埃博拉病毒是一种威胁生命的被忽视的热带疾病，最近在中非和西非发生了多次爆发后，最近在爆发中引起了人们的关注，被认为是蝙蝠或其他动物水库传播的人畜共患病。接触感染动物（包括灵长类动物或其他人类）后长达三周，人们会出现埃博拉病毒疾病（EVD）的症状，包括发烧，身体疼痛和疼痛，疲劳，腹泻和多系统器官衰竭，导致死亡率导致死亡率。最多90％。出血（出血）也可以在许多器官中发展，但是在最近的爆发中不太常见。

There have been两次疾病爆发over the past decade, the first and largest of which occurred between 2014 and 2016 in West Africa (with 28,616 cases and 11,310 deaths). Following a two-year gap the second ongoing outbreak began in the DRC in August of 2018, with 3462 cases and 2267 deaths as of April 27, 2020 .

最新的刚果民主共和国爆发中，新的治疗剂也已经成为一线希望

目前针对埃博拉疫苗的成功故事

There has been significant recent progress in the area of Ebola vaccine research, which is especially important in light of the concerning trend for larger and more frequent EVD outbreaks (以及该病毒可用于生物恐怖主义的持续风险）。

发现病毒本身后不久，首次生产埃博拉疫苗的尝试就开始了。这是基于灭活的整个病毒，但由于安全问题而被放弃。1996年，发现一种被称为“重组囊肿性口腔炎病毒”（VSV）的动物病毒，其人类疾病潜力有限，并且很容易被研究人员操纵以进行疫苗发现。如今，它是最突出的埃博拉疫苗的基础，显示出对埃博拉病毒感染的完全保护。

In 2001 the Public Health Agency of Canada’s National Microbiology Laboratory began developing this vaccine, making it fit for human protection. The randomised controlled trials were then led by teams from Norway and the World Health Organization (WHO), with important Canadian contributions and funding. Results showed that no cases of Ebola were seen in the group that received the vaccine immediately, yet 16 cases were seen in the group that initially received the placebo, resulting in a 100% vaccine efficacy.

鉴于这一成功，最近经过FDA批准的疫苗（以Ervebo品牌出售的RVSV-ZEBOV）在2018年8月1日当前的刚果民主共和国爆发爆发后7天实施；此后不久，超过90,000人接种疫苗。JANSEN感染性疾病和疫苗（J＆J的疫苗部门）的第二次疫苗也已在刚果民主共和国（DRC）发射（该研究仍在进行中）。

Treatment beyond vaccination

Beyond promising vaccine candidates, new therapeutics have also emerged as a silver lining from the most recent DRC outbreak. Following the 2014-16 West African outbreak, the WHO investigated implementing new therapeutics in outbreak settings.

结果，在2018年，当刚果民主共和国开始经历埃博拉病例数量增加时，他们准备好发射“ Pamoja Tulinde Maisha”（“一起挽救生命”）。该模型是自适应临床试验randomizing Ebola patients to several antiviral and monoclonal antibody based therapeutics .

Preliminary results of reduced mortality rates and the discovery of a new therapeutic vector has led to a change in study methodology with EVD patients being randomized to 2 treatment arms only (including a recombinant monoclonal antibody and a promising triple monoclonal antibody), although this research is still ongoing.

Conclusion

近年来，埃博拉暴发的大小和频率显着增加。随着人类的扩张持续到曾经仅由我们的动物占领的生态学，随着人类移民变得更加无处不在，我们只应该期望这种疫情会增加。幸运的是，高度有效且现已获得FDA批准的疫苗和治疗剂的最新发展为预防和控制未来的埃博拉病毒爆发的能力增强了。

近期全球EVD的集体经验还强调了，即使在世界上极具挑战性的紧急情况下，也可以进行高质量，严格的临床试验。毫无疑问，EVD在过去6年中对西部和中非造成了毁灭性的损失，不幸的是，只有在这种削减和生命损失的背景下，才真正取得了重大的科学收益。这些灾难性暴发的进展应激发并激发进一步的快速创新和投资，以便可以避免与EVD相关的未来灾难。