Quantum biochemical analysis of the binding interactions between a potential inhibitory drug and the Ebola viral glycoprotein.

Ebola virus disease (EVD) causes outbreaks and epidemics in West Africa that persist until today. The envelope glycoprotein of Ebola virus (GP) consists of two subunits, GP1 and GP2, and plays a key role in anchoring or fusing the virus to the host cell in its active form on the virion surface. Toremifene (TOR) is a ligand that mainly acts as an estrogen receptor antagonist; however, a recent study showed a strong and efficient interaction with GP. In this context, we aimed to evaluate the energetic affinity features involved in the interaction between GP and toremifene by computer simulation techniques using the Molecular Fractionation Method with Conjugate Caps (MFCC) scheme and quantum-mechanical (QM) calculations, as well as missense mutations to assess protein stability. We identified ASP522, GLU100, TYR517, THR519, LEU186, LEU515 as the most attractive residues in the EBOV glycoprotein structure that form the binding pocket. We divided toremifene into three regions and evaluated that region i was more important than region iii and region ii for the formation of the TOR-GP1/GP2 complex, which might control the molecular remodeling process of TOR. The mutations that caused more destabilization were ARG134, LEU515, TYR517 and ARG559, while those that caused stabilization were GLU523 and ASP522. TYR517 is a critical residue for the binding of TOR, and is highly conserved among EBOV species. Our results may help to elucidate the mechanism of drug action on the GP protein of the Ebola virus and subsequently develop new pharmacological approaches against EVD.Communicated by Ramaswamy H. Sarma.

Strategies in Medicinal Chemistry to Discover New Hit Compounds against Ebola Virus: Challenges and Perspectives in Drug Discovery.

Ebola Virus (EBOV) is an infectious disease that mainly affects the cardiovascular system. It belongs to the Filoviridae family, consisting of filamentous envelopes and non-segmented negative RNA genome. EBOV was initially identified in Sudan and Zaire (now named the Democratic Republic of Congo) around 1967. It is transmitted mainly by contact with secretions (blood, sweat, saliva, and tears) from infected wild animals, such as non-human primates and bats. It has gained more prominence in recent years due to the recent EBOV outbreaks that occurred from 2013 to 2016, resulting in approximately 28,000 infected individuals, with a mortality rate of 40- 70%, affecting mainly Liberia, Guinea, and Sierra Leone. Despite these alarming levels, there is still no FDA-approved drug for the effective treatment of these diseases. The most advanced drug to treat EBOV is remdesivir. However, it is a high-cost drug and is available only for intravenous use. In this sense, more investments are needed in the research focused on the development of new antiviral drugs. In this context, medicinal chemistry strategies have been improving and increasingly discovering new hits that can be used in the future as a treatment against these diseases. Thus, this review will address the main advances in medicinal chemistry, such as drug discovery through computational techniques (virtual screening and virtual high throughput screening), drug repurposing, phenotypic screening assays, and employing classical medicinal chemistry, such as bioisosterism, metabolism-based drug design, and the discovery of new inhibitors through natural products, thereby presenting several promising compounds that may contain the advance of these pathogens.

A Journey into the Clinical Relevance of Heme Oxygenase 1 for Human Inflammatory Disease and Viral Clearance: Why Does It Matter on the COVID-19 Scene?

Heme oxygenase 1 (HO-1), the rate-limiting enzyme in heme degradation, is involved in the maintenance of cellular homeostasis, exerting a cytoprotective role by its antioxidative and anti-inflammatory functions. HO-1 and its end products, biliverdin, carbon monoxide and free iron (Fe2+), confer cytoprotection against inflammatory and oxidative injury. Additionally, HO-1 exerts antiviral properties against a diverse range of viral infections by interfering with replication or activating the interferon (IFN) pathway. Severe cases of coronavirus disease 2019 (COVID-19), an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are characterized by systemic hyperinflammation, which, in some cases, leads to severe or fatal symptoms as a consequence of respiratory failure, lung and heart damage, kidney failure, and nervous system complications. This review summarizes the current research on the protective role of HO-1 in inflammatory diseases and against a wide range of viral infections, positioning HO-1 as an attractive target to ameliorate clinical manifestations during COVID-19.

Preparedness Tested: Severe Cerebral Malaria Presenting as a High-Risk Person Under Investigation for Ebola Virus Disease at a US Hospital.

In 2019, a 42-year-old African man who works as an Ebola virus disease (EVD) researcher traveled from the Democratic Republic of Congo (DRC), near an ongoing EVD epidemic, to Philadelphia and presented to the Hospital of the University of Pennsylvania Emergency Department with altered mental status, vomiting, diarrhea, and fever. He was classified as a "wet" person under investigation for EVD, and his arrival activated our hospital emergency management command center and bioresponse teams. He was found to be in septic shock with multisystem organ dysfunction, including circulatory dysfunction, encephalopathy, metabolic lactic acidosis, acute kidney injury, acute liver injury, and diffuse intravascular coagulation. Critical care was delivered within high-risk pathogen isolation in the ED and in our Special Treatment Unit until a diagnosis of severe cerebral malaria was confirmed and EVD was definitively excluded.This report discusses our experience activating a longitudinal preparedness program designed for rare, resource-intensive events at hospitals physically remote from any active epidemic but serving a high-volume international air travel port-of-entry.

Small interfering RNA for cancer treatment: overcoming hurdles in delivery.

In many ways, cancer cells are different from healthy cells. A lot of tactical nano-based drug delivery systems are based on the difference between cancer and healthy cells. Currently, nanotechnology-based delivery systems are the most promising tool to deliver DNA-based products to cancer cells. This review aims to highlight the latest development in the lipids and polymeric nanocarrier for siRNA delivery to the cancer cells. It also provides the necessary information about siRNA development and its mechanism of action. Overall, this review gives us a clear picture of lipid and polymer-based drug delivery systems, which in the future could form the base to translate the basic siRNA biology into siRNA-based cancer therapies.

Nanoplasmid Vectors Co-expressing Innate Immune Agonists Enhance DNA Vaccines for Venezuelan Equine Encephalitis Virus and Ebola Virus.

DNA vaccines expressing codon-optimized Venezuelan equine encephalitis virus (VEEV) and Ebola virus (EBOV) glycoprotein genes provide protective immunity to mice and nonhuman primates when delivered by intramuscular (IM) electroporation (EP). To achieve equivalent protective efficacy in the absence of EP, we evaluated VEEV and EBOV DNA vaccines constructed using minimalized Nanoplasmid expression vectors that are smaller than conventional plasmids used for DNA vaccination. These vectors may also be designed to co-express type I interferon inducing innate immune agonist genes that have an adjuvant effect. Nanoplasmid vaccinated mice had increased antibody responses as compared to those receiving our conventional pWRG7077-based vaccines when delivered by IM injection, and these responses were further enhanced by the inclusion of the innate immune agonist genes. The Nanoplasmid VEEV DNA vaccines also significantly increased protection against aerosol VEEV challenge as compared to the pWRG7077 VEEV DNA vaccine. Although all mice receiving the pWRG7077 and Nanoplasmid EBOV DNA vaccines at the dose tested survived EBOV challenge, only mice receiving the Nanoplasmid EBOV DNA vaccine that co-expresses the innate immune agonist genes failed to lose weight after challenge. Our results suggest that Nanoplasmid vectors can improve the immunogenicity and protective efficacy of alphavirus and filovirus DNA vaccines.

Ebola virus disease: An emerging and re-emerging viral threat.

The genus Ebolavirus from the family Filoviridae is composed of five species including Sudan ebolavirus, Reston ebolavirus, Bundibugyo ebolavirus, Taï Forest ebolavirus, and Ebola virus (previously known as Zaire ebolavirus). These viruses have a large non-segmented, negative-strand RNA of approximately 19 kb that encodes for glycoproteins (i.e., GP, sGP, ssGP), nucleoproteins, virion proteins (i.e., VP 24, 30,40) and an RNA dependent RNA polymerase. These viruses have become a global health concern because of mortality, their rapid dissemination, new outbreaks in West-Africa, and the emergence of a new condition known as "Post-Ebola virus disease syndrome" that resembles inflammatory and autoimmune conditions such as rheumatoid arthritis, systemic lupus erythematosus and spondyloarthritis with uveitis. However, there are many gaps in the understanding of the mechanisms that may induce the development of such autoimmune-like syndromes. Some of these mechanisms may include a high formation of neutrophil extracellular traps, an uncontrolled "cytokine storm", and the possible formation of auto-antibodies. The likely appearance of autoimmune phenomena in Ebola survivors suppose a new challenge in the management and control of this disease and opens a new field of research in a special subgroup of patients. Herein, the molecular biology, pathogenesis, clinical manifestations, and treatment of Ebola virus disease are reviewed and some strategies for control of disease are discussed.

Caracterización clínico epidemiológica de pacientes con ébola en un centro de tratamiento de Sierra Leona / Clinical-epidemiological characterization of Ebola disease in patients at a treatment center in Sierra Leone

Introducción: La enfermedad del ébola se dio a conocer por primera vez en 1976, con una letalidad muy elevada en todos los brotes detectados. Objetivo: Caracterizar clínica y epidemiológicamente a los pacientes portadores de la enfermedad por el virus del Ébola. Métodos: Se realizó un estudio observacional, descriptivo y transversal en 424 pacientes ingresados en un centro de tratamiento de ébola en la República de Sierra Leona, África occidental, con el diagnóstico confirmado mediante la técnica de reacción en cadena de la polimerasa para virus Ébola, durante el período de noviembre de 2014 hasta marzo de 2015. Resultados: Se muestra que el grupo etario más afectado fue el de 25 a 34 con un 25,9 por ciento. La mayor letalidad se presentó en los pacientes con más de 65 años de edad con un 44,4 por ciento. El síntoma que prevaleció fue la fiebre para un 61,8 por ciento, y el hipo se presentó en el 88,8 por ciento de los fallecidos. Conclusión: Se concluye que la enfermedad no tuvo distinción significativa con el sexo. La mayor letalidad se presentó en las edades geriátricas. Los síntomas más frecuentes fueron la fiebre, diarrea y el decaimiento. El hipo fue el signo que más se presentó en los pacientes que fallecieron(AU)

Introduction: Ebola disease was first reported in 1976 with a very high lethality in all outbreaks. Objective: To clinically and epidemiologically characterize the patients carriers of Ebola virus disease. Methods: we conducted an observational, descriptive and cross-sectional study in 424 patients admitted to an Ebola Treatment Center in the Republic of Sierra Leone, West Africa from November 2014 to March 2015. The polymerase chain reaction technique for Ebola virus confirmed the diagnosis. Medical records provided all data. Results: The age group most affected was 25 to 34 (25.9 percent). The highest lethality occurred in those over 65 years of age (44.4 percent ). Fever was the prevailing symptom (61.8 percent) and hiccups occurred in 88.8 percent of the deceased. Conclusion: Clinical manifestations were variable, although fever was the main symptom. Hiccup was a sign of poor prognosis when associated with a higher percentage of mortality. Lethality was high(AU)

T-Cell Response to Viral Hemorrhagic Fevers.

Viral hemorrhagic fevers (VHF) are a group of clinically similar diseases that can be caused by enveloped RNA viruses primarily from the families Arenaviridae, Filoviridae, Hantaviridae, and Flaviviridae. Clinically, this group of diseases has in common fever, fatigue, dizziness, muscle aches, and other associated symptoms that can progress to vascular leakage, bleeding and multi-organ failure. Most of these viruses are zoonotic causing asymptomatic infections in the primary host, but in human beings, the infection can be lethal. Clinical and experimental evidence suggest that the T-cell response is needed for protection against VHF, but can also cause damage to the host, and play an important role in disease pathogenesis. Here, we present a review of the T-cell immune responses to VHF and insights into the possible ways to improve counter-measures for these viral agents.

Memorias de un enfermero cubano cara a cara con el Ébola en Guinea Conakry / Memories of a Cuban Nurse face to face with Ebola in Guinea Conakry

Introducción: La enfermedad ocasionada por el virus Ébola ha sido la peor epidemia en África Occidental entre 2014 y 2015, se infectaron más de 27 000 personas, con más de 11 000 muertes en Guinea, Liberia y Sierra Leona. Cuba fue de los primeros países del mun do en dar respuesta al llamado de la Organización Mundial de la Salud y la Organización de Naciones Unidas para enfrentar la epidemia en los países afectados, enviando 256 profesionales Médicos y Enfermeros del Contingente Internacional "Henry Reeve". Objetivo: Exponer la experiencia de un enfermero cubano en el enfrentamiento de la epidemia del virus Ébola en África Occidental. Métodos: La investigación se realizó desde una perspectiva cualitativa, a fin de poner exponer las experiencias vividas por los colaboradores de la Brigada Médica Cubana "Henry Reeve" que enfrentaron la epidemia de Ébola en Guinea Conakry desde octubre de 2014 hasta mayo de 2015. Conclusiones: Los colaboradores regresaron con la satisfacción del deber cumplido, con cero casos confirmados de Ébola en el Centro de tratamiento y en la prefectura de Coyah, se concluyó la misión con una evaluación satisfactoria(AU)

Introduction: The Ebola virus disease has been the worst epidemic in West Africa between 2014 and 2015, more than 27 000 people were infected, with more than 11 000 deaths in Guinea, Liberia and Sierra Leone. Cuba was one of the first countries worldwide to respond to the call of the World Health Organization and the United Nations to confront the epidemic in the affected countries, sending 256 medical professionals and nurses of Henry Reeve International Contingent. Objective: To present a Cuban nurse's experience in confronting the Ebola virus epidemic in West Africa. Methods: The research was conducted from a qualitative perspective, in order to expose the experiences lived by the collaborators of Henry Reeve Cuban Medical Brigade, who confronted the Ebola epidemic in Guinea Conakry from October 2014 to May 2015. Conclusions: The collaborators returned with the satisfaction of the duty fulfilled, with zero confirmed cases of Ebola in the Treatment Center and in the Coyah prefecture; the mission was concluded with a satisfactory evaluation(AU)

On the Regularities of the Polar Profiles of Proteins Related to Ebola Virus Infection and their Functional Domains.

The number of fatalities and economic losses caused by the Ebola virus infection across the planet culminated in the havoc that occurred between August and November 2014. However, little is known about the molecular protein profile of this devastating virus. This work represents a thorough bioinformatics analysis of the regularities of charge distribution (polar profiles) in two groups of proteins and their functional domains associated with Ebola virus disease: Ebola virus proteins and Human proteins interacting with Ebola virus. Our analysis reveals that a fragment exists in each of these proteins-one named the "functional domain"-with the polar profile similar to the polar profile of the protein that contains it. Each protein is formed by a group of short sub-sequences, where each fragment has a different and distinctive polar profile and where the polar profile between adjacent short sub-sequences changes orderly and gradually to coincide with the polar profile of the whole protein. When using the charge distribution as a metric, it was observed that it effectively discriminates the proteins from their functional domains. As a counterexample, the same test was applied to a set of synthetic proteins built for that purpose, revealing that any of the regularities reported here for the Ebola virus proteins and human proteins interacting with Ebola virus were not present in the synthetic proteins. Our results indicate that the polar profile of each protein studied and its corresponding functional domain are similar. Thus, when building each protein from its functional domai-adding one amino acid at a time and plotting each time its polar profile-it was observed that the resulting graphs can be divided into groups with similar polar profiles.

Enfermedad por el virus Ébola medidas de bioseguridad / Ebola virus disease biosafety measures

Resumen El virus Ébola representa el patógeno prototipo de fiebre hemorrágica viral, causando una enfermedad severa de alta tasa de mortalidad. Esta alta mortalidad, combinada con la ausencia de vacunación y de un tratamiento específico, hace que el virus Ébola sea un patógeno importante para la salud pública. La fiebre hemorrágica de Ébola se cree es una zoonosis con persistencia del virus en especies de reservorios encontrados en áreas endémicas. A pesar de todos los esfuerzos realizados en cada brote para identificar los reservorios naturales no se conocen huéspedes potenciales ni los artrópodos vectores. El manejo de los casos está basado en el aislamiento de los pacientes y en el uso de barreras de aislamiento, tales como ropa e implementos de protección como respiradores. Debido a su rápida propagación la OMS declaró que la enfermedad por el virus Ébola representa una emergencia de salud pública más allá de las fronteras y exhortó a la comunidad internacional a tomar las acciones necesarias para detener la epidemia.

Abstract Ebola virus is regarded as the prototype pathogen of viral hemorrhagic fever, causing severe disease and high case fatality rates. This high fatality, combined with the absence ot treatment and vaccination options, makes Ebola virus an important public health pathogen. Ebola hemorrhagic fever is thought to be a classic zoonosis with persistence of the Ebola virus in a reservoir species generally found in endemic areas. Although much effort has been made to identify the natural reservoirs with every large outbreak of Ebola hemorrhagic fever, neither potential hosts norarthropod vectors have been identified. Case management is based on isolation of patients and use of strict barrier nursing procedures, such as protective clothing and respirators. In addition, its rapid propagation has led the Word Health Organization (WHO) to declare on August 2014 that Ebola virus disease represents a public health emergency of international concern and urged the international community to take action to stop its spread.

Enfermedad por el virus del Ébola en el Centro de Tratamiento Coyah / Ebola virus disease at the Coyah Treatment Center

Introducción: la enfermedad por Ébola tiene elevada letalidad y no existe tratamiento efectivo. Es necesario su estudio y estar preparados para el enfrentamiento de futuras epidemias. Objetivo: describir la distribución espacio-temporal y relación con variables de persona, lugar y tiempo, de los pacientes con la enfermedad por el virus del Ébola atendido en el Centro de Tratamiento de Coyah. Métodos: se realizó un estudio descriptivo transversal. El universo lo constituyó los pacientes ingresados (N= 350) en este centro. La información se obtuvo de las historias clínicas. Resultados: se confirmaron casos con Ébola 244 pacientes (69,71 por ciento de positividad), 53,28 por ciento del sexo femenino; la media de edades fue de 30 años; 5 días promedio entre el inicio de los síntomas y el ingreso (mediana de 4 días). El 90,57 por ciento de los enfermos procedía de la región Kindia y 61,07 por ciento de la prefectura Forecariah. El número de pacientes ingresados, según semana estadística, presentó las fluctuaciones características de los brotes epidémicos. En el centro se registraron 133 fallecidos (tasa de letalidad de 54,5 por cada 100 enfermos confirmados). Conclusiones: la elevada confirmación de casos caracterizó la enfermedad, presente fundamentalmente en mujeres jóvenes, con ingreso alrededor de una semana, a partir de los primeros síntomas. La incidencia semanal de casos presentó fluctuaciones características de brotes epidémicos. La tasa de letalidad de la enfermedad fue baja(AU)

Introduction: Ebola disease has a high lethality and there is no effective treatment. It is necessary to study it and be prepared for dealing of future epidemics. Objective: To describe the spatio temporal distribution and relationship with variables of person, place and time of the patients treated at the Ebola Treatment Center in Coyah. Methods: A cross-sectional descriptive study was carried out. The universe were the admitted patients (N= 350) in this Center. The information was obtained from the medical records. Results: Ebola cases were confirmed in 244 patients (69.71 percent positivity), 53.28 percent in females; the average age was 30 years; 5 days average between the onset of symptoms and admission (median of 5 days). 90.57 percent of the patients came from the Kindia Region and 61.07 percent from the Forecariah prefecture. The number of patients admitted, according to statistical week, presented the characteristic fluctuations of epidemic outbreaks. In the center there were 133 deaths (case fatality rate of 54.5 per 100 confirmed patients). Conclusions: The high confirmation of cases characterized the disease, present mainly in young women, with admission around the week, from the first symptoms. The weekly incidence of cases showed characteristic fluctuations of epidemic outbreaks. The case fatality rate was low(AU)

An immunoinformatics-derived DNA vaccine encoding human class II T cell epitopes of Ebola virus, Sudan virus, and Venezuelan equine encephalitis virus is immunogenic in HLA transgenic mice.

Immunoinformatics tools were used to predict human leukocyte antigen (HLA) class II-restricted T cell epitopes within the envelope glycoproteins and nucleocapsid proteins of Ebola virus (EBOV) and Sudan virus (SUDV) and the structural proteins of Venezuelan equine encephalitis virus (VEEV). Selected epitopes were tested for binding to soluble HLA molecules representing 5 class II alleles (DRB1*0101, DRB1*0301, DRB1*0401, DRB1*0701, and DRB1*1501). All but one of the 25 tested peptides bound to at least one of the DRB1 alleles, and 4 of the peptides bound at least moderately or weakly to all 5 DRB1 alleles. Additional algorithms were used to design a single "string-of-beads" expression construct with 44 selected epitopes arranged to avoid creation of spurious junctional epitopes. Seventeen of these 44 predicted epitopes were conserved between the major histocompatibility complex (MHC) of humans and mice, allowing initial testing in mice. BALB/c mice vaccinated with the multi-epitope construct developed statistically significant cellular immune responses to EBOV, SUDV, and VEEV peptides as measured by interferon (IFN)-γ ELISpot assays. Significant levels of antibodies to VEEV, but not EBOV, were also detected in vaccinated BALB/c mice. To assess immunogenicity in the context of a human MHC, HLA-DR3 transgenic mice were vaccinated with the multi-epitope construct and boosted with a mixture of the 25 peptides used in the binding assays. The vaccinated HLA-DR3 mice developed significant cellular immune responses to 4 of the 25 (16%) tested individual class II peptides as measured by IFN-γ ELISpot assays. In addition, these mice developed antibodies against EBOV and VEEV as measured by ELISA. While a low but significant level of protection was observed in vaccinated transgenic mice after aerosol exposure to VEEV, no protection was observed after intraperitoneal challenge with mouse-adapted EBOV. These studies provide proof of concept for the use of an informatics approach to design a multi-agent, multi-epitope immunogen and provide a basis for further testing aimed at focusing immune responses toward desired protective T cell epitopes.

A Perspective on the Development of Plant-Made Vaccines in the Fight against Ebola Virus.

The Ebola virus (EBOV) epidemic indicated a great need for prophylactic and therapeutic strategies. The use of plants for the production of biopharmaceuticals is a concept being adopted by the pharmaceutical industry, with an enzyme for human use currently commercialized since 2012 and some plant-based vaccines close to being commercialized. Although plant-based antibodies against EBOV are under clinical evaluation, the development of plant-based vaccines against EBOV essentially remains an unexplored area. The current technologies for the production of plant-based vaccines include stable nuclear expression, transient expression mediated by viral vectors, and chloroplast expression. Specific perspectives on how these technologies can be applied for developing anti-EBOV vaccines are provided, including possibilities for the design of immunogens as well as the potential of the distinct expression modalities to produce the most relevant EBOV antigens in plants considering yields, posttranslational modifications, production time, and downstream processing.

Clinical Features and Outcome of Ebola Virus Disease in Pediatric Patients: A Retrospective Case Series.

Clinical and outcome data on pediatric Ebola virus disease are limited. We report a case-series of 33 pediatric patients with Ebola virus disease in a single Ebola Treatment Center in 2014-2015. The case-fatality rate was 42%, with the majority of deaths occurring within 10 days of admission.

The Cuban Response to the Ebola Epidemic in West Africa: Lessons in Solidarity.

In December 2013 the first case of Ebola appeared in Guinea. In September 2014 the United Nations (UN) and its specialized agency the World Health Organization (WHO) issued a call for medical collaboration in response to the medical crisis and social disaster caused by the Ebola virus epidemic in West Africa. Cuban authorities responded immediately to the call by offering specialized help for the epidemic, in collaboration with WHO. A group of 256 Cuban doctors, nurses and other health professionals provided direct care during the Ebola epidemic in Sierra Leone, Liberia and Equatorial Guinea from October 2014 to April 2015. This paper explains the main features of the Cuban health system, describes the development of Cuba's international medical cooperation approach, and highlights the work done by Cuban health collaborators in addressing the damage caused by the Ebola epidemic. Information used includes reports and documents of the Ministry of Public Health of Cuba, reports of WHO and PAHO, and articles published in scientific journals and newspaper articles. The response of the Cuban medical teams to the Ebola epidemic in West Africa is only one example of the Cuban efforts to strengthening health care provision in areas of need throughout the world.

Avances científicos en las estrategias terapéuticas contra la enfermedad por virus del ébola / Scientific advances in therapeutic strategies against disease by ebola virus

La enfermedad por el virus del Ébola se conoce desde hace treinta años como mortal, contagiosa y de difícil diagnóstico y tratamiento. Numerosos estudios se han realizado para comprender la patogénesis del virus y con ello los posibles tratamientos que puedan generar control de la enfermedad. Sin embargo, no hay hasta la fecha un fármaco o vacuna con licencia para combatir el virus del Ébola. El tratamiento está basado solo en aliviar los síntomas y prevenir el contagio por medio de acciones que ayuden a minimizar el riesgo de infección. En esta revisión, se presentan las diferentes perspectivas del estado actual de la investigación sobre fármacos antivirales y vacunas en fases de desarrollo para la infección del virus del Ébola.

Ebola virus disease has been known for thirty years as a lethal, contagious and difficult to diagnose and treat disease. Numerous studies have been conducted to understand the pathogenesis of the virus and thus the possible treatments that may promote disease control. However, to date there is no licensed vaccine or medicine to fight Ebola virus. The treatment is based only on relieving symptoms and preventing contagion through actions that help minimize the risk of infection. This review presents different perspectives of the current state of research on antiviral medicine and vaccines in development stages for Ebola virus infection.

Problemas éticos y de salud planteados por la reciente epidemia de Ébola: ¿Qué debemos aprender? / Ethical and health issues posed by the recent Ebola epidemic: What should we learn?

The recent Ebola epidemic that affected several countries in Africa, with very high mortality and a pandemic threat, posed problems of justice, public health, prevention, treatment and research, each of which has relevant ethical issues. Despite severe initial difficulties, an effective international response was achieved, whose outcome has left significant teachings to be considered in order to deal with future epidemics or pandemics. In this article, the authors analyze the main problems faced during the Ebola epidemic, including the unequal distribution of health resources between countries, the need for international collaboration, the requirement for a review of the ethical standards of clinical trials in emergencies, and the necessity of an organized global system of prevention and timely response to these outbreaks. Authors conclude that at the present time health is a global issue without borders, that insufficient healthcare resources in some countries poses risks and affects all countries and that the confrontation of the threats of epidemics requires a solution based in universal solidarity. At the same time, a moral duty to investigate should be acknowledged, seeking a balance between sense of urgency, scientific rigor and involvement of local communities.