Anbx in Ebola

Q: Patients with Ebola virus should be covered at least for? - select one

A) Gram-negative pathogens

B) Gram-positive pathogens

Answer: A

Prevention and isolation are foremost in the Ebola outbreak, and in case of infection, supportive treatment is the mainstay.

Two antibody-based therapies that have shown effectiveness for the Ebola virus.

1. Atoltivimab, maftivimab, and odesivimab (REGN-EB3) – It's a triple-monoclonal antibody (mAb) product. This combination of three mAbs targets three nonoverlapping epitopes on the Ebola virus surface glycoprotein, providing potent virus neutralization.

2. Ansuvimab (mAb114) – This mAb was originally isolated from a survivor of Ebola virus disease and found to neutralize the virus.

Although critical care patients should be covered with broad-spectrum antibiotics, gram-negative pathogens are more common in Ebola patients and should be covered. Said that empiric gram-positive therapy should be added as hospital-acquired pneumonia or CLABSI (Central Line Associated Blood Stream Infections) can have low thresholds to occur. 

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References:

1. Kreuels B, Wichmann D, Emmerich P, et al. A case of severe Ebola virus infection complicated by gram-negative septicemia. N Engl J Med 2014; 371:2394.

2. Misasi J, Sullivan NJ. Immunotherapeutic strategies to target vulnerabilities in the Ebolavirus glycoprotein. Immunity 2021; 54:412.

3. Rayaprolu V, Fulton BO, Rafique A, et al. Structure of the Inmazeb cocktail and resistance to Ebola virus escape. Cell Host Microbe 2023; 31:260.