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WHO: 1 new Ebola case reported; treatments on the ground in DRC

Four out of five experimental Ebola treatments are on the ground in the Democratic Republic of the Congo and being administered under compassionate use, World Health Organization officials said.

One new case of the viral hemorrhagic disease was recently reported, adding to a tally of 62 confirmed or likely cases, including 27 deaths, across two rural regions and one city, Mbandaka, in the DRC.

The WHO is "cautiously optimistic" that Mbandaka's outbreak is under control after four confirmed cases, but the new case in the rural Eboko zone means that it is important to recognize that the spread of the disease is ongoing, said Peter Salama, deputy director-general of emergency preparedness and response, in a press conference exactly one month after the agency first reported the outbreak.

The four experimental therapies in the DRC have been ranked based on the availability of data, said Vasee Moorthy, WHO research coordinator, department of research, ethics and knowledge management.

An expert panel concluded that Mapp Biopharmaceutical Inc.'s ZMapp, a monoclonal antibody used in the 2014 western Africa epidemic, has the highest-quality data, followed by Gilead Sciences Inc.'s remdesivir, or GS 5734, an antiviral medicine.

Regeneron Pharmaceuticals Inc.'s REGN-EB3, or REGN3470-3471-3479, was deemed "very promising" and an option if ZMapp and remdesivir are not available. Officials emphasized that concerted efforts should be made to study it in in clinical trials.

FUJIFILM Holdings Corp.'s favipiravir, an antiviral medicine, was next on the priority list, with experts noting "considerable uncertainty" around its benefits. The U.S. National Institutes of Health's mAb114 was last on the list as it is in the early stages of development. Only favipiravir is not in the DRC at the moment, Salama said.

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"We're using the drugs under something called compassionate use, not under research protocol, and the major aim is to carefully monitor their use, for the purposes of improving the treatment outcomes and survival," Salama said. The agency announced their approval June 6, authorizing their use when patients are informed of their experimental status.

Worst-case scenario

The WHO released its regional preparedness plan — an outline for planning and emergency measures in nine neighboring countries — a day ahead of the press conference.

THe health organization said it will need $15.5 million over nine months to support its plan, which includes working with ministries of health to build surveillance and laboratory systems, screening processes and emergency response protocols.

Its main priorities are preparing the Republic of the Congo, which shares a long, porous river border with the DRC, and the Central African Republic, where conflict and poor infrastructure make an outbreak there "one of the worst-case scenarios," Moorthy said.

In the DRC, tracing the contacts that a person infected with Ebola has had over the course of the disease "has been a huge challenge," Salama said, adding that despite these challenges, "it's extremely likely that the vaccine has had a positive impact."

The agency began vaccinating contacts with Merck & Co. Inc.'s experimental V920 in May and recently said company officials would explore adding Johnson & Johnson's Ad26.ZEBOV, a two-dose pipeline vaccine, with Bavarian Nordic's MVA-BN-Filo to their arsenal.

"This is the hardest work in this outbreak response, to document every chain of transmission," Salama said. "We're not in a position to say that we've documented every chain of transmission."