| Re: [stem-ebola] Ebola Rapid Antigen Tests re: Ira |
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I heard on NPR from a pandemic expert of the Council on Foreign Relations that three companies are on the verge of submitting handheld Ebola testing devices to FDA for approval. Presumably, these can test to within 1/10,000,000 CL. I have no idea what mechanism or method is used in these to indicate the presence of Ebola, but will advise whn have more verified details. Could help with point of contact screening at customs checkpoints and other appropriate locations-- if they are truly reliable and dependable.
> Date: Wed, 15 Oct 2014 19:37:04 -0600 > From: alex@xxxxxxxxxxxxxx > To: stem-ebola@xxxxxxxxxxx > Subject: [stem-ebola] Ebola Rapid Antigen Tests re: Ira > > Thank you Ira for this very useful PDF. > > Ebola 'screening' is something I have been thinking about quite a bit > lately, as well as discussing with my spouse, who works as a P.A. in a > clinical setting. She is skeptical of lab testing because her clinical > experience has indicated often high rates of false negatives in certain > viral tests... Interestingly, she mentioned seeing a surprising amount > of false-negatives in HIV-1 patients subsets. (Perhaps the HIV-1 PCR > primers are different, or the antibodies do not bind as well? The > reason is unclear. The lab ended up doing both a Western Blot and PCR > on the HIV patient, who was eventually diagnosed after some initial > confusion.) > > Anyway... I thought that really the world needs a way to reliably > identify Ebola-infected patients at the time of symptom presentation (or > before , if that's even possible at all)... Perhaps this can be > achieved by slightly modifying existing innovative technologies. > > New Ebola screening technologies could check for infection using a > 'rapid test' , perhaps something robust enough for both clinical use and > field use. I published a post on the Operon Labs site suggesting the use > of antibody technology somewhat like the OraQuick home HIV-1 test, which > produces decent results within 20 minutes. In the article you posted > Ira, they discuss the Lassa field test, which operates much in the same > way as the home HIV OraQuick test. http://www.operonlabs.com/?q=node/13 > > The only real limitation I see in Ebola testing is this statement -- per > CDC (and I see no evidence to the contrary) -- is CDC writes that even > highly sensitive tests like RT-PCR will sometimes be Ebola > false-negative until 1-3 days after the onset of Ebola-symptoms. This > problem makes the use of testing for 'early detection' of Ebola > difficult and pointless, unless innovations are made in how the tests > work. > > Digression: In existing Ebola 'confirmatory' tests at state labs and > CDC, I've got to wonder what procedures are being used ... I'm not > familiar with the exact procedures... For RT-PCR, what primers are being > used, and what regions are they targeting? What are the primer > sequences? Have the Ebola RT-PCR primers been adapted for the 2014 > outbreak (if necessary)? I'd love to know the answers, but I don't at > the moment. > > What the world really needs is a portable Ebola test that is very > sensitive and accurate, and can be donated in large quantities. One way > to do this is to start with a test (like the experimental Lassa field > test) which uses 'blood drop' and 'on-the-spot' ELISA-type testing with > a 'wick' so to speak. > > But even this would still suffer from the CDC's 1 to 3 day lag time in > detection, relegating such testing to a mere 'rapid confirmatory' role > rather than any disease surveillance role . This would help at the > field hospitals, but it would not help with disease detection on > transnational flights or large-scale clinical surveillance. > > One workaround to increase the surveillance capabilities of Ebola > testing might be new ideas... Here is one of my ideas...Run an Ebola > Blood 'rapid-antigen' test *after* blood fractionation using only the > buffy coat from a vein draw (not a 'whole blood' drop). By testing the > buffy coat (leukocytes) only after blood centrifuging, one might be able > to develop a test with a far more accurate result, since PBMCs (minus > the lymphocytes) are the early targets in Ebola infection. > > Additionally, another enhancements to an Ebola test that occurred to me > (depending on whether ELISA/Antibody or PCR based) could use the > following method... > > 1. Prior to the test, homogenize the 'buffy coat' leukocyte membranes to > release and liberate the intracellular contents ... either ... > 2A. Liberate / Extract Antigenic viral proteins from > Monocytes/Macrophages (for ELISA type tests), or > 2B. Liberate / Extract Targeted viral RNAs from Monocytes/Macrophages > (for PCR). > > You could use a variety of disruption techniques like cell lysis buffers > , and/or bead disruption, etc, depending on the needs of the > application, and whether the tests need the proteins or the vRNA intact. > The key would be to target only leukocytes... More preferably , only > target Monocytes and Macrophages for testing. > > This latter suggested method (disruption / homogenization of leukocytes > in the buffy coat) might increase the specificity and sensitivity of > these 'rapid' Ebola tests, since the homogenization of leukocytes would > 'de-cloak' the Ebola virus from it's early hiding spot in the Monocytes > and Macrophages, exposing the infected cell contents to the test. > > Perhaps the false negative rates would go down, and the disease could > potentially be detected earlier than is possible now. > > With some luck (if possible with such technology), we might be able to > detect Ebola prior to manifestation of symptoms by looking specifically > in isolated and homogenized Monocytes and Macrophages. > > In any case... I'm looking forward to your call next week Ira. I'm sure > it will be a great discussion. > > Thanks, > Alex > > On 2014-10-15 10:51, Ira Schwartz wrote: > > See attached. > > Ira > > > > On Wed, Oct 15, 2014 at 1:02 AM, <alex@xxxxxxxxxxxxxx> wrote: > > > >> EBOLA VIRUS DISEASE - ex AFRICA (14): UN DOCTOR DIES, USA, > >> PREVENTION > >> > > ********************************************************************* > >> A ProMED-mail post > >> <http://www.promedmail.org [1]> > >> ProMED-mail is a program of the > >> International Society for Infectious Diseases > >> <http://www.isid.org [2]> > >> > >> In this update: > >> [1] UN doctor dies in Germany > >> [2] USA: Texas contact quarantined > >> [3] Prevention & false alarms > >> > >> ****** > >> [1] UN doctor dies in Germany > >> Date: Tue 14 Oct 2014 > >> Source: NBC News [edited] > >> > > <http://www.nbcnews.com/storyline/ebola-virus-outbreak/ebola-kills-united-nations-medic-hospital-leipzig-germany-n225151 > >> [3]> > >> > >> A United Nations medical worker [originally from Sudan] who was > >> infected with Ebola in Liberia has died despite "intensive medical > >> procedures," authorities said Tue [14 Oct 2014]. The St. Georg > >> hospital in Leipzig said the 56-year-old man, whose name has not > >> been > >> released, died overnight of the infection. It released no further > >> details. The man tested positive for Ebola on 6 Oct 2014, prompting > >> Liberia's UN peacekeeping mission to place 41 staff members who had > >> possibly been in contact with him under "close medical > >> observation." > >> He arrived in Leipzig for treatment on 9 Oct 2014, where he was put > >> into a special isolation unit... > >> > >> -- > >> Communicated by: > >> Ryan McGinnis > >> <ryan@xxxxxxxxxxxxxxxxxxx> > >> > >> ****** > >> [2] USA: Texas contact quarantined > >> Date: Tue 14 Oct 2014 > >> Source: Star Telegram [excerpted, edited] > >> > > <http://www.star-telegram.com/2014/10/14/6199347/facebook-founder-donates-25-million.html?rh=1 > >> [4]> > >> > >> "The lone person believed to have had direct contact with the Ebola > >> [nurse] works at Fort Worth-based Alcon and was admitted to Texas > >> Health Presbyterian Hospital with no symptoms," a company > >> spokeswoman > >> said... > >> > >> Alcon is a medical company that specializes in eye care products. > >> The > >> Alcon employee is being hospitalized as a precaution, the statement > >> said, adding: "The Alcon associate has not shown any signs or > >> symptoms > >> of the Ebola virus. After consultation with the Texas Department of > >> Health, we are confident that there is no risk for Alcon > >> associates. > >> We are working closely with the Centers for Disease Control and > >> Prevention and the Texas Department of Health to ensure we are > >> following proper public health measures." ... > >> > >> [Byline: Gordon Dickson] > >> > >> -- > >> Communicated by: > >> Jonathan Ezekiel <jezekiel@xxxxxxx> > >> > >> ****** > >> [3] Prevention & false alarms > >> > >> Belgium: No Ebola checks at Brussels Airport after flights from > >> Liberia > >> ----------------------------------------------- > >> Mon 13 Oct 2014: (NBC News) It's the classic airport scene: a man > >> hugs > >> his wife and 2 daughters at arrivals. But in this case, the > >> traveler > >> had just stepped off a plane from the Ebola-stricken Liberian > >> capital > >> of Monrovia, meaning that some might shy away from such embraces. > >> "I've been screened before getting on the plane," he pointed out > >> before heading for the exit. The twice-weekly flight from Monrovia > >> to > >> Brussels is now the only air link from that city to the European > >> continent and is the route most Americans would likely travel on > >> their > >> way home. Thomas Eric Duncan, who died in a Dallas hospital last > >> week, > >> traveled to the U.S. from Liberia via Brussels... > >> > > <http://www.nbcnews.com/storyline/ebola-virus-outbreak/no-ebola-checks-brussels-airport-after-flights-liberia-n223581 > >> [5]> > >> > >> [Byline: Carlo Angerer & Becky Bratu] > >> > >> [The link shows Ebola advice posters at Monrovia airport. - Mod.JW] > >> > >> -- > >> Brazil: Man suspected of carrying Ebola tested negative again. > >> ----------------------------------------------- > >> Mon 13 Oct 2014: (WSJ) A man suspected of carrying the ebolavirus > >> was > >> tested negative for the 2nd time, Brazil's Health Ministry said Mon > >> [13 Oct 2014]. The test eliminates the possibility of Ebola, Health > >> Minister Arthur Chioro told reporters. The man, identified by > >> authorities as a 47-year-old from Guinea, one of the 3 countries > >> hardest hit by the Ebola outbreak, was isolated at a Rio de Janeiro > >> hospital... Doctors were still monitoring for other possible > >> diseases, > >> even after Ebola had been ruled out... Two blood tests were made, > >> following standard protocol to deal with the deadly virus. Dozens > >> of > >> people who had contact with the man were monitored, but now they > >> are > >> no longer under watch, he said. The minister said the case showed > >> Brazil is ready to deal with the epidemic. He also said that the > >> risk > >> of contagion in the country is low. > >> > > <http://online.wsj.com/articles/in-brazil-man-suspected-of-carrying-ebola-tested-negative-again-1413231294 > >> [6]> > >> > >> [Byline: Paulo Trevisani] > >> > >> -- > >> Kenya ex South Sudan: passenger dies, Ebola negative > >> ---------------------------------------------------------------- > >> Mon 13 Oct 2014: (Hara Ethiopia) Anxiety has gripped Kenya after a > >> female passenger from South Sudan died on Saturday night [11 Oct > >> 2014] > >> from Ebola-like symptoms after arriving in the country. Health > >> officials at Kenya's Jomo Kenyatta International Airport (JKIA) > >> told > >> Xinhua on Sun [12 Oct 2014] that the female passenger on board the > >> Kenya Airways flight alighted at 6:45 p.m. with high fever and > >> bleeding from the openings of her body. "We have not established > >> what > >> exactly caused the death, but medical officials including the > >> director > >> of medical services are carrying out tests to establish the cause," > >> an > >> official who sought anonymity told Xinhua by telephone. > >> > >> The official said the female passenger who had arrived from Juba > >> was > >> later rushed to the hospital but died in the evening... The > >> incident > >> caused panic at the busy airport, which was immediately deserted > >> for > >> hours after the death of the passenger... Kenya is vulnerable > >> because > >> it is a major transport hub, with many flights from West Africa, a > >> WHO > >> official said... > >> > > <http://haraethiopiadotcom.wordpress.com/2014/10/13/ebola-outbreak-spreads-in-ethiopia-kenya-and-south-sudan-as-passenger-dies-at-kenyas-jomo-kenyatta-international-airport > >> [7]> > >> > >> [The passenger tested negative for Ebola virus disease: > >> > > <http://www.standardmedia.co.ke/health/article/2000137966/suspected-ebola-case-at-jkia-tests-negative > >> [8]>. > >> > >> The Ethiopian and Kenyan governments said that they would not ban > >> flights from the 4 countries hit by Ebola. Ethiopia's and Kenya's > >> national carriers are major airlines connecting countries across > >> Africa and have on their part been pursuing the usual flights into > >> West Africa. Bole international airport [Addis Ababa] and Jomo > >> Kenyatta International Airport (JKIA) [Nairobi] so far haven't any > >> infrared thermometers or non-contact thermometers to measure body > >> temperature of in-bound and out-bound passengers for possible Ebola > >> symptoms. - Mod.JW] > >> > >> -- > >> Nigeria: 850 solders returning from peacekeeping in Liberia [in > >> March > >> 2015] to be quarantined. > >> > > ------------------------------------------------------------------------------------------------------------ > >> Mon 13 Oct 2014: (BellaNaija) Ever since the World Health > >> Organization > >> (WHO) declared Nigeria Ebola-free, the government has been doing > >> everything within its power to ensure that status is maintained. As > >> a > >> result, precautionary measures are being taken as 850 Nigerian > >> soldiers who are on a peace-keeping mission in Liberia, where the > >> Ebola epidemic is rampant, return to Nigeria in March 2015. > >> Arrangements are already being made to quarantine the soldiers in > >> Gwagwalada, Abuja for 28 days before they rejoin their respective > >> platoons, The Stream reports. > >> > > <http://www.bellanaija.com/2014/10/13/ebola-850-nigerian-soldiers-returning-from-liberia-to-be-quarantined/ > >> [9]> > >> > >> -- > >> Sierra Leone: peacekeepers bound for Somalia quarantined over Ebola > >> > > ---------------------------------------------------------------------------------- > >> Tue 14 Oct 2014 (Reuters) A battalion of 800 Sierra Leone soldiers > >> awaiting deployment as peacekeepers in Somalia has been placed in > >> quarantine after one of its members tested positive for the deadly > >> ebolavirus, military officials said on Tue [14 Oct 2014]. The > >> soldiers > >> were due to relieve the West African nation's contingent already > >> deployed with Somalia's African Union peacekeeping mission, known > >> as > >> AMISOM. However, they will now be subject to a 21-day isolation > >> period, a senior officer in Sierra Leone's army told Reuters, > >> asking > >> not to be named. Colonel Michael Samoura, spokesman of the Republic > >> of > >> Sierra Leone Armed Forces, confirmed that a member of the battalion > >> had tested positive for the disease. He said the soldier was > >> infected > >> after leaving the military camp where the force is based without > >> permission... > >> > > <http://www.reuters.com/article/2014/10/14/us-health-ebola-idUSKCN0I311420141014 > >> [10]> > >> > >> [Byline: Umaru Fofana] > >> > >> -- > >> USA: Texas nurse's dog quarantined > >> ------------------------------------------ > >> Mon 13 Oct 2014: (ABC News) Officials say a one-year-old King > >> Charles > >> Spaniel has been taken from the Dallas apartment of an > >> Ebola-infected > >> nurse and will be cared for at an undisclosed location. [The > >> nurse's] > >> apartment is being thoroughly cleaned after tests over the weekend > >> confirmed she is infected. Dallas County Judge Clay Jenkins said > >> Monday evening [13 Oct 2014] that the dog would be cared for in an > >> "undisclosed location in a humane, caring way." City spokeswoman > >> Sana > >> Syed says the dog named Bentley will be comfortable and have toys > >> to > >> play with while he is monitored away from people. > >> > > <http://abcnews.go.com/US/wireStory/dallas-officials-vow-care-ebola-patients-dog-26166242 > >> [11]> > >> > >> -- > >> Communicated by: > >> ProMED-mail > >> <promed@xxxxxxxxxxxxxx> > >> > >> [A HealthMap/ProMED-mail map can be accessed at: > >> <http://healthmap.org/promed/p/106 [12]>.] > >> > >> [See Also: > >> Ebola virus disease - ex Africa (13): Ethiopia susp., USA (TX) > >> prevention 20141013.2859164 > >> Ebola virus disease - ex Africa (12): USA new case, Spain, more > >> quarantined 20141012.2856660 > >> Ebola virus disease - ex Africa (11): Europe, threat to N. America, > >> recurrence 20141011.2854247 > >> Ebola virus disease - ex Africa (10): WHO, UN, Liberia, medevac, S. > >> Leone, USA 20141010.2851248 > >> Ebola virus disease - ex Africa (09): WHO, Spain, Australia, > >> Canada, > >> USA 20141009.2848352 > >> Ebola virus disease - ex Africa (08): US death, concern re. spread, > >> travel ban 20141008.2843902 > >> Ebola virus disease - ex Africa (07): Europe cases, USA quarantine > >> stations 20141007.2840925 > >> Ebola virus disease - ex Africa (06): Spain case, USA case, US case > >> medevaced 20141006.2837374 > >> Ebola virus disease - ex Africa (05): USA ex Liberia, prevention > >> 20141005.2834301 > >> Ebola virus disease - ex Africa (04): USA ex Liberia, prevention > >> 20141004.2832236 > >> Ebola virus disease - ex Africa (03): USA ex Liberia, Germany case > >> ex > >> S. Leone 20141003.2830392 > >> Ebola virus disease - ex Africa (02): USA ex Liberia, prevention, > >> false alarms 20141002.2827166 > >> Ebola virus disease - ex Africa: USA ex Liberia, WHO > >> 20141001.2823539 > >> Ebola virus disease - West Africa (184): USA (TX) first case ex > >> Liberia 20140930.2819341] > >> .................................................sb/jw/msp/ml > >> *##########################################################* > >> ************************************************************ > >> ProMED-mail makes every effort to verify the reports that > >> are posted, but the accuracy and completeness of > >> the > >> information, and of any statements or opinions > >> based > >> thereon, are not guaranteed. The reader assumes all risks in > >> using information posted or archived by ProMED-mail. ISID > >> and its associated service providers shall not be held > >> responsible for errors or omissions or held liable for any > >> damages incurred as a result of use or reliance upon posted > >> or archived material. > >> ************************************************************ > >> Donate to ProMED-mail. Details available at: > >> <http://www.isid.org/donate/ [13]> > >> ************************************************************ > >> Visit ProMED-mail's web site at <http://www.promedmail.org [1]>. > >> Send all items for posting to: promed@xxxxxxxxxxxxxx (NOT to > >> an individual moderator). If you do not give your full name > >> name and affiliation, it may not be posted. You may unsub- > >> scribe at <http://ww4.isid.org/promedmail/subscribe.php [14]>. > >> For assistance from a human being, send mail to: > >> <postmaster@xxxxxxxxxxxxxx>. > >> ############################################################ > >> ############################################################ > >> > >> List-Unsubscribe: http://ww4.isid.org/promedmail/subscribe.php [14] > >> _______________________________________________ > >> stem-ebola mailing list > >> stem-ebola@xxxxxxxxxxx > >> To change your delivery options, retrieve your password, or > >> unsubscribe from this list, visit > >> https://dev.eclipse.org/mailman/listinfo/stem-ebola [15] > > > > -- > > Dr. Ira B. Schwartz > > Head, Nonlinear Dynamical Systems Section > > Code 6792 > > Naval Research Laboratory > > Washington, DC 20375 > > ira.schwartz@xxxxxxxxxxxx > > ira.schwartz@xxxxxxxxx > > > > Links: > > ------ > > [1] http://www.promedmail.org > > [2] http://www.isid.org > > [3] > > http://www.nbcnews.com/storyline/ebola-virus-outbreak/ebola-kills-united-nations-medic-hospital-leipzig-germany-n225151 > > [4] > > http://www.star-telegram.com/2014/10/14/6199347/facebook-founder-donates-25-million.html?rh=1 > > [5] > > http://www.nbcnews.com/storyline/ebola-virus-outbreak/no-ebola-checks-brussels-airport-after-flights-liberia-n223581 > > [6] > > http://online.wsj.com/articles/in-brazil-man-suspected-of-carrying-ebola-tested-negative-again-1413231294 > > [7] > > http://haraethiopiadotcom.wordpress.com/2014/10/13/ebola-outbreak-spreads-in-ethiopia-kenya-and-south-sudan-as-passenger-dies-at-kenyas-jomo-kenyatta-international-airport > > [8] > > http://www.standardmedia.co.ke/health/article/2000137966/suspected-ebola-case-at-jkia-tests-negative > > [9] > > http://www.bellanaija.com/2014/10/13/ebola-850-nigerian-soldiers-returning-from-liberia-to-be-quarantined/ > > [10] > > http://www.reuters.com/article/2014/10/14/us-health-ebola-idUSKCN0I311420141014 > > [11] > > http://abcnews.go.com/US/wireStory/dallas-officials-vow-care-ebola-patients-dog-26166242 > > [12] http://healthmap.org/promed/p/106 > > [13] http://www.isid.org/donate/ > > [14] http://ww4.isid.org/promedmail/subscribe.php > > [15] https://dev.eclipse.org/mailman/listinfo/stem-ebola > > > > _______________________________________________ > > stem-ebola mailing list > > stem-ebola@xxxxxxxxxxx > > To change your delivery options, retrieve your password, or > > unsubscribe from this list, visit > > https://dev.eclipse.org/mailman/listinfo/stem-ebola > _______________________________________________ > stem-ebola mailing list > stem-ebola@xxxxxxxxxxx > To change your delivery options, retrieve your password, or unsubscribe from this list, visit > https://dev.eclipse.org/mailman/listinfo/stem-ebola |