Ebola, the ZMapp Serum, and the Changing Dr. Brantley Story

a reply to: loam

So we go back to what I said earlier, and CNN also now says it...

Brantly asked that Writebol be given the first dose because he was younger and he thought he had a better chance of fighting it, and she agreed. However, as the first vial was still thawing, Brantly's condition took a sudden turn for the worse. Brantly began to deteriorate and developed labored breathing. He told his doctors he thought he was dying, according to a source with firsthand knowledge of the situation.

Knowing his dose was still frozen, Brantly asked if he could have Writebol's now-thawed medication. It was brought to his room and administered through an IV. Within an hour of receiving the medication, Brantly's condition dramatically improved. He began breathing easier; the rash over his trunk faded away. One of his doctors described the events as "miraculous."

a reply to: AlphaHawk

Of course Brantly knew there were two doses and initially may have offered the first thawing vial up. Although, I really don't understand why both couldn't have been thawed at the same time.

But in any event, Graham said there was only enough serum for one person before the vials had even arrived at the hospital.

I honestly really don't get what you are saying? If you have two vials in a shipment, then why not say so? Graham chose not to disclose there was enough serum for both parties, regardless of who would or did take it first.

originally posted by: loam
a reply to: Staroth

Exactly.

According to a CDC spokesperson testing for Ebola takes 1-2 days after they receive the samples. The primary testing is PCR. This is performed on blood that has been treated to kill and live virus. So far CDC has tested samples from around 6 people who had symptoms consistent with Ebola and a travel history to the affected region.

Link.

But the UK announced almost immediately that she was negative. Of course, no mention too that rapid tests commonly produce false negatives. Brantley, Sawyer, & Nshamdze all tested negative on their first tests.

How commonly are these false negatives produced in these rapid tests?

There is a scientific report from 2002 saying that they can occur in people in the acute stages of a hemmoragic fever but just how common is it? According to doctors this woman did not have a hemmorhagic fever. I think this should be confirmed before deciding that all Ebola testing we hear about must be producing false results.

That study also reccmends testing dilute samples to overcome the problem, that was 12 years ago so why believe the testing methods are based on old outdated methods?

a reply to: DrHammondStoat

originally posted by: DrHammondStoat
How commonly are these false negatives produced in these rapid tests?

I haven't been able to track down a precise answer yet, but....

Brantley initially tested negative.

Sawyer initially tested negative.

Nshamdze initially tested negative.

All three had Ebola.

False-Negative Results of PCR Assay with Plasma of Patients with Severe Viral Hemorrhagic Fever

The more I read about Ebola the more it sounds man-made and strategically released so that the world would watch and get very frightened - and then bumph! a vaccine against it.

If that scenario does turn out to be the truth in the long run, I really do think that this is the lowest of the low for a money making scheme. The more populous we get, the more the threat of Ebola and other diseases becomes.

originally posted by: loam
a reply to: kruphix

The news stories didn't just conflict, the SOURCE's story did. Do your research and read the quotes from Samaritan and the CDC.

"Experimental drug likely saved Ebola patients
By Dr. Sanjay Gupta and Danielle Dellorto, CNN
updated 10:17 PM EDT, Mon August 4, 2014"

: us.cnn.com...

Unless I'm missing something this story doesn't have any direct quotes from the CDC .
we are told

"It's believed Brantly and Writebol, who worked with the aid organization Samaritan's Purse, contracted Ebola from another health care worker at their hospital in Liberia, although the official Centers for Disease Control and Prevention case investigation has yet to be released.'

and

Brantly and Writebol were aware of the risk of taking a new, little-understood treatment and gave informed consent, according to two sources familiar with the care of the missionary workers.

So we have a piece based on info. from an anonymous source and interpreted by the journalists at CNN. ANY news story is subject to the interpretation and manipulation of the journalist who writes it whether it contains direct quotes or not.

News stories differ for the above reasons so I dont see how people are shocked at this. One vial of this serum being thawed and ready before the others is a perfectly logical explanation for the 'discrepancy' in reports. The person from Samaritans purse may have been focussed exclusively on what was avaialble at the time he was interviewed which is understandable given the fast acting nature of this disease, so he said 'only one was available' - at the time of the interview.

Again it comes down to interpretation by reporters.

originally posted by: loam
a reply to: DrHammondStoat

originally posted by: DrHammondStoat
How commonly are these false negatives produced in these rapid tests?

I haven't been able to track down a precise answer yet, but....

Brantley initially tested negative.

Sawyer initially tested negative.

Nshamdze initially tested negative.

All three had Ebola.

False-Negative Results of PCR Assay with Plasma of Patients with Severe Viral Hemorrhagic Fever

I didn't know about those three testing negative so thanks for that info!

This raises the question though, if the false positives in the study from 2002 are caused by the acute stages of Ebola, why did Brantly test negative in what appeared to be an early stage?

I haven't looked at the others yet but could there be other explanations for why they tested negative? I sincerely hope it is not because of something unusual or dare I say it some kind of mutation of the virus. Hopefully someone with a better knowledge of these could say what would casue negatives results in the early stages.

a reply to: DrHammondStoat

You need to start reading here.

Direct from the source.

Hope that explains it.

a reply to: DrHammondStoat

I'm assuming the field test is very unreliable at any stage. The PCR test described above is the one the CDC is using and takes two days.

So short answer is they all seem unreliable.

I have looked into Brantley , Sawyer and Nshamdze initially testing negative.

I can't find any mention of Sawyer testing negative for Ebola , it seems he got negative results only on HIV and Malaria.

hospital officials say, he was tested for both malaria and HIV AIDS. However, when both tests came back negative, he was then asked whether he had made contact with any person with the Ebola Virus, .........

...... Back in Lagos, authorities at the First Consultants Hospital in Obalende decided that despite Sawyer’s denial, they would test him for Ebola, due to the fact that he had just arrived from Liberia, where there has been an outbreak of the disease with more than 100 deaths. The hospital issued a statement this week stating that Sawyer was quarantined immediately after he was discovered to have been infected with the deadly virus.

www.frontpageafricaonline.com...

Still Patrick Nshamdze was tested in Africa and it came back negative , Brantley's initial test came back negative too.

I suppose it's possible that testing in Western hospitals may be better, but we still can't say that all Ebola tests are subject to this false positive effect, I don't think it was the case for Sawyer at all, as he seems to have got a positive result.

originally posted by: loam
a reply to: DrHammondStoat

You need to start reading here.

Direct from the source.

Hope that explains it.

I thought you were basing things on the difference between quotes from the CDC and Samaritans purse?

Franklin Graham is the Samaritans purse source and the other article in your OP doesn't have quotes from the CDC, just an anonymous source...... so no, I don't see how any 'official' sources are contradicting each other.

Interesting side note...this source says there were three vials:

Meanwhile, a source familiar with details of the treatment said that three top secret, experimental vials stored at subzero temperatures were flown into Liberia last week in a last-ditch effort to save two American missionary workers who had contracted the virus.

Link.

originally posted by: DrHammondStoat

Again it comes down to interpretation by reporters.

I have a few issues with this statement.

1. That dog don't hunt anymore.
2. Calling the reporters implying that they are journalists isn't flying anymore.
3. Irresponsible reporting is dangerous and so is being an apologist for it.
4. People who apply this rule to only what they want to believe are dangerous too.
5. All the more reason to keep questioning them and their "stories" and intentions.

If true, could the third have been intended for Sawyer?


a reply to: loam
If true, think the third vial could the third have been intended for Sawyer?

originally posted by: loam
a reply to: DrHammondStoat

I'm assuming the field test is very unreliable at any stage. The PCR test described above is the one the CDC is using and takes two days.

So short answer is they all seem unreliable.

Sorry I have to be pedantic here, the study you are referring to was from 2002. I don't believe it is the exact test the CDC are using, a similar type yes but things have moved on from there.

There are later studies.

Currently there are no commercial kits for diagnosis of VHFs, but a number of different diagnostics are available at specialized laboratories. Nowadays, early diagnosis is mainly based on direct detection of viral antigens or RNA. In particular the United States Army Medical Research Institute of Infectious Diseases [9] (2010) and New York Columbia University [10,11] (2006) , have recently developed multiplex PCR assays for specific detection of multiple VHFs. Although field data are limited (available only for Lassa), these systems have been evaluated for the detection of a consistent number of different agents form viral cultures, such as Ebola, Marburg, Lassa, Machupo, Junin, Sabia, Guanarito, Andes and Sin Nombre.

www.biomedcentral.com...



and this one from 2004 seems to be a seminal study, I believe the CDC would be aware of it's findings and reccomendations.

The intersting thing here is that false positives occur too, so whilst people are worried about reports of people testing negative for Ebola not being true, by that logic shouldn't this also cast doubt on anyone that tests positive?

The data presented here also illustrate the drawback of the reliance on any single diagnostic assay alone, including the RT-PCR assay, for EHF diagnosis. The most serious shortcoming of the RT-PCR assay is the greater ease with which false positives and false negatives can be generated.
A nested assay is especially prone to template contamination because there is the extra high-risk step of physically opening the first-round reactions, thus increasing the potential exposure to high concentrations of DNA amplicons. This risk may increase as the outbreak continues, as more and more positive samples are analyzed. In this outbreak, there were three PCR+ Ag− samples that by analysis of duplicate samples were later shown to be falsely positive by PCR. Most of the potentially false-positive samples occurred in the later stages of the outbreak.
The individuals from whom the 10 unresolved samples were taken were unavailable for subsequent sampling to verify or disprove the initial results. While a false positive can clearly put an individual at unnecessary risk by causing the person to be placed in a high-risk environment (e.g., an Ebola isolation ward), more serious consequences can occur from false negatives. With a false-negative result, a person may be released into the community with the understanding that they do not have EHF, when in fact they have the potential to become highly contagious and, at least initially, assume their symptoms are not due to EHF.

Because of the serious potential for false positives and negatives, we do not rely solely on a single diagnostic test but instead on a collection of tests that together establish a laboratory diagnosis. For instance, sole reliance on the first RT-PCR assay (using the Filo A and B primers) used in the beginning phase of the outbreak would have led to the initial misclassification of 19 of 46 samples. The false negatives could have resulted for a number of reasons, which include but are not limited to inhibitor contamination of the RNA preps, a low copy number of the target sequence (particularly in the first days after the onset of symptoms in nonfatal cases), and nucleotide mismatches between primer and target sequences that are a result of the unique genetic identity of the particular ebolavirus strain. In addition, the RNA extractions were performed under suboptimal conditions, as ice was not available and the ambient temperature was often ≥30°C. The first point, regarding inhibitor or protein contamination, can easily be dealt with in the laboratory by repurification of the sample and/or dilution of the RNA prior to analysis (10)

www.ncbi.nlm.nih.gov...

Also from this study it is confirmed that testing in hot temperatures increases false negatives and positives , which obviously wouldn't be a problem in the USA or Europe and some of these problems can be 'easily dealt with'. It is also reccomended that this single test is not relied upon, so do we believe the CDC only do this test and have ignored such reccomendations?

And what about the actual number of false negatives? Unless my interpretation is wrong, this study had 10 false negatives out of 246.

Of the 246 PCR-positive (PCR+) samples, 196 were concordant with the antigen-capture assay (i.e., PCR+ Ag+), leaving 50 samples that were discordant with the antigen-capture assay (PCR+ Ag−). Among the 50 discordant samples, 17 (representing 13 patients) were obtained very early in the acute phase of disease, just after the onset of symptoms but prior to testing positive by antigen capture (early detection) in subsequent samples. Another 20 PCR+ Ag− specimens (representing 18 patients) were obtained during the convalescent phase, coincident with IgM (data not shown) and/or IgG responses. These convalescent-phase patients often remained PCR positive for 24 to 48 h (the maximum interval was 72 h) after clearing detectable antigen.The remaining 13 discordant samples represented potential false positives, as determined by using the antigen-capture ELISA as the reference standard (assuming no antigen false positives) to which the RT-PCR assay was compared. Three of the potential false-positive samples were later proven to be PCR− Ag− by testing of duplicate samples from the same patient, and 10 were unresolvable due to the lack of additional confirmatory samples.

So by my reckoning based on that study that's around 4% of results not being accurate? Maybe we should not presume there are alot of false positives, at least not in testing in the US or Europe.

Some more info just in regarding the Serum -

www.businessweek.com...

Very interesting article. Seems there are quite a few companies involved in this, and it seems it's been going on for quite a while too.

The antibody work came out of research projects funded more than a decade ago by the U.S. Army to develop treatments and vaccines against potential bio-warfare agents, such as the Ebola virus, Arntzen said in a telephone interview.

originally posted by: ~Lucidity

originally posted by: DrHammondStoat

Again it comes down to interpretation by reporters.

I have a few issues with this statement.

1. That dog don't hunt anymore.
2. Calling the reporters implying that they are journalists isn't flying anymore.
3. Irresponsible reporting is dangerous and so is being an apologist for it.
4. People who apply this rule to only what they want to believe are dangerous too.
5. All the more reason to keep questioning them and their "stories" and intentions.

If true, could the third have been intended for Sawyer?


a reply to: loam
If true, think the third vial could the third have been intended for Sawyer?

It does not make me an apologist for bad or irresponsible reporting just because I've pointed out that people are human and interpret what they hear and see differently, these are subconcious biases that we all have. I had absolutely no agenda what so ever by using the words reporter and journalist in one statement, they are words which have a similar meaning.

It doesn't mean that these people have a nefarious agenda just because they interpret information differently than someone else.

Neither am I a person that doesn't question things, I just like to consider more than one angle. ie. the OP says that the narrative has changed in an attempt to mislead us....another interpretation is that the information has been interpreted inccorrectly. I can't say 100% which one of those it is. So I am questioning the theory put forth here by the OP and people question mine, it's called debate.

originally posted by: grantbeedSeems there are quite a few companies involved in this, and it seems it's been going on for quite a while too.

Mapp Reynolds Tekmira Monsanto NIH JPM-MCS

www.tekmira.com...

They partner and share a lot.

www.mappbio.com...

Thanks OP for the post! I immediately sent a link to my coworkers since we're all following this closely. Obviously, we're not being told everything. It's all a lie and sooner or later # will hit the fan.

a reply to: loam
One vial - Two vials - Three?
But in all the huh-bub...we lose track of the ebola-surviving-boy that donated a unit of blood to save the life of the doctor that saved his own...
So - did Brantley get the boy's blood...AND the serum?
Or...just the serum?

If just the serum... Where'd the story about the survivor-turn-savior come from?

originally posted by: loam
a reply to: WanDash

Except the primary SOURCES for these stories is Samaritans and the CDC. The contradictions come from THEM.

THEY said one thing.....and then another completely different thing.

Yea, imagine that. lol

I don't think any of us in the general public will ever get the entire story, nor the facts.

And I would wager if we do it will be distortion at best.