Earlier this year, infectious disease specialist and Ebola survivor Ian Crozier made headlines when physicians found traces of the virus lurking in his eye, months after he had been declared free of the disease. Soon after, Crozier, who had contracted the virus while working in the Ebola Treatment Unit in Kenema, Sierra Leone, made the following remarks when asked about the promise of experimental anti-viral drugs:
"... we may have more to gain by paying attention to some relatively simple things. Most of the sickness and mortality in Ebola initially stems from severe losses through diarrhea and vomiting. So if we can figure out how to deliver intensive support that centers on fluid replacement, we may do much more to change the course of the disease than any single anti-viral drug."
It was a fascinating comment, especially since anti-viral drugs, both for Ebola and beyond, are booming—the market is poised to have revenues of more than $30 billion by 2017. And in just the past year, the infectious disease sector has been buzzing with positive anti-viral news on the Ebola front. Mapp Pharmaceuticals began clinical trials of its antibody drug, ZMapp, in Liberia. Chimerix (cmrx) announced the start—and then the stop—of clinical trials for its anti-viral drug brincidofovir. And last month, infectious disease specialists at London's Royal Free Hospital reported an anti-viral drug, favipiravir, appeared to prevent infection after exposure to Ebola-contaminated needles. But despite all these encouraging results, no single drug has jumped out as the go-to therapy for Ebola's incapacitating—and usually deadly—symptoms.
"It's the nature of healthcare: the pill always seems like the easiest way to approach a problem," says Venkat Rajan, global director of the Visionary Healthcare Program at Frost & Sullivan. "There can be a reluctance to go to devices because they may appear more invasive or seem like they have more risk for procedural complications."
Rajan says that the medical device market is making strides in the infectious disease space, particularly when it comes to infection prevention and patient handling. But while there isn't yet a device that provides Crozier's fluid retention support, there are other intriguing options.
"We are seeing a lot of initiatives where people are looking to robotics to manage an Ebola outbreak," says Rajan, listing a personal assistant robot that takes care of some aspects of patient management as a potential example. "Those kind of programs limit the amount of exposure to caregivers, especially those who might not have adequate training to handle it," he says.
Current also trends have companies looking at the use of sensors, robotics, and analytics to better understand the nature of infectious disease, and how and why a particular pathogen spreads, says Rajan. But he says there is also opportunity for manufacturers to develop new devices that can help manage a patient's condition once they have been infected as well.
One example of a device doing the "relatively simple things" Crozier mentioned is the Hemopurifier, a bio-filtration device that captures viruses and toxic proteins in the blood. Made by San Diego-based Aethlon Medical, it removes the pathogens from the blood so the body is better equipped to fight off the infection. Hemopurifier can be used for the treatment of Ebola, as well as for HIV, hepatitis C, and other illnesses. TIME Magazine named the device one of the best inventions of 2014.
"People don't recognize that there are hundreds of viruses that are infectious to man, and of those pathogens, there are fewer than ten or so that can be addressed with anti-viral drugs," says Aethlon Medical chairman and CEO James Joyce.
Joyce believes there's opportunity for new approaches that can have a broad spectrum of capabilities against viruses—and not just the ones we know of today, but new ones that may emerge tomorrow. But the challenge is advancing solutions like Aethon's through old, established funding and development pathways geared towards drugs, not devices.
"Government research dollars help direct and keep researchers on those kind of development pathways," he says. "There's extreme opportunity for novel approaches that have broad spectrum capabilities against viral pathogens—and not just those we know today, but the new ones that may emerge."
Rajan also agrees that such innovation needs to go beyond Ebola. "We live in a global ecosystem—the next outbreak may come to our own doorstep fairly quickly," he says. "We need to be able to handle whatever comes our way upfront, not react to it after the outbreak, whether it's Ebola or something else."
But as urgent and scary as these needs are, they're also full of opportunity and hope. Rajan thinks more companies will be investing in multi-purpose devices in the future. "Biotechnology has come up with some very innovative solutions to medical problems in the past," he says. "So, in the future, we're going to need more pushes from innovators to come up with different ideas to manage these diseases."