5 ms·

I want to know how long it will take for Ebola to evolve a resistance to this therapy.

by Medicalidiot 7y ago

mars4rp 7y ago
How you would know that? You only could know after it happened. Evolution is random.
- worldsayshi 7y ago
  Well, going out on a limb here, there should still be some way to give a statistical apprehension of how likely such mutation could be over time. But I'm not aware if there's any feasibility of doing that today.
- deleted 7y ago
  [deleted]
duskwuff 7y ago
This therapy is intended for use in an intensive care environment. If the patient is able to pass on their infection in that environment, something is very wrong.
- Fomite 7y ago
  Treating Ebola patients in intensive care environments without a single breach in containment protocol is astonishingly difficult, even for trained and experienced teams.
_Nat_ 7y ago
Viruses tend to evolve pretty quickly. In fact, Ebola's already not just one strain, so differing Ebola strains are likely more prone to different versions of this treatment. In practice, it'll probably work out to be sorta like the issue with flu vaccinations, where health organizations will have to predict which strains are likely to be out there and then prepare accordingly. Still, even if Ebola somehow rapidly evolved to completely ward off the current treatments, it's moreso the technology that created these treatments that's a breakthrough. So, if Ebola adapts, presumably they'd just update the treatments. That said, the current treatments probably aren't very optimized yet, either. These are early successes; future results seem liable to be much better.
mbuinl989 7y ago
Its an RNA virus, so like flu it evolves all the time. RNA viruses replicate because there is no check on the NA helix when a cell replicates, unlike DNA which by virtue of being a double helix, a basic checksum method to ensure consistency of the DNA helix which the adaptive immune system relies on to do its job. It is why flu vaccines can be ineffective by the end of the flu season. It takes about 2 weeks to grow a flu virus in sterile eggs, the most "high tech" solution known to man currently. Every time someone with flu sneezes, they are emitting new multiple strains of the flu virus. The other problem with Ebola is it can hide in parts of the body where the adaptive immune system does not work, places like the eye and testes. So even though the virus may not show up in test results, it could reappear when someone's immune system is weakened sometime in the future. There are other ways to kill it though. Just for reference, someone I know works at Porton Down in the UK, MOD facility, they told me Ebola is nothing compared to some of the viruses and bacteria they have in their facilities. In other words there are far worse things to be worried about than Ebola.
pvaldes 7y ago
> I want to know how long it will take for Ebola to evolve a resistance to this therapy. Maybe never. A lot of time in any case, probably. Ebola is a plant's virus adapted to trees. Evolved to use bats (and probably arboreal snakes also) but can't survive for a long time in primates, and can't survive in soil at long term. We are a dead end for it. Would need infected humans munching some inedible leaves of a tropical tree or visiting hollow trunks where bats live. News cases of Ebola in the future will be from a new strain, but this does not imply evolution or resistance. Is just that the number of ebola specimens in contact with humans is limited.
- Medicalidiot 7y ago
  In practical terms, there will be a resistance that develops eventually. Even though the reservoir is hypothesized to be bats, that doesn't have much significance because of its ability spread from person to person without a vector. What is notable about Ebola is that its virulence keeps dropping while its ability to spread has significantly increased. The larger issue is that Ebola is in areas that don't have the resources to handle any serious outbreak. It's becoming more likely that Ebola is going to be self sustaining soon. I'm kind of amazed that a comment expressing interest in when this therapy will be obsolete, see that 96% of bacteria are resistant to Penicillin G now, gets a negative response. Drugs are only effective when the pathogen is still sensitive to them.
  - Dylan16807 7y ago
    For a resistance to develop, ebola that has been exposed to the treatment inside a hospital has to escape back into the wild. There are significant barriers in the way of that. If everyone on penicillin was kept in an isolation chamber, the effectiveness over time would be different.
    - Medicalidiot 7y ago
      As someone who works in a hospital, we can bleach every single patient room, wear all the PPE we want, but pathogens will always spread; the only question is when, not if. Even in an isolation chamber a resistance to penicillin would develop independently of each other as penicillin resistance is usually predicated on a mutation in the penicillin binding protein.

I want to know how long it will take for Ebola to evolve a resistance to this therapy.

mars4rp 7y ago

How you would know that? You only could know after it happened. Evolution is random.

worldsayshi 7y ago
Well, going out on a limb here, there should still be some way to give a statistical apprehension of how likely such mutation could be over time. But I'm not aware if there's any feasibility of doing that today.
deleted 7y ago
[deleted]

duskwuff 7y ago

This therapy is intended for use in an intensive care environment. If the patient is able to pass on their infection in that environment, something is very wrong.

Fomite 7y ago
Treating Ebola patients in intensive care environments without a single breach in containment protocol is astonishingly difficult, even for trained and experienced teams.

_Nat_ 7y ago

Viruses tend to evolve pretty quickly. In fact, Ebola's already not just one strain, so differing Ebola strains are likely more prone to different versions of this treatment. In practice, it'll probably work out to be sorta like the issue with flu vaccinations, where health organizations will have to predict which strains are likely to be out there and then prepare accordingly. Still, even if Ebola somehow rapidly evolved to completely ward off the current treatments, it's moreso the technology that created these treatments that's a breakthrough. So, if Ebola adapts, presumably they'd just update the treatments. That said, the current treatments probably aren't very optimized yet, either. These are early successes; future results seem liable to be much better.

mbuinl989 7y ago

Its an RNA virus, so like flu it evolves all the time. RNA viruses replicate because there is no check on the NA helix when a cell replicates, unlike DNA which by virtue of being a double helix, a basic checksum method to ensure consistency of the DNA helix which the adaptive immune system relies on to do its job. It is why flu vaccines can be ineffective by the end of the flu season. It takes about 2 weeks to grow a flu virus in sterile eggs, the most "high tech" solution known to man currently. Every time someone with flu sneezes, they are emitting new multiple strains of the flu virus. The other problem with Ebola is it can hide in parts of the body where the adaptive immune system does not work, places like the eye and testes. So even though the virus may not show up in test results, it could reappear when someone's immune system is weakened sometime in the future. There are other ways to kill it though. Just for reference, someone I know works at Porton Down in the UK, MOD facility, they told me Ebola is nothing compared to some of the viruses and bacteria they have in their facilities. In other words there are far worse things to be worried about than Ebola.

pvaldes 7y ago

> I want to know how long it will take for Ebola to evolve a resistance to this therapy. Maybe never. A lot of time in any case, probably. Ebola is a plant's virus adapted to trees. Evolved to use bats (and probably arboreal snakes also) but can't survive for a long time in primates, and can't survive in soil at long term. We are a dead end for it. Would need infected humans munching some inedible leaves of a tropical tree or visiting hollow trunks where bats live. News cases of Ebola in the future will be from a new strain, but this does not imply evolution or resistance. Is just that the number of ebola specimens in contact with humans is limited.

Medicalidiot 7y ago
In practical terms, there will be a resistance that develops eventually. Even though the reservoir is hypothesized to be bats, that doesn't have much significance because of its ability spread from person to person without a vector. What is notable about Ebola is that its virulence keeps dropping while its ability to spread has significantly increased. The larger issue is that Ebola is in areas that don't have the resources to handle any serious outbreak. It's becoming more likely that Ebola is going to be self sustaining soon. I'm kind of amazed that a comment expressing interest in when this therapy will be obsolete, see that 96% of bacteria are resistant to Penicillin G now, gets a negative response. Drugs are only effective when the pathogen is still sensitive to them.
- Dylan16807 7y ago
  For a resistance to develop, ebola that has been exposed to the treatment inside a hospital has to escape back into the wild. There are significant barriers in the way of that. If everyone on penicillin was kept in an isolation chamber, the effectiveness over time would be different.
  - Medicalidiot 7y ago
    As someone who works in a hospital, we can bleach every single patient room, wear all the PPE we want, but pathogens will always spread; the only question is when, not if. Even in an isolation chamber a resistance to penicillin would develop independently of each other as penicillin resistance is usually predicated on a mutation in the penicillin binding protein.