Ebola is a devastating disease, but hope for a treatment may rest within the blood of survivors—along with the prospect of building stronger blood systems for the West African countries overwhelmed by the recent outbreak.
When Ebola broke out in West Africa last year, the region’s fragile health systems could not cope. That is one reason why the virus spread so quickly, and proved so devastating, particularly in the hardest-hit countries: Guinea, Liberia, and Sierra Leone.
By mid-April 2015, more than 10,800 people in these countries lost their lives to Ebola, and more than 26,000 cases had been reported, according to the World Health Organization (WHO).
Now that new cases are dwindling, the WHO and other international organizations are investing more resources towards clinical trials to explore treatment options and pledging to help rebuild the region’s health systems before another crisis erupts. Blood testing and donation systems are an important part of that effort, and the fact that blood may hold a key to a cure for Ebola has attracted the funders necessary to bring critical improvements, including the Bill and Melinda Gates Foundation and the Safe Blood Africa Foundation. Stanford Blood Center donors in the past have supported efforts to strengthen blood systems overseas as well, such as work through the which helped send essential equipment to Nigeria.
Even before the 2014 Ebola outbreak, blood systems in the region had old, broken-down equipment and lacked the personnel needed to safely collect and process blood, the WHO reported, and the systems virtually fell apart when the outbreak hit. Journalist Amy Maxmen visited a blood bank in Sierra Leone, and described what she saw in an article for Al Jazeera: “At the country’s blood-bank headquarters in Freetown, a single rusted refrigerator stores donor blood and a lab technician enters data into an outdated computer. In the eastern region of the country, the main blood bank suffers from unreliable electricity. The director points to a handwritten log of the days when the refrigerator went down and stored blood went bad.”
In addition to improving the equipment and training personnel, more voluntary (unpaid) donors are needed in Guinea and Liberia. Before the Ebola outbreak, only about 10% of the blood supply in these countries came from voluntary donors … and after Ebola that number slipped to 4% in Guinea. Sierra Leone had boosted its voluntary blood donor rate to 44% pre-Ebola; now it has fallen to 10-15%, the WHO reports.
There is hope for general strengthening of the blood systems, though, nested within the international community’s resolve to rebuild the region’s health systems and with clinical trials involving the use of plasma as a treatment underway in Guinea, Liberia, and Sierra
With the recent Ebola outbreak, the lack of effective drugs renewed interest in another possible treatment: the use of convalescent plasma as a therapy. It stems from the hope that plasma from survivors contains antibodies that help fight the virus; this plasma could be transfused in currently infected patients and potentially be an effective treatment in future outbreaks. An earlier trial in 1995, described in the Journal of Infectious Diseases, pointed to successful results. There is anecdotal evidence from people treated with the therapy in the current outbreak … but those patients also received aggressive supportive care and experimental drugs, making it hard to pinpoint the role the transfusions played in their recovery.
The early results from the controlled trials underway in the region look promising and the prospect holds great appeal for use in West Africa, more so than expensive drug prospects. It would be far easier to implement in poor countries, freeing them from dealing with drug manufacturer . is also the hope that using virus-inactivated plasma, a process detailed in a report published in Emerging Infectious Diseases (EID), could alleviate the testing burden for poor countries, which struggle to screen donated blood for viruses like HIV.
The current Ebola outbreak won’t be over until West Africa reports zero cases, but now is the time for the international community to work hard to be better prepared the next time and the recent push for innovative treatments and stronger blood systems reinforces what all Stanford Blood Center donors know: the lifesaving power of blood.