As fears rise over the confirmed case of Nipah in Kerala, The Lede brings you an exclusive interview with the scientist who found the drug
Recovery chances of a Nipah virus-infected patient are uncertain even if the ‘wonder drug’ brought from Australia is administered, said the founder of the drug to The Lede in an exclusive interview.
Dr Christopher C Broder, Professor and Chair of the Department of Microbiology at the Uniformed Services University of the Health Sciences in the United States is the brain behind the ‘wonder drug’ named m102.4.
This antibody is now being brought to Kerala from Australia to treat the patient found infected with the Nipah virus as well as others who have been exposed to the patient.
But will the drug work on an already infected patient? “We simply do not know this at this time,” Dr Broder told The Lede.
There is no way to know either as to how long it would take for an infected patient to recover, once the drug is administered. “We simply do not know this at this time,” Dr Broder reiterated.
“It has never yet been given to a confirmed Nipah infected and sick individual. All cases in Australia, the antibody was given immediately upon a known exposure to possible infection and before illness (post-exposure prophylaxis). We do not have evidence in people that it is effective in an already sick person, it has never been done. We, of course, hope that it might.”
Dr Christopher Broder to The Lede
Isolated by Dr Broder, a human monoclonal antibody called m102.4 is the drug which is being used to neutralise the Nipah virus and prevent it from infecting more cells in the human body.
According to him, this drug is also effective against Nipah’s sister virus, the Hendra virus prevalent in Australia.
While one set of clinical trials have been conducted on humans, these have been largely patients who were at risk of being exposed to the Nipah virus. He told The Lede that no serious adverse effects were found in humans from the administration of the m102.4 antibody.
“There were dozens of people in the Australian clinical trial. Also, m102.4 has been given at high dose (20 mg/kg) in 14 people (13 in Australia and 1 in the United States) by compassionate emergency protocol because of a high risk of either Hendra or Nipah exposure,” he said.
According to Dr Broder, the drug binds to a specific protein (G protein) on the virus or virus-infected cell and is given intravenously.
On the dosage, he said that their studies in animals have led to a single dose in people being equivalent to 20 milligrams per kilogram of body weight.
The drug, he says, equips the human immune system to fight the virus. “In our animal studies, the antibody helps the subject fight the virus infection,” said Dr Broder. “Together, the antibody, if given early enough, and the subject’s natural immune response to virus infection will allow full recovery. Our best studies have indicated two doses two days apart, is effective in containing the virus in animals,” he added.
But earlier the administration of the antibody, the better the chances of fighting the virus, said Dr Broder.
“The antibody should be at the ready to be given to other people that were in contact with a Nipah infected person; should fever begin in such a person, the antibody should be tried as soon as possible in those people.”
Dr Christopher Broder to The Lede
On Tuesday, Kerala Health Minister had said that the state has procured Indian Council of Medical Research (ICMR) license for drugs brought from Australia.
In 2018, when 17 people died due to the Nipah virus, a 50-dose consignment of the m102.4 antibody developed by Christopher Broder was brought to India and dispatched to Kozhikode Government Medical College for further administration to Nipah patients.
Rajeev Sadanandan, former Additional Chief Health Secretary, who led the Nipah containment operations in 2018, told The Lede that m102.4 was used in 2018 and it is the same drug which will be used now.
“Yes. It’s the same drug,” Sadanandan said when asked about what the Kerala Health Minister KK Shylaja was referring to in her Facebook post – if the medicine arranged to be brought from Australia for treating Nipah patients was m102.4.
In her Facebook post, the minister wrote - “Though the public must take necessary precautions, they have no reason to panic. Specially trained medical professionals are leading the treatment efforts. Drugs have been made available. Have also procured ICMR license for drugs brought from Australia.”
Sadanandan’s service as Advisor has been extended to help handle the situation.
Responding to a message sent by The Lede, Dr Sarita RL, Directorate of Health Services, also confirmed the same.
When asked whether the m102.4 drug isolated by Christopher Broder is being used to treat Nipah patients, she replied - “Yes.”
As per latest reports, the government said in a release that 311 people from various districts with whom the student had interacted were under observation.
Earlier on Tuesday, Minister Shailaja had told the media that the results of blood samples of the student, which were tested at the National Institute of Virology in Pune, were positive for Nipah.
The minister said four people — three who attended to the student initially and one person who studied with him — were suffering from fever and sore throat.
They were shifted to the isolation ward set up at the Kalamassery Medical College Hospital here for a detailed medical examination.
A bulletin issued by the government in the evening said a list of 311 people, who have interacted with the student, has been prepared and they were under medical observation.
The student hailing from North Paravur in Ernakulam district is studying in a college in Thodupuzha in Idukki district.
The student, who was suffering from fever, had gone to Thrissur district with a group of students to attend a training programme.
The government urged people not to panic and take precautionary measures to prevent the spread of the disease.
Chief Minister Pinarayi Vijayan said there was no need to panic as the health network would rise up to the challenge.
“We are in constant contact with the Union Ministry for Health. A team of experts have arrived in Kochi. Their guidelines will also be used to tackle the virus outbreak,” Vijayan said in a Facebook post.
Under the supervision of the state health minister, all necessary preparations have been completed, Vijayan said, adding those who came in contact with the infected person have been traced and are under observation.
Extending all assistance to the state government to deal with the situation, the centre has rushed a six-member team comprising an epidemiologist to Kerala.
A control room has also been set up and the Strategic Health Operations Centre (SHOC) of the National Centre for Disease Control (NCDC) has been activated, the phone number for which is 011-23978046, a health ministry statement said in New Delhi.
On Wednesday, the Kerala Health Minister has said that the health condition is stable of patient is satisfactory and blood samples of other five suspected cases have been sent to the Pune Institute.
“There is no need to panic. Drug has been brought to Kochi. However, as the patient’s health condition is stable, the drug will not be administered now,” the minister said.
According to state government figures, the Nipah virus had claimed 17 lives - 14 in Kozhikode and three in neighbouring Malappuram in May last year.
The m102.4 drug that fights Nipah is currently produced in the US.
“We gave the cell line that makes the antibody (for free) to Queensland, Australia and they are producing it there,” Dr Broder told The Lede. “The antibody produced in Australia was also used in a Phase I human safety trial. We are now in the process of giving the cell line that produces the antibody to the Serum Institute and ICMR in India (for free) so that India can make their own antibody drug in India and not have to source it from Australia,” he said.
However, the paperwork involved has been frustrating, Broder added.
When asked how he invented the drug, he said that they decided some years ago in 2005 to isolate human anti-Nipah/Hendra antibodies to the Nipah/Hendra experimental vaccine made in 2001.
“The vaccine is soluble G protein, so we used it to identify and isolate m102.4 (the human antibody). We wanted to develop a therapy (the antibody) for Nipah and Hendra infection, this is called passive immunization,” he added.
Dr Broder said that his team was working on making a human version of the G vaccine for Nipah and Hendra.
Fruit bats of the Pteropodidae family are the natural hosts of the Nipah virus.
Nipah virus can be transmitted to humans from animals (such as bats or pigs), or contaminated foods and can also be transmitted directly from human-to-human.
According to the WHO, Nipah virus is a newly emerging disease that can be transmitted from its reservoir (natural wildlife host), the flying foxes (fruit bats), to both animals and humans.