canada (PHAC). PHAC licensed it to a small company, NewLink Genetics, which started developing the vaccine; NewLink in turn licensed it to Merck in 2014. It was used in its investigational form, rVSV-ZEBOV (on compassionate basis) in the DRC in a 2018 outbreak in Équateur province, and has since been used extensively in the 2018- 19 Kivu Ebola outbreak, with over 90,000 people vaccinated.[7] The vaccine was approved for medical use in the United States in December of 2019 under the trade name ERVEBO.
Proper Name: Ebola Zaire Vaccine, Live
Trade Name: ERVEBO®
Manufacturer: Merck Sharp & Dohme Corp.
INDICATION: Indicated for the prevention of disease caused by Zaire ebolavirus in individuals 18 years of age and older.[7]
Dosage and Administration
Administer a single 1 mL dose of ERVEBO intramuscularly.
Dosage Forms and Strengths
1 mL suspension for injection supplied as a single-dose vial.
Contraindications
Severe allergic reaction
(e.g.,anaphylaxis) to any component of ERVEBO.
(e.g.,anaphylaxis) to any component of ERVEBO.
Adverse Reactions
The most common injection-site adverse events were injection-site pain (70%), swelling (17%), and redness (12%). The most common systemic adverse events reported following vaccination with ERVEBO were headache (37%), feverishness (34%), muscle pain (33%), fatigue (19%), joint pain (18%), nausea (8%), arthritis (5%), rash (4%) and abnormal sweating (3%).
Preparation
Thaw vial at room temperature until no visible ice is present. Do not thaw the vial in a refrigerator. Gently invert vial several times. The vaccine is a colorless to slightly brownish-yellow liquid with no particulates visible. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to
Description
ERVEBO (Ebola Zaire Vaccine, Live) is a sterile suspension for intramuscular injection. It is a live recombinant viral vaccine consisting of a vesicular stomatitis virus (VSV) backbone deleted for the VSV envelope glycoprotein and substituted with the envelope glycoprotein of the Zaire ebolavirus (Kikwit 1995 strain). The vaccine virus is grown in serum-free Vero cell cultures. The virus is harvested from the cell culture medium, purified, formulated with stabilizer solution, filled into vials and stored frozen. When thawed, ERVEBO is a colorless to slightly brownish-yellow liquid with no particulates visible. Each 1 mL dose of ERVEBO contains a minimum of 72 million plaque forming units (pfu) of vaccine virus in a stabilizer solution containing 10 mM Tromethamine (Tris) and 2.5 mg/mL rice-derived recombinant human serum albumin. Each 1 mL dose may contain residual amounts of host cell DNA (≤10 ng) and benzonase (≤15 ng). The vaccine may contain trace amounts of rice protein. The product contains no preservatives.[6]
Conclusion
Viruses pose threat to humans in the form of many diseases. Diseases like Ebola are lethal. This is endemic to the African continent and epidemic too. There have been Ebola outbreaks in the recent decades, so, a lot of research has been done on this to develop the ERVEBO vaccine. The vaccine in its investigational form rVSV-ZEBOV was recommended by the Strategic Advisory Group of Experts on Immunization (SAGE) for use in Ebola outbreaks caused by the Zaire strain of the virus, in the event where there was no licensed vaccine. It was used on compassionate grounds on contacts, and contacts of contacts of confirmed Ebola virus disease patients (dead or alive), health care and frontline workers (local and international) in the affected areas. Now, the authorities have given approval to ERVEBO on fast track basis on 19th Dec 2019. Isolation of the patients plays an important role in curbing the disease along with the vaccine. Still lots needs to be done on antivirals and vaccines. Hopefully, the commercial production of the vaccine by MSD will commence soon which will save many lives.
References
[1] http://www.who.int/en/news-room/fact- sheets/detail/ebola-virus-disease
[1] http://www.who.int/en/news-room/fact- sheets/detail/ebola-virus-disease
[2] https://www.webmd.com/a-to-z-guides/ebola-fever- virus-infection
[3] Kuhn, J. H.; Becker, S.; Ebihara, H.; Geisbert, T. W.; Johnson, K. M.; Kawaoka, Y.; Lipkin, W. I.; Negredo, A I.; Netesov, S. V.; Nichol, S. T.; Palacios, G.; Peters, C. J.; Tenorio, A.; Volchkov, V. E.; Jahrling, P. B. (2010). of ology. "Proposal for a revised taxonomy of the family Filoviridae: Classification, names of taxa and iruses, and virus bbreviations". Archives 155 (12): 2083–103. doi:10.1007/s00705-010-0814- x. PMC 3074192. PMID 21046175.
[4] https://www.cdc.gov/vhf/ebola/resources/virus- ecology.html
[5] https://en.wikipedia.org/wiki/Ebola_virus_disease
[6] https://www.fda.gov/vaccines-blood-biologics/ervebo
[6] https://www.fda.gov/vaccines-blood-biologics/ervebo
[7] https://en.wikipedia.org/wiki/RVSV-ZEBOV_vaccine
[8] https://www.who.int/emergencies/diseases/ebola/frequen tly-asked-questions/ebola-vaccine
[8] https://www.who.int/emergencies/diseases/ebola/frequen tly-asked-questions/ebola-vaccine
BeAffable Products Series - 3
Bring
Home Tradition
Handcrafted things form a part of style
these days. BeAffable brings exquisite collection of such rural crafts which
are fused with modernity to match your home décor. We have much in store!
v The Dhokra Art
Dhokra art is the folk art form of central and
eastern India. The Dhokra Damar tribes are traditional metal smiths of West
Bengal, distant cousins of Chhattisgarh tribes. This primitive art is much in demand
because of its expressive simplicity, enchanting motifs and forceful form. The
store proffers products depicting animal figures, religious images, bowls,
lamps and likes which have been hugely appreciated for its otherness. The Chirku Mirki pair is going to delight
you with its daintiness.
Dhokra is a non–ferrous metal casting using the lost-wax casting technique. A clay core, roughly the shape of the
final cast image is prepared. The clay core is covered by a layer of wax
composed of pure beeswax, resin and nut oil. The wax is then shaped and carved in with the finer details
of design. It is then covered with layers of clay, which takes the negative
form of the wax on the inside, thus becoming a mould with drain ducts. The wax
is then replaced by the molten metal, often brass scrap. The liquid metal
poured in hardens between the core and the inner surface of the mould taking
the same shape as the wax. The outer layer of clay is then chipped off and the
metal icon is polished and finished as desired.
vThe Warli Painting
Warli paintings are the tribal wall
paintings of the warli tribes of Maharashtra. Warlis are the largest tribes of
Maharashtra living in northern outskirts of Mumbai. Existence of Warli
paintings dates back to 10th century AD, but the style of Warli painting was
discovered only in early 1970’s. Womenfolks mainly used to do the paintings on
the mud walls of the houses. Warli used to be painted on austere mud base using
only white colour with occasional yellow and red dots. Since the 1970s, warli
painting has moved off the walls and onto paper and canvas.
The most important aspect of the
painting is that it depicts social life. Pictures of human beings and animals,
along with scenes from daily life are created in a loose rhythmic pattern. The
paintings are beautifully executed and resembles pre-historic cave paintings in
execution and usually depict scenes of human figures engaged in activities like
hunting, dancing, sowing and harvesting.
These extremely rudimentary paintings,
use circles, triangles and squares. The circle and triangle come from the observation
of nature, the circle representing the sun and the moon, the triangle derived
from mountains and pointed trees. Only the square seems to obey a different
logic and seems to be a human invention, indicating a sacred enclosure or a
piece of land. So the central motive in each ritual painting is the square, the
chauk; inside it we find Palaghata, the mother goddess, symbolizing fertility.
Beaffable Warli products are perfect
blend of authenticity and modernity. Visit www.beaffable.in for exclusive collection of Warli items and give your home a
handmade touch.
vGobar Hastkriti
Sounds filthy? Perhaps yes, at first.
But here is the “dirty little secret”. Let’s start on touching that briefly.
Cow is symbolic of the Earth and cow dung is considered holy. We can think of
it being utilised as fertilizer, as fuel in lieu of firewood or as an
anti-pollutant. However, introducing happy corner in your house with a cow dung
article is beyond imagination. Well! That’s where the magic is created… The
magic of creation!
From Stinky
to Funky -
Methanol gets evaporated from fresh cow dung when dried and the foul smell
starts to disappear which when heated removes the stench altogether. After
cleaning, it is compressed into sheets through machine and heated to make it
hard. The clay is then polished to make it water resistant and finally it is
ready for the artist to give shape to its imagination.
Gobar hastkriti has products ranging
from a small dhoop batti to a puja-ghar, card holders to beautifully painted
wall hangings, traditional toran to marvellous mirrors. Just Explore!
vOthers
Some other interesting, useful and decorative pieces include items like wrought iron products, copper carafe, bajot which can be used in puja room, flower pots made of clay, earthern kadai and such.
Written By Manju Daga
BeAffable Products Series - 2
We Customize We Personalize
Custom products have the power to
transform players to a team, elevate a gathering to an event and make the
moment even more momentous. It has the power to reunite with unity and gives
the feeling of sameness and oneness.
Expressing
yourself with T-shirts
There
is so much to being an Indian that one can never be proud enough. Our t-shirts
not only capture the essence of Indian culture and tradition but also elicit
the spark of patriotism. We represent the rich heritage in the form of
monuments, indigenous handicrafts, delectable cuisine, unvarying phrases and
suchlike graphics.
The T-shirts used for customizing are
of finest quality. They are best fit, in attractive colours and affordable. The
printing makes the design look even more appealing. So if you want to create
some treasured memories, your Indian friend is all here to help you. Just speak
your mind in your own style and get your T-shirts done exactly the way you have
imagined!
Sealed with a bow, a gift always strengthens the bond of relationship. These unique pieces will not only give a special touch but will always remain as a valuable gift to own. Be it a lovely collage photo frame, a magic cup with a personal message and picture or a cushion cover to match your need. So just hang on tight! BeAffable has products galore.
- Manju Daga
#BeAffable Products Series
www.beaffable.in
Reflecting glorious India
~ Written by Manju Daga
Terracotta literally means ‘baked earth’ and is made from
natural clay, giving it a reddish-brown color. It may be glazed for durability
or to add color. It is water proof and sturdy. Terracotta was traditionally
used to create figures of deities on festive occasions and ceremonies besides
its use in jewellery and handicrafts.
#BeAffable
~ Written by Manju Daga
#BeAffable welcomes you to a truly Indian one stop shop.
BeAffable is a wish; a wish to bring India to the fore. A wish to, do its bit in strengthening the rich roots and culture.
BeAffable is a dream; a dream, for the craftsmen to weave their way
forward, in the global sphere. With the concept of promoting the country’s
creative artisans and their products, the outlet also promises to offer
attractive prices for their creations.
The
Rustic Charm of Jewellery
BeAffable brings a wide collection of jewellery to match
with our attire to enhance our charisma.
With the changing trend,
gold and platinum are not the only metals getting the shape of ornaments but
unconventional materials (viz.
Terracotta, Jute, Shell, etc.) are being used artistically to make
jewellery. Today’s woman finds art jewellery fashionable, stylish and modern.
vThe
Sahariya’s Clay Necklaces
The clay culture of Sahariya is counted as richest folk art
of Central India that was believed to have faded in oblivion time long past. As
nature is the store house of resources, a mirror of and for culture, the tribe
has been using this valuable gift of Earth for limning their culture, religion
and even the problems they faced.
The process on the whole takes 15-20 days to turn raw clay
into an aesthetic work of art. After giving the desired shape with simple
knives, intricate motifs are engraved on the greenware. The moulded clay is
then allowed to dry in shade till the moisture content reduces to zero after
which it is heated in the ground covering it with cow dung cakes. The process
imparts amazing shades giving each piece a look of its own. Hence, no two
pieces are ever alike.
The skilled hands then finely paint this creativity with the
help of a tool made from the wood of pomegranate tree. The ink used is made by
mixing the gum of Dhawda tree and graphite. The pendant is finally ornamented
with gems like Agate (Hakik in Persian), Zed stone (Jade), Chinese Zed stone,
Feroza and so on. To complement, different strings of beads are used to give
extra finesse to the ornament.
vEarrings
Filigree is an
ornamental work of fine metal wires (interwoven gold and silver wires) formed
into delicate tracery. Historically, the silver filigree work (Tarakasi) from
Cuttack, a city in Odisha, is more than 500 years old and traditionally done by
local artisans.
They work with
an alloy of 90% or more pure silver. The lump of silver is melted and poured
into rod like mould and after cooling it is placed into a machine which presses
the moulded alloy into long, thin workable wires. It is then hand crafted into,
intricate designs before it is cooled and soldered which ensures detailing to
remain intact. Techniques such as granulation, snow glazing and casting are
used innovatively to heighten the effect.
With the
changing trends and varied taste of customers, a tinge of modernity has been
fused with tradition. The store has some good collection of such silver
filigree earrings to match ethnic and modern wear.... Take a look!
Terracotta earrings one of the favourites these days is made of natural clay.
Jute earrings
Jute, also called as the golden fibre, is a long, soft, shiny vegetable fiber that can be spun into coarse, strong threads. Jute is
used for preparing ropes, gunny bags, textiles and now jewellery. The handmade jute earrings decked in beads, painted in
bright shades are quite enticing especially for young crowd who like to team it
with Indian ethnic and Indo western outfits. This eco-friendly jewellery can
serve as an excellent gift for your friends as well.
Shell earrings
Sea shells have been made into beautiful earrings. These pieces
of jewellery are unique in the sense that they are made of real sea shells.
Also look for some really ethnic bronze jhumkas and go
traditional.
English class
Dr. A.P.J.Abdul Kalam
has rightly said, “Sometimes it’s better to bunk a class and enjoy with
friends, because today when I look back, marks never make me laugh, but
memories do…”
We were in class XI or
XII G when half of our class decided to bunk our English lecture. As soon as we
started running off from our ground floor classroom, Chakraborty Sir, our
English teacher spotted us and came trailing behind us shouting at us,” Girls
come back, girls come back, girls…”
He came till the cycle
stand to take us back to class. Finally, he succeeded in taking some of us back
to the class who were unsuccessful in out running him.
On reaching the
classroom, we ran and sat at our benches as if we were not the part of bunking
and it was the others who were running off! Once in the class, Sir asked the
students who were trying to bunk the class to stand up. Nobody stood up. This
added up to his anger. Slowly, some of us stood up and started staring at
others who were still not ready to stand up. Then all the unsuccessful bunking
students stood up and got a nice scolding.
Marks!
Even after over two decades, this event is embedded in my memory vividly.
We were in class IX H
Sanskrit section. English Sir had come to our class with the corrected answer
sheets of our half yearly exam.
As he started
distributing the answer sheets, first, he called out Roll no. 2. My roll no.
was 2. I was startled as to why had he started with my no instead of roll no 1
which is the usual practice. As soon as I stood up at my desk with the feeling
that I have done very badly in the exam, Sir gave a look of disbelief at me. He
repeated loudly,” Roll no 2” so that the real roll no 2 would stand up. I
meekly admitted that my roll no is 2 which he was not ready to believe getting
me confused as well.
Finally, Sir handed
over my answer sheet announcing that I had scored the highest marks in class
(52/60). I was elated…
Sir had least expected
me to top the subject as I was a very quiet and introvert person as also the
fact that Sanskrit section was a class full of brilliant students.
Memories! Memories! Picnic
It’s been so
many years now, 26 years to be precise, that I have only faint recollection of
the sequence of events.
Since the school
didn’t arrange a picnic for us, we decided that we are grown up enough to plan
a picnic to Bordih dam for ourselves. We were in class X H at that time.
We thought,
maybe we were grownups, but we should take some elders with us as it was not a
school picnic and teachers would not be accompanying us. This would also help
all the students to get permission at the home front. So, we started scouting
for the elders. My paternal uncle and aunt were guests at our place at the
time. I convinced them and we got parents of another student to accompany us.
When we reached the
school on Monday morning, all of the happy go lucky students of our picnic were
in for a shock! We were made to stand in front of the Principal’s office and
asked to bring our parents to school without which we would not be allowed into
the school premises.
When I went home
to tell this to my parents, they were not ready to meet the Principal, Borle
Sir.
I did not go to
school for may be a week and kept crying for as many days. My uncle and aunt
tried to console me saying I need not worry since they had accompanied us. But
for me, it was a matter of worry all the more and I would start sobbing louder.
Also, we as our
friends, started analyzing the situation as to why our parents were called. We
arrived at the conclusion that we went for the picnic on a Saturday, ie, we
bunked our classes that day and the other mistake was to board the bus for the
picnic in front of our school main gate! If it would have been a Sunday,
nothing of this sort would have happened…
Then somehow I
braved to go to school where I was surprised to find that I could attend
classes without being stopped by any teacher. After a few years, I came to know
that my father had talked to the Principal on the phone and kept it a secret so
that I would learn a lesson from this episode.
Getting started....
I have been wanting to write for so long....It took me such a long time ....to open a blogspot with my sister's help, name it, so many topics came in my mind but days went off like a bullet train. Now after about more than a year I am attempting to write..
thinking what to start with....
Photography as my first topic!! Maybe because it is close to my heart.
How drastically has photography changed in recent years! Earlier then it was difficult for people even to own a camera and now you get cameras in mobiles! So everyone has become a photographer and that too good ones.... That's because you don't need a reel in the camera now, thanks to digital you can practice number of times & choose the pro ones. Sometimes the photographs by amateurs are even better then professionals.
Happy clicking !!!!
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