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 The conclusion is based on the cases of 84 people treated with
plasma in Conakry, Guinea, in the hope that the antibodies in the
fluid would help patients fight off the virus the way they did in
the surviving donors.
The death rate was 31 percent with the plasma, compared to 38
percent in a control group of 418 sufferers treated at the same
medical center who did not receive survivor plasma, according to the
results in the New England Journal of Medicine.
When the researchers adjusted for other factors that can affect
survival, such as the age of the victims, the effect of plasma
therapy was even less impressive.
"Of course you would like to dream and see a very strong reduction
in mortality, but we didn't see this," chief author Dr. Johan van
Griensven of the Institute of Tropical Medicine in Antwerp, Belgium,
told Reuters Health.
A key limitation of that study is that it's not known how many
virus-fighting antibodies were in the plasma of the donors. Because
Ebola virus disease, or EVD, is so dangerous, that analysis needs to
be done in laboratories with special safety equipment, which are not
available in affected countries, the researchers write.
"We might have anticipated there would be an effect" with plasma
from survivors, said Dr. William Schaffner, an infectious disease
specialist at Vanderbilt University Medical Center in Nashville, who
was not connected with the research.
The fact that no benefit was seen "does not mean antibodies to Ebola
are not going to be a good treatment," he cautioned. The plasma
donors might not have been fully recovered, he noted, so the fluid
might not have been rich in antibodies.
There were hints that some groups did benefit, though.
Children younger than five years old, known to have a poor
prognosis, had the highest risk of death in the control group, but
four of the five patients in this age group treated with
convalescent plasma survived, van Griensven and his colleagues
write. Although pregnant women with EVD also have a poor prognosis,
six of the eight pregnant women treated with convalescent plasma
survived, they add.
In another Ebola study, published as a letter to the Journal,
researchers with the World Health Organization report that men
treated in Guinea, Liberia and Sierra Leone had a lower survival
rate than women.
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The disease killed 67.1 percent of the infected men versus 63
percent of the women.
The difference persisted even after adjusting for age, symptoms, and
the amount of time it took for the person to seek medical help after
falling ill, said coauthor Dr. Christl Donnelly of Imperial College
London.
"People hadn't found that before. But because we had such a large
epidemic we can see it consistently," she told Reuters Health.
Men were no more likely to become infected with EVD than women. But
they did, typically, wait 12 hours longer to seek help than women.
That's 12 additional hours they were capable of spreading the virus
to others, the researchers note.
Yet, Donnelly said, that 12-hour delay didn't seem responsible for
the higher death rate among males.
Schaffner is not so sure. "Twelve hours is 12 hours. Maybe that's
not so trivial. … This can, at certain stages, be a rapidly moving
infection. This is intriguing, interesting and worth another look."
As of Dec. 27, according to the WHO, 28,637 people have been
infected with Ebola in the recent outbreak; 11,315 of those died.
The most recent epidemic began two years ago in Guinea. On Dec. 29,
WHO declared the country to be free of the disease. If no new cases
emerge by Jan. 14, the epidemic will be considered over.
SOURCE: http://bit.ly/1ZFjFmR and http://bit.ly/1P8OWqT New England
Journal of Medicine, online January 6, 2016.
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