The Ebola virus disease (EVD) epidemic in West Africa is the largest on record, responsible for >28,599 cases and >11,299 deaths 1. Genome sequencing in viral outbreaks is desirable in order to characterize the infectious agent to determine its evolutionary rate, signatures of host adaptation, identification and monitoring of diagnostic targets and responses to vaccines and treatments. The Ebola virus genome (EBOV) substitution rate in the Makona strain has been estimated at between 0.87 × 10−3 to 1.42 × 10−3 mutations per site per year. This is equivalent to 16 to 27 mutations in each genome, meaning that sequences diverge rapidly enough to identify distinct sub-lineages during a prolonged epidemic 2-7. Genome sequencing provides a high-resolution view of pathogen evolution and is increasingly sought-after for outbreak surveillance. Sequence data may be used to guide control measures, but only if the results are generated quickly enough to inform interventions 8. Genomic surveillance during the epidemic has been sporadic due to a lack of local sequencing capacity coupled with practical difficulties transporting samples to remote sequencing facilities 9. In order to address this problem, we devised a genomic surveillance system that utilizes a novel nanopore DNA sequencing instrument. In April 2015 this system was transported in standard airline luggage to Guinea and used for real-time genomic surveillance of the ongoing epidemic. Here we present sequence data and analysis of 142 Ebola virus (EBOV) samples collected during the period March to October 2015. We were able to generate results in less than 24 hours after receiving an Ebola positive sample, with the sequencing process taking as little as 15-60 minutes. We show that real-time genomic surveillance is possible in resource-limited settings and can be established rapidly to monitor outbreaks.

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Objective: To report the experience of Gynecology Department of the University Hospital of Treichville in the management of the inflammatory breast cancers. Methodology: We conducted a retrospective and descriptive study on cases of the inflammatory breast cancers managed in the Gynecology Department of the University Hospital of Treichville, from January 2011 to December 2015. Results: We collected 44 cases of inflammatory breast cancer representing 17.9% of all breast cancers. The average age of patients was 46.5 years (32 -70 years) and among them, the majority had inadequate socioeconomic level (90.9%). The risk factor for cancer found in the majority of patients was the age of first menstrual periods before the age of 12 years (52.3%). The average consultation time was long (10 months) and several patients had extensive inflammatory signs (38.6%), with lymph node involvement (84.1%) and metastases (36.4%). At the histological analysis, the most common type was invasive ductal carcinoma (81.8%), SBR grade III (54.5%). Regarding treatment, mastectomy according to Patey associated with a chemotherapy was performed in 22.7% cases. The evolution has been marked by an overall 5-year survival of 20%. Conclusion: The management of inflammatory breast cancers was late and incomplete in our service making poor prognosis.

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