Ending Ebola: The 2014 Ebola Outbreak

What did we know about Ebola before 2014?  Fatal. Cruel. Limited to Sub-Saharan Africa.

Last year this all changed.

In 2014 an outbreak in Central Africa gained global media attention. Not only the largest epidemic of the disease to date, so far resulting in over 22,000  suspected cases and  nearly 9 000 deaths (WHO report 01/02/2015), it is also the first to impact the Western world. So where do we stand a year into the outbreak?

What is Ebola?

image1Ebola, first reported in 1976, takes its name from a river near one of the original affected areas.   Four different viruses are known to cause the disease humans, after being transmitted by wild animals.. The infection spreads between individuals through direct contact with bodily fluids.

Symptoms can take up to a month to develop – beginning as typical “flu-like” signs (fever, fatigue, muscle pain) before becoming more severe (vomiting, diarrhoea, organ damage, internal/external bleeding).  On average 50% of Ebola cases result in death, although the mortality rate can be as high as 90%, depending on the source.
Since being first identified, nearly 20 major outbreaks have been reported. Despite the ruthlessness of the disease, no cure or direct treatment has ever been developed and therapeutic plans tend to focus on supportive measures.

The 2014 Ebola outbreak

Although   first reported in late March, in fact it all started in December 2013 with the source a 1 year old boy in Guinea West Africa. A series of misdiagnosis meant it took 4 months for cases to be identified as Ebola.

image2By this time the virus had taken hold of Africa. Not only had the vicious disease already been suspected to have infected 80 individuals and caused 50 deaths, but cases had by now been  reported in other parts of West Africa.

The outbreak was by now too large to contain. Within 6 months the disease would spread beyond the continent, as far as Europe and the USA, becoming one of the most talked about global health epidemics of the 21st century.

What has the therapeutic impact of the 2014 Ebola outbreak been?

Late last year the Ebola epidemic was still rife. With the death rate at 70% and no direct treatment available, the World Health Organisation had no other plan except to take the unprecedented step of allowing the use of un-trialled treatments.

image3Now trials of several novel therapeutic plans are underway or about to commence in West Africa.

Another treatment involves the use of blood/plasma from recovered patients. Known as convalescent plasma therapy, the treatment is quick to develop, easy to implement (even in poor countries), with a potential bank of thousands of Ebola survivors to act as donors.
So while drug development may appear more beneficial for the long-term fight against Ebola, and indeed the effectiveness of several agents is currently being assessed in these areas, blood-based therapies may be more suited for the current outbreak.

Early 2015 also saw the beginning of two separate vaccination trials.

Vaccinations allow the body to build immunity against a specific virus, in this case Ebola. Both newly developed vaccines already passed Phase I clinical trials and have been shown safe for human use. Thus, February this year saw the start of Phase II and Phase III trials in West Africa. It is hoped these trials will determine the safety and effectiveness in a broader infected population and one day the working vaccine will become available internationally on a large-scale.


Controlling the spread of Ebola

image5One of the main driving factors behind the outbreak last year was the confusion regarding diagnosis. Since Ebola symptoms resemble those of other diseases in Africa, such as malaria and typhoid, Ebola can often be misidentified – especially in areas where cases have never been reported.

To increase the odds of surviving, and limit the spread of the virus, those infected need to be rapidly identified, isolated and begin treatment as soon as possible. Tools which allow this to happen are currently being trialled in the most affected areas of Africa . One such tool involves low-resource kit that can identify the virus within 15 minutes.

Will the 2014 Ebola outbreak see the development of a direct Ebola treatment?

The unusual move of allowing un-trialled treatments creates the perfect opportunity to test the effectiveness of many new potential therapeutic plans quickly in a real-life scenario. However, these trials are not in any means controlled. So sadly even if a therapy is believed to be  effective, it will have to go through further trials before it is  deemed safe enough for widespread use – a process that can take several years.

In addition, the encouraging news that we have begun to slow transmission and are now in the process of ending the epidemic may have a negative impact on the tests. Already a trial of a potential Ebola drug in Liberia has been stopped because the case numbers have dropped to a level, at which the effectiveness of the drug cannot be clearly confirmed. .
After a year of the mass heartbreak caused by Ebola the seemingly unstoppable disease appears to be finally slowing. Although the trials of the new treatments have created hope for a solution, there is still plenty of work to do before we eradicate Ebola.

Post by: Claire Wilson


Ebola Virus Disease. World Health Organisation.

Ebola raises profile of blood-based therapy. Declan Butler, Nature.

Ebola vaccines, therapies and diagnostics.

New 15-minute test for Ebola to be trialled in Guinea. Wellcome Trust.

Wellcome Trust-funded Ebola treatment trial stopped in Liberia.

Jetlag: the ultimate holiday blues

image1Holidays are coming… Holidays are coming… And for most of us this means a few festive weeks in cosy England. However an annoyingly smug few will be flying off on long journeys this Christmas. Despite living in an age where crossing multiple time zones can be done with ease, our bodies have yet to catch up,  leaving us unable to fully cope with long-distance flights. So this Christmas many jetsetters will be given an unwanted present … the dreaded jet lag.

Jetlag: a growing 21st century problem

Jetlag is when your body struggles to adjust to a new time zone, leaving you feeling tired and confused. While symptoms generally wear off after a couple of days, it has been suggested jetlag may have long term cognitive effects.

The condition is due to changes to your internal body clock, which is regulated by the circadian rhythm.  Set over a 24 hour period, a tiny collection of cells in the brain called the hypothalamic suprachiasmatic nucleus (SCN) anticipate night and day. This master body clock co-ordinates with other body clocks within organs and tissues, controlling everything from our appetite to blood pressure.   Therefore, it is no surprise that when we disturb our circadian rhythm by crossing one of the world’s 24 different time zones, our bodies take a while to adjust to a new routine.


The simplicity of taking long flights has resulted in millions of people undertaking these journeys each year, with rates increasing annually. Currently, the longest commercial flight lasts around 16 hours and stretches 13,790km between Sydney and Dallas, longer than a non-stop bird migration.  Constant advances in aviation therefore mean that there is a developing need to overcome the detrimental effects of the so called “first world problem” that is jet lag.

Current treatment for jetlag

image3At this time no direct treatment exists, with passengers undertaking several behavioural adjustments to minimise the effects. These include avoiding caffeine and alcohol during the trip and establishing a local routine immediately upon arrival by avoiding napping and spending time outdoors.  Personally, I can concur these tricks are often very inconvenient. Having to remain awake until a normal bedtime following landing in the UK at 7:30am from New York was not ideal the day before Leeds Festival!

However, treatment may soon be available. Evidence has suggested that the consumption of melatonin could be ideal in overcoming jet lag. The circadian rhythm works by the SCN interacting with other areas of the brain, influencing neurohumoral activity. This includes regulating the production of hormones – such as melatonin- by the pineal gland.

Is melatonin the solution for jetlag?

image4Melatonin is the most well-known chronobiotic, a class of time-shifting drugs that alter circadian rhythms.  Produced during the evening when it begins to get dark, with levels peaking during the night, melatonin helps you sleep by causing drowsiness as well as lowering body temperature, heart rate and blood pressure. While not licensed at the moment, short term melatonin treatment appears to be both safe and remarkably effective in reducing /preventing jetlag.

With melatonin having obvious therapeutic potential, drug companies are keen to overcome its restricted access through the development of substances which act in a similar manner: so-called melatonin agonists. Ramelteon is the first in this new class of drugs to be approved by the US Food and Drug Administration for long-term treatment of sleep disorders, with many others in various stages of clinical trials.

Future of flying

The severity of jetlag is dependent on many things, including the length of the flight, numbers of time zones crossed and even the direction (hint for your next holiday: avoid travelling west-to-east!).  So while more work is needed to figure out the correct treatment plans for the drugs highlighted above, it appears flying long distances may soon become a breeze.

Post by: Claire Wilson.

The Science of Fear

Haloween1Think of Halloween and FEAR comes to mind. From the scary horrors of the darkest of our imagination to just the thought of pestering children knocking on your door! We’ve all been there. Facing our worst nightmares. Heart starts racing. Palms sweating. Stomach turning. But what is fear?

Fear has been with us since the dawn of time. Promoting survival, fear allows the animal kingdom to handle threats through the well-known fight-or-flight response. Faced with danger we either attack and escape or freeze- whatever is best for our survival. So, through evolution, those who feared the “best” survived, reproduced and passed their fears on to their children.

Haloween2So does being a scared-y cat makes you a dream catch?

Not quite. Over the course of time, fear began to evolve in human society. Alongside our rooted survival-fears, we began to develop our own personal fears. Our personal experiences unconsciously shape what we fear, meaning we now have the potential of being scared of anything – from bananas to zebras.

So, with so many potential fears surrounding us, the body’s response to these possible fearful stimuli must be controlled.

Our brains translate information about a fearful scenario – i.e. ghosts, ghouls, upcoming deadlines- and decide the right course of action. The resulting hormonal responses in the body leads to the standard fearful feelings we all know and loath.

Haloween3Advancements in imaging, such as magnetic resonance imaging (MRI) and positron emission tomography (PET), have helped show the key areas of the brain involved – identifying the Amygdala as fear central. This evolutionarily conserved, almond-shaped group of neurons, located deep within the brain is essential for emotion, decision-making and memory – all crucial features of fear.

The amygdala can be activated by a variety of stimuli that entices any of our senses. As the hub of fear, it is believed to process information about the threat, assesses the level of fear, bringing about an appropriate response. Many studies have confirmed the role of the amygdala in fear using visual stimuli.

Amygdala activation shown using MRI

Conscious fear responses provoked by images of common phobias like snakes and spiders occurs alongside amygdala activation. Interestingly, in the absence of conscious stimuli, the amygdala still becomes activated. In these experiments, subjects were again shown the images but only momentarily so they never actually became aware of the threat. However they still suffered impeding fear alongside enhanced amygdala activity.

So with the amygdala being incredibly crucial for fear on all levels of our consciousness, what would life be like without the amygdala?

Well we are actually able to see. A few years ago a case came to light of a 44 year-old woman who was essentially fearless.

Referred to as “SM”, the woman suffered from an incredibly rare, less then 300 cases ever reported, genetic disorder called Urbach-Wiethe Disease. The disorder affects the extracellular matrix, the cells scaffold, meaning the symptoms vary drastically between cases. Usually the disease causes hardening of the brain and, in the case of SM, progressive degeneration of the amygdala.

The case of SM proved to be a unique way to continue exploring the amygdala. SM’s response to situations, from exposure to her once personal fears, a visit to the world’s scariest house to endless viewing of horror films, shown she failed to experience any sort of fear.

Haloween5While this may seem wonderful, we need to remember fear is essential for survival. Never the attacker, SM has found herself as the victim of numerous crimes in her lifetime, including being threatened at knife point and being involved in an abusive relationship. During these horrific ordeals, while feeling emotions like anger, she has never felt fear. Without amygdala function, SM is vulnerable, unable to sense looming threats

So this Halloween, when you feel fear trickling down your spine, remember the most terrifying fear is not being able to feel fear itself!


Post by: Claire Wilson

Some references to sink your fangs into over Halloween

  • Feinstein, J.S., et al., The Human Amygdala and the Induction and Experience of Fear. Current Biology, 2011. 21(1): p. 34-38.
  • Ohman, A., The role of the amygdala in human fear: automatic detection of threat. Psychoneuroendocrinology, 2005. 30(10): p. 953-8.[1]
  • Ohman, A., et al., On the unconscious subcortical origin of human fear. Physiol Behav, 2007. 92(1-2): p. 180-5.

The Fractal Factor: Patterns in Nature – The Building of the MegaMenger at this year’s Manchester Science Festival

Aristotle once said “In all things of nature there is something of the marvellous.” Living in a world brimming with technology, it is easy to forget the beauty and wonder of the world around us -unless it is accompanied by an Instagram filter, of course.

Despite the glorious diversity of the world we live in, we commonly see naturally occurring image1patterns. While early Greek philosophers were the first to investigate these shapes, the science behind these patterns still draws curiosity now in the 21st century. At the upcoming Manchester Science Festival an attempt to build the world’s largest fractal (the mathematical model behind some these patterns in nature) is taking place in the hope of enthusing and exciting the public about the wonders of maths.

What is a fractal?

How do trees grow? A single root divides into two branches which in turn each divide into two and so on and so forth. In the end the pattern made by a single twig is the same as the complex branches of a giant oak. So no matter at which scale you look at it, the patterns made by the branches are similar, and this self-similarity is mathematically termed a fractal.

image3These self-similar patterns are not only seen in trees, but also rivers and clouds, the cardiovascular system, broccoli – the list is endless. Since the 17th century the mathematics concept underlying these shapes has been investigated, with the mathematician Benoit Mandelbrot coining the term fractal in 1975. He defined a fractal as “a rough or fragmented geometric shape that can be split into parts, each of which is image2(at least approximately) a reduced-size copy of the whole”.

So – in a nutshell – fractals are infinite patterns made by repeating the same process over and over again to form structures which appear the same no matter which scale you look at them. They also happen to be an important and commonly occurring part of the world we live in!

The MegaMenger Project

The 8th annual Manchester Science Festival is set to run from 23rd October to 2nd
November. Showcasing a wide range of playful and imaginative projects to enthuse the public, one of this year’s star attraction events is the building of the MegaMenger. Scatted across twenty cities worldwide, a series of Menger Sponges will be displayed which will hopefully form the world’s largest 3D fractal – the MegaMenger!

How are Menger Sponges made?

Menger Sponges are fractal cubes named after their inventor Karl Menger. To form a Menger Sponge, you begin with a cube and divide it into 27 smaller cubes. Then you remove the smaller cube in the middle of each face and in the very centre of the cube. This is a level-1 Menger Sponge. By simply repeating the process of dividing each of these small cubes and removing central cubes, level-2, level-3 and so on cubes are formed.


In the MegaMenger project, each city will build a level-3 cube. These 3D fractals will be made of 20 cubes, each made of 20 smaller cubes that -you guessed it- are made of another 20 smaller cubes. The smallest cubes are simply made of 6 business cards. Using over a million business cards, the twenty level-3 Menger Sponges will form a distributed level-4 sponge – the largest ever made out of business cards.

How to get involved?

For a week starting from 20th October these fractals will begin to take shape across the world. Here at Manchester Science Festival on the Saturday and Sunday, 24th and 25th October, drop-in sessions are taking place at the Museum of Science & Industry so you can pop by to witness the build in action and find out more about the magic of fractals!

By visiting www.megamenger.com you can get more information about the enormous world record attempt and print off Menger cards so you can make your own 3D fractal.

Happy building!!!!

Useful links

• Manchester Science Festival. http://www.manchestersciencefestival.com/

• More about Fractals. http://fractalfoundation.org/resources/what-are-fractals/

October these fractals will begin to take shape across the world. Here and 25th October, drop-in sessions

Post by: Claire Wilson

HIV baby cure: One year on

HIV1With over 30 million sufferers worldwide, HIV remains the world’s leading infectious killer. The human immunodeficiency virus attacks the immune system, leaving it unable to fight infections, resulting in AIDS. Improving HIV care is one of the top 10 global health priorities. Therefore, when research published last year suggested a baby had been “cured” of HIV; tabloids quickly began to speculate, with some implying the elusive cure may be closer than we imagined. One year on, with similar cases set to be presented at AIDS 2014, the leading international conference on AIDS, what is the significance of this major breakthrough in terms of tackling the large-scale HIV pandemic?

“Absence of Detectable HIV-1 Viremia after Treatment Cessation in an Infant”

HIV2In 2010, a baby was born prematurely to a mother whose HIV was only discovered during delivery.   With no prenatal care, and therefore a high risk of exposure to the virus, the gutsy call was made to begin aggressive treatment with a combination of three antiretroviral drugs at just 30 hours old.  Infection was confirmed soon after and the child remained receiving therapy.

Surprisingly, within days the level of HIV had rapidly diminished and within a month was non-detectable. However, the successful therapy was unexpectedly ceased after 18 months as the mother stopped taking the child to scheduled appointments. When the child was finally examined again, at 23 months, she remained free from infection despite not being on HIV medication. At the time of the paper the child continued to be in remission, gaining the title “the baby cured of HIV”.

Impact on cases involving babies born with HIV

HIV3The doctors quickly emphasised the therapy proposed was a “functional cure”. With the child recently beginning to shown early signs of infection, it appears the treatment silenced the virus for a substantial period of time rather than eliminating it. In reality, cases involving mother-to-baby transmission are rare. Standard HIV pre-natal treatment can lower the risk to 2%.  Therefore in areas where there are a significantly higher number of cases, such as Sub-Saharan Africa, the main factor is the sub-standard levels of health care rather than the need for new treatment.

Is a new, miraculous treatment now available?

HIV4The therapy itself wasn’t novel as it used readily available antiretroviral drugs; the “novel” aspect of the therapy was the early approach. This is already known to be advantageous as early aggressive treatment is thought to prevent viral reservoirs forming. HIV reservoirs are what hide the virus, making it resistant to the both the immune system and medication, and form within hours of infection.

Can adults now be cured of HIV?

There has been speculation that the immune response of a newborn is more suited to cope with HIV than an adults. Not only are babies immune systems immature, resulting in a milder reaction to the virus, but they lack the memory “defender” cells that are the target of the dangerous viral reservoirs. However, last year several adults were reported to have undergone a similar “functional cure”. Having undergone early antiretroviral treatment, 14 out of 70 patients remained virus free for at least 3 years, following cessation of therapy. This suggests that 5%-15% of HIV patients could eradicate the virus through early treatment.

Early treatment plans would not benefit current sufferers but could help tackle new cases. While treating the virus as soon as possible seems like an obvious idea, it appears it would be difficult to implement. Not only do 1 in 5 sufferers remain unaware they are infected, but the stigma associated with HIV means many people are reluctant to get tested. Therefore, before getting excited over the potential of early treatment regimes, the bigger challenge of identifying the infection promptly needs to be addressed.

The “functional cure” has provided hope and opened new areas for scientists to explore. Importantly, it strengthened the idea that early treatment is vital. However bigger social and development issues, involving improving health care in poorer societies and ensuring early identification, need to be addressed before the findings can be translated into the “HIV cure” that has been widely speculated.

Post by: Claire Wilson


Persaud, D., et al., Absence of Detectable HIV-1 Viremia after Treatment Cessation in an Infant. New England Journal of Medicine, 2013. 369(19): p. 1828-1835.

Saez-Cirion, A., et al., Post-Treatment HIV-1 Controllers with a Long-Term Virological Remission after the Interruption of Early Initiated Antiretroviral Therapy ANRS VISCONTI Study. Plos Pathogens, 2013. 9(3).