San Diego Researchers Help With Urgent Effort To Stop Ebola In Africa
KPBS Midday Edition Segments / May 8, 2019
As health workers in the Democratic Republic of Congo work to stop the spread of another highly contagious Ebola outbreak, researchers in San Diego are working on a cure.
Speaker 1: 00:00 Urgent efforts are underway in Africa to stop another deadly Ebola outbreak in San Diego. Scientist are working on a cure. KPBS health reporter Susan Murphy talked to one researcher who says the outbreak is very concerning and so are the five other strains of the highly contagious virus. A growing Ebola epidemic in the Democratic Republic of Congo has killed more than a thousand people since August. The World Health Organization reports the rate of new infections is climbing substantially. Nearly half of the deaths have occurred in the last eight weeks,
Speaker 2: 00:35 so we're flying from San Diego to Congo with eight crates of supplies to go and do our laboratory research there and bring the data back here.
Speaker 1: 00:43 Erica Oleman Sapphire is a professor at the La Jolla Institute for Immunology. She also directs a consortium of Ebola researchers from 40 labs on five continents. She says the difference between this Ebola outbreak and the outbreak in 2013 that killed 11,000 people is a candidate vaccine that is currently being used in the region. It could help stop the spread of the highly contagious virus, but there are challenges.
Speaker 2: 01:09 Challenge, the stopping it. It's going to be all the civil unrest. There were multiple groups, multiple militia groups are significant distrust of institutions of governments, significant distrust of foreigners, so it's really hard to come in there and say, here, take this vaccine or let us take care of your people.
Speaker 1: 01:29 She says approximately 100,000 people have been vaccinated. Out of the nearly 8 million people who live in the region, most of the vaccinated have been health workers and people who have come into contact with an infected person.
Speaker 2: 01:42 It looks so far like only 15 of those have become sick. The data that we don't have is how many of those hundred thousand have been exposed and that will tell us how effective the vaccine is. If 100,000 have been exposed and 15 got sick, that's a really good vaccine, but if only 20 were exposed and 15 of those 20 got sick, that's not a very good vaccine.
Speaker 1: 02:04 According to the World Health Organization, the Ebola virus spreads quickly and is usually fatal. Symptoms include fever, vomiting, diarrhea, muscle pain and internal and external bleeding. Omen sapphires team is studying samples from people who have been vaccinated and samples from people who have come into contact with an Ebola patient.
Speaker 2: 02:24 Students, postdocs and technicians in my laboratory or from the La Jolla Institute of immunology had been rotating in and out of Congo all year using the molecules that we make and that we engineer here to identify cases, understand what kinds of immune responses have been elicited by the vaccine and how broadly protective the vaccine may or may not be.
Speaker 1: 02:45 She says the currency Ebola outbreak is deeply concerning because the virus is spreading in a dense and highly mobile population near the border with Uganda and Rwanda, but she says even more concerning, there are at least five other strains of the Ebola virus that have equally deadly pandemic potential.
Speaker 2: 03:02 We're looking at people that have survived. We're looking at elderly people with a lifetime exposure of hunting, of eating bushmeat or of health care work that are now immune to all of these different species and we're looking at what their immune system has come up with, protect them.
Speaker 1: 03:15 She says studying the antibodies Ebola survivors have made is key and finding a treatment. There are six different
Speaker 2: 03:23 kinds of Ebola virus and there are about 50% different in the sequence that spells them out. So the vaccine is only protective against one. We call this the Zaire kind. Well there's also the Sudan Chi, the Blue Bujo kind, the bone, Bali kind, lots of cons and each one of them has equivalent pandemic potential, but we don't know what's going to emerge next.
Speaker 1: 03:44 She's mapping the viruses molecules using high resolution photographs to understand where the virus is vulnerable and where to target a therapy or vaccine. She compares it to military intelligence photos
Speaker 2: 03:57 when we know how to drop a bomb on a particular bad guy in a particular chair sitting in a particular room and figure it compound without collateral damage. It's because we had those high resolution photographs that tell us exactly where to hit. This is what my lab does against viruses like Ebola
Speaker 1: 04:12 for almonds, Sapphire, and her team. The Congo outbreak and the potential of related viral outbreaks has renewed her urgency to find a cure.
Speaker 2: 04:20 And so we need to be prepared for what might come at us for the next outbreak. We need vaccines that are broadly protective and we need treatments that we can mobilize for whatever people might've become infected with.
Speaker 1: 04:32 Omen Sapphire is planning to return to the Congo to study Ebola the summer. Susan Murphy Kpbs News. As you just heard in Susan Murphy Story, the World Health Organization is sounding an alarm as the Ebola epidemic and the Democratic Republic of Congo continues to claim hundreds of lives. That alarm is being heard here in San Diego. While researchers try to find a vaccine, local hospitals are preparing for an outbreak at Rady children's hospital. Teams of doctors and nurses have been practicing Ebola drills. Joining me to talk more about that is Megan Medina, a registered nurse who is the infection control coordinator at Rady children's hospital. Meghan, welcome. Hi, how are you? Good, thanks. Now this Ebola epidemic is happening in the Democratic Republic of Congo. Why is it so important for a hospital here in San Diego to be prepared?
Speaker 3: 05:23 Well, Ebola is a definitely a scary disease, not something that we expect to see here or want to see here, but there are a lot of other highly pathogenic diseases out there are emerging diseases, novel viruses that we want to be prepared for. So it's really more about being prepared for more than just Ebola. Hmm. And what happens during any bola drill at Rady children's hospital? So we have a couple of different levels of training that happened. Our first line of training is a, with all of our staff nurses, just being able to quickly identify patients who might have Ebola or be suspected to have Ebola and them quickly. Our next level would be donning and doffing training. And this is kind of our bread and butter and this is the highest risk situation that we deal with, um, when we take care of patients with highly pathogenic diseases.
Speaker 3: 06:10 So we want to make sure that people are putting on their personal protective equipment carefully, appropriately. And then also removing it carefully because that's the highest risk of contamination is when you're taking off a personal protective equipment. After that, we start to do some skills focused training. So we'll have our clinicians wearing their personal protective equipment practicing skills. So practicing ivy starts intubations, central line placements, um, even just basic nursing care that would be different from when you're just providing that care on a daily basis. And then finally we have our full scenario drills where we actually will admit a patient run through that process, make sure all of our systems are in place, see how quickly we can get our, uh, special infectious disease unit put in place and just run through all of our processes. How long have you guys been doing these Ebola drills and preparing for this?
Speaker 3: 07:01 So we were designated as an Ebola treatment center about four years ago. And so that's when we started developing our program. And we've been doing drills, um, ever since. And I know the hospital has already taken steps to deal with Kawasaki Disease and the possibility of a measles outbreak. And what systems, like, you know, isolation rooms for example, are in place to specifically deal with Ebola or, or are they all the same systems? So a, we do have negative pressure rooms throughout our hospital to admit patients with infectious diseases like tuberculosis or measles. And we do use those on a routine basis. Um, throughout the year. Our Ebola unit is actually a, a unit that we set up in the event that we have a special infectious disease patient come in. So we will set it up. We have two different areas that we can set it up in and we do that pretty quickly and that's where we would provide care for these special infectious disease patients.
Speaker 3: 07:52 You know, and it's one thing to control the spread of the virus among the general population, but how do you keep medical professionals like yourself safe from contracting and even spreading such a deadly disease? Yeah, that's a great question. And that's exactly why we do these drills. It's really about keeping our staff safe when they're providing care to our patients. Um, so use of personal protective equipment is key. So our providers will wear things like tyvek suits, booties, a coverall, I'm that's impervious to blood or other body fluids and also a papper. So a an air purifier that they were to help filter the air and protect them from anything that might be airborne. When Ebola emerged a few years ago in Texas, a medical professional who was treating a patient contracted the disease, a breakdown in communication was blamed for that. What have medical professionals learn from that situation as we all face an epidemic, I think that's what's really made it exciting for us to get involved as an assessment center is it gives us the opportunity to prepare and practice and make sure that we have processes in place so we don't have those communication breakdowns and our staff are protected when they're taking care of patients.
Speaker 3: 08:57 What is the risk of of that, uh, disease making its way to San Diego? Luckily now after the outbreak a couple of years ago, we do have a lot of really good systems in place to track travelers that are coming here and since San Diego, you don't really travel directly from Africa. We are limited and in the possibility of us getting an Ebola patient directly here without having some sort of former knowledge. We have really good communication. In place with our local health department. And so that helps. So if there ever is a patient out in the community that they're monitoring, that might have been in an area that has Ebola, the health department typically knows about that patient and they're communicating with us to let us know this patient's out there and we're keeping an eye on them. They, they could potentially be coming in. So we at least have that for knowledge as well.
Speaker 3: 09:42 And what's the first thing you look for in a patient who comes to the hospital? So, um, anytime we have a patient present, we quickly triage them to see if they have any symptoms of an infectious disease in general. So we ask about fever, rash, abdominal pain, vomiting, diarrhea, all of those things. That's just our triage every day for our patients. Um, and then we also ask questions about travel history. So when we're talking about Ebola, we're, we're interested in African countries that they may have traveled to. But you know, in a case of measles we might be interested even in just domestic travel. So we kind of tried to adapt that travel screening best we can to whatever we're seeing out there in the community. And what should people do on their own to help prevent the potential spread of Ebola or anything else.
Speaker 3: 10:23 And how can people prevent a pandemic in general? Just good basic infection control practices. I think making sure you're washing your hands, making sure you're getting vaccinated, especially if you're traveling to international countries. It's essential that vaccinations are happening. And then I'm just being aware of who you're interacting with that may have traveled outside of the country. Even just having that knowledge when you present to the hospital, it can help. I've been speaking with Megan Medina, a registered nurse, who is the infection control coordinator at Rady children's hospital. And Megan, thank you for joining us. Thank you.