Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Monday, September 22, 2014

The Right Attitude

"They have the right attitude. They're collaborative, they're co-operative, they share their information readily and they have a global perspective. And they know exactly what needs to be done.
Jim LeDuc, director, Galveston National Laboratory, University of Texas Medical Branch

"We really felt that to be properly prepared for all of the possible diseases that we were seeing spreading ... that it was better and wise for Canada to have a Level 4 laboratory."
Dr. Harvey Artsob former head, zoonotic diseases, National Microbiology Laboratory, Winnipeg

"Heinz basically introduced Gary to me saying 'He's a really good guy, it would be great if we could find a job for him. So I hired him and it w as one of the smartest things I ever did."
"People had been trying (to make Ebola monoclonals) for years and couldn't. And we had people who were very good at making monoclonals."
Dr. Frank Plummer, retired head, National Microbiology Laboratory, Canada

"I think that Frank's motto is: Set your people free. And I think basically he created the environment there."
Dr. Gary Kobinger

"Out of small things and maybe being lucky -- I'm sure being lucky -- and maybe certain people making the right decisions, Canada became a player in the game."
"And I think that was the concept."
Dr. Heinz Feldmann, chief, National Microbiology Laboratory
Heinz Feldmann, right, and Allen Grolla, left, work in a mobile laboratory installed by specialists of the National Public Health Agency of Canada, which enables teams on the ground to conduct rapid and precise diagnosis of new suspected Ebola cases and other diseases, within two to six hours, in Mweka, Congo, Friday, Sept. 28, 2007. Heinz Feldmann, right, and Allen Grolla, left, work in a mobile laboratory installed by specialists of the National Public Health Agency of Canada, which enables teams on the ground to conduct rapid and precise diagnosis of new suspected Ebola cases and other diseases, within two to six hours, in Mweka, Congo, Friday, Sept. 28, 2007. Photo: THE CANADIAN PRESS/AP Photo/WHO

Dr. Plummer, though retired after fourteen years as head of the National Microbiology Laboratory in Winnipeg, is understandably proud of the work conducted at the laboratory, particularly now when the attention of the medical global community is riveted on West Africa battling an unprecedented threat of Ebola virus that has already taken almost three thousand lives, killing at a rate of up to 80% of its victims.

Two of the most seriously troublesome viruses yet known to modern mankind, Ebola and Marburg both of which infect animals and occasionally cross the species barrier from animal to human is afflicting the West African countries of Guinea, Liberia, Sierra Leone, Nigeria, and Senegal and threatening to spread, causing the World Health Organization to name it an urgent global viral health emergency requiring international cooperation to halt its surge.

The latest WHO statement resulting from its second emergency meeting of the International Health Regulations Committee states the following:
  • Flight cancellations and other travel restrictions continue to isolate affected countries resulting in detrimental economic consequences, and hinder relief and response efforts risking further international spread; the Committee strongly reiterated that there should be no general ban on international travel or trade, except for the restrictions outlined in the previous recommendations regarding the travel of EVD cases and contacts.
  • The Committee also advised that affected countries should fully engage with the transport sector, especially the aviation and maritime sectors, to facilitate a mutual understanding of potentially diverse viewpoints and develop a coordinated response.
  • Where extraordinary supplemental measures such as quarantine are considered necessary in States with intense and widespread transmission, States should ensure that they are proportionate and evidence-based, and that accurate information, essential services and commodities, including food and water, are provided to the affected populations.
  • Many responders have lost their lives due to the nature of the response work; the Committee stressed that affected countries should ensure health care workers receive:
    • adequate security measures for their safety and protection;
    • appropriate education and training on infection prevention and control;
    • support to families of deceased health care workers;
    • and access to adequate health care services, in particular for international health care workers.
  • Challenges in implementation of standard Ebola control measures (case finding and contact tracing, case management, safe burials, social mobilization) in affected countries warrant measures to augment their implementation, including through deepened community engagement, in areas of intense transmission.
  • All States should reinforce preparedness, validate preparation plans and check their state of preparedness through simulations and adequate training of personnel. 
Heinz Feldmann, the lab's first special pathogens head, along with Gary Kobinger who became his successor as the current branch head share the attitude that the director of the Galveston National Laboratory spoke of so admiringly. When the federal government determined that a state-of-the-art lab should be located and built in Winnipeg replacing the aging Health Canada facilities in Ottawa, it was up in the air whether the new complex would contain a Level 4 lab, a designation reflecting the rigid pathogen-containment safety space required for work on dangerous pathogens.

Which, when the decision was made, required that someone expert in the field be brought into the picture. The search for that expert led to a young German researcher working in Marburg, Germany whose research on Ebola and Marburg viruses distinguished him. Dr. Feldmann was convinced to make the move from Germany to Canada upon meeting the NML leaders. Under his direction the lab created vaccines for Ebola and Marburg widely thought promising.

UP to one thousand vials of the Ebola vaccine named VSV-EBOV were donated to the World Health Organization, to be used in the outbreak once preliminary trials indicate its safety for humans. It has proven highly effective and safe in trials with non-human primates. As well, this type of required an on-site laboratory, and so they created a mobile lab, a low-tech lab-in-a-suitcase whose useful practicality promised to revolutionize testing in remote locations where these viruses most often occur.

Dr. Gary Kobinger works in a mobile laboratory installed by specialists of the National Public Health Agency of Canada, in Mweka Congo, on Friday    Christopher Black/The Canadian Press

Dr. Kobinger, born in Europe, raised in Quebec, had been working on an Ebola vaccine while at the University of Pennsylvania. In Winnipeg, he has continued his work on the vaccine. Using a technique known as monoclonal antibodies he has distinguished himself in the process. Antibodies are produced by the immune system to protect against foreign invasions. Scientists study how to identify which antibody targets a specific pathogen, and when they succeed, they grow that antibody, then called monoclonals.

A cocktail of three Ebola monoclonals was produced by Dr. Kobinger and his team of scientists. Also working on a monoclonal cocktail of three antibodies were scientists at the Medical Research Institute of Infectious Diseases located in Frederick, Maryland. Dr. Kobinger thought to optimize the cocktails by combining two of Winnipeg's monoclonals and one produced by the U.S. army team; that result was ZMapp.


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