Combining vaccines, optimised supportive care, and therapeutics for Ebola virus disease increases survival

Even small numbers of infections with a high-consequence pathogen exerts tremendous pressure on health systems through the infection and loss of health-care providers and the diversion of resources away from essential health services. Importantly, the greatest reduction in mortality occurred among those who were both vaccinated and received a therapeutic, a finding which was also reported in the PALM study, suggesting a potential additive effect of vaccination and treatment.6 Coulborn and colleagues identified a potential mechanism underlying the improved mortality benefit among vaccinated patients by showing a significant decrease in viraemia in patients who were vaccinated at least 10 days before symptom onset, compared with patients who were not vaccinated. Coulborn and colleagues; the investigators in the PALM and Ebola Ca Suffit! studies; and the many health-care workers on the ground engaging with the community to build trust, delivering vaccines, and providing direct patient care are owed a tremendous debt of gratitude for conducting the research needed to improve outcomes from this and other epidemic-prone diseases.