Management of pregnant women infected with Ebola virus in a treatment centre in Guinea, June 2014

Baggi, Franca; Taybi, A.; Kurth, Andreas; Herp, Michel Van; Di, Antonino; Wölfel, Roman; Günther, Stephan; Decroo, Tom; Declerck, Hilde; Jonckheere, Sylvie

doi:10.2807/1560-7917.es2014.19.49.20983

Cited by 79 publications

(84 citation statements)

References 5 publications

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“…Fetal movement and heartbeat were lost on day 11, labor was induced on day 15, and a stillborn baby was delivered. Despite the mother's negative EBOV results, high levels of EBOV RNA were found in the fetal blood, placenta, amniotic fluid, and meconium of the infant [44]. This case illustrates the potential need for special precautions and infection control during delivery of EVD survivors, particularly when temporally proximal to acute EVD.…”

Section: Viral Persistencementioning

confidence: 86%

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Neurological Complications of Ebola Virus Infection

2016

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Ebola virus disease is one of the deadliest pathogens known to man, with a mortality rate between 25-90% depending on the species and outbreak of Ebola. Typically, it presents with fever, headache, voluminous vomiting and diarrhea, and can progress to a hemorrhagic illness; neurologic symptoms, including meningoencephalitis, seizures, and coma, can also occur. Recently, an outbreak occurred in West Africa, affecting > 28,000 people, and killing > 11,000. Owing to the magnitude of this outbreak, and the large number (>17,000) of Ebola survivors, the medical and scientific communities are learning much more about the acute manifestations and sequelae of Ebola. A number of neurologic complications can occur after Ebola, such as seizures, memory loss, headaches, cranial nerve abnormalities, and tremor. Ebola may also persist in some immunologically privileged sites, including the central nervous system, and can rarely lead to relapse in disease. Owing to these findings, it is important that survivors are evaluated and monitored for neurologic symptoms. Much is unknown about this disease, and treatment remains largely supportive; however, with ongoing clinical and basic science, the mechanisms of how Ebola affects the central nervous system and how it persists after acute disease will hopefully become more clear, and better treatments and clinical practices for Ebola patients will be developed.

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Section: Viral Persistencementioning

confidence: 86%

“…A pregnant woman treated at a Medecins Sans Frontières ETU in Guinea was described by Baggi et al [44]. This 7-months-pregnant woman was treated for EVD and was EBOV negative by RT-PCR in the blood on day 8 after symptom onset and remained negative on day 10.…”

Section: Viral Persistencementioning

confidence: 95%

Neurological Complications of Ebola Virus Infection

2016

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“…Besides human diagnostics, the EMLabs provided high-quality laboratory expertise to support research and development activities for the assessment of new Ebola rapid diagnostics, for Ebola treatment trials and for Ebola vaccine research [24][25][26]. They were also engaged with other partners in operational research to review or confirm public health prevention and control strategies [27].…”

Section: Discussionmentioning

confidence: 99%

Mobile diagnostics in outbreak response, not only for Ebola: a blueprint for a modular and robust field laboratory

et al. 2015

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We established a modular, rapidly deployable laboratory system that provides diagnostic support in resource-limited, remote areas. Developed as a quick response asset to unusual outbreaks of infectious diseases worldwide, several of these laboratories have been used as part of the World Health Organization response to the Ebola virus outbreaks by teams of the ‘European Mobile Lab’ project in West Africa since March 2014. Within three days from deployment, the first European mobile laboratory became operational at the Ebola Treatment Unit (ETU) in Guéckédou, southern Guinea. Deployment in close proximity to the ETU decreased the turnaround time to an average of 4 h instead of several days in many cases. Between March 2014 and May 2015, more than 5,800 samples were tested in this field laboratory. Further EMLab units were deployed to Nigeria, Liberia and Sierra Leone in the following months of the Ebola outbreak. The technical concept of the EMLab units served as a blueprint for other mobile Ebola laboratories which have been set up in Mali, Côte d’Ivoire, Sierra Leone and other countries in West Africa. Here, we describe design, capabilities and utility of this deployable laboratory system for use in response to disease outbreaks, epidemiological surveillance and patient management.

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“…Unpublished reports have linked two cases of Ebola in neonates to breast milk from an asymptomatic mother confirmed by PCR to harbor viral RNA (T. Brooks, personal communication). More extensive evidence has accumulated for the persistence of viral RNA in body fluids, with detection by RT-PCR in sweat or skin swabs as late as day 40 of illness (15,116), in vaginal secretions as late as day 33 of illness (15,28,118), in urine as late as day 30 of illness (116,118), in rectal swabs or stool as late as day 29 of illness (15,28,118), in conjunctival fluid as late as day 28 of illness (28,118), in saliva as late as day 24 of illness (15,118), and in amniotic fluid (timing unspecified) (119). Sampling methods and testing strategies have not been consistent across studies, and little is known about the correlation of positive RT-PCR results with risk of viral transmission.…”

Section: Detection Of Viral Persistence In Nonblood Body Fluidsmentioning

confidence: 99%

Diagnosis of Ebola Virus Disease: Past, Present, and Future

2016

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SUMMARYLaboratory diagnosis of Ebola virus disease plays a critical role in outbreak response efforts; however, establishing safe and expeditious testing strategies for this high-biosafety-level pathogen in resource-poor environments remains extremely challenging. Since the discovery of Ebola virus in 1976 via traditional viral culture techniques and electron microscopy, diagnostic methodologies have trended toward faster, more accurate molecular assays. Importantly, technological advances have been paired with increasing efforts to support decentralized diagnostic testing capacity that can be deployed at or near the point of patient care. The unprecedented scope of the 2014-2015 West Africa Ebola epidemic spurred tremendous innovation in this arena, and a variety of new diagnostic platforms that have the potential both to immediately improve ongoing surveillance efforts in West Africa and to transform future outbreak responses have reached the field. In this review, we describe the evolution of Ebola virus disease diagnostic testing and efforts to deploy field diagnostic laboratories in prior outbreaks. We then explore the diagnostic challenges pervading the 2014-2015 epidemic and provide a comprehensive examination of novel diagnostic tests that are likely to address some of these challenges moving forward.

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Management of pregnant women infected with Ebola virus in a treatment centre in Guinea, June 2014

Cited by 79 publications

References 5 publications

Neurological Complications of Ebola Virus Infection

Neurological Complications of Ebola Virus Infection

Mobile diagnostics in outbreak response, not only for Ebola: a blueprint for a modular and robust field laboratory

Diagnosis of Ebola Virus Disease: Past, Present, and Future

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