Journal of Infectious Diseases
Volume 211 Issue 8 April 15, 2015
http://jid.oxfordjournals.org/content/current

Large-scale Convalescent Blood and Plasma Transfusion Therapy for Ebola Virus Disease
Robert L. Colebunders1,2 and Robert O. Cannon2
Author Affiliations
1Department of Clinical Sciences, Institute of Tropical Medicine
2Epidemiology and Social Medicine, University of Antwerp, Belgium
(See the major article by Gutfraind and Meyers on pages 1262–7.)
Extract
An effective therapy for Ebola virus disease (EVD) not only will lower the case-fatality rate but also will provide an incentive for patients to seek treatment, thereby enhancing primary and secondary prevention efforts. While several experimental drugs are being considered, the World Health Organization (WHO) has prioritized Ebola convalescent whole blood (CWB) and convalescent plasma (CP) transfusion for evaluation because this can be done relatively quickly and, if proven to be safe and effective, could be implemented without delay [1]. The use of blood from recuperated individuals has a long history of use for treatment of other serious infectious diseases and, with appropriate precautions, is generally considered safe [2].

However, the WHO has indicated that this intervention must be considered as experimental for EVD and, therefore, that initial studies should be conducted within a clinical trial framework [1].

In this issue of The Journal of Infectious Diseases, Gutfraind and Meyers [3] extend an Ebola virus transmission model published by the Centers for Disease Control and Prevention (CDC) [4] to include large-scale hospital-based convalescent donations and transfusions. Using epidemiological estimates for Ebola in Liberia and assuming that convalescent transfusions reduce the case-fatality rate to 12.5% [5], they calculated that, under a 30% hospitalization rate, CWB and CP transfusions are estimated to reduce the number of deaths in Liberia by 65 (0.37%; 95% confidence interval [CI], .07%–2.6%) and 151 (0.9%; 95% CI, .21%–11%), respectively. They conclude that transfusion therapy for Ebola is a low-cost measure that can potentially save many lives in Liberia but will not measurably influence incidence.

There are, however, at least 8 major issues to consider in determining the advisability of implementing a large-scale CWB…