Prevalence of infection among asymptomatic and paucisymptomatic contact persons exposed to Ebola virus in Guinea: a retrospective, cross-sectional observational study

Diallo, Mamadou Hassimiou; Rabilloud, Muriel; Ayouba, Ahidjo; Touré, Abdoulaye; Thaurignac, Guillaume; Keïta, Abdoulaye; Butel, Christelle; Kpamou, Cécé; Barry, Thierno Alimou; Sall, Mariama Djouldé; Camara, Ibrahima; Leroy, Sandrine; Msellati, Philippe; Écochard, René; Peeters, Martine; Sow, Mamadou; Delaporte, Éric; Etard, Jean‐François; Aboubacar, Diaby; Balde, Alseny; Baldé, I; Bamba, Amara; Cámara, A. Larrauri; Conte, Aboubacar Mamy; Delfraissy, Jean‐François; Diallo, Amadou; Doumbouya, Saran; Kamano, Emile Souro; Koivogui, Joel Balle; Delaunay, Charlotte Lanièce; Lévy, Yves; Monemou, Jean Louis; Povogui, Moriba; Sakouvogui, Maou; Soumah, Abdoul Karim; Subtil, Fabien; Sylla, Aboubacar Hawa; Taverne, Bernard; Yazdanpanah, Yazdan

doi:10.1016/s1473-3099(18)30649-2

Cited by 35 publications

(20 citation statements)

References 28 publications

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“…In these settings, we anticipate that most of the time no anti-ZEBOV antibody responses would be detected. Recent works nevertheless highlighted the detection of anti-ZEBOV antibodies in healthy people, presumably reflecting asymptomatic infections or paucisymptomatic cases, with different seroprevalences [32][33][34]. Since a long and persistent antibody response is observed in Ebola survivors, we could assume that survivors are protected against re-infection and therefore have minor chance to get infected and spread infection in outbreak settings [35].…”

Section: Discussionmentioning

confidence: 99%

Characterization and analytical validation of a new antigenic rapid diagnostic test for Ebola virus disease detection

et al. 2020

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Hemorrhagic fever outbreaks are difficult to diagnose and control in part because of a lack of low-cost and easily accessible diagnostic structures in countries where etiologic agents are present. Furthermore, initial clinical symptoms are common and shared with other endemic diseases such as malaria or typhoid fever. Current molecular diagnostic methods such as polymerase chain reaction require trained personnel and laboratory infrastructure, hindering diagnostics at the point of need, particularly in outbreak settings. Therefore, rapid diagnostic tests such as lateral flow can be broadly deployed and are typically well-suited to rapidly diagnose hemorrhagic fever viruses, such as Ebola virus. Early detection and control of Ebola outbreaks require simple, easy-to-use assays that can detect very low amount of virus in blood. Here, we developed and characterized an immunoassay test based on immunochromatography coupled to silver amplification technology to detect the secreted glycoprotein of EBOV. The glycoprotein is among the first viral proteins to be detected in blood. This strategy aims at identifying infected patients early following onset of symptoms by detecting low amount of sGP protein in blood samples. The limit of detection achieved by this sGP-targeted kit is 2.2 x 10 4 genome copies/ml in plasma as assayed in a monkey analytical cohort. Clinical performance evaluation showed a specificity of 100% and a sensitivity of 85.7% when evaluated with plasma samples from healthy controls and patients infected with Zaire Ebola virus from Macenta, Guinea. This rapid and accurate diagnostic test could therefore be used in endemic countries for early detection of infected individuals in point of care settings. Moreover, it could also support efficient clinical triage in hospitals or clinical

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Section: Discussionmentioning

confidence: 99%

Characterization and analytical validation of a new antigenic rapid diagnostic test for Ebola virus disease detection

et al. 2020

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“…Of note, antibody responses may not reliably develop or may be delayed in acutely symptomatic patients with EVD. Thus, PCR-based testing is optimal in the acutely ill patient (from blood samples) and also for detection of EBOV RNA in amniotic fluid, breast milk, ocular fluid, saliva, seminal fluid, stool, sweat, tears, urine and vaginal fluid even after blood samples begin to test negative 36,40,57,134,161,162 .…”

Section: Diagnosis Of Acute Evdmentioning

confidence: 99%

Ebola virus disease

Jacob

Crozier

Fischer

et al. 2020

Nat Rev Dis Primers

374

345

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To date, 12 distinct filoviruses have been described 1. The seven filoviruses that have been found in humans belong either to the genus Ebolavirus (Bundibugyo virus (BDBV), Ebola virus (EBOV), Reston virus (RESTV), Sudan virus (SUDV) and Taï Forest virus (TAFV); Fig. 1) or to the genus Marburgvirus (Marburg virus (MARV) and Ravn virus (RAVV)) 2. The WHO International Classification of Diseases Revision 11 (ICD-11) of 2018 recognizes two major subcategories of filovirus disease (FVD): Ebola disease caused by BDBV, EBOV, SUDV or TAFV, and Marburg disease caused by MARV or RAVV. Ebola virus disease (EVD) is defined as a disease only caused by EBOV. This subcategorization of FVD is largely based on the increasing evidence of molecular differences between ebolaviruses and marburgviruses, differences that may influence virus-host reservoir tropism, pathogenesis and disease phenotype in accidental primate hosts 2. Since the discovery of filoviruses in 1967 (reF. 3), 43 FVD outbreaks (excluding at least five laboratoryacquired infections) have been recorded in or exported from Africa 4. The epidemiological definition of outbreak is one or more cases above the known endemic prevalence. For example, the single case of TAFV infection recorded in a setting in which FVD had never been reported before (Côte d'Ivoire) 5 is still considered an outbreak. All FVD outbreaks, with the exception of that caused by TAFV, were characterized by extremely high case-fatality rates (CFRs, also known as lethality). Until 2013, the most extensive outbreak, caused by SUDV, involved 425 cases and 224 deaths (CFR 52.7%) 6. The overall limited numbers of FVD cases (1967-2013: 2,886 cases including 1,982 deaths 4), the typical remote and rural locations of outbreaks and the often delayed announcement of new outbreaks to the international community 7 have prevented the systematic study of clinical FVD in humans. Thus, the commonly used description of FVD was derived either from observation of small groups of patients in care settings that were not well-equipped for diagnosis, treatment and disease characterization, or from observations of even smaller samples, such as individuals who were transferred from Equatorial Africa to Europe and the USA or who fell sick in Europe or the USA after contracting the virus elsewhere. Pathological characterization of FVD via autopsies has been rare 7,8. In the absence of extensive human clinical data, FVD could only be defined further via the use of experimental animal infections 9,10 .

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“…Given that we detected antibodies in people as early as May 2017, our data also support analysis suggesting that EBOV could have been circulating in the North Kivu region 1–2 years before the outbreak began [ 5 ]. It is not known how frequently asymptomatic or paucisymptomatic Ebola virus infection occurs, however, a number of studies show a high level of exposure in asymptomatic household contacts of EVD-positive patients, and in contacts with mild clinical symptoms who were not diagnosed with EVD [ 32 , 33 ]. EVD symptoms can vary from flu-like to acute hemorrhagic fever and death [ 34 ], thus, the non-specific nature of some clinical symptoms may mean that EVD cases are not recognized until more severe symptoms (eg.…”

Section: Discussionmentioning

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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Prevalence of infection among asymptomatic and paucisymptomatic contact persons exposed to Ebola virus in Guinea: a retrospective, cross-sectional observational study

Cited by 35 publications

References 28 publications

Characterization and analytical validation of a new antigenic rapid diagnostic test for Ebola virus disease detection

Characterization and analytical validation of a new antigenic rapid diagnostic test for Ebola virus disease detection

Ebola virus disease

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

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