New filovirus disease classification and nomenclature

Kuhn, Jens H.; Adachi, Takuya; Adhikari, Neill K. J.; Arribas, José Ramón; Bah, Ibrahima; Bausch, Daniel G.; Bhadelia, Nahid; Borchert, Matthias; Brantsæter, Arne Broch; Brett-Major, David M.; Burgess, Timothy; Chertow, Daniel S.; Chute, Christopher G.; Cieslak, Theodore J.; Colebunders, Robert; Crozier, Ian; Davey, Richard T.; Clerck, Hilde Johanna Yvonne De; Delgado, Rafaël; Evans, Laura; Fallah, Mosoka; Fischer, William A.; Fletcher, Tom; Fowler, Robert; Grünewald, Thomas; Hall, Andy; Hewlett, Angela; Hoepelman, Andy I. M.; Houlihan, Catherine; Ippolito, Giuseppe; Jacob, Shevin T.; Jacobs, Michael; Jakob, Robert; Jacquérioz, Frédérique; Kaiser, Laurent; Kalil, André C.; Kamara, Rashidatu Fouad; Kapetshi, Jimmy; Klenk, Hans‐Dieter; Kobinger, Gary P.; Kortepeter, Mark G.; Kraft, Colleen S.; Kratz, Thomas; Bosa, Henry S Kyobe; Lado, Marta; Lamontagne, François; Lane, H Cliff; Lobel, Leslie; Lutwama, Julius J.; Lyon, G. Marshall; Massaquoi, Moses; Massaquoi, Thomas; Mehta, Aneesh K.; Makuma, Vital Mondonge; Murthy, Srinivas; Musoke, Tonny Seikikongo; Muyembe‐Tamfum, Jean‐Jacques; Nakyeyune, Phiona; Nanclares, Carolina; Nanyunja, Miriam; Nsio-Mbeta, Justus; O’Dempsey, Tim; Pawęska, Janusz T.; Peters, C. J.; Piot, Peter; Rapp, C.; Renaud, Bertrand; Ribner, Bruce S.; Sabeti, Pardis C.; Schieffelin, John S.; Slenczka, Werner; Soka, Moses J; Sprecher, Armand; Strong, James E.; Swanepoel, Robert; Uyeki, Timothy M.; Herp, Michel Van; Vetter, Pauline; Wohl, David A.; Wolf, Timo; Wolz, Anja; Wurie, Alie; Yoti, Zabulon

doi:10.1038/s41579-019-0187-4

Cited by 94 publications

(78 citation statements)

References 3 publications

(3 reference statements)

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“…Ebolaviruses fall under the order Mononegavirales and the filoviridae family, and whose viral genome comprises a single negative stranded RNA with negative polarity. Within the genus of Ebolavirus, 6 species have been identified, though only 4-Zaire Ebola virus, Bundibugyo virus, Sudan virus and Tai Forest virus-are known to cause disease in humans; no serious illness has been reported from Bombali or Reston ebolavirus [19,20]. Non-human primates (NHP) and bats are considered the natural reservoirs of Ebola virus, with the virus capable of causing zoonotic outbreaks.…”

Section: Epidemiologymentioning

confidence: 99%

Treatment of Ebola-related critical illness

et al. 2020

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To explore contemporary clincial case management of patients with Ebola virus disease. Methods: A narrative review from a clinical perspective of clinical features, diagnostic tests, treatments and outcomes of patients with Ebola virus disease. Results: Substantial advances have been made in the care of patients with Ebola virus disease (EVD), precipitated by the unprecedented extent of the 2014-2016 outbreak. There has been improved point-of-care diagnostics, improved characterization of the clinical course of EVD, improved patient-optimized standards of care, evaluation of effective anti-Ebola therapies, administration of effective vaccines, and development of innovative Ebola treatment units. A better understanding of the Ebola virus disease clinical syndrome has led to the appreciation of a central role for critical care clinicians-over 50% of patients have life-threatening complications, including hypotension, severe electrolyte imbalance, acute kidney injury, metabolic acidosis and respiratory failure. Accordingly, patients often require critical care interventions such as monitoring of vital signs, intravenous fluid resuscitation, intravenous vasoactive medications, frequent diagnostic laboratory testing, renal replacement therapy, oxygen and occasionally mechanical ventilation. Conclusion: With advanced training and adherence to infection prevention and control practices, clinical interventions, including critical care, are feasible and safe to perform in critically ill patients. With specific anti-Ebola medications, most patients can survive Ebola virus infection.

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Section: Epidemiologymentioning

confidence: 99%

Treatment of Ebola-related critical illness

et al. 2020

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“…Six closely related viruses, each a member of a separate species, are currently known: Ebola virus (EBOV), species Zaire ebolavirus; Sudan virus (SUDV), species Sudan ebolavirus; Bundibugyo virus (BDBV), species Bundibugyo ebolavirus; Taï Forest virus (TAFV), species Taï Forest ebolavirus; Reston virus (RESTV), species Reston ebolavirus; and tentatively Bombali virus (BOMV), species Bombali ebolavirus [1]. Amongst these, EBOV is currently responsible for the majority of human infections and is the etiological agent of Ebola virus disease (EVD) [2]. EVD is characterized by acute onset of constitutional signs and symptoms, typically after an incubation period of 6-12 days, followed by emesis, diarrhea, multiorgan system dysfunction or failure, and occasionally hemorrhage.…”

Section: Introductionmentioning

confidence: 99%

Delayed recognition of Ebola virus disease is associated with longer and larger outbreaks

Matson

Chertow

Munster

2020

Emerging Microbes & Infections

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The average time required to detect an Ebola virus disease (EVD) outbreak following spillover of Ebola virus (EBOV) to a primary human case has remained essentially unchanged for over 40 years, with some of the longest delays in detection occurring in recent decades. In this review, our aim was to examine the relationship between delays in detection of EVD and the duration and size of outbreaks, and we report that longer delays are associated with longer and larger EVD outbreaks. Historically, EVD outbreaks have typically been comprised of less than 100 cases (median = 60) and have lasted less than 4 months (median = 118 days). The ongoing outbreak in Democratic Republic of the Congo, together with the 2013-2016 west Africa outbreak, are stark outliers amidst these trends and had two of the longest delays in detection on record. While significant progress has been made in the development of EVD countermeasures, implementation during EVD outbreaks is problematic. Thus, EVD surveillance must be improved by the broad deployment of modern diagnostic tools, as prompt recognition of EVD has the potential to stem early transmission and ultimately limit the duration and size of outbreaks.

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“…Since the first EVD outbreak in the DRC in Kikwit in 1976, there have been eight outbreaks caused by Ebola virus (EBOV, species Zaire ebolavirus ) in the DRC [ 2 ], but the current outbreak is the first reported outbreak in the eastern region of the country. There have been Ebola disease (EBOD) [ 3 ] outbreaks to the north in the Isiro and Dungu Health Zones of Province Orientale in eastern DRC and across the border in Uganda, including in the Bundibugyo and Kibale districts adjacent to North Kivu, but those were caused by Bundibugyo (BDBV, species Bundibugyo ebolavirus ) and Sudan (SUDV, species Sudan ebolavirus ) viruses [ 2 , 4 , 5 ]. The current outbreak is not epidemiologically linked to the EVD outbreak that occurred in the Bikoro Health Zone of Equateur Province, DRC from May to August 2018 (more than 780 miles away), and viral genome sequences confirm that the isolate that circulated in eastern DRC was phylogenetically distinct from the other known EBOV strains, suggesting an independent introduction into people.…”

Section: Introductionmentioning

confidence: 99%

“…Ebolaviruses belong to the genus Ebolavirus (family Filoviridae ) and can cause severe and fatal hemorrhagic disease in humans and non-human primates [ 7 ]. They are non-segmented, negative-sense, single-stranded RNA viruses that code for seven distinct viral proteins, and the genus contains six recognized species EBOV, SUDV, BDBV, Taï Forest (TAFV, species Taï Forest ebolavirus ), Reston (RESTV, species Reston ebolavirus (RESTV), and Bombali (BOMV, species Bombali ebolavirus ) [ 3 , 8 – 10 ]. All ebolaviruses except BOMV and RESTV are known to cause clinical disease in people with fatality rates ranging from 25 to 90% [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Spillover of ebolaviruses into people in eastern Democratic Republic of Congo prior to the 2018 Ebola virus disease outbreak

Goldstein

Belaganahalli

Syaluha³

et al. 2020

One Health Outlook

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Background The second largest Ebola virus disease (EVD) outbreak began in the Democratic Republic of Congo in July 2018 in North Kivu Province. Data suggest the outbreak is not epidemiologically linked to the 2018 outbreak in Equateur Province, and that independent introduction of Ebola virus (EBOV) into humans occurred. We tested for antibodies to ebolaviruses in febrile patients seeking care in North Kivu Province prior to the EVD outbreak. Methods Patients were enrolled between May 2017 and April 2018, before the declared start of the outbreak in eastern DRC. Questionnaires were administered to collect demographic and behavioural information to identify risk factors for exposure. Biological samples were evaluated for ebolavirus nucleic acid, and for antibodies to ebolaviruses. Prevalence of exposure was calculated, and demographic factors evaluated for associations with ebolavirus serostatus. Results Samples were collected and tested from 272 people seeking care in the Rutshuru Health Zone in North Kivu Province. All patients were negative for filoviruses by PCR. Intial screening by indirect ELISA found that 30 people were reactive to EBOV-rGP. Results were supported by detection of ebolavirus reactive linear peptides using the Serochip platform. Differential screening of all reactive serum samples against the rGP of all six ebolaviruses and Marburg virus (MARV) showed that 29 people exhibited the strongest reactivity to EBOV and one to Bombali virus (BOMV), and western blotting confirmed results. Titers ranged from 1:100 to 1:12,800. Although both sexes and all ages tested positive for antibodies, women were significantly more likely to be positive and the majority of positives were in February 2018. Conclusions We provide the first documented evidence of exposure to Ebola virus in people in eastern DRC. We detected antibodies to EBOV in 10% of febrile patients seeking healthcare prior to the declaration of the 2018–2020 outbreak, suggesting early cases may have been missed or exposure ocurred without associated illness. We also report the first known detection of antibodies to BOMV, previously detected in bats in West and East Africa, and show that human exposure to BOMV has occurred. Our data suggest human exposure to ebolaviruses may be more frequent and geographically widespread.

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New filovirus disease classification and nomenclature

Cited by 94 publications

References 3 publications

Treatment of Ebola-related critical illness

Treatment of Ebola-related critical illness

Delayed recognition of Ebola virus disease is associated with longer and larger outbreaks

Spillover of ebolaviruses into people in eastern Democratic Republic of Congo prior to the 2018 Ebola virus disease outbreak

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