Comparative Analysis of Serologic Cross-Reactivity Using Convalescent
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A Multicenter, Multi-Outbreak, Randomized, Controlled Safety And
2018 Ebola MCM RCT Protocol Page 1 of 92 IND#: 125530 CONFIDENTIAL 4 October 2019, version 7.0 A Multicenter, Multi-Outbreak, Randomized, Controlled Safety and Efficacy Study of Investigational Therapeutics for the Treatment of Patients with Ebola Virus Disease Short Title: 2018 Ebola MCM RCT Protocol Sponsored by: Office of Clinical Research Policy and Regulatory Operations (OCRPRO) National Institute of Allergy and Infectious Diseases 5601 Fishers Lane Bethesda, MD 20892 NIH Protocol Number: 19-I-0003 Protocol IND #: 125530 ClinicalTrials.gov Number: NCT03719586 Date: 4 October 2019 Version: 7.0 CONFIDENTIAL This document is confidential. No part of it may be transmitted, reproduced, published, or used by other persons without prior written authorization from the study sponsor and principal investigator. 2018 Ebola MCM RCT Protocol Page 2 of 92 IND#: 125530 CONFIDENTIAL 4 October 2019, version 7.0 KEY ROLES DRC Principal Investigator: Jean-Jacques Muyembe-Tamfum, MD, PhD Director-General, DRC National Institute for Biomedical Research Professor of Microbiology, Kinshasa University Medical School Kinshasa Gombe Democratic Republic of the Congo Phone: +243 898949289 Email: [email protected] Other International Investigators: see Appendix E Statistical Lead: Lori Dodd, PhD Biostatistics Research Branch, DCR, NIAID 5601 Fishers Lane, Room 4C31 Rockville, MD 20852 Phone: 240-669-5247 Email: [email protected] U.S. Principal Investigator: Richard T. Davey, Jr., MD Clinical Research Section, LIR, NIAID, NIH Building 10, Room 4-1479, Bethesda, -
Rabbit Anti-Marburgvirus (MARV) VLP Pab ELISA Data
4 Research Court, Suite 300 Rockville, MD 20850 877-411-2041 [email protected] Rabbit anti-Marburgvirus (MARV) VLP pAb ELISA Data: Catalog #: 04-0005 IgG IgG + IgG + Lot #: MMIG201001IBT Dilution MMARV ZEBOV 1:X Antigen Antigen Immunogen: MARV (Musoke strain) Virus-like Particles (VLPs) containing glycoprotein (GP) 1000 3.30 2.66 Nucleoprotein (NP), and viral protein (VP40). 3162 3.07 1.80 10000 2.68 0.89 Description: Protein A purified rabbit polyclonal 31623 1.87 0.37 antibody reactive to MARV VLP raised in New 100000 0.99 0.14 Zealand white rabbits. 316228 0.43 0.05 1000000 0.17 0.02 Supplied: 0.5 mg of antibody is supplied in PBS at a concentration of 5.75 mg/mL. 0.01% Sodium azide has been added. -Antigen is coated on ELISA plates overnight. -Add 200µl blocking buffer then wash wells with Clonality: Polyclonal PBST. -Antiserum is diluted semi-log. Relevance: the filovirus Marburgvirus is a -Incubate antibody for 2 hour. Category A (NIAID) and HHS select agent. -Wash unbound antibodies and add HRP- Recommended Dilutions: conjugated anti-rabbit IgG. -Wash plates and add substrate to develop color for ELISA: Assay-dependent dilution. 20 minutes. WB: Assay-dependent dilution -Read absorbance at 650nm. Amount of color is directly proportional to amount of antibodies. Storage: 2-3 weeks +4oC, -20◦C long term Western Blot Cross Reactivity: Historical data showed some cross-reactivity with Ebola Virus (EBOV) and -Antiserum recognizes Marburg musoke Sudan Virus (SUDV) VLP’s, most likely due to glycoprotein, nucleoprotein, and VP40 antibodies against Baculovirus proteins since the VLP’s were expressed in SF9-Baculovirus system. -
MARBURG HEMORRHAGIC FEVER (Marburg HF)
MARBURG HEMORRHAGIC FEVER (Marburg HF) REPORTING INFORMATION • Class A: Report immediately via telephone the case or suspected case and/or a positive laboratory result to the local public health department where the patient resides. If patient residence is unknown, report immediately via telephone to the local public health department in which the reporting health care provider or laboratory is located. Local health departments should report immediately via telephone the case or suspected case and/or a positive laboratory result to the Ohio Department of Health (ODH). • Reporting Form(s) and/or Mechanism: o Immediately via telephone. o For local health departments, cases should also be entered into the Ohio Disease Reporting System (ODRS) within 24 hours of the initial telephone report to the ODH. • Key fields for ODRS reporting include: import status (whether the infection was travel-associated or Ohio-acquired), date of illness onset, and all the fields in the Epidemiology module. AGENT Marburg hemorrhagic fever is a rare, severe type of hemorrhagic fever which affects both humans and non-human primates. Caused by a genetically unique zoonotic RNA virus of the family Filoviridae, its recognition led to the creation of this virus family. The five species of Ebola virus are the only other known members of the family Filoviridae. Marburg virus was first recognized in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt, Germany and in Belgrade, Yugoslavia (now Serbia). A total of 31 people became ill, including laboratory workers as well as several medical personnel and family members who had cared for them. -
A Novel Ebola Virus VP40 Matrix Protein-Based Screening for Identification of Novel Candidate Medical Countermeasures
viruses Communication A Novel Ebola Virus VP40 Matrix Protein-Based Screening for Identification of Novel Candidate Medical Countermeasures Ryan P. Bennett 1,† , Courtney L. Finch 2,† , Elena N. Postnikova 2 , Ryan A. Stewart 1, Yingyun Cai 2 , Shuiqing Yu 2 , Janie Liang 2, Julie Dyall 2 , Jason D. Salter 1 , Harold C. Smith 1,* and Jens H. Kuhn 2,* 1 OyaGen, Inc., 77 Ridgeland Road, Rochester, NY 14623, USA; [email protected] (R.P.B.); [email protected] (R.A.S.); [email protected] (J.D.S.) 2 NIH/NIAID/DCR/Integrated Research Facility at Fort Detrick (IRF-Frederick), Frederick, MD 21702, USA; courtney.fi[email protected] (C.L.F.); [email protected] (E.N.P.); [email protected] (Y.C.); [email protected] (S.Y.); [email protected] (J.L.); [email protected] (J.D.) * Correspondence: [email protected] (H.C.S.); [email protected] (J.H.K.); Tel.: +1-585-697-4351 (H.C.S.); +1-301-631-7245 (J.H.K.) † These authors contributed equally to this work. Abstract: Filoviruses, such as Ebola virus and Marburg virus, are of significant human health concern. From 2013 to 2016, Ebola virus caused 11,323 fatalities in Western Africa. Since 2018, two Ebola virus disease outbreaks in the Democratic Republic of the Congo resulted in 2354 fatalities. Although there is progress in medical countermeasure (MCM) development (in particular, vaccines and antibody- based therapeutics), the need for efficacious small-molecule therapeutics remains unmet. Here we describe a novel high-throughput screening assay to identify inhibitors of Ebola virus VP40 matrix protein association with viral particle assembly sites on the interior of the host cell plasma membrane. -
MARBURG VIRUS [African Hemorrhagic Fever, Green Or Vervet Monkey Disease]
MARBURG VIRUS [African Hemorrhagic Fever, Green or Vervet Monkey Disease] SPECIES: Nonhuman primates, especially african green monkeys & macaques AGENT: Agent is classified as a Filovirus. It is an RNA virus, superficially resembling rhabdoviruses but has bizarre branching and filamentous or tubular forms shared with no other known virus group on EM. The only other member of this class of viruses is ebola virus. RESERVOIR AND INCIDENCE: An acute highly fatal disease first described in Marburg, Germany in 1967. Brought to Marburg in a shipment of infected African Green Monkeys from Uganda. 31 people were affected and 7 died in 1967. Exposure to tissue and blood from African Green monkeys (Cercopithecus aethiops) or secondary contact with infected humans led to the disease. No disease occurred in people who handled only intact animals or those who wore gloves and protective clothing when handling tissues. A second outbreak was reported in Africa in 1975 involving three people with no verified contact with monkeys. Third and fourth outbreaks in Kenya 1980 and 1987. Natural reservoir is unknown. Monkeys thought to be accidental hosts along with man. Antibodies have been found in African Green monkeys, baboons, and chimpanzees. 100% fatal in experimentally infected African Green Monkeys, Rhesus, squirrel monkeys, guinea pigs, and hamsters. TRANSMISSION: Direct contact with infected blood or tissues or close contact with infected patients. Virus has also been found in semen, saliva, and urine. DISEASE IN NONHUMAN PRIMATES: No clinical signs occur in green monkeys, but the disease is usually fatal after experimental infection of other primate species. Leukopenia and petechial hemorrhages throughout the body of experimentally infected monkeys, sometimes with GI hemorrhages. -
How Severe and Prevalent Are Ebola and Marburg Viruses?
Nyakarahuka et al. BMC Infectious Diseases (2016) 16:708 DOI 10.1186/s12879-016-2045-6 RESEARCHARTICLE Open Access How severe and prevalent are Ebola and Marburg viruses? A systematic review and meta-analysis of the case fatality rates and seroprevalence Luke Nyakarahuka1,2,5* , Clovice Kankya2, Randi Krontveit3, Benjamin Mayer4, Frank N. Mwiine2, Julius Lutwama5 and Eystein Skjerve1 Abstract Background: Ebola and Marburg virus diseases are said to occur at a low prevalence, but are very severe diseases with high lethalities. The fatality rates reported in different outbreaks ranged from 24–100%. In addition, sero-surveys conducted have shown different seropositivity for both Ebola and Marburg viruses. We aimed to use a meta-analysis approach to estimate the case fatality and seroprevalence rates of these filoviruses, providing vital information for epidemic response and preparedness in countries affected by these diseases. Methods: Published literature was retrieved through a search of databases. Articles were included if they reported number of deaths, cases, and seropositivity. We further cross-referenced with ministries of health, WHO and CDC databases. The effect size was proportion represented by case fatality rate (CFR) and seroprevalence. Analysis was done using the metaprop command in STATA. Results: The weighted average CFR of Ebola virus disease was estimated to be 65.0% [95% CI (54.0–76.0%), I2 = 97.98%] whereas that of Marburg virus disease was 53.8% (26.5–80.0%, I2 = 88.6%). The overall seroprevalence of Ebola virus was 8.0% (5.0%–11.0%, I2 = 98.7%), whereas that for Marburg virus was 1.2% (0.5–2.0%, I2 = 94.8%). -
Taï Forest Virus Does Not Cause Lethal Disease in Ferrets
microorganisms Article Taï Forest Virus Does Not Cause Lethal Disease in Ferrets Zachary Schiffman 1,2,† , Feihu Yan 3,†, Shihua He 2, Kevin Tierney 2, Wenjun Zhu 2 , Karla Emeterio 1,2, Huajun Zhang 1, Logan Banadyga 2,* and Xiangguo Qiu 2 1 Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3E 0J9, Canada; [email protected] (Z.S.); [email protected] (K.E.); [email protected] (H.Z.) 2 Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB R3E 3R2, Canada; [email protected] (S.H.); [email protected] (K.T.); [email protected] (W.Z.); [email protected] (X.Q.) 3 Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun 130122, China; [email protected] * Correspondence: [email protected] † These authors contributed equally. Abstract: Filoviruses are zoonotic, negative-sense RNA viruses, most of which are capable of causing severe disease in humans and nonhuman primates, often with high case fatality rates. Among these viruses, those belonging to the Ebolavirus genus—particularly Ebola virus, Sudan virus, and Bundibugyo virus—represent some of the most pathogenic to humans. Taï Forest virus (TAFV) is thought to be among the least pathogenic ebolaviruses; however, only a single non-fatal case has been documented in humans, in 1994. With the recent success of the ferret as a lethal model for a number of ebolaviruses, we set out to evaluate its suitability as a model for TAFV. Our results demonstrate that, unlike other ebolaviruses, TAFV infection in ferrets does not result in lethal disease. -
Risk Assessment and Risk Mitigation Review(S)
CENTER FOR DRUG EVALUATION AND RESEARCH APPLICATION NUMBER: 761169Orig1s000 RISK ASSESSMENT and RISK MITIGATION REVIEW(S) Division of Risk Management (DRM) Office of Medication Error Prevention and Risk Management (OMEPRM) Office of Surveillance and Epidemiology (OSE) Center for Drug Evaluation and Research (CDER) Application Type BLA Application Number 761169 PDUFA Goal Date October 25, 2020 OSE RCM # 2020-264 Reviewer Name(s) Elizabeth Everhart, MSN, RN, ACNP Team Leader Naomi Boston, PharmD Acting Deputy Division Doris Auth, PharmD Director Review Completion Date August 10, 2020; date entered into DARRTS, August 20, 2020 Subject Evaluation of Need for a REMS Established Name atoltivimab – odesivimab – maftivimab (REGN-EB3) Trade Name Inmazeb Name of Applicant Regeneron Pharmaceuticals, Inc. Therapeutic Class Human IgG monoclonal antibody Formulation Solution for infusion Dosing Regimen 50 mg of each mAb/kg (3mL/kg) IV (b) (4) × 1 1 Reference ID: 4659652 Table of Contents EXECUTIVE SUMMARY ............................................................................................................................................................3 1 Introduction........................................................................................................................................................................3 2 Background .........................................................................................................................................................................3 2.1 Product Information..............................................................................................................................................3 -
761169Orig1s000
CENTER FOR DRUG EVALUATION AND RESEARCH APPLICATION NUMBER: 761169Orig1s000 OTHER REVIEW(S) LABEL AND LABELING REVIEW Division of Medication Error Prevention and Analysis (DMEPA) Office of Medication Error Prevention and Risk Management (OMEPRM) Office of Surveillance and Epidemiology (OSE) Center for Drug Evaluation and Research (CDER) *** This document contains proprietary information that cannot be released to the public*** Date of This Review: October 7, 2020 Requesting Office or Division: Division of Antivirals (DAV) Application Type and Number: BLA 761169 Product Name, Dosage Form, Inmazeb (atoltivimab, maftivimab, and odesivimab-ebgn) and Strength: Injection 241.7 mg/241.7 mg/241.7 mg per 14.5 mL (16.67 mg/16.67 mg/16.67 mg per mL) Product Type: Multi-Ingredient Product Rx or OTC: Prescription (Rx) Applicant/Sponsor Name: Regeneron Pharmaceuticals, Inc. (Regeneron) FDA Received Date: February 25, 2020 OSE RCM #: 2020-263 DMEPA Safety Evaluator: Valerie S. Vaughan, PharmD DMEPA Associate Director of Mishale Mistry, PharmD, MPH Nomenclature and Labeling: 1 1 REASON FOR REVIEW As part of the approval process for Inmazeb injection, 241.7 mg/241.7 mg/241.7 mg per 14.5 mL (16.67 mg/16.67 mg/16.67 mg per mL), the Division of Antivirals (DAV) requested that we review the proposed labels and labeling for areas that may lead to medication errors. 2 MATERIALS REVIEWED We considered the materials listed in Table 1 for this review. The Appendices provide the methods and results for each material reviewed. Table 1. Materials Considered for this -
Ebola Virus Disease (EVD), Implications of Introduction in the Americas
Ebola virus disease (EVD), implications of introduction in the Americas Corrigendum1 - 13 August 2014 Given the current situation of Ebola virus disease (EVD) in West Africa, the Pan American Health Organization / World Health Organization (PAHO/WHO) advises its Member States to remain vigilant for potential introduction of EVD in the Americas, to raise the awareness and knowledge of health care providers and to strengthen the implementation of standard precautions for infection prevention and control in health care facilities at all levels. 1. Ebola virus disease (EVD) – Key facts Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever), is a severe, often fatal illness, with a case fatality rate of up to 90%. There are no licensed specific treatments or vaccine available for use in people or animals. Genus Ebolavirus is 1 of 3 members of the Filoviridae family (filovirus), along with genus Marburgvirus and genus Cuevavirus. Genus Ebolavirus comprises 5 distinct species: Bundibugyo ebolavirus (BDBV), Zaire ebolavirus (EBOV), Reston ebolavirus (RESTV), Sudan ebolavirus (SUDV) and Taï Forest ebolavirus (TAFV). The incubation period of Ebola virus disease (EVD) varies from 2 to 21 days, with an observed average of 8 to 10 days. Following the introduction of Ebola virus in the human population through animal-to-human transmission, person-to-person transmission by direct contact body fluids/secretions of infected persons is considered the principal mode of transmission. Indirect contact with environment and fomites soiled with contaminated bodily fluids (e.g. needles) may also occur. Airborne transmission has not been documented during previous EVD outbreaks. There is no risk of transmission during the incubation period. -
Ebola and Marburg Virus Disease Epidemics: Preparedness, Alert, Control and Evaluation
EBOLA STRATEGY Ebola and Marburg virus disease epidemics: preparedness, alert, control and evaluation August 2014 © World Health Organization 2014. All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. WHO/HSE/PED/CED/2014.05 Contents Acknowledgements ............................................................................................................ 5 List of abbreviations and acronyms ................................................................................... 6 Chapter 1 – Introduction .................................................................................................... 7 1.1 Purpose of the document and target audience .................................................................... -
Black Plague Claims Researcher
Is there hope for containment by drugs and vaccines? Current Research on Ebola Treatments Under a magnification of 25,000X, this digitally-colorized scanning electron bola continues to micrograph (SEM) depicts numerous plague West Africa as filamentous Ebola virus particles (red) E budding from a chronically-infected it infringes upon the USA. VERO E6 cell (blue). From the NIAID. Meanwhile, there is a scrambleA to develop and specific to the proteins of approve new treatment Ebola. The antibodies are options for this deadly designed to disease. bind and neutralize the Ebola virus. ZMAPP has been used By Christopher Massey Several promising on an emergency basis to treat November, 2014 vaccinations and therapies some victims of Ebola. have been developed over the last couple of decades, but However, due to the limited they have yet to be thoroughly number of doses produced, Christopher Massey is the tested for use in humans. the safety and efficacy of Research and Development Some treatments have been ZMAPP has not been fully Manager at Hardy Diagnostics. tried on human subjects in determined. ZMAPP is emergency situations, but produced in genetically He earned his degree in their safety and efficacy are engineered tobacco plants, microbiology at Cal Poly in still unknown. which makes the production San Luis Obispo, California. of new doses a slow process. Phase 1 trials are being HardyDiagnostics.com ZMAPP planned and are expected to start soon. The most widely publicized proposed treatment is ZMAPP. This therapeutic agent, developed by MAPP Biopharmaceutical, is a chimera of three separate monoclonal antibodies with Marburg virus were also significant benefit of TEKMIRA protected when BCX-4430 Brincidofovir is that it can be was administered up to 48 taken orally as a tablet and is Tekmira has answered with a hours after infection.