# Ebola Virus BDBV Fundamentals and Best Hope for Treatment

## Метаданные

- **Канал:** MedCram - Medical Lectures Explained CLEARLY
- **YouTube:** https://www.youtube.com/watch?v=E2Mpl4IUCdo
- **Дата:** 28.05.2026
- **Длительность:** 21:32
- **Просмотры:** 27,072

## Описание

Roger Seheult, MD of MedCram explores the fundamentals of Ebola virus and the best hope for treatment, especially of the BDBV species. See all Dr. Seheult's videos at: https://www.medcram.com/

(This video was recorded on May 28th, 2026)

Roger Seheult, MD is the co-founder and lead professor at https://www.medcram.com/

He is Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine and an Associate Professor at the University of California, Riverside School of Medicine.


LINKS / REFERENCES:

US taps small San Diego biotech for experimental Ebola treatment as epidemic worsens (Fierce) | https://www.fiercebiotech.com/biotech/us-taps-small-san-diego-biotech-experimental-ebola-treatment-epidemic-worsens?utm_medium=email&utm_source=nl&utm_campaign=LS-NL-FierceBiotechResearch

Mapp Bio stays mum during Ebola media storm (Fierce) | https://www.fiercebiotech.com/biotech/mapp-bio-stays-mum-during-ebola-media-storm

A Two-Antibody Pan-Ebolavirus Cocktail Confers Broad Therapeutic Protection in Ferrets and Nonhuman Primates (Cell) | https://www.cell.com/cell-host-microbe/fulltext/S1931-3128(18)30632-2


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#ebola #virus #outbreak

## Содержание

### [0:00](https://www.youtube.com/watch?v=E2Mpl4IUCdo) Segment 1 (00:00 - 05:00)

Med Cram dot com. Welcome to another Med Cram video. We're going to talk about the Bundibugyo Ebola outbreak in the Democratic Republic of Congo. This is going on in Central Africa. It has spread somewhat into Uganda, and this is an area that is war-torn, and diagnostics and treatments is difficult. And so, it seems as though this outbreak has accelerated faster than we would have liked it to before actually getting a handle on it. There are now travel restrictions for people coming from that area, and screening that needs to happen when people are traveling from that area. This is not an airborne virus. It is spread by bodily contact with fluids, and we're going to talk a little bit more about it today. And specifically, we're going to talk about one of our best hopes at actually treating this particular virus, and we'll talk about some of the evidence here in this video. But first, let's talk about some of the basics here. The first thing that you need to know is that there's actually a lot of different viruses that are known as, quote, Ebola viruses. So, we need to show the different species of Ebola viruses. The first one is Zaire, which is abbreviated as EBOV. The next one is Sudan, and of course, these are named after where they were discovered. And this is SUDV, and that's not the one that we're dealing with currently. And the last one is the Bundibugyo, and that one is abbreviated BDBV. There are others, but these are the main ones that you should know about. They are in different locations in Africa, but this is the current one that we are dealing with right now here in May of 2026. This was first recognized in 2007 in Western Uganda, and specifically in the Bundibugyo district in Western Uganda. This was in 2007-2008, and the discovery paper at that time reported that it was a new Ebola virus species genetically distinct from the other ones by at least 30% at the genome level. And this is important because if you have tests that are specifically looking at these Ebola viruses, you're going to get a negative results if you're testing it that way. So you have to use tests that are inclusive of all of these viruses or specifically one that is designed for this particular Ebola virus. That first outbreak that occurred, there was about 116 confirmed cases. In one investigation, the case fatality rate back then in 2007 was 34%. There was another lab confirmed analysis reported 43 acute phase confirmed cases with 17 deaths or about a case fatality rate of 40%. And the second known after 2007 was actually in the Democratic Republic of Congo in 2012. So we've seen that type of outbreak and at that time there was only 59 cases and 34 deaths. So we have far exceeded that at this point with well over 2-300 cases and climbing. And actually as of now on May 26th, the deaths have risen over 220 and suspected cases are near a thousand at this point. Just for the specifics, the WHO says that the DRC and Uganda declared a BDBV outbreak on May 15, 2026 and the WHO declared a public health emergency of international concern on May 17, 2026. As of the May 21st update, again there was 700, so we're now talking about May of 2026. We see here on May 21st 746 suspected cases with 176 deaths. Those numbers are going up rapidly at this point. Let's talk about transmission. And it's important to understand this that transmission is direct contact with blood or body fluids. So specifically, what are the highest risk settings? It's when you're at bedside care without any kind of personal protective equipment. It's at healthcare facilities and it's specifically handling the dead bodies for burial afterwards. And there's been some interesting situations where the hospitals have refused to release the bodies and families have become very upset because they are not able to have the body for burial. And there's been some camps and some structures that have been put up for healthcare purposes that have been burned down. What about incubation? Basically, I remember it as two days to three weeks. So 2 to 21 days is basically the incubation. However, when they've looked at this before, the average incubation period was about 6 and 1/2 days. In terms of reservoirs, there's really no distinctive data that we can point to and say specifically that's where it is. However, they have done testing looking for RNA material in

### [5:00](https://www.youtube.com/watch?v=E2Mpl4IUCdo&t=300s) Segment 2 (05:00 - 10:00)

different populations and also antibodies in asymptomatic animals. And the leading suspects would be the fruit bats, although we don't have definitive evidence of that at this point. Let's talk about diagnostics. Part of that are symptoms. Symptoms are pretty non-specific. So it starts off with fever, fatigue, myalgias, headache, sore throat, and it can progress to advanced symptoms like vomiting, diarrhea, abdominal pain, organ dysfunction. So depending on which organ, if it's the liver, that'll look different than if it's the heart, that'll look different if it's the lungs. Then that progresses to shock and sometimes bleeding. So not everybody gets bleeding, but sometimes it leads to that. The average incubation period was 6 and 1/2 days. So essentially, in terms of lab tests for diagnostics, you're talking about PCR. The key here is that there is a Zaire specific Ebola virus, and that is going to cause you to get a false negative if you use it for the Bundibugyo Ebola. So, do not use that one. There is a pan filovirus Ebola assay, which looks at all of the different viruses that we talked about, and that would be positive. So, again, do not use the GeneXpert Ebola assay. Do not, because that's going to give you a false negative. What you need to use is the pan filovirus Ebola assay. Okay, let's talk about vaccines or treatment. So, there is a vaccine that is licensed for Ebola virus called Ervebo, and there's also some treatments that are actually FDA-approved called Inmazeb and also Ebanga. The problem is that all of these are only for the Zaire Ebola virus. They do not work for the Bundibugyo Ebola virus. So, none of these are available. So, what we're saying here is that there is no approved vaccine or treatment for this particular virus, the Bundibugyo Ebola virus. And so, instead, what we have to rely on here is good supportive care. And what do we mean by that? We mean fluids when the patient is in shock, electrolytes when they're being lost because of diarrhea, hemodynamic support when the blood pressure is falling and the patient is going into septic shock, symptom control, treatment of co-infections that might occur. All of these things improve survival. This is what I do every day in the intensive care unit. I take patients just like this and treat them, and the problem is that it's very intensive, obviously. These patients require constant care, where you will have only a maximum of two patients per nurse if you're doing two to one ICU care like I do in the United States specifically in California. As you start to get more and more patients per nurse, it becomes difficult to be able to take care of these type of patients and do a good job. So, the problem is that there's so many of them in an outbreak that it becomes very, very difficult to provide this type of care and you get an overwhelming of resources. We've seen this before. And what you need is early treatment and or perhaps a vaccine to reduce the number of people that get this disease so you're not overwhelming the healthcare system. Basically, the bottom line is Bundibugyo is generally less lethal historically than Zaire Ebola, but it's still about 30 to 50% historical case fatality rate and obviously extremely serious. The current concern is that it doesn't spread like influenza or COVID. It's not airborne. You've got to actually be in contact with bodily fluids. The problem is that it's in a region where it's very difficult to control this. It's war-torn. There's not a lot of resources and it's hard to take care of these patients. And so as a result of that, this is spreading and it's likely to spread to distant areas. And so that is the key at this point. And so it's important to get involved with this early as possible. This is going to be a developing story, but what I want to shift to at this point is emerging treatments that are not yet approved, that are benchtop, that are in animals, but are showing some really good outcomes. And so I want to turn to a paper and talk about that next. This is a paper that was published in 2019 by Bornholdt in Cell Host & Microbe. It was a international collaboration with a number of different authors. The title is a two antibody pan Ebola virus cocktail confers broad therapeutic protection in ferrets and non-human primates. What they basically did was they got two antibodies from some people that survived Ebola and took these human antibodies and actually did tests on animals with real Ebola virus of different types, specifically the Sudan, the Zaire, and the Bundibugyo virus. And they wanted to see whether or

### [10:00](https://www.youtube.com/watch?v=E2Mpl4IUCdo&t=600s) Segment 3 (10:00 - 15:00)

not these antibodies could actually help in specific types of situations. Let's read this summary of the paper. It says, "Recent and ongoing outbreaks of Ebola virus disease underscore the predictable nature of Ebola virus re-emergence and the urgent need for antiviral treatments. Unfortunately, available experimental vaccines and immunotherapeutics are specific for a single member of the Ebola virus genus. So, here they are. " We talked about the same ones that we talked about, EBOV, which is the Zaire. "These are ineffective against other Ebola viruses associated with EVD, including Sudan and the Bundibugyo virus. Here we show that MBP134AF, a pan-Ebola virus therapeutic comprising two broadly neutralizing human antibodies, affords unprecedented effectiveness and potency as a therapeutic countermeasure to antigenically diverse Ebola viruses. " What do they mean there? Here is some antibodies that we got from humans that simply don't attack the Zaire Ebola virus, but actually all of them. And they call it this combination of these two antibodies into this therapeutic called MBP134AF. Say that it could fully protect ferrets against lethal Zaire, Sudan, and the one that we're talking about, Bundibugyo infection, as a single 25 mg per kilogram dose. All three viruses they were able to protect against. So, it provides a successful model for rapid discovery and translational advancement in immunotherapeutics targeting emergent infectious diseases. So, let's go through this and show you the data that makes us think that this might work. This is for the Ebola Zaire. And what we're looking at here is days post infection and survival. This is where the rubber meets the road right here. And what you see here is there is the yellow and the green antibodies. And in this case, they're both the same, in this case 15 mg, and there's four of them. You can see that both yellow and green, in terms of survival, they start out at 100% and they go all the way across at 100%, whereas the control groups and also the historical controls that they put into that, they basically drop off and are dead. All of them are dead by day 6 7 8. You can see here that the amount of virus in the system goes up a lot with those that got the control, but it stays low antibodies. And again here, days post infection, and another way of actually measuring the virus, virus goes up when you don't get the antibodies, stays pretty low when you get either antibody. Now, this works not only for Zaire, but also for Sudan. You can see here the green goes right across. In this case, the blue was only 5 mg. And you can see here that the 5 mg dose, which was a third, did not really work very well for Sudan. So, Sudan needs the 15. Again, you can see the blue and the control group not so good, but the green, the 15 mg, the higher dose, worked great. Another way of looking at the blue, the virus goes up here, it can't suppress it, it gets higher with the blue, but when you do the 15 in the green, it stays suppressed. Let's go to the one that we all care about right now here in May of 2026, which is the Bundy Bujold. That's this one, 15 and five. Does the blue hold up with the Bundy Bujold? The answer is yes, not as well as the green, so 15 mg would be better than five, but it's a better than the control group in terms of survival. You can see here again, the blue not so well as the green. Blue not so good, but actually better. It performed better here in the Bunny Bujo than it did up here in Sudan. This is really the important part here. We can go into some other details about why this works. Let's take a look. This is figure two. I'm not going to spend a lot of time on this. It shows that it works. And the reason why I'm not going to spend a lot of time here is that this is the Zaire version of Ebola, the Zaire species, and that's not the species that we're concerned about right now. I am going to stop on figure three because this is an important thing here. What they're doing in these antibodies is not only are they finding antibodies that are human antibodies that work against the Ebola virus, in this case the Bunny Bujo, but they're also attaching the stick of the antibody so that it can bind the patient's cells even better. And that has a name. It's called afucosylation, a f u c o s y l a t i o n, afucosylation. And what they're doing is they're taking off a sugar called fucose. It's not fructose, but fucose. And when they take this off, as here they have a minus c h o, they're taking off a sugar. Notice what happens. That has the highest amount of recruitment to these natural killer cells. One of the highest recruitment to natural killer cells. Over here, again, one of the highest increase in interferon from natural killer cells. What this does is this type of manufacturing where they basically take this sugar off produces stronger natural killer cell activation

### [15:00](https://www.youtube.com/watch?v=E2Mpl4IUCdo&t=900s) Segment 4 (15:00 - 20:00)

markers, including CD107A, gamma interferon, and MIP-1 beta. This is really important. Not only there, you can also see it here again. The negative CHO gets you the highest amount of natural killer cells. One of Over here, in terms of phagocytic scores, you can see that by far the highest phagocytic scores here is when you take off that sugar from that stick on the antibody and it binds the natural killer cells better. Figure four is going to be really important because what they do currently is they cause these antibodies to be produced by plant cells, actually specifically tobacco plants. They have that currently, but they can't really upscale it for mass production if you need to have it for thousands of people. And so what you do is you need to figure out a way of upscaling this. And what they're showing here is how to produce a percent weight change. You can see how much protein is being made. You have these CHO K1 AF produced. These are cells that can actually produce them. This can be manufactured up as a factory. So you can make a lot of these antibodies. And then this here is a plant that actually produces it currently. So you can see here that the blue production is closely mirrored to the yellow production, which means that this is a viable way of making this antibody in a large-scale application. So it looks as though this should be able to make this and upscale it pretty well in this type of way. This is figure five from the paper. I'm not going to spend a lot of time because this is the Sudan data. That's not the one that we're concerned about. But I am going to stop here at this particular figure because this is the one that we're going to be really interested in. This is the BDBV. So the Bundibugyo virus. In this case, they actually showed it with macaques to see whether or not this would actually improve it. So what are we looking at here? The white circles are the control groups and the greens are all of the different types of antibodies specifically. And what you can see here is that it works. So there was about only a 20% mortality here in these animals where there was 100% mortality in those that didn't get it. This is 25 mg per kilogram dose here. And we're looking at percent survival here. In terms of the viral log, you can see all the ones that got green went up slightly, then came right back down, and the ones that got nothing, virus went up and stayed up. Here you can see again, green goes up, green goes down, green stays down, white goes up, stays up. That's not good. When you have that many viral particles still flowing. In terms of clinical score, you can see that the control whites go up, stay up, greens never go up at all. What about body temperature? You can see what happens to body temperature. We've talked about the innate immune system. Body temperature plummets when you have the control group. That's not good for your innate immune system, whereas with the antibodies circulating, temperature up, have a fever, and then it comes back and goes to normal. In terms of platelets, we see that platelets drop, they go into septic shock, and they die, and you can see here that platelets rebound in a good way and actually fight the infection. Let's talk about alkaline phosphatase. That's a biomarker. Not much change here with the green, but again, with the white, it goes up. What about alanine aminotransferase? This is ALT and AST. Again, liver function tests. You can see here, white goes up, and green goes up, and then comes back down. Green goes up, comes back down. That's all very good. So, you can imagine that it doesn't take long to figure out who is actually going to be producing this, and we have this article here from May 20th of 2026. So, almost 7 years later, US taps small San Diego biotech for experimental Ebola treatment as an epidemic worsens. As the outbreak of Ebola in Central Africa continues to worsen, the federal government has tapped a little-known biotech in San Diego to provide doses of an experimental antibody that may be used to treat the deadly virus. The biotech MAP Biopharmaceutical, by the way, I have no financial connection to this company, has shipped doses for potential use in high-risk individuals, a spokesperson for the Department of Health and Human Services told Fierce as part of a coordinated preparedness effort. And by the way, Fierce is the publication and we'll put a link to all of this here in the description below. The antibody, the one that we just talked about in the study, was originally developed in collaboration with the Biomedical Advanced Research and Development Authority for Sudan virus, a species of Ebola virus separate from the Bundibugyo species that is causing the current epidemic. But the treatment has shown potential laboratory studies to be effective against Bundibugyo, too, the spokesperson said. You can see here that Mapp, the company, lists an antibody therapy for Sudan virus as MBP134 on its pipeline. And this is exactly the same antibody that we just talked about in that study. They said they're going to have more information on this in the near future. Zeitlin also pointed Fierce to two publications on MBP134

### [20:00](https://www.youtube.com/watch?v=E2Mpl4IUCdo&t=1200s) Segment 5 (20:00 - 21:00)

outlining the antibody's cocktail discovery and preclinical effectiveness. The two antibodies that make up MBP134 were isolated from a survivor of the 2013 2016 Ebola outbreak in West Africa, the worst epidemic of the disease ever recorded. MBP134 then proved capable of protecting ferrets and rhesus macaques from three Ebola viruses, including Bundibugyo. We just actually reviewed that paper and we have a link to that paper in the description below. So, this is something that they're looking at. Let's see. I'm sure they're going to be following these people prospectively to see whether or not this antibody actually has some benefit. Because the antibody is not an approved product, additional details about its supply, production, and procurement process are not being provided, according to the spokesperson. There's an article here that we'll put a link to that shows that a couple of Americans were actually treated with this in the past. And you can see that there was some controversy associated with its use. Not only to whom it was given to, but the fact that it was manufactured in tobacco plants. I think that is enough for today. If you enjoyed this, please subscribe. Give us a comment below about what you think of this, and please don't forget to join us at medcram. com for more continuing medical education videos.

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*Источник: https://ekstraktznaniy.ru/video/52064*