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Bond NG, Shore KR, Engel EJ, Coonan EE, Al-Hasan F, Gbakie MA, Kamara FK, Kanneh L, Momoh M, Kanneh IM, Sandi JD, Elliott D, Ficenec SC, Smira AR, Fischer WA, Wohl DA, Robinson JE, Shaffer JG, Garry RF, Samuels RJ, Grant DS, Schieffelin JS. Ebola Virus-Specific Neutralizing Antibody Persists at High Levels in Survivors 2 Years After Resolution of Disease in a Sierra Leonean Cohort. J Infect Dis 2024:jiae155. [PMID: 38801652 DOI: 10.1093/infdis/jiae155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Indexed: 05/29/2024] Open
Abstract
Ebola virus (EBOV) infection results in Ebola virus disease (EVD), an often severe disease with a nonspecific presentation. Since its recognition, periodic outbreaks of EVD continue to occur in sub-Saharan Africa. The 2013-2016 West African EVD outbreak was the largest recorded, resulting in a substantial cohort of EVD survivors with persistent health complaints and variable immune responses. In this study, we characterize humoral immune responses in EVD survivors and their contacts in Eastern Sierra Leone. We found high levels of EBOV IgG in EVD survivors and lower yet substantial antibody levels in household contacts, suggesting subclinical transmission. Neutralizing antibody function was prevalent but variable in EVD survivors, raising questions about the durability of immune responses from natural infection with EBOV. Additionally, we found that certain discrete symptoms-ophthalmologic and auditory-are associated with EBOV IgG seropositivity, while an array of symptoms are associated with the presence of neutralizing antibody.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Mambu Momoh
- Kenema Government Hospital, Sierra Leone
- Eastern Technical University, Kenema, Sierra Leone
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Adriaensen W, Oostvogels S, Levy Y, Leigh B, Kavunga-Membo H, Watson-Jones D. Urgent considerations for booster vaccination strategies against Ebola virus disease. THE LANCET. INFECTIOUS DISEASES 2024:S1473-3099(24)00210-X. [PMID: 38734010 DOI: 10.1016/s1473-3099(24)00210-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/09/2024] [Accepted: 03/13/2024] [Indexed: 05/13/2024]
Abstract
With two endorsed and prophylactic vaccines against Zaire ebolavirus (referred to hereafter as EBOV), the number of individuals vaccinated against EBOV worldwide is estimated to range between 500 000 and 1 000 000 individuals, increasing with every renewed EBOV threat and vaccination campaign. Therefore, re-exposure of previously vaccinated health-care workers, and possibly community members, could become more frequent. In the absence of long-term data on vaccine efficacy and duration of protection, we urgently need to understand revaccination strategies that could maximise the level of protection. In this Personal View, we highlight the scarcity of available evidence to guide revaccination recommendations for the accumulating groups of previously vaccinated communities or front-line health-care workers that could be redeployed or re-exposed in the next EBOV outbreak(s). This evidence base is crucial to identify optimal target populations and the frequency of booster doses, and guide vaccine interchangeability (especially in settings with limited or unpredictable vaccine supplies), while preventing vaccine mistrust, equity concerns, and exclusion of vulnerable populations. We discuss five priority gaps (to whom, when, and how frequently, to provide booster doses; long-term correlates and thresholds of protection; the effect of vector-directed immunity and viral variant protection; comparative research in mix-and-match schedules; and implementation concerns) that should be urgently tackled to adapt the initial EBOV prophylactic vaccination strategies considering potential booster dose vaccinations.
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Affiliation(s)
- Wim Adriaensen
- Clinical Immunology Unit, Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium.
| | - Selien Oostvogels
- Clinical Immunology Unit, Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Yves Levy
- Vaccine Research Institute, INSERM U955, Université Paris-Est Créteil, Créteil, France
| | - Bailah Leigh
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Hugo Kavunga-Membo
- Rodolphe Merieux Laboratory INRB-Goma, Goma, Democratic Republic of the Congo; University of Goma, Goma, Democratic Republic of the Congo
| | - Deborah Watson-Jones
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK; Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
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Durant O, Marzi A. Ebola virus disease sequelae and viral persistence in animal models: Implications for the future. PLoS Pathog 2024; 20:e1012065. [PMID: 38512815 PMCID: PMC10956775 DOI: 10.1371/journal.ppat.1012065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Abstract
Ebola virus disease (EVD), caused by infection with Ebola virus, results in severe, acute illness with a high mortality rate. As the incidence of outbreaks of EVD increases and with the development and approval of medical countermeasures (MCMs) against the acute disease, late phases of EVD, including sequelae, recrudescence, and viral persistence, are occuring more frequently and are now a focus of ongoing research. Existing animal disease models recapitulate acute EVD but are not suitable to investigate the mechanisms of these late disease phenomena. Although there are challenges in establishing such a late disease model, the filovirus research community has begun to call for the development of an EBOV persistence model to address late disease concerns. Ultimately, this will aid the development of MCMs against late disease and benefit survivors of future EVD and filovirus outbreaks.
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Affiliation(s)
- Olivia Durant
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana, United States of America
| | - Andrea Marzi
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana, United States of America
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Nkuba-Ndaye A, Dilu-Keti A, Tovar-Sanchez T, Diallo MSK, Mukadi-Bamuleka D, Kitenge R, Formenty P, Legand A, Edidi-Atani F, Thaurignac G, Pelloquin R, Mbala-Kingebeni P, Toure A, Ayouba A, Muyembe-Tamfum JJ, Delaporte E, Peeters M, Ahuka-Mundeke S. Effect of anti-Ebola virus monoclonal antibodies on endogenous antibody production in survivors of Ebola virus disease in the Democratic Republic of the Congo: an observational cohort study. THE LANCET. INFECTIOUS DISEASES 2024; 24:266-274. [PMID: 38043556 DOI: 10.1016/s1473-3099(23)00552-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/10/2023] [Accepted: 08/23/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND The use of specific anti-Ebola virus therapy, especially monoclonal antibodies, has improved survival in patients with Ebola virus disease. We aimed to assess the effect of monoclonal antibodies on anti-Ebola virus antibody responses in survivors of the 2018-20 Ebola outbreak in the Democratic Republic of the Congo. METHODS In this observational prospective cohort study, participants were enrolled at three Ebola survivor clinics in Beni, Mangina, and Butembo (Democratic Republic of the Congo). Eligible children and adults notified as survivors of Ebola virus disease (ie, who had confirmed Ebola virus disease [RT-PCR positive in blood sample] and were subsequently declared recovered from the virus [RT-PCR negative in blood sample] with a certificate of recovery from Ebola virus disease issued by an Ebola treatment centre) during the 2018-20 Ebola virus disease outbreak were invited to participate in the study. Participants were recruited on discharge from Ebola treatment centres and followed up for 12-18 months depending on recruitment date. Routine follow-up assessments were done at 1, 3, 6, and 12-18 months after inclusion. We collected sociodemographic (age, sex, visit site), clinical (anti-Ebola virus drugs), and laboratory data (RT-PCR and Ct values). The primary outcome was the antibody concentrations against Ebola virus glycoprotein, nucleoprotein, and 40-kDa viral protein antigens over time assessed in all participants. Antibody concentrations were measured by the multiplex immunoassay, and the association between anti-Ebola virus antibody levels and the relevant exposures, such as anti-Ebola virus disease drugs (ansuvimab, REGN-EB3, ZMapp, or remdesivir), was assessed using both linear and logistic mixed regression models. This study is registered at ClinicalTrials.gov, NCT04409405. FINDINGS Between April 16, 2020, and Oct 18, 2021, 1168 survivors were invited to participate in the Les Vainqueurs d'Ebola cohort study. 787 survivors were included in the study, of whom 358 had data available for antibody responses. 85 (24%) of 358 were seronegative for at least two Ebola virus antigens on discharge from the Ebola treatment centre. The antibody response over time fluctuated but a continuous decrease in an overall linear evolution was observed. Quantitative modelling showed a decrease in nucleoprotein, glycoprotein, and VP-40 antibody concentrations over time (p<0·0001) with the fastest decrease observed for glycoprotein. The probability of being seropositive for at least two antigens after 36 months was 53·6% (95% CI 51·6-55·6) for participants who received ansuvimab, 73·5% (71·5-75·5) for participants who received REGN-EB3, 76·8% (74·8-78·8) for participants who received remdesivir, and 78·5% (76·5-80·5) for participants who received ZMapp. INTERPRETATION Almost a quarter of survivors were seronegative on discharge from the Ebola treatment centre and antibody concentrations decreased rapidly over time. These results indicate that monoclonal antibodies might negatively affect the production of anti-Ebola virus antibodies in survivors of Ebola virus disease which could increase the risk of reinfection or reactivation. FUNDING The French National Agency for AIDS Research-Emergent Infectious Diseases-The French National Institute of Health and Medical Research, the French National Research Institute for Development, and the European and Developing Countries Clinical Trials Partnership. TRANSLATION For the French translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Antoine Nkuba-Ndaye
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Service de Microbiologie, Département de Biologie Médicale, Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo; TransVIHMI, Université de Montpellier, Institut de Recherche pour le Développement, Institut National de la Santé et de la Recherche Médicale, Montpellier, France.
| | - Angele Dilu-Keti
- TransVIHMI, Université de Montpellier, Institut de Recherche pour le Développement, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | - Tamara Tovar-Sanchez
- TransVIHMI, Université de Montpellier, Institut de Recherche pour le Développement, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | - Mamadou Saliou Kalifa Diallo
- TransVIHMI, Université de Montpellier, Institut de Recherche pour le Développement, Institut National de la Santé et de la Recherche Médicale, Montpellier, France; Centre de Recherche et de Formation en Infectiologie de Guinée, Université Gamal Abdel Nasser de Conakry, Conakry, Guinea; Department of Infectious Diseases, Donka National Hospital, Conakry, Guinea
| | - Daniel Mukadi-Bamuleka
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Service de Microbiologie, Département de Biologie Médicale, Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Richard Kitenge
- Programme National de Soins et de Suivi des Personnes Guéries, Ministère de Santé Publique, city, Democratic Republic of the Congo
| | | | - Anaïs Legand
- Health Emergencies Program, WHO, Geneva, Switzerland
| | - François Edidi-Atani
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Guillaume Thaurignac
- TransVIHMI, Université de Montpellier, Institut de Recherche pour le Développement, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | - Raphael Pelloquin
- TransVIHMI, Université de Montpellier, Institut de Recherche pour le Développement, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | - Placide Mbala-Kingebeni
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Service de Microbiologie, Département de Biologie Médicale, Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Abdoulaye Toure
- Centre de Recherche et de Formation en Infectiologie de Guinée, Université Gamal Abdel Nasser de Conakry, Conakry, Guinea; Department of Infectious Diseases, Donka National Hospital, Conakry, Guinea
| | - Ahidjo Ayouba
- TransVIHMI, Université de Montpellier, Institut de Recherche pour le Développement, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | - Jean-Jacques Muyembe-Tamfum
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Service de Microbiologie, Département de Biologie Médicale, Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Eric Delaporte
- TransVIHMI, Université de Montpellier, Institut de Recherche pour le Développement, Institut National de la Santé et de la Recherche Médicale, Montpellier, France; Montpellier University Hospital, Montpellier, France
| | - Martine Peeters
- TransVIHMI, Université de Montpellier, Institut de Recherche pour le Développement, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | - Steve Ahuka-Mundeke
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Service de Microbiologie, Département de Biologie Médicale, Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
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Ntoumi F, Veas F. Preparedness for future outbreaks: strengthening surveillance of survivors of Ebola virus disease. THE LANCET. INFECTIOUS DISEASES 2024; 24:221-223. [PMID: 38043557 DOI: 10.1016/s1473-3099(23)00567-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 09/06/2023] [Indexed: 12/05/2023]
Affiliation(s)
- Francine Ntoumi
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; Congolese Foundation for Medical Research, Brazzaville, Republic of the Congo.
| | - Francisco Veas
- French Research Institute for Sustainable Development, Montpellier University, HydroSciences Montpellier, Montpellier, France; Copernicus Integrated Biosafety and Environmental Risk Solutions, CIBERS, Montpellier, France
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Stephens MT, Juniastuti, Sulistiawati, Dossen PC. The potential risk components and prevention measures of the Ebola virus disease outbreak in Liberia: An in-depth interview with the health workers and stakeholders. BELITUNG NURSING JOURNAL 2024; 10:67-77. [PMID: 38425680 PMCID: PMC10900057 DOI: 10.33546/bnj.3069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/01/2023] [Accepted: 01/13/2024] [Indexed: 03/02/2024] Open
Abstract
Background The Ebola virus, a highly infectious and deadly pathogen, has posed a significant public health threat in West Africa for several decades. Liberia is one of the most severely affected countries. Healthcare personnel, including nurses, are on the front lines of patient care, and their perspectives are invaluable in understanding the challenges that arise during outbreaks, especially in implementing prevention measures. Objective This study aimed to explore the potential risk components and prevention measures of the Ebola virus disease (EVD). Methods This study used an exploratory descriptive qualitative design. Five stakeholders, ten doctors and five nurses who had suffered from EVD during the outbreak in Liberia participated in semi-structured interviews to provide their experience and comprehensive perspectives on EVD. Data were collected from February 2022-August 2023. NVivo 12 plus was used for inductive thematic analysis. Results Six themes and several subthemes emerged: 1) transmission modes (body contact, body fluid, sexual intercourse, traditional burial), 2) funeral attendance (traditional practices and crowded gatherings), 3) community-led prevention (promoting good hygiene practices, increasing awareness, contact tracing, and surveillance), 4) Ebola virus vaccine (false sense of security, potential side effects, and limited data), 5) challenges in implementing prevention measures (inadequate health infrastructures, difficulty of tracing infected people, lack of resources, and cultural-social barriers), 6) Liberia's health systems (a weak, underfunded, fragile health infrastructure, lack of health facilities and shortage of health workers). Conclusion Several potential risk components contributing to the EVD outbreak should be a public concern. Strengthening the current healthcare system supported by local community and international aid providers (multidisciplinary teams) is needed to anticipate behavioral problems and to improve the efficacy of the prevention measures appropriate to the conditions in Liberia. Accordingly, the nurses' compliance with the recommended prevention practices is necessary.
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Affiliation(s)
- Moses Tende Stephens
- Master Program of Basic Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Health Science, United Methodist University, Monrovia, Liberia
| | - Juniastuti
- Department of Medical Microbiology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Sulistiawati
- Department of Public Health and Prevention Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Peter Chilaque Dossen
- Department of Health Science Education, William V.S Tubman University, Maryland, Liberia
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Keita M, Cherif IS, Polonsky JA, Boland ST, Kandako Y, Cherif MS, Kourouma M, Kamano AA, Bah H, Fofana IS, Ki-Zerbo GA, Dagron S, Chamla D, Gueye AS, Keiser O. Factors Associated with Reliable Contact Tracing During the 2021 Ebola Virus Disease Outbreak in Guinea. J Epidemiol Glob Health 2024:10.1007/s44197-024-00202-y. [PMID: 38372893 DOI: 10.1007/s44197-024-00202-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 01/30/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND In 2021, an Ebola virus disease (EVD) outbreak was declared in Guinea, linked to persistent virus from the 2014-2016 West Africa Epidemic. This paper analyzes factors associated with contact tracing reliability (defined as completion of a 21-day daily follow-up) during the 2021 outbreak, and transitively, provides recommendations for enhancing contact tracing reliability in future. METHODS We conducted a descriptive and analytical cross-sectional study using multivariate regression analysis of contact tracing data from 1071 EVD contacts of 23 EVD cases (16 confirmed and 7 probable). RESULTS Findings revealed statistically significant factors affecting contact tracing reliability. Unmarried contacts were 12.76× more likely to miss follow-up than those married (OR = 12.76; 95% CI [3.39-48.05]; p < 0.001). Rural-dwelling contacts had 99% lower odds of being missed during the 21-day follow-up, compared to those living in urban areas (OR = 0.01; 95% CI [0.00-0.02]; p < 0.01). Contacts who did not receive food donations were 3× more likely to be missed (OR = 3.09; 95% CI [1.68-5.65]; p < 0.001) compared to those who received them. Contacts in health areas with a single team were 8× more likely to be missed (OR = 8.16; 95% CI [5.57-11.96]; p < 0.01) than those in health areas with two or more teams (OR = 1.00; 95% CI [1.68-5.65]; p < 0.001). Unvaccinated contacts were 30.1× more likely to be missed compared to vaccinated contacts (OR = 30.1; 95% CI [5.12-176.83]; p < 0.001). CONCLUSION Findings suggest that contact tracing reliability can be significantly influenced by various demographic and organizational factors. Considering and understanding these factors-and where possible addressing them-may be crucial when designing and implementing contact tracing strategies during future outbreaks in low-resource settings.
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Affiliation(s)
- Mory Keita
- World Health Organization, Regional Office for Africa, Brazzaville, Congo.
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | | | - Jonathan A Polonsky
- Geneva Centre of Humanitarian Studies, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Epicentre, Geneva, Switzerland
| | - Samuel T Boland
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
- Chatham House, London, UK
| | - Youba Kandako
- Country Office for Guinea, World Health Organization, Conakry, Guinea
| | | | - Mamadou Kourouma
- Country Office for Guinea, World Health Organization, Conakry, Guinea
| | | | - Houssainatou Bah
- Country Office for Guinea, World Health Organization, Conakry, Guinea
| | | | | | - Stephanie Dagron
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Dick Chamla
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Abdou Salam Gueye
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Olivia Keiser
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Kinganda-Lusamaki E, Whitmer S, Lokilo-Lofiko E, Amuri-Aziza A, Muyembe-Mawete F, Makangara-Cigolo JC, Makaya G, Mbuyi F, Whitesell A, Kallay R, Choi M, Pratt C, Mukadi-Bamuleka D, Kavunga-Membo H, Matondo-Kuamfumu M, Mambu-Mbika F, Ekila-Ifinji R, Shoemaker T, Stewart M, Eng J, Rajan A, Soke GN, Fonjungo PN, Otshudiema JO, Folefack GLT, Pukuta-Simbu E, Talundzic E, Shedroff E, Bokete JL, Legand A, Formenty P, Mores CN, Porzucek AJ, Tritsch SR, Kombe J, Tshapenda G, Mulangu F, Ayouba A, Delaporte E, Peeters M, Wiley MR, Montgomery JM, Klena JD, Muyembe-Tamfum JJ, Ahuka-Mundeke S, Mbala-Kingebeni P. 2020 Ebola virus disease outbreak in Équateur Province, Democratic Republic of the Congo: a retrospective genomic characterisation. THE LANCET. MICROBE 2024; 5:e109-e118. [PMID: 38278165 PMCID: PMC10849974 DOI: 10.1016/s2666-5247(23)00259-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/08/2023] [Accepted: 08/15/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND The Democratic Republic of the Congo has had 15 Ebola virus disease (EVD) outbreaks, from 1976 to 2023. On June 1, 2020, the Democratic Republic of the Congo declared an outbreak of EVD in the western Équateur Province (11th outbreak), proximal to the 2018 Tumba and Bikoro outbreak and concurrent with an outbreak in the eastern Nord Kivu Province. In this Article, we assessed whether the 11th outbreak was genetically related to previous or concurrent EVD outbreaks and connected available epidemiological and genetic data to identify sources of possible zoonotic spillover, uncover additional unreported cases of nosocomial transmission, and provide a deeper investigation into the 11th outbreak. METHODS We analysed epidemiological factors from the 11th EVD outbreak to identify patient characteristics, epidemiological links, and transmission modes to explore virus spread through space, time, and age groups in the Équateur Province, Democratic Republic of the Congo. Trained field investigators and health professionals recorded data on suspected, probable, and confirmed cases, including demographic characteristics, possible exposures, symptom onset and signs and symptoms, and potentially exposed contacts. We used blood samples from individuals who were live suspected cases and oral swabs from individuals who were deceased to diagnose EVD. We applied whole-genome sequencing of 87 available Ebola virus genomes (from 130 individuals with EVD between May 19 and Sept 16, 2020), phylogenetic divergence versus time, and Bayesian reconstruction of phylogenetic trees to calculate viral substitution rates and study viral evolution. We linked the available epidemiological and genetic datasets to conduct a genomic and epidemiological study of the 11th EVD outbreak. FINDINGS Between May 19 and Sept 16, 2020, 130 EVD (119 confirmed and 11 probable) cases were reported across 13 Équateur Province health zones. The individual identified as the index case reported frequent consumption of bat meat, suggesting the outbreak started due to zoonotic spillover. Sequencing revealed two circulating Ebola virus variants associated with this outbreak-a Mbandaka variant associated with the majority (97%) of cases and a Tumba-like variant with similarity to the ninth EVD outbreak in 2018. The Tumba-like variant exhibited a reduced substitution rate, suggesting transmission from a previous survivor of EVD. INTERPRETATION Integrating genetic and epidemiological data allowed for investigative fact-checking and verified patient-reported sources of possible zoonotic spillover. These results demonstrate that rapid genetic sequencing combined with epidemiological data can inform responders of the mechanisms of viral spread, uncover novel transmission modes, and provide a deeper understanding of the outbreak, which is ultimately needed for infection prevention and control during outbreaks. FUNDING WHO and US Centers for Disease Control and Prevention.
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Affiliation(s)
- Eddy Kinganda-Lusamaki
- Pathogen Genomics Laboratory, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Service de Microbiologie, Cliniques Universitaires, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo; TransVIHMI, University of Montpellier, Institut de Recherche pour le Développement, INSERM, Montpellier, France
| | - Shannon Whitmer
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Emmanuel Lokilo-Lofiko
- Pathogen Genomics Laboratory, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Adrienne Amuri-Aziza
- Pathogen Genomics Laboratory, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Francisca Muyembe-Mawete
- Pathogen Genomics Laboratory, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Service de Microbiologie, Cliniques Universitaires, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jean Claude Makangara-Cigolo
- Pathogen Genomics Laboratory, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Service de Microbiologie, Cliniques Universitaires, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | | | | | - Amy Whitesell
- Service de Microbiologie, Cliniques Universitaires, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Ruth Kallay
- Emergency Response and Recovery Branch USA, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mary Choi
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Catherine Pratt
- Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Daniel Mukadi-Bamuleka
- Pathogen Genomics Laboratory, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Service de Microbiologie, Cliniques Universitaires, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Hugo Kavunga-Membo
- Pathogen Genomics Laboratory, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Meris Matondo-Kuamfumu
- Pathogen Genomics Laboratory, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Service de Microbiologie, Cliniques Universitaires, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Fabrice Mambu-Mbika
- Pathogen Genomics Laboratory, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Service de Microbiologie, Cliniques Universitaires, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Richard Ekila-Ifinji
- Pathogen Genomics Laboratory, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Service de Microbiologie, Cliniques Universitaires, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Trevor Shoemaker
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Miles Stewart
- Johns Hopkins University Applied Physics Laboratory, Johns Hopkins University, Laurel, MD, USA
| | - Julia Eng
- Johns Hopkins University Applied Physics Laboratory, Johns Hopkins University, Laurel, MD, USA
| | - Abraham Rajan
- Johns Hopkins University Applied Physics Laboratory, Johns Hopkins University, Laurel, MD, USA
| | - Gnakub N Soke
- Division of Global Health Protection, US Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo
| | - Peter N Fonjungo
- Division of Global HIV and Tuberculosis, US Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo
| | | | | | - Elisabeth Pukuta-Simbu
- Pathogen Genomics Laboratory, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Emir Talundzic
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elizabeth Shedroff
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Anaïs Legand
- Health Emergencies Programme, WHO, Geneva, Switzerland
| | | | - Christopher N Mores
- Global Health Department, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Abigail J Porzucek
- Global Health Department, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Sarah R Tritsch
- Global Health Department, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - John Kombe
- Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | | | - Felix Mulangu
- Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | - Ahidjo Ayouba
- TransVIHMI, University of Montpellier, Institut de Recherche pour le Développement, INSERM, Montpellier, France
| | - Eric Delaporte
- TransVIHMI, University of Montpellier, Institut de Recherche pour le Développement, INSERM, Montpellier, France
| | - Martine Peeters
- TransVIHMI, University of Montpellier, Institut de Recherche pour le Développement, INSERM, Montpellier, France
| | - Michael R Wiley
- Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA; PraesensBio, Omaha, NE, USA
| | - Joel M Montgomery
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - John D Klena
- Viral Special Pathogens Branch, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jean-Jacques Muyembe-Tamfum
- Pathogen Genomics Laboratory, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Service de Microbiologie, Cliniques Universitaires, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Steve Ahuka-Mundeke
- Pathogen Genomics Laboratory, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Service de Microbiologie, Cliniques Universitaires, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Placide Mbala-Kingebeni
- Pathogen Genomics Laboratory, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Service de Microbiologie, Cliniques Universitaires, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo.
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9
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Dobbs KR, Lobb A, Dent AE. Ebola virus disease in children: epidemiology, pathogenesis, management, and prevention. Pediatr Res 2024; 95:488-495. [PMID: 37903937 DOI: 10.1038/s41390-023-02873-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/06/2023] [Accepted: 10/12/2023] [Indexed: 11/01/2023]
Abstract
Ebola disease is a severe disease with extremely high case-fatality rates ranging from 28-100%. Observations made during the 2013-2016 West African epidemic improved our understanding of the clinical course of Ebola disease and accelerated the study of therapeutic and preventative strategies. The epidemic also highlighted the unique challenges associated with providing optimal care for children during Ebola disease outbreaks. In this review, we outline current understanding of Ebola disease epidemiology, pathogenesis, management, and prevention, highlighting data pertinent to the care of children. IMPACT: In this review, we summarize recent advancements in our understanding of Ebola disease epidemiology, clinical presentation, and therapeutic and preventative strategies. We highlight recent data pertinent to the care of children and pregnant women and identify research gaps for this important emerging viral infection in children.
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Affiliation(s)
- Katherine R Dobbs
- Case Western Reserve University School of Medicine, Cleveland, OH, USA.
- UH Rainbow Babies and Children's Hospital, Cleveland, OH, USA.
| | - Alyssa Lobb
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Arlene E Dent
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
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10
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Chen Z, Lemey P, Yu H. Approaches and challenges to inferring the geographical source of infectious disease outbreaks using genomic data. THE LANCET. MICROBE 2024; 5:e81-e92. [PMID: 38042165 DOI: 10.1016/s2666-5247(23)00296-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/03/2023] [Accepted: 09/13/2023] [Indexed: 12/04/2023]
Abstract
Genomic data hold increasing potential in the elucidation of transmission dynamics and geographical sources of infectious disease outbreaks. Phylogeographic methods that use epidemiological and genomic data obtained from surveillance enable us to infer the history of spatial transmission that is naturally embedded in the topology of phylogenetic trees as a record of the dispersal of infectious agents between geographical locations. In this Review, we provide an overview of phylogeographic approaches widely used for reconstructing the geographical sources of outbreaks of interest. These approaches can be classified into ancestral trait or state reconstruction and structured population models, with structured population models including popular structured coalescent and birth-death models. We also describe the major challenges associated with sequencing technologies, surveillance strategies, data sharing, and analysis frameworks that became apparent during the generation of large-scale genomic data in recent years, extending beyond inference approaches. Finally, we highlight the role of genomic data in geographical source inference and clarify how this enhances understanding and molecular investigations of outbreak sources.
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Affiliation(s)
- Zhiyuan Chen
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Philippe Lemey
- Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Clinical and Evolutionary Virology, KU Leuven, Leuven, Belgium
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
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11
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Huttner A, Agnandji ST, Engler O, Hooper JW, Kwilas S, Ricks K, Clements TL, Jonsdottir HR, Nakka SS, Rothenberger S, Kremsner P, Züst R, Medaglini D, Ottenhoff T, Harandi AM, Siegrist CA. Antibody responses to recombinant vesicular stomatitis virus-Zaire Ebolavirus vaccination for Ebola virus disease across doses and continents: 5-year durability. Clin Microbiol Infect 2023; 29:1587-1594. [PMID: 37661067 DOI: 10.1016/j.cmi.2023.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/27/2023] [Accepted: 08/28/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVES To report 5-year persistence and avidity of antibodies produced by the live-attenuated recombinant vesicular stomatitis virus (rVSV) expressing the Zaire Ebolavirus (ZEBOV) glycoprotein (GP), known as rVSV-ZEBOV (Ervebo®). METHODS Healthy adults vaccinated with 300,000 or 10-50 million plaque-forming units of rVSV-ZEBOV in the WHO-coordinated trials of 2014-2015 were followed for up to 4 (Lambaréné, Gabon) and 5 (Geneva, Switzerland) years. We report seropositivity rates, geometric mean titres (GMTs), and population distribution of ZEBOV-GP ELISA IgG antibodies, neutralizing antibodies (pseudovirus and live-virus neutralization) and antibody avidity; the primary outcome was ZEBOV-GP ELISA IgG GMTs at 4 or 5 years compared with 1 year (Y1) after immunization. RESULTS Among the 168 eligible vaccinees (Geneva: 97 and Lambaréné: 71) enrolled 1 year post-immunization, 146 (87%) remained enrolled at 4 years (Geneva: n = 88, Lambaréné: n = 58), and 84 (87%, Geneva) at 5 years post-vaccination. ZEBOV-GP ELISA IgG GMTs plateaued, with no declining trend from 1 year through the last time point assessed (1147.8 [95% CI 874.3-1507.0] at Y1 versus 1548.1 [95% CI 1136.6-2108.5] at Y5 in Geneva volunteers receiving ≥10 million plaque-forming units of rVSV-ZEBOV), their avidity matching that of ZEBOV convalescents. Live-virus neutralizing antibodies were detected for shorter periods and in fewer vaccinees (53/95 [56%] at Y1 versus 35/84 [42%] at Y5 in Geneva volunteers, all dose levels). DISCUSSION Titres at Y1 emerged as a correlate of antibody persistence at Y5. The findings of persistent ZEBOV-GP ELISA IgG titres yet shorter-lasting, lower titres of live-virus neutralizing antibodies suggest the contribution of antibody-mediated protective mechanisms other than neutralization. Long-term clinical efficacy of rVSV-ZEBOV, however, requires further study.
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Affiliation(s)
- Angela Huttner
- Division of Infectious Diseases, University Hospitals of Geneva, Geneva, Switzerland; Clinical Trials Unit, Centre for Clinical Research, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland; Centre for Vaccinology, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland.
| | - Selidji Todagbe Agnandji
- Centre de Recherches Médicales de Lambaréné, Campus CERMEL, Lambaréné, Gabon; Institut für Tropenmedizin, Reisemedizin und Humanparasitologie Universitätsklinikum Tübingen, Tübingen, Germany; GermanCenter for Infection Research (DZIF), Partner Site Tübingen, Tübingen, Germany
| | - Olivier Engler
- Spiez Laboratory, Federal Office for Civil Protection, Spiez, Switzerland
| | - Jay W Hooper
- Foundational Science Directorate, US Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Steve Kwilas
- Foundational Science Directorate, US Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Keersten Ricks
- Foundational Science Directorate, US Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Tamara L Clements
- Foundational Science Directorate, US Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Hulda R Jonsdottir
- Spiez Laboratory, Federal Office for Civil Protection, Spiez, Switzerland
| | - Sravya Sowdamini Nakka
- Department of Microbiology and Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sylvia Rothenberger
- Spiez Laboratory, Federal Office for Civil Protection, Spiez, Switzerland; Institute of Microbiology, University Hospital Center and University of Lausanne, Lausanne, Switzerland
| | - Peter Kremsner
- Centre de Recherches Médicales de Lambaréné, Campus CERMEL, Lambaréné, Gabon; Institut für Tropenmedizin, Reisemedizin und Humanparasitologie Universitätsklinikum Tübingen, Tübingen, Germany; GermanCenter for Infection Research (DZIF), Partner Site Tübingen, Tübingen, Germany
| | - Roland Züst
- Spiez Laboratory, Federal Office for Civil Protection, Spiez, Switzerland
| | - Donata Medaglini
- Laboratory of Molecular Microbiology and Biotechnology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Tom Ottenhoff
- Department of Infectious Diseases, Leiden Hospital Centre and University Hospital, Leiden, The Netherlands
| | - Ali M Harandi
- Department of Microbiology and Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Vaccine Evaluation Centre, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Claire-Anne Siegrist
- Centre for Vaccinology, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
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12
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Kasumba DM, Misasi J, Mulangu S, Mbala-Kingebeni P. Exploring host-virus interaction to improve immunotherapy against Ebola virus. Trends Pharmacol Sci 2023; 44:857-861. [PMID: 37845170 DOI: 10.1016/j.tips.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/07/2023] [Accepted: 09/20/2023] [Indexed: 10/18/2023]
Abstract
Recent immunological advances have led to the development of FDA-approved immunotherapies against Ebola virus (EBOV). However, patients with high viral loads have not seen as large a benefit as mild cases. Here we discuss areas of investigation that may lead to adjunctive immune therapy for patients with severe EBOV disease.
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Affiliation(s)
- Dacquin M Kasumba
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Axis of Molecular Immunology and Pathogenesis, Molecular Biology Unit, Department of Basic Sciences, Faculty of Medicine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo.
| | - John Misasi
- National Institutes of Health, National Institute of Allergy and Infectious Diseases, Vaccine Research Center, Bethesda, MD 20892, USA.
| | - Sabue Mulangu
- Global Medical Affairs, Ridgeback Biotherapeutics, Miami, FL, USA.
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13
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Prasad AN, Agans KN, Geisbert JB, Borisevich V, Deer DJ, Dobias NS, Comer JE, Woolsey C, Fenton KA, Geisbert TW, Cross RW. Natural History of Nonhuman Primates After Oral Exposure to Ebola Virus Variant Makona. J Infect Dis 2023; 228:S571-S581. [PMID: 37348509 PMCID: PMC10651204 DOI: 10.1093/infdis/jiad225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/03/2023] [Accepted: 06/21/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND The primary route of infection by Ebola virus (EBOV) is through contact of mucosal surfaces. Few studies have explored infection of nonhuman primates (NHPs) via the oral mucosa, which is a probable portal of natural infection in humans. METHODS To further characterize the pathogenesis of EBOV infection via the oral exposure route, we challenged cohorts of cynomolgus monkeys with low doses of EBOV variant Makona. RESULTS Infection with 100 or 50 PFU of EBOV Makona via the oral route resulted in 50% and 83% lethality, respectively. Animals that progressed to fatal disease exhibited lymphopenia, marked coagulopathy, high viral loads, and increased levels of serum markers of inflammation and hepatic/renal injury. Survival in these cohorts was associated with milder fluctuations in leukocyte populations, lack of coagulopathy, and reduced or absent serum markers of inflammation and/or hepatic/renal function. Surprisingly, 2 surviving animals from the 100- and 50-PFU cohorts developed transient low-level viremia in the absence of other clinical signs of disease. Conversely, all animals in the 10 PFU cohort remained disease free and survived to the study end point. CONCLUSIONS Our observations highlight the susceptibility of NHPs, and by extension, likely humans, to relatively low doses of EBOV via the oral route.
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Affiliation(s)
- Abhishek N Prasad
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Krystle N Agans
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Joan B Geisbert
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Viktoriya Borisevich
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Daniel J Deer
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Natalie S Dobias
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Jason E Comer
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Courtney Woolsey
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Karla A Fenton
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Thomas W Geisbert
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Robert W Cross
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
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14
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Judson SD, Munster VJ. The Multiple Origins of Ebola Disease Outbreaks. J Infect Dis 2023; 228:S465-S473. [PMID: 37592878 PMCID: PMC10651193 DOI: 10.1093/infdis/jiad352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/10/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND The origins of Ebola disease outbreaks remain enigmatic. Historically outbreaks have been attributed to spillover events from wildlife. However, recent data suggest that some outbreaks may originate from human-to-human transmission of prior outbreak strains instead of spillover. Clarifying the origins of Ebola disease outbreaks could improve detection and mitigation of future outbreaks. METHODS We reviewed the origins of all Ebola disease outbreaks from 1976 to 2022 to analyze the earliest cases and characteristics of each outbreak. The epidemiology and phylogenetic relationships of outbreak strains were used to further identify the likely source of each outbreak. RESULTS From 1976 to 2022 there were 35 Ebola disease outbreaks with 48 primary/index cases. While the majority of outbreaks were associated with wildlife spillover, resurgence of human-to-human transmission could account for roughly a quarter of outbreaks caused by Ebola virus. Larger outbreaks were more likely to lead to possible resurgence, and nosocomial transmission was associated with the majority of outbreaks. CONCLUSIONS While spillover from wildlife has been a source for many Ebola disease outbreaks, multiple outbreaks may have originated from flare-ups of prior outbreak strains. Improving access to diagnostics as well as identifying groups at risk for resurgence of ebolaviruses will be crucial to preventing future outbreaks.
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Affiliation(s)
- Seth D Judson
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Vincent J Munster
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana, USA
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15
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Ji X, Fisher AA, Su S, Thorne JL, Potter B, Lemey P, Baele G, Suchard MA. Scalable Bayesian Divergence Time Estimation With Ratio Transformations. Syst Biol 2023; 72:1136-1153. [PMID: 37458991 PMCID: PMC10636426 DOI: 10.1093/sysbio/syad039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 06/13/2023] [Accepted: 06/30/2023] [Indexed: 11/08/2023] Open
Abstract
Divergence time estimation is crucial to provide temporal signals for dating biologically important events from species divergence to viral transmissions in space and time. With the advent of high-throughput sequencing, recent Bayesian phylogenetic studies have analyzed hundreds to thousands of sequences. Such large-scale analyses challenge divergence time reconstruction by requiring inference on highly correlated internal node heights that often become computationally infeasible. To overcome this limitation, we explore a ratio transformation that maps the original $N-1$ internal node heights into a space of one height parameter and $N-2$ ratio parameters. To make the analyses scalable, we develop a collection of linear-time algorithms to compute the gradient and Jacobian-associated terms of the log-likelihood with respect to these ratios. We then apply Hamiltonian Monte Carlo sampling with the ratio transform in a Bayesian framework to learn the divergence times in 4 pathogenic viruses (West Nile virus, rabies virus, Lassa virus, and Ebola virus) and the coralline red algae. Our method both resolves a mixing issue in the West Nile virus example and improves inference efficiency by at least 5-fold for the Lassa and rabies virus examples as well as for the algae example. Our method now also makes it computationally feasible to incorporate mixed-effects molecular clock models for the Ebola virus example, confirms the findings from the original study, and reveals clearer multimodal distributions of the divergence times of some clades of interest.
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Affiliation(s)
- Xiang Ji
- Department of Mathematics, School of Science & Engineering, Tulane University, 6823 St. Charles Avenue, New Orleans, LA 70118, USA
| | - Alexander A Fisher
- Department of Statistical Science, Duke University, 214 Old Chemistry, Durham, NC 27708, USA
| | - Shuo Su
- MOE International Joint Collaborative Research Laboratory for Animal Health & Food Safety, Jiangsu Engineering Laboratory of Animal Immunology, Institute of Immunology, College of Veterinary Medicine, Nanjing Agricultural University, No. 1 Weigang, Xiaolingwei District, Nanjing, Jiangsu 210095, China
| | - Jeffrey L Thorne
- Bioinformatics Research Center, North Carolina State University, Raleigh, NC, USA
- Department of Statistics, North Carolina State University, Raleigh, NC, USA
- Department of Biological Sciences, North Carolina State University, Ricks Hall, 1 Lampe Dr, Raleigh, NC 27607, USA
| | - Barney Potter
- Department of Microbiology, Immunology and Transplantation, Rega Institute, Herestraat 49, 3000 Leuven, Belgium
| | - Philippe Lemey
- Department of Microbiology, Immunology and Transplantation, Rega Institute, Herestraat 49, 3000 Leuven, Belgium
| | - Guy Baele
- Department of Microbiology, Immunology and Transplantation, Rega Institute, Herestraat 49, 3000 Leuven, Belgium
| | - Marc A Suchard
- Department of Biomathematics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, 695 Charles E Young Dr S, Los Angeles, CA 90095, USA
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16
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Weber N, Nagy M, Markotter W, Schaer J, Puechmaille SJ, Sutton J, Dávalos LM, Dusabe MC, Ejotre I, Fenton MB, Knörnschild M, López-Baucells A, Medellin RA, Metz M, Mubareka S, Nsengimana O, O'Mara MT, Racey PA, Tuttle M, Twizeyimana I, Vicente-Santos A, Tschapka M, Voigt CC, Wikelski M, Dechmann DK, Reeder DM. Robust evidence for bats as reservoir hosts is lacking in most African virus studies: a review and call to optimize sampling and conserve bats. Biol Lett 2023; 19:20230358. [PMID: 37964576 PMCID: PMC10646460 DOI: 10.1098/rsbl.2023.0358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/25/2023] [Indexed: 11/16/2023] Open
Abstract
Africa experiences frequent emerging disease outbreaks among humans, with bats often proposed as zoonotic pathogen hosts. We comprehensively reviewed virus-bat findings from papers published between 1978 and 2020 to evaluate the evidence that African bats are reservoir and/or bridging hosts for viruses that cause human disease. We present data from 162 papers (of 1322) with original findings on (1) numbers and species of bats sampled across bat families and the continent, (2) how bats were selected for study inclusion, (3) if bats were terminally sampled, (4) what types of ecological data, if any, were recorded and (5) which viruses were detected and with what methodology. We propose a scheme for evaluating presumed virus-host relationships by evidence type and quality, using the contrasting available evidence for Orthoebolavirus versus Orthomarburgvirus as an example. We review the wording in abstracts and discussions of all 162 papers, identifying key framing terms, how these refer to findings, and how they might contribute to people's beliefs about bats. We discuss the impact of scientific research communication on public perception and emphasize the need for strategies that minimize human-bat conflict and support bat conservation. Finally, we make recommendations for best practices that will improve virological study metadata.
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Affiliation(s)
- Natalie Weber
- Department of Migration, Max Planck Institute of Animal Behavior, Radolfzell, Germany
- University of Ulm, Institute of Evolutionary Ecology and Conservation Genomics, Ulm, Germany
| | - Martina Nagy
- Museum für Naturkunde, Leibniz-Institute for Evolution and Biodiversity Science, Berlin, Germany
| | - Wanda Markotter
- Centre for Viral Zoonoses, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Juliane Schaer
- Museum für Naturkunde, Leibniz-Institute for Evolution and Biodiversity Science, Berlin, Germany
- Institute of Biology, Humboldt University, Berlin, Germany
| | - Sébastien J. Puechmaille
- ISEM, University of Montpellier, Montpellier, France
- Institut Universitaire de France, Paris, France
- Zoological Institute and Museum, University of Greifswald, Greifswald, Germany
| | | | - Liliana M. Dávalos
- Department of Ecology and Evolution and Consortium for Inter-Disciplinary Environmental Research, Stony Brook University, Stony Brook, USA
| | | | - Imran Ejotre
- Institute of Biology, Humboldt University, Berlin, Germany
- Muni University, Arua, Uganda
| | - M. Brock Fenton
- Department of Biology, University of Western Ontario, London, Ontario, Canada
| | - Mirjam Knörnschild
- Museum für Naturkunde, Leibniz-Institute for Evolution and Biodiversity Science, Berlin, Germany
- Evolutionary Ethology, Institute for Biology, Humboldt-Universität zu Berlin, Berlin, Germany
- Smithsonian Tropical Research Institute, Balboa, Ancón, Panama
| | | | - Rodrigo A. Medellin
- Institute of Ecology, National Autonomous University of Mexico, Mexico City, Mexico
| | | | - Samira Mubareka
- Sunnybrook Research Institute and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | | | - M. Teague O'Mara
- Department of Migration, Max Planck Institute of Animal Behavior, Radolfzell, Germany
- Smithsonian Tropical Research Institute, Balboa, Ancón, Panama
- Bat Conservation International Austin, TX, USA
- Department of Biological Sciences, Southeastern Louisiana University, Hammond, LA, USA
| | - Paul A. Racey
- Centre for Ecology and Conservation, University of Exeter, Exeter, UK
| | - Merlin Tuttle
- Merlin Tuttle's Bat Conservation, Austin, TX USA
- Department of Integrative Biology, University of Texas, Austin, USA
| | | | - Amanda Vicente-Santos
- Graduate Program in Population Biology, Ecology and Emory University, Atlanta, GA, USA
- Department of Biology, University of Oklahoma, Norman, OK, USA
| | - Marco Tschapka
- University of Ulm, Institute of Evolutionary Ecology and Conservation Genomics, Ulm, Germany
- Smithsonian Tropical Research Institute, Balboa, Ancón, Panama
| | | | - Martin Wikelski
- Department of Migration, Max Planck Institute of Animal Behavior, Radolfzell, Germany
- Department of Biology, University of Konstanz, Konstanz, Germany
| | - Dina K.N. Dechmann
- Department of Migration, Max Planck Institute of Animal Behavior, Radolfzell, Germany
- Smithsonian Tropical Research Institute, Balboa, Ancón, Panama
- Department of Biology, University of Konstanz, Konstanz, Germany
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17
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Dupuy LC, Spiropoulou CF, Towner JS, Spengler JR, Sullivan NJ, Montgomery JM. Filoviruses: Scientific Gaps and Prototype Pathogen Recommendation. J Infect Dis 2023; 228:S446-S459. [PMID: 37849404 PMCID: PMC11009505 DOI: 10.1093/infdis/jiad362] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Abstract
Viruses in the family Filoviridae, including the commonly known Ebola (EBOV) and Marburg (MARV) viruses, can cause severe hemorrhagic fever in humans and nonhuman primates. Sporadic outbreaks of filovirus disease occur in sub-Saharan Africa with reported case fatality rates ranging from 25% to 90%. The high mortality and increasing frequency and magnitude of recent outbreaks along with the increased potential for spread from rural to urban areas highlight the importance of pandemic preparedness for these viruses. Despite their designation as high-priority pathogens, numerous scientific gaps exist in critical areas. In this review, these gaps and an assessment of potential prototype pathogen candidates are presented for this important virus family.
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Affiliation(s)
- Lesley C Dupuy
- Virology Branch, Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Christina F Spiropoulou
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jonathan S Towner
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jessica R Spengler
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nancy J Sullivan
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts, USA
| | - Joel M Montgomery
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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18
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Peeters M, Champagne M, Ndong Bass I, Goumou S, Ndimbo Kumugo SP, Lacroix A, Esteban A, Meta Djomsi D, Soumah AK, Mbala Kingebeni P, Mba Djonzo FA, Lempu G, Thaurignac G, Mpoudi Ngole E, Kouanfack C, Mukadi Bamuleka D, Likofata J, Muyembe Tamfum JJ, De Nys H, Capelle J, Toure A, Delaporte E, Keita AK, Ahuka Mundeke S, Ayouba A. Extensive Survey and Analysis of Factors Associated with Presence of Antibodies to Orthoebolaviruses in Bats from West and Central Africa. Viruses 2023; 15:1927. [PMID: 37766333 PMCID: PMC10536003 DOI: 10.3390/v15091927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
The seroprevalence to orthoebolaviruses was studied in 9594 bats (5972 frugivorous and 3622 insectivorous) from Cameroon, the Democratic Republic of Congo (DRC) and Guinea, with a Luminex-based serological assay including recombinant antigens of four orthoebolavirus species. Seroprevalence is expressed as a range according to different cut-off calculations. Between 6.1% and 18.9% bat samples reacted with at least one orthoebolavirus antigen; the highest reactivity was seen with Glycoprotein (GP) antigens. Seroprevalence varied per species and was higher in frugivorous than insectivorous bats; 9.1-27.5% versus 1.3-4.6%, respectively. Seroprevalence in male (13.5%) and female (14.4%) bats was only slightly different and was higher in adults (14.9%) versus juveniles (9.4%) (p < 0.001). Moreover, seroprevalence was highest in subadults (45.4%) when compared to mature adults (19.2%), (p < 0.001). Our data suggest orthoebolavirus circulation is highest in young bats. More long-term studies are needed to identify birthing pulses for the different bat species in diverse geographic regions and to increase the chances of detecting viral RNA in order to document the genetic diversity of filoviruses in bats and their pathogenic potential for humans. Frugivorous bats seem more likely to be reservoirs of orthoebolaviruses, but the role of insectivorous bats has also to be further examined.
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Affiliation(s)
- Martine Peeters
- TransVIHMI, University of Montpellier, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche pour le Développement (IRD), 34394 Montpellier, France; (M.C.); (A.L.); (A.E.); (G.T.); (E.D.)
| | - Maëliss Champagne
- TransVIHMI, University of Montpellier, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche pour le Développement (IRD), 34394 Montpellier, France; (M.C.); (A.L.); (A.E.); (G.T.); (E.D.)
| | - Innocent Ndong Bass
- Centre de Recherche sur les Maladies Emergentes et Réémergentes (CREMER), Yaounde P.O. Box 1857, Cameroon; (I.N.B.); (D.M.D.); (F.A.M.D.); (C.K.)
| | - Souana Goumou
- Centre de Recherche et de Formation en Infectiologie de Guinée (CERFIG), Université Gamal Abdel Nasser de Conakry, Conakry BP6629, Guinea; (S.G.); (A.K.S.); (A.T.); (A.K.K.)
| | - Simon-Pierre Ndimbo Kumugo
- National Institute of Biomedical Research (INRB), Kinshasa P.O. Box 1197, Democratic Republic of the Congo; (S.-P.N.K.); (P.M.K.); (G.L.); (D.M.B.); (J.-J.M.T.); (S.A.M.)
| | - Audrey Lacroix
- TransVIHMI, University of Montpellier, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche pour le Développement (IRD), 34394 Montpellier, France; (M.C.); (A.L.); (A.E.); (G.T.); (E.D.)
| | - Amandine Esteban
- TransVIHMI, University of Montpellier, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche pour le Développement (IRD), 34394 Montpellier, France; (M.C.); (A.L.); (A.E.); (G.T.); (E.D.)
| | - Dowbiss Meta Djomsi
- Centre de Recherche sur les Maladies Emergentes et Réémergentes (CREMER), Yaounde P.O. Box 1857, Cameroon; (I.N.B.); (D.M.D.); (F.A.M.D.); (C.K.)
| | - Abdoul Karim Soumah
- Centre de Recherche et de Formation en Infectiologie de Guinée (CERFIG), Université Gamal Abdel Nasser de Conakry, Conakry BP6629, Guinea; (S.G.); (A.K.S.); (A.T.); (A.K.K.)
| | - Placide Mbala Kingebeni
- National Institute of Biomedical Research (INRB), Kinshasa P.O. Box 1197, Democratic Republic of the Congo; (S.-P.N.K.); (P.M.K.); (G.L.); (D.M.B.); (J.-J.M.T.); (S.A.M.)
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa P.O. Box 1197, Democratic Republic of the Congo
| | - Flaubert Auguste Mba Djonzo
- Centre de Recherche sur les Maladies Emergentes et Réémergentes (CREMER), Yaounde P.O. Box 1857, Cameroon; (I.N.B.); (D.M.D.); (F.A.M.D.); (C.K.)
| | - Guy Lempu
- National Institute of Biomedical Research (INRB), Kinshasa P.O. Box 1197, Democratic Republic of the Congo; (S.-P.N.K.); (P.M.K.); (G.L.); (D.M.B.); (J.-J.M.T.); (S.A.M.)
| | - Guillaume Thaurignac
- TransVIHMI, University of Montpellier, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche pour le Développement (IRD), 34394 Montpellier, France; (M.C.); (A.L.); (A.E.); (G.T.); (E.D.)
| | - Eitel Mpoudi Ngole
- Centre de Recherche sur les Maladies Emergentes et Réémergentes (CREMER), Yaounde P.O. Box 1857, Cameroon; (I.N.B.); (D.M.D.); (F.A.M.D.); (C.K.)
| | - Charles Kouanfack
- Centre de Recherche sur les Maladies Emergentes et Réémergentes (CREMER), Yaounde P.O. Box 1857, Cameroon; (I.N.B.); (D.M.D.); (F.A.M.D.); (C.K.)
| | - Daniel Mukadi Bamuleka
- National Institute of Biomedical Research (INRB), Kinshasa P.O. Box 1197, Democratic Republic of the Congo; (S.-P.N.K.); (P.M.K.); (G.L.); (D.M.B.); (J.-J.M.T.); (S.A.M.)
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa P.O. Box 1197, Democratic Republic of the Congo
| | - Jacques Likofata
- Laboratoire Provincial de Mbandaka, Equateur, Democratic Republic of the Congo;
| | - Jean-Jacques Muyembe Tamfum
- National Institute of Biomedical Research (INRB), Kinshasa P.O. Box 1197, Democratic Republic of the Congo; (S.-P.N.K.); (P.M.K.); (G.L.); (D.M.B.); (J.-J.M.T.); (S.A.M.)
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa P.O. Box 1197, Democratic Republic of the Congo
| | - Helene De Nys
- Astre, CIRAD, INRAE, University of Montpellier, 34398 Montpellier, France; (H.D.N.); (J.C.)
- Astre, CIRAD, 6 Lanark Road, Harare, Zimbabwe
| | - Julien Capelle
- Astre, CIRAD, INRAE, University of Montpellier, 34398 Montpellier, France; (H.D.N.); (J.C.)
| | - Abdoulaye Toure
- Centre de Recherche et de Formation en Infectiologie de Guinée (CERFIG), Université Gamal Abdel Nasser de Conakry, Conakry BP6629, Guinea; (S.G.); (A.K.S.); (A.T.); (A.K.K.)
| | - Eric Delaporte
- TransVIHMI, University of Montpellier, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche pour le Développement (IRD), 34394 Montpellier, France; (M.C.); (A.L.); (A.E.); (G.T.); (E.D.)
| | - Alpha Kabinet Keita
- Centre de Recherche et de Formation en Infectiologie de Guinée (CERFIG), Université Gamal Abdel Nasser de Conakry, Conakry BP6629, Guinea; (S.G.); (A.K.S.); (A.T.); (A.K.K.)
| | - Steve Ahuka Mundeke
- National Institute of Biomedical Research (INRB), Kinshasa P.O. Box 1197, Democratic Republic of the Congo; (S.-P.N.K.); (P.M.K.); (G.L.); (D.M.B.); (J.-J.M.T.); (S.A.M.)
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa P.O. Box 1197, Democratic Republic of the Congo
| | - Ahidjo Ayouba
- TransVIHMI, University of Montpellier, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche pour le Développement (IRD), 34394 Montpellier, France; (M.C.); (A.L.); (A.E.); (G.T.); (E.D.)
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19
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Hussein HA. Brief review on ebola virus disease and one health approach. Heliyon 2023; 9:e19036. [PMID: 37600424 PMCID: PMC10432691 DOI: 10.1016/j.heliyon.2023.e19036] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 07/31/2023] [Accepted: 08/07/2023] [Indexed: 08/22/2023] Open
Abstract
Ebola virus disease (EVD) is a severe and highly fatal zoonotic disease caused by viruses in the family Filoviridae and genus Ebolavirus. The disease first appeared in Zaire near the Ebola River in 1976, now in the Democratic Republic of the Congo. Since then, several outbreaks have been reported in different parts of the world, mainly in Africa, leading to the identification of six distinct viral strains that cause disease in humans and other primates. Bats are assumed to be the main reservoir hosts of the virus, and the initial incidence of human epidemics invariably follows exposure to infected forest animals through contact or consumption of bush meat and body fluids of forest animals harboring the disease. Human-to-human transmission occurs when contaminated body fluids, utensils, and equipment come in contact with broken or abraded skin and mucous membranes. EVD is characterized by sudden onset of 'flu-like' symptoms (fever, myalgia, chills), vomiting and diarrhea, then disease rapidly evolves into a severe state with a rapid clinical decline which may lead potential hemorrhagic complications and multiple organ failure. Effective EVD prevention, detection, and response necessitate strong coordination across the animal, human, and environmental health sectors, as well as well-defined roles and responsibilities evidencing the significance of one health approach; the natural history, epidemiology, pathogenesis, and diagnostic procedures of the Ebola virus, as well as prevention and control efforts in light of one health approach, are discussed in this article.
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Affiliation(s)
- Hassan Abdi Hussein
- College of Veterinary Medicine, Department of One Health Tropical Infectious Disease, Jigjiga University, P.O. Box: 1020, Jigjiga, Ethiopia
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20
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Ye W, Ye C, Li J, Lei Y, Zhang F. Lessons from Pasteur may help prevent the deadly relapse of Ebola in patients: Using contingency vaccination to avoid Ebola relapse in immune-privileged organs. Front Immunol 2023; 14:1060481. [PMID: 37020563 PMCID: PMC10067591 DOI: 10.3389/fimmu.2023.1060481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 03/06/2023] [Indexed: 03/22/2023] Open
Affiliation(s)
- Wei Ye
- Department of Microbiology, School of Preclinical Medicine, Airforce Medical University: Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Chuantao Ye
- Department of Infectious Diseases, Tangdu Hospital, Airforce Medical University: Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Jia Li
- Department of Neurology, Xi’an International Medical Center Hospital, Xi’an, Shaanxi, China
| | - Yingfeng Lei
- Department of Microbiology, School of Preclinical Medicine, Airforce Medical University: Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Fanglin Zhang
- Department of Microbiology, School of Preclinical Medicine, Airforce Medical University: Fourth Military Medical University, Xi’an, Shaanxi, China
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21
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Cross RW, Prasad AN, Woolsey CB, Agans KN, Borisevich V, Dobias NS, Comer JE, Deer DJ, Geisbert JB, Rasmussen AL, Lipkin WI, Fenton KA, Geisbert TW. Natural history of nonhuman primates after conjunctival exposure to Ebola virus. Sci Rep 2023; 13:4175. [PMID: 36914721 PMCID: PMC10011569 DOI: 10.1038/s41598-023-31027-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/06/2023] [Indexed: 03/16/2023] Open
Abstract
Transmission of Ebola virus (EBOV) primarily occurs via contact exposure of mucosal surfaces with infected body fluids. Historically, nonhuman primate (NHP) challenge studies have employed intramuscular (i.m.) or small particle aerosol exposure, which are largely lethal routes of infection, but mimic worst-case scenarios such as a needlestick or intentional release, respectively. When exposed by more likely routes of natural infection, limited NHP studies have shown delayed onset of disease and reduced mortality. Here, we performed a series of systematic natural history studies in cynomolgus macaques with a range of conjunctival exposure doses. Challenge with 10,000 plaque forming units (PFU) of EBOV was uniformly lethal, whereas 5/6 subjects survived lower dose challenges (100 or 500 PFU). Conjunctival challenge resulted in a protracted time-to death compared to i.m. Asymptomatic infection was observed in survivors with limited detection of EBOV replication. Inconsistent seropositivity in survivors may suggest physical or natural immunological barriers are sufficient to prevent widespread viral dissemination.
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Affiliation(s)
- Robert W Cross
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA
| | - Abhishek N Prasad
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA
| | - Courtney B Woolsey
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA
| | - Krystle N Agans
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA
| | - Viktoriya Borisevich
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA
| | - Natalie S Dobias
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA
| | - Jason E Comer
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA
| | - Daniel J Deer
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA
| | - Joan B Geisbert
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA
| | - Angela L Rasmussen
- Center for Infection and Immunity, Columbia Mailman School of Public Health, New York, NY, 10032, USA
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, SK, Canada
| | - Walter Ian Lipkin
- Center for Infection and Immunity, Columbia Mailman School of Public Health, New York, NY, 10032, USA
| | - Karla A Fenton
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA
| | - Thomas W Geisbert
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA.
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA.
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22
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Hunegnaw R, Honko AN, Wang L, Carr D, Murray T, Shi W, Nguyen L, Storm N, Dulan CNM, Foulds KE, Agans KN, Cross RW, Geisbert JB, Cheng C, Ploquin A, Stanley DA, Geisbert TW, Nabel GJ, Sullivan NJ. A single-shot ChAd3-MARV vaccine confers rapid and durable protection against Marburg virus in nonhuman primates. Sci Transl Med 2022; 14:eabq6364. [PMID: 36516269 DOI: 10.1126/scitranslmed.abq6364] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Marburg virus (MARV) causes a severe hemorrhagic fever disease in primates with mortality rates in humans of up to 90%. MARV has been identified as a category A bioterrorism agent by the Centers for Disease Control and Prevention (CDC) and priority pathogen A by the National Institute of Allergy and Infectious Diseases (NIAID), needing urgent research and development of countermeasures because of the high public health risk it poses. The recent cases of MARV in West Africa underscore the substantial outbreak potential of this virus. The potential for cross-border spread, as had occurred during the 2014-2016 Ebola virus outbreak, illustrates the critical need for MARV vaccines. To support regulatory approval of the chimpanzee adenovirus 3 (ChAd3)-MARV vaccine that has completed phase 1 trials, we showed that the nonreplicating ChAd3 vector, which has a demonstrated safety profile in humans, protected against a uniformly lethal challenge with MARV/Ang. Protective immunity was achieved within 7 days of vaccination and was maintained through 1 year after vaccination. Antigen-specific antibodies were an immune correlate of protection in the acute challenge model, and their concentration was predictive of protection. These results demonstrate that a single-shot ChAd3-MARV vaccine generated a protective immune response that was both rapid and durable with an immune correlate of protection that will support advanced clinical development.
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Affiliation(s)
- Ruth Hunegnaw
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Anna N Honko
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD 20892, USA.,National Emerging Infectious Diseases Laboratories (NEIDL), Boston University, Boston, MA 02118, USA
| | - Lingshu Wang
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Derick Carr
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Tamar Murray
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Wei Shi
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Lam Nguyen
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Nadia Storm
- National Emerging Infectious Diseases Laboratories (NEIDL), Boston University, Boston, MA 02118, USA
| | - Caitlyn N M Dulan
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Kathryn E Foulds
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Krystle N Agans
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Robert W Cross
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Joan B Geisbert
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Cheng Cheng
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Aurélie Ploquin
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Daphne A Stanley
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Thomas W Geisbert
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Gary J Nabel
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Nancy J Sullivan
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD 20892, USA
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23
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Forni D, Cagliani R, Clerici M, Sironi M. Disease-causing human viruses: novelty and legacy. Trends Microbiol 2022; 30:1232-1242. [PMID: 35902319 DOI: 10.1016/j.tim.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 01/13/2023]
Abstract
About 270 viruses are known to infect humans. Some of these viruses have been known for centuries, whereas others have recently emerged. During their evolutionary history, humans have moved out of Africa to populate the world. In historical times, human migrations resulted in the displacement of large numbers of people. All these events determined the movement and dispersal of human-infecting viruses. Technological advances have resulted in the characterization of the genetic variability of human viruses, both in extant and in archaeological samples. Field studies investigated the diversity of viruses hosted by other animals. In turn, these advances provided insight into the evolutionary history of human viruses back in time and defined the key events through which they originated and spread.
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Affiliation(s)
- Diego Forni
- Scientific Institute IRCCS E. MEDEA, Bioinformatics, Bosisio Parini, Italy
| | - Rachele Cagliani
- Scientific Institute IRCCS E. MEDEA, Bioinformatics, Bosisio Parini, Italy
| | - Mario Clerici
- Department of Physiopathology and Transplantation, University of Milan, Milan, Italy; Don C. Gnocchi Foundation ONLUS, IRCCS, Milan, Italy
| | - Manuela Sironi
- Scientific Institute IRCCS E. MEDEA, Bioinformatics, Bosisio Parini, Italy.
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24
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Besombes C, Mbrenga F, Schaeffer L, Malaka C, Gonofio E, Landier J, Vickos U, Konamna X, Selekon B, Dankpea JN, Von Platen C, Houndjahoue FG, Ouaïmon DS, Hassanin A, Berthet N, Manuguerra JC, Gessain A, Fontanet A, Nakouné-Yandoko E. National Monkeypox Surveillance, Central African Republic, 2001-2021. Emerg Infect Dis 2022; 28:2435-2445. [PMID: 36328951 PMCID: PMC9707566 DOI: 10.3201/eid2812.220897] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Abstract
We analyzed monkeypox disease surveillance in Central African Republic (CAR) during 2001-2021. Surveillance data show 95 suspected outbreaks, 40 of which were confirmed as monkeypox, comprising 99 confirmed and 61 suspected monkeypox cases. After 2018, CAR's annual rate of confirmed outbreaks increased, and 65% of outbreaks occurred in 2 forested regions bordering the Democratic Republic of the Congo. The median patient age for confirmed cases was 15.5 years. The overall case-fatality ratio was 7.5% (12/160) for confirmed and suspected cases, 9.6% (8/83) for children <16 years of age. Decreasing cross-protective immunity from smallpox vaccination and recent ecologic alterations likely contribute to increased monkeypox outbreaks in Central Africa. High fatality rates associated with monkeypox virus clade I also are a local and international concern. Ongoing investigations of zoonotic sources and environmental changes that increase human exposure could inform practices to prevent monkeypox expansion into local communities and beyond endemic areas.
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Affiliation(s)
- Camille Besombes
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Festus Mbrenga
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Laura Schaeffer
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Christian Malaka
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Ella Gonofio
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Jordi Landier
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Ulrich Vickos
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Xavier Konamna
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Benjamin Selekon
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Joella Namsenei Dankpea
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Cassandre Von Platen
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Franck Gislain Houndjahoue
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Daniel Sylver Ouaïmon
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Alexandre Hassanin
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Nicolas Berthet
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Jean-Claude Manuguerra
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
| | - Antoine Gessain
- Sorbonne Université, Paris, France (C. Besombes)
- Institut Pasteur, Paris (C. Besombes, L. Schaeffer, C. Von Platen, N. Berthet, J.-C. Manuguerra, A. Gessain, A. Fontanet)
- Institut Pasteur, Bangui, Central African Republic (F. Mbrenga, C. Malaka, E. Gonofio, X. Konamna, B. Selekon, J. Namsenei Dankpea, E. Nakouné Yandoko)
- Aix Marseille Université, Marseille, France (J. Landier)
- Centre Hospitalier Universitaire, Bangui (F.G. Houndjahoue, D.S. Ouaïmon)
- Sorbonne Université, Paris (A. Hassanin)
- Institut Pasteur of Shanghai, Shanghai, China (N. Berthet)
- Conservatoire National des Arts et Métiers, Paris (A. Fontanet)
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25
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Crea TM, Collier KM, Klein EK, Sevalie S, Molleh B, Kabba Y, Kargbo A, Bangura J, Gbettu H, Simms S, O'Leary C, Drury S, Schieffelin JS, Betancourt TS. Social distancing, community stigma, and implications for psychological distress in the aftermath of Ebola virus disease. PLoS One 2022; 17:e0276790. [PMID: 36322544 PMCID: PMC9629629 DOI: 10.1371/journal.pone.0276790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
Background The 2013–2016 Ebola virus disease (EVD) epidemic resulted in more infections and deaths than all prior outbreaks in the 40-year history of this virus combined. This study examines how experiences of EVD infection, and preventive measures such as social distancing, were linked to experiences of stigma and social exclusion among those reintegrating into their communities. Methods Key informant interviews (n = 42) and focus group discussions (n = 27) were conducted in districts with a high prevalence of EVD and representing geographical and ethnic diversity (n = 228 participants). The final sample was composed of adults (52%) and children (48%) who were EVD-infected (46%) and -affected (42%) individuals, and community leaders (12%). Data were coded using a Grounded Theory approach informed by Thematic Content Analysis, and analyzed using NVivo. Interrater reliability was high, with Cohen’s κ = 0.80 or higher. Findings Participants described two main sources of EVD-related stress: isolation from the community because of social distancing and other prevention measures such as quarantine, and stigma related to infected or affected status. Participants linked experiences of social isolation and stigma to significant distress and feelings of ostracization. These experiences were particularly pronounced among children. Sources of support included community reintegration over time, and formal community efforts to provide education and establish protection bylaws. Interpretation This study found that social distancing and EVD-related stigma were each prominent sources of distress among participants. These results suggest that isolation because of infection, and the enduring stigmatization of infected individuals and their families, demand coordinated responses to prevent and mitigate additional psychosocial harm. Such responses should include close engagement with community leaders to combat misinformation and promote community reintegration.
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Affiliation(s)
- Thomas M Crea
- School of Social Work, Boston College, Chestnut Hill, Massachusetts, United States of America
| | - K Megan Collier
- School of Social Work, Boston College, Chestnut Hill, Massachusetts, United States of America
| | - Elizabeth K Klein
- School of Social Work, Boston College, Chestnut Hill, Massachusetts, United States of America
| | | | | | - Yusuf Kabba
- Sierra Leone Association of Ebola Survivors, Freetown, Sierra Leone
| | - Abdulai Kargbo
- Sierra Leone Association of Ebola Survivors, Freetown, Sierra Leone
| | | | | | - Stewart Simms
- School of Social Work, Boston College, Chestnut Hill, Massachusetts, United States of America
| | - Clara O'Leary
- School of Social Work, Boston College, Chestnut Hill, Massachusetts, United States of America
| | - Stacy Drury
- School of Medicine, Tulane University, New Orleans, Louisiana, United States of America
| | - John S Schieffelin
- School of Medicine, Tulane University, New Orleans, Louisiana, United States of America
| | - Theresa S Betancourt
- School of Social Work, Boston College, Chestnut Hill, Massachusetts, United States of America
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26
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Keita M, Polonsky J, Finci I, Mbala-Kingebeni P, Ilumbulumbu MK, Dakissaga A, Ngwama JK, Tosalisana MK, Ahuka-Mundeke S, Gueye AS, Dagron S, Keiser O, Fall IS. Investigation of and Strategies to Control the Final Cluster of the 2018-2020 Ebola Virus Disease Outbreak in the Eastern Democratic Republic of Congo. Open Forum Infect Dis 2022; 9:ofac329. [PMID: 36168547 PMCID: PMC9499850 DOI: 10.1093/ofid/ofac329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background On April 10, 2020, while the independent committee of the International Health Regulation was meeting to decide whether the 10th Ebola outbreak in the Demogratic Republic of Congo still constituted a Public Health Emergency of International Concern, a new confirmed case was reported in the city of Beni, the last epicenter of the epidemic. This study aimed to understand the source of this cluster and learn from the implemented control strategies for improved response in the future. Methods We conducted a combined epidemiological and genomic investigation to understand the origins and dynamics of transmission within this cluster and describe the strategy that successfully controlled the outbreak. Results Eight cases were identified as belonging to this final cluster. A total of 1028 contacts were identified. Whole-genome sequencing revealed that all cases belonged to the same cluster, the closest sequence to which was identified as a case from the Beni area with symptom onset in July 2019 and a difference of just 31 nucleotides. Outbreak control measures included community confinement of high-risk contacts. Conclusions This study illustrates the high risk of additional flare-ups in the period leading to the end-of-outbreak declaration and the importance of maintaining enhanced surveillance and confinement activities to rapidly control Ebola outbreaks.
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Affiliation(s)
- Mory Keita
- Regional Office for Africa, World Health Organization, Brazzaville, Congo.,Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Jonathan Polonsky
- Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland.,World Health Organization, Geneva, Switzerland
| | - Iris Finci
- European Program for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | - Michel Kalongo Ilumbulumbu
- Division Provinciale de la Santé du Nord-Kivu, Ministère de la Santé, Goma, Democratic Republic of Congo
| | - Adama Dakissaga
- Ministère de la Santé, Direction Régionale de la Santé du Plateau central, Ziniaré, Burkina Faso
| | - John Kombe Ngwama
- Direction Générale de la Lutte contre la Maladie, Ministère de la Santé, Kinshasa, Democratic Republic of Congo
| | - Michel Kasereka Tosalisana
- Division Provinciale de la Santé du Nord-Kivu, Ministère de la Santé, Goma, Democratic Republic of Congo
| | - Steve Ahuka-Mundeke
- Institut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of Congo
| | - Abdou Salam Gueye
- Regional Office for Africa, World Health Organization, Brazzaville, Congo
| | - Stephanie Dagron
- Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Olivia Keiser
- Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland
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27
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Ebola-Detect: A differential serodiagnostic assay for Ebola virus infections and surveillance in the presence of vaccine-induced antibodies. EBioMedicine 2022; 82:104186. [PMID: 35901660 PMCID: PMC9326332 DOI: 10.1016/j.ebiom.2022.104186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/05/2022] [Accepted: 07/08/2022] [Indexed: 11/20/2022] Open
Abstract
Background Ebola virus (EBOV) vaccines containing glycoprotein (GP) provide protection against severe Ebola virus disease (EVD). EBO vaccinations elicit antibodies that are detectable in Ebola serodiagnostic tests, as EBOV GP is a major target antigen. This vaccine-induced seropositivity presents issues with early detection of natural EBOV infections, following vaccination and during surveillance, leading to ‘uninfected’ vaccine trial participants being falsely diagnosed as ‘EBOV infected’ potentially resulting in long-term social and economic distress. Since mass vaccinations are being employed to curtail the recurrent EBOV epidemics in multiple African countries, it is, therefore, essential to differentiate vaccine-induced from natural infection–induced antibodies by a differential serodiagnosis assay for accurate detection of Ebola virus infections. Methods To develop a serodiagnostic test that can differentiate between individuals with EBOV infection-induced antibodies and individuals with EBOV vaccine-induced antibodies, we analysed peptides of EBOV viral protein 40 (VP40), viral protein 35 (VP35) and nucleocapsid protein (NP) using an ELISA with a panel of 181 human sera collected from healthy controls, EBO vaccinees, and EBOV-infected survivors. Receiver Operating Characteristic (ROC) curve analysis was used to calculate sensitivity and specificity of the assay. A simple peptide-based serodiagnostic assay was used to evaluate detection of breakthrough EBOV infections in vaccinated non-human primates (NHP) in EBOV challenge studies. Findings We identified conserved peptide sequences in EBOV VP40, VP35 and NP, produced soon after EBOV infection that are not part of the current EBO vaccine target antigens. The new ELISA-based differential serodetection assay termed ‘EBOV-Detect’ demonstrated >94% specificity and 96% sensitivity for diagnosis of EBOV infection. Importantly, the uninfected vaccine-trial participants scored negative in ‘EBOV-Detect’ assay. The results from the NHPs EBOV challenge study established that post-EBO vaccination serum scored negative in ‘EBOV-Detect’ and all NHPs with Ebola breakthrough infections, following EBOV challenge, were serodiagnosed positively with EBOV-Detect. Interpretation The new ‘EBOV-Detect’ is a simple and sensitive serodiagnostic assay that can specifically differentiate between natural Ebola virus infected and those with vaccine-induced immunity. This could potentially be implemented as a robust diagnostic tool for epidemiology and surveillance of EBOV infections during and after outbreaks, especially in countries with mass Ebola vaccinations. Funding The antibody characterization work described in this manuscript was supported by FDA Office of Counterterrorism and Emerging Threats (OCET) - Medical Countermeasures initiative (MCMi) grant- OCET 2019-1018 and Defense Threat Reduction Agency (HDTRA1930447) funds to S.K.
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28
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Crozier I, Britson KA, Wolfe DN, Klena JD, Hensley LE, Lee JS, Wolfraim LA, Taylor KL, Higgs ES, Montgomery JM, Martins KA. The Evolution of Medical Countermeasures for Ebola Virus Disease: Lessons Learned and Next Steps. Vaccines (Basel) 2022; 10:1213. [PMID: 36016101 PMCID: PMC9415766 DOI: 10.3390/vaccines10081213] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/27/2022] [Accepted: 07/27/2022] [Indexed: 11/26/2022] Open
Abstract
The Ebola virus disease outbreak that occurred in Western Africa from 2013-2016, and subsequent smaller but increasingly frequent outbreaks of Ebola virus disease in recent years, spurred an unprecedented effort to develop and deploy effective vaccines, therapeutics, and diagnostics. This effort led to the U.S. regulatory approval of a diagnostic test, two vaccines, and two therapeutics for Ebola virus disease indications. Moreover, the establishment of fieldable diagnostic tests improved the speed with which patients can be diagnosed and public health resources mobilized. The United States government has played and continues to play a key role in funding and coordinating these medical countermeasure efforts. Here, we describe the coordinated U.S. government response to develop medical countermeasures for Ebola virus disease and we identify lessons learned that may improve future efforts to develop and deploy effective countermeasures against other filoviruses, such as Sudan virus and Marburg virus.
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Affiliation(s)
- Ian Crozier
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD 21702, USA;
| | - Kyla A. Britson
- U.S. Department of Health and Human Services (DHHS), Assistant Secretary for Preparedness and Response (ASPR), Biomedical Advanced Research and Development Authority (BARDA), Washington, DC 20201, USA; (K.A.B.); (D.N.W.); (J.S.L.)
- U.S. Department of Health and Human Services (DHHS), Assistant Secretary for Preparedness and Response (ASPR), Biomedical Advanced Research and Development Authority (BARDA), Oak Ridge Institute for Science and Education (ORISE) Postdoctoral Fellow, Oak Ridge, TN 37831, USA
| | - Daniel N. Wolfe
- U.S. Department of Health and Human Services (DHHS), Assistant Secretary for Preparedness and Response (ASPR), Biomedical Advanced Research and Development Authority (BARDA), Washington, DC 20201, USA; (K.A.B.); (D.N.W.); (J.S.L.)
| | - John D. Klena
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (J.D.K.); (J.M.M.)
| | - Lisa E. Hensley
- Integrated Research Facility, National Institute of Allergy and Infectious Diseases, Fort Detrick, MD 12116, USA;
| | - John S. Lee
- U.S. Department of Health and Human Services (DHHS), Assistant Secretary for Preparedness and Response (ASPR), Biomedical Advanced Research and Development Authority (BARDA), Washington, DC 20201, USA; (K.A.B.); (D.N.W.); (J.S.L.)
| | - Larry A. Wolfraim
- U.S. Department of Health and Human Services (DHHS), National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID), Rockville, MD 20852, USA; (L.A.W.); (K.L.T.); (E.S.H.)
| | - Kimberly L. Taylor
- U.S. Department of Health and Human Services (DHHS), National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID), Rockville, MD 20852, USA; (L.A.W.); (K.L.T.); (E.S.H.)
| | - Elizabeth S. Higgs
- U.S. Department of Health and Human Services (DHHS), National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID), Rockville, MD 20852, USA; (L.A.W.); (K.L.T.); (E.S.H.)
| | - Joel M. Montgomery
- Viral Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (J.D.K.); (J.M.M.)
| | - Karen A. Martins
- U.S. Department of Health and Human Services (DHHS), Assistant Secretary for Preparedness and Response (ASPR), Biomedical Advanced Research and Development Authority (BARDA), Washington, DC 20201, USA; (K.A.B.); (D.N.W.); (J.S.L.)
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Loayza Mafayle R, Morales-Betoulle ME, Romero C, Cossaboom CM, Whitmer S, Alvarez Aguilera CE, Avila Ardaya C, Cruz Zambrana M, Dávalos Anajia A, Mendoza Loayza N, Montaño AM, Morales Alvis FL, Revollo Guzmán J, Sasías Martínez S, Alarcón De La Vega G, Medina Ramírez A, Molina Gutiérrez JT, Cornejo Pinto AJ, Salas Bacci R, Brignone J, Garcia J, Añez A, Mendez-Rico J, Luz K, Segales A, Torrez Cruz KM, Valdivia-Cayoja A, Amman BR, Choi MJ, Erickson BR, Goldsmith C, Graziano JC, Joyce A, Klena JD, Leach A, Malenfant JH, Nichol ST, Patel K, Sealy T, Shoemaker T, Spiropoulou CF, Todres A, Towner JS, Montgomery JM. Chapare Hemorrhagic Fever and Virus Detection in Rodents in Bolivia in 2019. N Engl J Med 2022; 386:2283-2294. [PMID: 35704480 DOI: 10.1056/nejmoa2110339] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND In June 2019, the Bolivian Ministry of Health reported a cluster of cases of hemorrhagic fever that started in the municipality of Caranavi and expanded to La Paz. The cause of these cases was unknown. METHODS We obtained samples for next-generation sequencing and virus isolation. Human and rodent specimens were tested by means of virus-specific real-time quantitative reverse-transcriptase-polymerase-chain-reaction assays, next-generation sequencing, and virus isolation. RESULTS Nine cases of hemorrhagic fever were identified; four of the patients with this illness died. The etiologic agent was identified as Mammarenavirus Chapare mammarenavirus, or Chapare virus (CHAPV), which causes Chapare hemorrhagic fever (CHHF). Probable nosocomial transmission among health care workers was identified. Some patients with CHHF had neurologic manifestations, and those who survived had a prolonged recovery period. CHAPV RNA was detected in a variety of human body fluids (including blood; urine; nasopharyngeal, oropharyngeal, and bronchoalveolar-lavage fluid; conjunctiva; and semen) and in specimens obtained from captured small-eared pygmy rice rats (Oligoryzomys microtis). In survivors of CHHF, viral RNA was detected up to 170 days after symptom onset; CHAPV was isolated from a semen sample obtained 86 days after symptom onset. CONCLUSIONS M. Chapare mammarenavirus was identified as the etiologic agent of CHHF. Both spillover from a zoonotic reservoir and possible person-to-person transmission were identified. This virus was detected in a rodent species, O. microtis. (Funded by the Bolivian Ministry of Health and others.).
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MESH Headings
- Animals
- Arenaviruses, New World/genetics
- Arenaviruses, New World/isolation & purification
- Bolivia/epidemiology
- Cross Infection/transmission
- Cross Infection/virology
- Disease Transmission, Infectious
- Hemorrhagic Fever, American/complications
- Hemorrhagic Fever, American/genetics
- Hemorrhagic Fever, American/transmission
- Hemorrhagic Fever, American/virology
- Hemorrhagic Fevers, Viral/genetics
- Hemorrhagic Fevers, Viral/transmission
- Hemorrhagic Fevers, Viral/virology
- High-Throughput Nucleotide Sequencing
- Humans
- Polymerase Chain Reaction
- RNA, Viral/genetics
- RNA, Viral/isolation & purification
- Rats/virology
- Rodentia/virology
- Viral Zoonoses/transmission
- Viral Zoonoses/virology
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Affiliation(s)
- Roxana Loayza Mafayle
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Maria E Morales-Betoulle
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Carla Romero
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Caitlin M Cossaboom
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Shannon Whitmer
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Carlos E Alvarez Aguilera
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Cinthia Avila Ardaya
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Mirian Cruz Zambrana
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Andrés Dávalos Anajia
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Nelly Mendoza Loayza
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Ana-Maria Montaño
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Fernando L Morales Alvis
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Jimmy Revollo Guzmán
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Sebastián Sasías Martínez
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Gricel Alarcón De La Vega
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Armando Medina Ramírez
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Jhemis T Molina Gutiérrez
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Alex J Cornejo Pinto
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Renata Salas Bacci
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Julia Brignone
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Jorge Garcia
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Arletta Añez
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Jairo Mendez-Rico
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Kleber Luz
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Ariel Segales
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Karen M Torrez Cruz
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Adolfo Valdivia-Cayoja
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Brian R Amman
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Mary J Choi
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Bobbie-Rae Erickson
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Cynthia Goldsmith
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - James C Graziano
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Allison Joyce
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - John D Klena
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Austin Leach
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Jason H Malenfant
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Stuart T Nichol
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Ketan Patel
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Tara Sealy
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Trevor Shoemaker
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Christina F Spiropoulou
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Alison Todres
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Jonathan S Towner
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
| | - Joel M Montgomery
- From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.)
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Gourronc FA, Rebagliati M, Kramer-Riesberg B, Fleck AM, Patten JJ, Geohegan-Barek K, Messingham KN, Davey RA, Maury W, Klingelhutz AJ. Adipocytes are susceptible to Ebola Virus infection. Virology 2022; 573:12-22. [DOI: 10.1016/j.virol.2022.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 12/23/2022]
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Djomsi DM, Mba Djonzo FA, Ndong Bass I, Champagne M, Lacroix A, Thaurignac G, Esteban A, De Nys H, Bourgarel M, Akoachere JF, Delaporte E, Ayouba A, Cappelle J, Mpoudi Ngole E, Peeters M. Dynamics of Antibodies to Ebolaviruses in an Eidolon helvum Bat Colony in Cameroon. Viruses 2022; 14:v14030560. [PMID: 35336967 PMCID: PMC8951055 DOI: 10.3390/v14030560] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 11/16/2022] Open
Abstract
The ecology of ebolaviruses is still poorly understood and the role of bats in outbreaks needs to be further clarified. Straw-colored fruit bats (Eidolon helvum) are the most common fruit bats in Africa and antibodies to ebolaviruses have been documented in this species. Between December 2018 and November 2019, samples were collected at approximately monthly intervals in roosting and feeding sites from 820 bats from an Eidolon helvum colony. Dried blood spots (DBS) were tested for antibodies to Zaire, Sudan, and Bundibugyo ebolaviruses. The proportion of samples reactive with GP antigens increased significantly with age from 0–9/220 (0–4.1%) in juveniles to 26–158/225 (11.6–70.2%) in immature adults and 10–225/372 (2.7–60.5%) in adult bats. Antibody responses were lower in lactating females. Viral RNA was not detected in 456 swab samples collected from 152 juvenile and 214 immature adult bats. Overall, our study shows that antibody levels increase in young bats suggesting that seroconversion to Ebola or related viruses occurs in older juvenile and immature adult bats. Multiple year monitoring would be needed to confirm this trend. Knowledge of the periods of the year with the highest risk of Ebolavirus circulation can guide the implementation of strategies to mitigate spill-over events.
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Affiliation(s)
- Dowbiss Meta Djomsi
- Laboratoire de Virologie-Cremer, Institut de Recherches Médicales et d’Études des Plantes Médicinales (IMPM), Yaoundé P.O. Box 13033, Cameroon; (D.M.D.); (F.A.M.D.); (I.N.B.)
| | - Flaubert Auguste Mba Djonzo
- Laboratoire de Virologie-Cremer, Institut de Recherches Médicales et d’Études des Plantes Médicinales (IMPM), Yaoundé P.O. Box 13033, Cameroon; (D.M.D.); (F.A.M.D.); (I.N.B.)
| | - Innocent Ndong Bass
- Laboratoire de Virologie-Cremer, Institut de Recherches Médicales et d’Études des Plantes Médicinales (IMPM), Yaoundé P.O. Box 13033, Cameroon; (D.M.D.); (F.A.M.D.); (I.N.B.)
| | - Maëliss Champagne
- Transvihmi, Institut de Recherche pour le Développement (IRD), University of Montpellier, Inserm, 34394 Montpellier, France; (M.C.); (A.L.); (G.T.); (A.E.); (E.D.); (A.A.)
| | - Audrey Lacroix
- Transvihmi, Institut de Recherche pour le Développement (IRD), University of Montpellier, Inserm, 34394 Montpellier, France; (M.C.); (A.L.); (G.T.); (A.E.); (E.D.); (A.A.)
| | - Guillaume Thaurignac
- Transvihmi, Institut de Recherche pour le Développement (IRD), University of Montpellier, Inserm, 34394 Montpellier, France; (M.C.); (A.L.); (G.T.); (A.E.); (E.D.); (A.A.)
| | - Amandine Esteban
- Transvihmi, Institut de Recherche pour le Développement (IRD), University of Montpellier, Inserm, 34394 Montpellier, France; (M.C.); (A.L.); (G.T.); (A.E.); (E.D.); (A.A.)
| | - Helene De Nys
- ASTRE, CIRAD, Harare, Zimbabwe; (H.D.N.); (M.B.)
- ASTRE, CIRAD, INRAE, University of Montpellier, 34398 Montpellier, France
| | - Mathieu Bourgarel
- ASTRE, CIRAD, Harare, Zimbabwe; (H.D.N.); (M.B.)
- ASTRE, CIRAD, INRAE, University of Montpellier, 34398 Montpellier, France
| | - Jane-Francis Akoachere
- Department of Microbiology and Parasitology, University of Buea, Buea P.O. Box 63, Cameroon; (J.-F.A.); (J.C.)
| | - Eric Delaporte
- Transvihmi, Institut de Recherche pour le Développement (IRD), University of Montpellier, Inserm, 34394 Montpellier, France; (M.C.); (A.L.); (G.T.); (A.E.); (E.D.); (A.A.)
| | - Ahidjo Ayouba
- Transvihmi, Institut de Recherche pour le Développement (IRD), University of Montpellier, Inserm, 34394 Montpellier, France; (M.C.); (A.L.); (G.T.); (A.E.); (E.D.); (A.A.)
| | - Julien Cappelle
- Department of Microbiology and Parasitology, University of Buea, Buea P.O. Box 63, Cameroon; (J.-F.A.); (J.C.)
| | - Eitel Mpoudi Ngole
- Laboratoire de Virologie-Cremer, Institut de Recherches Médicales et d’Études des Plantes Médicinales (IMPM), Yaoundé P.O. Box 13033, Cameroon; (D.M.D.); (F.A.M.D.); (I.N.B.)
| | - Martine Peeters
- Transvihmi, Institut de Recherche pour le Développement (IRD), University of Montpellier, Inserm, 34394 Montpellier, France; (M.C.); (A.L.); (G.T.); (A.E.); (E.D.); (A.A.)
- Correspondence:
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Forrester JV, Mölzer C, Kuffova L. Immune Privilege Furnishes a Niche for Latent Infection. FRONTIERS IN OPHTHALMOLOGY 2022; 2:869046. [PMID: 38983514 PMCID: PMC11182092 DOI: 10.3389/fopht.2022.869046] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 02/15/2022] [Indexed: 07/11/2024]
Abstract
The microenvironment of the CNS (eye and brain) is fertile ground for infection if the barriers are breached. The result of pathogen invasion is often devastating destruction of tissues. In the eye, inflammation is broadly classified either as "infectious" (i.e. caused by infection) or "non-infectious". However, increasingly, forms of intraocular inflammation (IOI), which clinically appear to be "non-infectious" turn out to be initiated by infectious agents, suggesting that pathogens have been retained in latent or persistent form within ocular tissues and have reactivated to cause overt disease. A similar pathogenesis applies to latent infections in the brain. Not all CNS tissues provide an equally protective niche while different pathogens escape detection using different strategies. This review summarises how immune privilege (IP) in the CNS may be permissive for latent infection and allow the eye and the brain to act as a reservoir of pathogens which often remain undetected for the lifetime of the host but in states of immune deficiency may be activated to cause sight- and life-threatening inflammation.
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Affiliation(s)
- John V Forrester
- Ocular Immunology Group, Section of Infection and Immunity, Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | - Christine Mölzer
- Ocular Immunology Group, Section of Infection and Immunity, Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | - Lucia Kuffova
- Ocular Immunology Group, Section of Infection and Immunity, Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom
- Eye Clinic, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
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Shaffer KCL, Hui S, Bratcher A, King LB, Mutombe R, Kavira N, Kompany JP, Tambu M, Musene K, Mukadi P, Mbala P, Gadoth A, West BR, Ilunga BK, Kaba D, Muyembe-Tanfum JJ, Hoff NA, Rimoin AW, Saphire EO. Pan-ebolavirus serology study of healthcare workers in the Mbandaka Health Region, Democratic Republic of the Congo. PLoS Negl Trop Dis 2022; 16:e0010167. [PMID: 35255093 PMCID: PMC8929691 DOI: 10.1371/journal.pntd.0010167] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 03/17/2022] [Accepted: 01/13/2022] [Indexed: 01/03/2023] Open
Abstract
Although multiple antigenically distinct ebolavirus species can cause human disease, previous serosurveys focused on only Zaire ebolavirus (EBOV). Thus, the extent of reactivity or exposure to other ebolaviruses, and which sociodemographic factors are linked to this seroreactivity, are unclear. We conducted a serosurvey of 539 healthcare workers (HCW) in Mbandaka, Democratic Republic of the Congo, using ELISA-based analysis of serum IgG against EBOV, Sudan ebolavirus (SUDV) and Bundibugyo ebolavirus (BDBV) glycoproteins (GP). We compared seroreactivity to risk factors for viral exposure using univariate and multivariable logistic regression. Seroreactivity against different GPs ranged from 2.2–4.6%. Samples from six individuals reacted to all three species of ebolavirus and 27 samples showed a species-specific IgG response. We find that community health volunteers are more likely to be seroreactive against each antigen than nurses, and in general, that HCWs with indirect patient contact have higher anti-EBOV GP IgG levels than those with direct contact. Seroreactivity against ebolavirus GP may be associated with positions that offer less occupational training and access to PPE. Those individuals with broadly reactive responses may have had multiple ebolavirus exposures or developed cross-reactive antibodies. In contrast, those individuals with species-specific BDBV or SUDV GP seroreactivity may have been exposed to an ebolavirus not previously known to circulate in the region. Zaire ebolavirus is known to circulate in the Mbandaka region of the Democratic Republic of the Congo, causing outbreaks in 2018 and 2020. However, we do not know the range of exposure to the local population. Here, we examined the seroprevalence of 539 local Congolese healthcare workers in the Mbandaka region with no known ebolavirus exposure. We found serological evidence indicating contact with at least one species of ebolavirus from these donors. Seroreactivity among the donors to the different glycoprotein antigens ranged between 2.2–4.6%. We observed correlations between jobs with indirect access to patients and a higher seroprevalence, which may be due to less training and less access to personal protective equipment. Our findings suggest that exposure to ebolaviruses may be more frequent than previously known and that lesser-skilled individuals in healthcare work may have a higher likelihood of ebolavirus exposure.
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Affiliation(s)
- Kelly C. L. Shaffer
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, California, United States of America
| | - Sean Hui
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, California, United States of America
| | - Anna Bratcher
- Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Liam B. King
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, California, United States of America
- Department of Medicine, University of California, San Diego, La Jolla, California, United States of America
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, California, United States of America
| | - Rachel Mutombe
- Institut National de Recherche Biomedicale, Kinshasa, Democratic Republic of the Congo
| | - Nathalie Kavira
- Institut National de Recherche Biomedicale, Kinshasa, Democratic Republic of the Congo
| | - Jean Paul Kompany
- Institut National de Recherche Biomedicale, Kinshasa, Democratic Republic of the Congo
| | - Merly Tambu
- Institut National de Recherche Biomedicale, Kinshasa, Democratic Republic of the Congo
| | - Kamy Musene
- Institut National de Recherche Biomedicale, Kinshasa, Democratic Republic of the Congo
| | - Patrick Mukadi
- Institut National de Recherche Biomedicale, Kinshasa, Democratic Republic of the Congo
| | - Placide Mbala
- Institut National de Recherche Biomedicale, Kinshasa, Democratic Republic of the Congo
| | - Adva Gadoth
- Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Brandyn R. West
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, California, United States of America
| | - Benoit Kebela Ilunga
- Directorate of Disease Control, Ministry of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Didine Kaba
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | | | - Nicole A. Hoff
- Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, United States of America
- * E-mail: (NAH); (AWR); (EOS)
| | - Anne W. Rimoin
- Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, United States of America
- * E-mail: (NAH); (AWR); (EOS)
| | - Erica Ollmann Saphire
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, California, United States of America
- Department of Medicine, University of California, San Diego, La Jolla, California, United States of America
- * E-mail: (NAH); (AWR); (EOS)
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The development of broad-spectrum antiviral medical countermeasures to treat viral hemorrhagic fevers caused by natural or weaponized virus infections. PLoS Negl Trop Dis 2022; 16:e0010220. [PMID: 35259154 PMCID: PMC8903284 DOI: 10.1371/journal.pntd.0010220] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The Joint Program Executive Office for Chemical, Biological, Radiological, and Nuclear Defense (JPEO-CBRND) began development of a broad-spectrum antiviral countermeasure against deliberate use of high-consequence viral hemorrhagic fevers (VHFs) in 2016. The effort featured comprehensive preclinical research, including laboratory testing and rapid advancement of lead molecules into nonhuman primate (NHP) models of Ebola virus disease (EVD). Remdesivir (GS-5734, Veklury, Gilead Sciences) was the first small molecule therapeutic to successfully emerge from this effort. Remdesivir is an inhibitor of RNA-dependent RNA polymerase, a viral enzyme that is essential for viral replication. Its robust potency and broad-spectrum antiviral activity against certain RNA viruses including Ebola virus and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) led to its clinical evaluation in randomized, controlled trials (RCTs) in human patients during the 2018 EVD outbreak in the Democratic Republic of the Congo (DRC) and the ongoing Coronavirus Disease 2019 (COVID-19) pandemic today. Remdesivir was recently approved by the US Food and Drug Administration (FDA) for the treatment of COVID-19 requiring hospitalization. Substantial gaps remain in improving the outcomes of acute viral infections for patients afflicted with both EVD and COVID-19, including how to increase therapeutic breadth and strategies for the prevention and treatment of severe disease. Combination therapy that joins therapeutics with complimentary mechanisms of action appear promising, both preclinically and in RCTs. Importantly, significant programmatic challenges endure pertaining to a clear drug and biological product development pathway for therapeutics targeting biodefense and emerging pathogens when human efficacy studies are not ethical or feasible. For example, remdesivir's clinical development was facilitated by outbreaks of Ebola and SARS-CoV-2; as such, the development pathway employed for remdesivir is likely to be the exception rather than the rule. The current regulatory licensure pathway for therapeutics targeting rare, weaponizable VHF agents is likely to require use of FDA's established Animal Rule (21 CFR 314.600-650 for drugs; 21 CFR 601.90-95 for biologics). The FDA may grant marketing approval based on adequate and well-controlled animal efficacy studies when the results of those studies establish that the drug is safe and likely to produce clinical benefit in humans. In practical terms, this is anticipated to include a series of rigorous, well-documented, animal challenge studies, to include aerosol challenge, combined with human safety data. While small clinical studies against naturally occurring, high-consequence pathogens are typically performed where possible, approval for the therapeutics currently under development against biodefense pathogens will likely require the Animal Rule pathway utilizing studies in NHPs. We review the development of remdesivir as illustrative of the effort that will be needed to field future therapeutics against highly lethal, infectious agents.
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Nkuba-Ndaye A, Mukadi-Bamuleka D, Bulabula-Penge J, Thaurignac G, Edidi-Atani F, Mambu-Mbika F, Danga-Yema B, Matondo-Kuamfumu M, Kinganda-Lusamaki E, Bisento N, Lumembe-Numbi R, Kabamba-Lungenyi G, Kitsa-Mutsumbirwa D, Kambale-Sivihwa N, Boillot F, Delaporte E, Mbala-Kingebeni P, Ayouba A, Peeters M, Ahuka-Mundeke S. Added value of an anti-Ebola serology for the management of clinically suspect Ebola virus disease patients discharged as negative in an epidemic context. J Infect Dis 2022; 226:352-356. [PMID: 35176762 PMCID: PMC9400424 DOI: 10.1093/infdis/jiac057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/16/2022] [Indexed: 11/14/2022] Open
Abstract
Background Survivors from Ebola virus disease (EVD) may be at the origin of EVD resurgence. Methods Simultaneous reactivity to at least 2 Ebola virus or Zaire ebolavirus (EBOV) antigens was detected in 11 of 488 (2.3%; 95% confidence interval [CI], 1.1–4.0) suspected EVD patients who were discharged as negative after 2 consecutive negative tests during the 10th Ebola outbreak in the Democratic Republic of the Congo. Results After extrapolating the total number of individuals discharged as negative during the entire outbreak, we estimated a total of 1314 additional missed Ebola cases. Conclusions These findings emphasize the usefulness of an EBOV serology analysis and the importance of extending epidemic surveillance to clinically suspected cases who were discharged as negative.
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Affiliation(s)
- Antoine Nkuba-Ndaye
- Recherches Translationnelles sur le VIH et Maladies Infectieuses, Université de Montpellier/INSERM U1175, Institut de Recherche pour le Développement, Montpellier, France.,Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.,Département de Biologie Médicale, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Daniel Mukadi-Bamuleka
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.,Département de Biologie Médicale, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Junior Bulabula-Penge
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.,Département de Biologie Médicale, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Guillaume Thaurignac
- Recherches Translationnelles sur le VIH et Maladies Infectieuses, Université de Montpellier/INSERM U1175, Institut de Recherche pour le Développement, Montpellier, France
| | - François Edidi-Atani
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.,Département de Biologie Médicale, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Fabrice Mambu-Mbika
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.,Département de Biologie Médicale, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Bernice Danga-Yema
- Département de Biologie Médicale, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Meris Matondo-Kuamfumu
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.,Département de Biologie Médicale, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Eddy Kinganda-Lusamaki
- Recherches Translationnelles sur le VIH et Maladies Infectieuses, Université de Montpellier/INSERM U1175, Institut de Recherche pour le Développement, Montpellier, France.,Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.,Département de Biologie Médicale, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Nella Bisento
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Raphaël Lumembe-Numbi
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.,Département de Biologie Médicale, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Gabriel Kabamba-Lungenyi
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.,Département de Biologie Médicale, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Divine Kitsa-Mutsumbirwa
- Laboratoire mobile pour MVE, Institut National de Recherche Biomédicale, Butembo, Nord-Kivu, Democratic Republic of the Congo
| | - Nelson Kambale-Sivihwa
- Laboratoire mobile pour MVE, Institut National de Recherche Biomédicale, Beni, Nord-Kivu, Democratic Republic of the Congo
| | | | - Eric Delaporte
- Recherches Translationnelles sur le VIH et Maladies Infectieuses, Université de Montpellier/INSERM U1175, Institut de Recherche pour le Développement, Montpellier, France
| | - Placide Mbala-Kingebeni
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.,Département de Biologie Médicale, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Ahidjo Ayouba
- Recherches Translationnelles sur le VIH et Maladies Infectieuses, Université de Montpellier/INSERM U1175, Institut de Recherche pour le Développement, Montpellier, France
| | - Martine Peeters
- Recherches Translationnelles sur le VIH et Maladies Infectieuses, Université de Montpellier/INSERM U1175, Institut de Recherche pour le Développement, Montpellier, France
| | - Steve Ahuka-Mundeke
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.,Département de Biologie Médicale, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
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Sherwood LJ, Hayhurst A. Generating Uniformly Cross-Reactive Ebolavirus spp. Anti-nucleoprotein Nanobodies to Facilitate Forward Capable Detection Strategies. ACS Infect Dis 2022; 8:343-359. [PMID: 34994194 DOI: 10.1021/acsinfecdis.1c00478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
It is often challenging for a single monoclonal antibody to cross-react equally with all species of a particular viral genus that are separated by time and geographies to ensure broad long-term global immunodiagnostic use. Here, we set out to isolate nanobodies or single-domain antibodies (sdAbs) with uniform cross-reactivity to the genus Ebolavirus by immunizing a llama with recombinant nucleoprotein (NP) representing the 5 cultivated species to assemble a phage display repertoire for mining. Screening sdAbs for reactivity against the C-terminal domain of NP guided the isolation of clones that could perform as both captor and tracer for polyvalent antigen in sandwich assays. Two promising sdAbs had equivalent reactivities across all 5 species and greatly enhanced the equilibrium concentration at 50% (EC50) for recombinant NP when compared with a differentially cross-reactive nonimmune sdAb isolated previously. Uniform reactivity and enhanced sensitivity were relayed to live virus titrations, resulting in lower limits of detection of 2-5 pfu for the best sdAbs, representing 10-, 20-, and 100-fold improvements for Zaire, Sudan/Reston, and Taï Forest viruses, respectively. Fusions of the sdAbs with ascorbate peroxidase (APEX2) and mNeonGreen generated one-step immunoreagents useful for colorimetric and fluorescent visualization of cellular NP. Both sdAbs were also able to recognize recombinant NPs from the recently discovered Bombali virus, a putative sixth Ebolavirus species unknown at the start of these experiments, validating the forward capabilities of the sdAbs. The simplicity and modularity of these sdAbs should enable advances in antigen-based diagnostic technologies to be retuned toward filoviral detection relatively easily, thereby proactively safeguarding human health.
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Affiliation(s)
- Laura Jo Sherwood
- Disease Intervention and Prevention, Texas Biomedical Research Institute, San Antonio, Texas 78227, United States
| | - Andrew Hayhurst
- Disease Intervention and Prevention, Texas Biomedical Research Institute, San Antonio, Texas 78227, United States
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37
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Liu J, Trefry JC, Babka AM, Schellhase CW, Coffin KM, Williams JA, Raymond JLW, Facemire PR, Chance TB, Davis NM, Scruggs JL, Rossi FD, Haddow AD, Zelko JM, Bixler SL, Crozier I, Iversen PL, Pitt ML, Kuhn JH, Palacios G, Zeng X. Ebola virus persistence and disease recrudescence in the brains of antibody-treated nonhuman primate survivors. Sci Transl Med 2022; 14:eabi5229. [PMID: 35138912 DOI: 10.1126/scitranslmed.abi5229] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Effective therapeutics have been developed against acute Ebola virus disease (EVD) in both humans and experimentally infected nonhuman primates. However, the risk of viral persistence and associated disease recrudescence in survivors receiving these therapeutics remains unclear. In contrast to rhesus macaques that survived Ebola virus (EBOV) exposure in the absence of treatment, we discovered that EBOV, despite being cleared from all other organs, persisted in the brain ventricular system of rhesus macaque survivors that had received monoclonal antibody (mAb) treatment. In mAb-treated macaque survivors, EBOV persisted in macrophages infiltrating the brain ventricular system, including the choroid plexuses. This macrophage infiltration was accompanied by severe tissue damage, including ventriculitis, choroid plexitis, and meningoencephalitis. Specifically, choroid plexus endothelium-derived EBOV infection led to viral persistence in the macaque brain ventricular system. This resulted in apoptosis of ependymal cells, which constitute the blood-cerebrospinal fluid barrier of the choroid plexuses. Fatal brain-confined recrudescence of EBOV infection manifested as severe inflammation, local pathology, and widespread infection of the ventricular system and adjacent neuropil in some of the mAb-treated macaque survivors. This study highlights organ-specific EBOV persistence and fatal recrudescent disease in rhesus macaque survivors after therapeutic treatment and has implications for the long-term follow-up of human survivors of EVD.
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Affiliation(s)
- Jun Liu
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - John C Trefry
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - April M Babka
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - Christopher W Schellhase
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - Kayla M Coffin
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - Janice A Williams
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - Jo Lynne W Raymond
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - Paul R Facemire
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - Taylor B Chance
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - Neil M Davis
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - Jennifer L Scruggs
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - Franco D Rossi
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - Andrew D Haddow
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - Justine M Zelko
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - Sandra L Bixler
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - Ian Crozier
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD 21702, USA
| | - Patrick L Iversen
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - Margaret L Pitt
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - Jens H Kuhn
- Integrated Research Facility at Fort Detrick (IRF-Frederick), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Frederick, MD 21702, USA
| | - Gustavo Palacios
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - Xiankun Zeng
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
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38
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Immunogenicity of rVSVΔG-ZEBOV-GP Ebola vaccination in exposed and potentially exposed persons in the Democratic Republic of the Congo. Proc Natl Acad Sci U S A 2022; 119:2118895119. [PMID: 35110410 PMCID: PMC8833182 DOI: 10.1073/pnas.2118895119] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2021] [Indexed: 12/21/2022] Open
Abstract
This paper describes findings from a seroepidemiologic study involving a cohort of Ebola-vaccinated individuals from North Kivu, Democratic Republic of the Congo (DRC), who were studied as part of a collaborative effort between American and Congolese scientists and epidemiologists. Our study examines antibody response at 21 d and 6 mo postvaccination after single-dose rVSVΔG-ZEBOV-GP vaccination among Ebola virus disease–exposed and potentially exposed populations in the DRC. At 21 d of follow-up, 87.2% had an antibody response. Additionally, 95.6% demonstrated antibody persistence at 6 mo of follow-up. These findings give crucial evidence that antibody response and persistence after Ebola vaccination is robust in outbreak settings in the DRC, knowledge that significantly informs the use of vaccination for outbreak control. Despite more than 300,000 rVSVΔG-ZEBOV-glycoprotein (GP) vaccine doses having been administered during Ebola virus disease (EVD) outbreaks in the Democratic Republic of the Congo (DRC) between 2018 and 2020, seroepidemiologic studies of vaccinated Congolese populations are lacking. This study examines the antibody response at 21 d and 6 mo postvaccination after single-dose rVSVΔG-ZEBOV-GP vaccination among EVD-exposed and potentially exposed populations in the DRC. We conducted a longitudinal cohort study of 608 rVSVΔG-ZEBOV-GP–vaccinated individuals during an EVD outbreak in North Kivu Province, DRC. Participants provided questionnaires and blood samples at three study visits (day 0, visit 1; day 21, visit 2; and month 6, visit 3). Anti-GP immunoglobulin G (IgG) antibody titers were measured in serum by the Filovirus Animal Nonclinical Group anti-Ebola virus GP IgG enzyme-linked immunosorbent assay. Antibody response was defined as an antibody titer that had increased fourfold from visit 1 to visit 2 and was above four times the lower limit of quantification at visit 2; antibody persistence was defined as a similar increase from visit 1 to visit 3. We then examined demographics for associations with follow-up antibody titers using generalized linear mixed models. A majority of the sample, 87.2%, had an antibody response at visit 2, and 95.6% demonstrated antibody persistence at visit 3. Being female and of young age was predictive of a higher antibody titer postvaccination. Antibody response and persistence after Ebola vaccination was robust in this cohort, confirming findings from outside of the DRC.
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Ye W, Wang Y, Lei Y, Zhang F. Persistent viral shedding after acute Lassa fever: thorough evidence arouses more noteworthy concerns. THE LANCET MICROBE 2022; 3:e329. [DOI: 10.1016/s2666-5247(22)00030-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 01/21/2022] [Indexed: 10/19/2022] Open
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40
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Mukadi-Bamuleka D, Sanogo YO, Bulabula-Penge J, Morales-Betoulle ME, Fillon P, Woodruff P, Choi MJ, Whitesell A, Todres AM, De Weggheleire A, Legand A, Muyembe-Tamfum JJ, Formenty P, Klena JD, Montgomery JM, Ahuka-Mundeke S. Postmortem Surveillance for Ebola Virus Using OraQuick Ebola Rapid Diagnostic Tests, Eastern Democratic Republic of the Congo, 2019–2020. Emerg Infect Dis 2022; 28:420-424. [PMID: 35076001 PMCID: PMC8798676 DOI: 10.3201/eid2802.210981] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
After a pilot study, we tested 443 cadavers using OraQuick Ebola rapid diagnostic tests during surveillance after the 10th Ebola outbreak in the Democratic Republic of the Congo. No false negative and 2% false-positive results were reported. Quickly returning results and engaging the community enabled timely public health actions.
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Hoff NA, Bratcher A, Mukadi P, Ahuka S, Kabamba M, Musene K, Halbrook M, Dzogong C, Mwamba GN, Mbala P, Kelly JD, Kompany JP, Tambu M, Kaba D, Kebela-Ilunga B, Muyemebe-Tamfum JJ, Rimoin AW. Increasing Ebola transmission behaviors 6 months post-vaccination: Comparing vaccinated and unvaccinated populations near 2018 Mbandaka Ebola outbreak in the Democratic Republic of Congo. Vaccine 2021; 39:7464-7469. [PMID: 34799143 PMCID: PMC8687134 DOI: 10.1016/j.vaccine.2021.10.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/01/2021] [Accepted: 10/26/2021] [Indexed: 12/01/2022]
Abstract
Background In 2018, the Democratic Republic of the Congo (DRC) declared its 9th and 10th Zaire ebolavirus (EBOV) outbreaks, in the Equateur province (end: July 2018), and in the eastern provinces including North Kivu (end: June 2020). The DRC Ministry of Health deployed the rVSV-vectored glycoprotein (VSV-EBOV) vaccine in response during both outbreaks. Methods A cohort of vaccinated and unvaccinated individuals from the Equateur province were enrolled and followed prospectively for 6 months. Among participants included in this analysis, 505 were vaccinated and 1,418 were unvaccinated. Differences in transmission behaviors pre- and post- outbreak were identified, along with associations between behaviors and vaccination. Results There was an overall increase in the proportion of both unvaccinated and vaccinated individuals in Mbandaka who participated in risky activities post-outbreak. Travel outside of the province pre-outbreak was associated with vaccination. Post-outbreak, vaccinated individuals were less likely to participate in funeral traditions than unvaccinated individuals. Conclusion A net increase in activities considered high risk was observed in both groups despite significant efforts to inform the population of risky behaviors. The absence of a reduction in transmission behavior post-outbreak should be considered for improving future behavior change campaigns in order to prevent recurrent outbreaks.
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Affiliation(s)
- Nicole A Hoff
- Department of Epidemiology, University of California, Los Angeles, Fielding School of Public Health, Los Angeles, CA, USA.
| | - Anna Bratcher
- Department of Epidemiology, University of California, Los Angeles, Fielding School of Public Health, Los Angeles, CA, USA.
| | - Patrick Mukadi
- Institut National de Recherche Biomédicale, Kinshasa, Congo
| | - Steve Ahuka
- Institut National de Recherche Biomédicale, Kinshasa, Congo
| | - Michel Kabamba
- National Expanded Program for Immunization, Kinshasa, Congo
| | - Kamy Musene
- Institut National de Recherche Biomédicale, Kinshasa, Congo
| | - Megan Halbrook
- Department of Epidemiology, University of California, Los Angeles, Fielding School of Public Health, Los Angeles, CA, USA.
| | | | | | - Placide Mbala
- Institut National de Recherche Biomédicale, Kinshasa, Congo
| | - J Daniel Kelly
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA.
| | | | - Merly Tambu
- Institut National de Recherche Biomédicale, Kinshasa, Congo
| | - Didine Kaba
- Ecole de Sante Publique, Université de Kinshasa, Kinshasa, Congo.
| | - Benoit Kebela-Ilunga
- Direction de lutte contre la Maladie-Ministère de la Santé Publique, Kinshasa, Congo
| | | | - Anne W Rimoin
- Department of Epidemiology, University of California, Los Angeles, Fielding School of Public Health, Los Angeles, CA, USA.
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Metcalf CJE, Andriamandimby SF, Baker RE, Glennon EE, Hampson K, Hollingsworth TD, Klepac P, Wesolowski A. Challenges in evaluating risks and policy options around endemic establishment or elimination of novel pathogens. Epidemics 2021; 37:100507. [PMID: 34823222 PMCID: PMC7612525 DOI: 10.1016/j.epidem.2021.100507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/20/2021] [Accepted: 10/06/2021] [Indexed: 11/12/2022] Open
Abstract
When a novel pathogen emerges there may be opportunities to eliminate transmission - locally or globally - whilst case numbers are low. However, the effort required to push a disease to elimination may come at a vast cost at a time when uncertainty is high. Models currently inform policy discussions on this question, but there are a number of open challenges, particularly given unknown aspects of the pathogen biology, the effectiveness and feasibility of interventions, and the intersecting political, economic, sociological and behavioural complexities for a novel pathogen. In this overview, we detail how models might identify directions for better leveraging or expanding the scope of data available on the pathogen trajectory, for bounding the theoretical context of emergence relative to prospects for elimination, and for framing the larger economic, behavioural and social context that will influence policy decisions and the pathogen’s outcome.
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Affiliation(s)
- C Jessica E Metcalf
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA; Princeton School of Public and International Affairs, Princeton University, Princeton, USA.
| | | | - Rachel E Baker
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA; Princeton High Meadows Environmental Institute, Princeton University, Princeton, NJ, USA
| | - Emma E Glennon
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, UK
| | - Katie Hampson
- Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow, Glasgow, UK
| | - T Deirdre Hollingsworth
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, UK
| | - Petra Klepac
- London School of Hygiene and Tropical Medicine, London, UK
| | - Amy Wesolowski
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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Chakroun K, Taouai M, Porkolab V, Luczkowiak J, Sommer R, Cheneau C, Mathiron D, Ben Maaouia MA, Pilard S, Abidi R, Mullié C, Fieschi F, Cragg PJ, Halary F, Delgado R, Benazza M. Low-Valent Calix[4]arene Glycoconjugates Based on Hydroxamic Acid Bearing Linkers as Potent Inhibitors in a Model of Ebola Virus Cis-Infection and HCMV-gB-Recombinant Glycoprotein Interaction with MDDC Cells by Blocking DC-SIGN. J Med Chem 2021; 64:14332-14343. [PMID: 34524803 DOI: 10.1021/acs.jmedchem.1c00818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In addition to a variety of viral-glycoprotein receptors (e.g., heparan sulfate, Niemann-Pick C1, etc.), dendritic cell-specific intercellular adhesion molecule-3-grabbing nonintegrin (DC-SIGN), from the C-type lectin receptor family, plays one of the most important pathogenic functions for a wide range of viruses (e.g., Ebola, human cytomegalovirus (HCMV), HIV-1, severe acute respiratory syndrome coronavirus 2, etc.) that invade host cells before replication; thus, its inhibition represents a relevant extracellular antiviral therapy. We report two novel p-tBu-calixarene glycoclusters 1 and 2, bearing tetrahydroxamic acid groups, which exhibit micromolar inhibition of soluble DC-SIGN binding and provide nanomolar IC50 inhibition of both DC-SIGN-dependent Jurkat cis-cell infection by viral particle pseudotyped with Ebola virus glycoprotein and the HCMV-gB-recombinant glycoprotein interaction with monocyte-derived dendritic cells expressing DC-SIGN. A unique cooperative involvement of sugar, linker, and calixarene core is likely behind the strong avidity of DC-SIGN for these low-valent systems. We claim herein new promising candidates for the rational development of a large spectrum of antiviral therapeutics.
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Affiliation(s)
- Khouloud Chakroun
- Laboratoire de Glycochimie des Antimicrobiens et des Agroressources (LG2A-UMR7378-CNRS), Université de Picardie Jules Verne, 10 Rue Baudelocque, Amiens, 80039 Cédex, France.,Faculté des Sciences de Bizerte, Laboratoire d'Application de la Chimie aux Ressources et Substances Naturelles et à l'Environnement (LACReSNE) Unité ≪Interactions Moléculaires Spécifiques≫, Université de Carthage Zarzouna-Bizerte, Zarzouna-Bizerte, Tennessee 7021, Tunisia
| | - Marwa Taouai
- Laboratoire de Glycochimie des Antimicrobiens et des Agroressources (LG2A-UMR7378-CNRS), Université de Picardie Jules Verne, 10 Rue Baudelocque, Amiens, 80039 Cédex, France.,Faculté des Sciences de Bizerte, Laboratoire d'Application de la Chimie aux Ressources et Substances Naturelles et à l'Environnement (LACReSNE) Unité ≪Interactions Moléculaires Spécifiques≫, Université de Carthage Zarzouna-Bizerte, Zarzouna-Bizerte, Tennessee 7021, Tunisia
| | - Vanessa Porkolab
- Univ. Grenoble Alpes, CNRS, CEA, Institut de Biologie Structurale, GrenobleF-38044, France
| | - Joanna Luczkowiak
- Laboratorio de Microbiología Molecular, Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid 28041, Spain
| | - Roman Sommer
- Chemical Biology of Carbohydrates, Helmholtz Institute for Pharmaceutical Research Saarland, Saarbrücken66123, Germany
| | - Coraline Cheneau
- Nantes Université, Inserm, CHU Nantes, Center for Research in Transplantation and Immunology UMR1064, ITUN, Nantes44093, France
| | - David Mathiron
- UFR des Sciences Bâtiment Serres-Transfert Rue Dallery, Passage du sourire d'Avril, Amiens 80039 Cedex 1, France
| | - Mohamed Amine Ben Maaouia
- Laboratoire de Glycochimie des Antimicrobiens et des Agroressources (LG2A-UMR7378-CNRS), Université de Picardie Jules Verne, 10 Rue Baudelocque, Amiens, 80039 Cédex, France.,Faculté des Sciences de Bizerte, Laboratoire d'Application de la Chimie aux Ressources et Substances Naturelles et à l'Environnement (LACReSNE) Unité ≪Interactions Moléculaires Spécifiques≫, Université de Carthage Zarzouna-Bizerte, Zarzouna-Bizerte, Tennessee 7021, Tunisia
| | - Serge Pilard
- UFR des Sciences Bâtiment Serres-Transfert Rue Dallery, Passage du sourire d'Avril, Amiens 80039 Cedex 1, France
| | - Rym Abidi
- Faculté des Sciences de Bizerte, Laboratoire d'Application de la Chimie aux Ressources et Substances Naturelles et à l'Environnement (LACReSNE) Unité ≪Interactions Moléculaires Spécifiques≫, Université de Carthage Zarzouna-Bizerte, Zarzouna-Bizerte, Tennessee 7021, Tunisia
| | - Catherine Mullié
- Laboratoire AGIR-UR UPJV 4294, UFR de Pharmacie, Université de Picardie Jules Verne, Amiens80037, France
| | - Franck Fieschi
- Univ. Grenoble Alpes, CNRS, CEA, Institut de Biologie Structurale, GrenobleF-38044, France
| | - Peter J Cragg
- School of Pharmacy and Biomolecular Science, University of Brighton, Brighton BN2 4GJ, U.K
| | - Franck Halary
- Nantes Université, Inserm, CHU Nantes, Center for Research in Transplantation and Immunology UMR1064, ITUN, Nantes44093, France
| | - Rafael Delgado
- Laboratorio de Microbiología Molecular, Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid 28041, Spain
| | - Mohammed Benazza
- Laboratoire de Glycochimie des Antimicrobiens et des Agroressources (LG2A-UMR7378-CNRS), Université de Picardie Jules Verne, 10 Rue Baudelocque, Amiens, 80039 Cédex, France
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Abstract
The role of carriers in the persistence of foot-and-mouth disease in buffalo is quantified.
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Affiliation(s)
- Katie Hampson
- Institute of Biodiversity, Animal Health, and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Daniel Haydon
- Institute of Biodiversity, Animal Health, and Comparative Medicine, University of Glasgow, Glasgow, UK
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Languon S, Quaye O. Impacts of the Filoviridae family. Curr Opin Pharmacol 2021; 60:268-274. [PMID: 34482213 DOI: 10.1016/j.coph.2021.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/13/2021] [Accepted: 07/27/2021] [Indexed: 11/19/2022]
Abstract
Over 40 filovirus disease outbreaks have been reported since the discovery of the first member of the Filoviridae family, and most of the outbreaks have occurred in Africa. In addition to deaths (primary impacts), there have also been health, social, economic, and political effects (secondary impacts) due to the outbreaks. Two large filovirus disease outbreaks have occurred in West and Central Africa in recent times, and direct and indirect repercussions resulting from the outbreaks underscores the need to strengthen the capacity of health services in disease hotspots.
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Affiliation(s)
- Sylvester Languon
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana; Global Virus Network (GVN), 725 West Lombard St., Baltimore, MD, 21201, USA
| | - Osbourne Quaye
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana; Global Virus Network (GVN), 725 West Lombard St., Baltimore, MD, 21201, USA.
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46
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Resurgence of Ebola virus in 2021 in Guinea suggests a new paradigm for outbreaks. Nature 2021; 597:539-543. [PMID: 34526718 DOI: 10.1038/s41586-021-03901-9] [Citation(s) in RCA: 99] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/11/2021] [Indexed: 02/08/2023]
Abstract
Seven years after the declaration of the first epidemic of Ebola virus disease in Guinea, the country faced a new outbreak-between 14 February and 19 June 2021-near the epicentre of the previous epidemic1,2. Here we use next-generation sequencing to generate complete or near-complete genomes of Zaire ebolavirus from samples obtained from 12 different patients. These genomes form a well-supported phylogenetic cluster with genomes from the previous outbreak, which indicates that the new outbreak was not the result of a new spillover event from an animal reservoir. The 2021 lineage shows considerably lower divergence than would be expected during sustained human-to-human transmission, which suggests a persistent infection with reduced replication or a period of latency. The resurgence of Zaire ebolavirus from humans five years after the end of the previous outbreak of Ebola virus disease reinforces the need for long-term medical and social care for patients who survive the disease, to reduce the risk of re-emergence and to prevent further stigmatization.
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48
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Khan FMA, Hasan MM, Kazmi Z, Dos Santos Costa AC, Aborode AT, Ahmad S, Essar MY. Ebola and COVID-19 in Democratic Republic of Congo: grappling with two plagues at once. Trop Med Health 2021; 49:67. [PMID: 34429168 PMCID: PMC8383245 DOI: 10.1186/s41182-021-00356-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/18/2021] [Indexed: 01/13/2023] Open
Abstract
In February 2021, a new Ebola virus disease outbreak was confirmed amid the COVID-19 pandemic in the Democratic Republic of Congo. Although the country has successfully contained the outbreak amid its fight against the COVID-19 pandemic, the epidemiological situation is still concerning, primarily due to the risk of an increase in the number of COVID-19 cases. The coexistence of both outbreaks increased the burden on the country’s health system mainly because Ebola response programs were redirected to the COVID-19 national response. Strategies adopted and lessons learned from previous Ebola outbreaks were crucial to developing the COVID-19 national response. To tackle the challenges of combating both the viruses, it is essential to adopt multidisciplinary measures such as prevention, education, and vaccination campaigns, promoting hygiene and social distancing practices, and improving diagnostic and management protocols. This paper discusses the efforts, challenges, and possible solutions to grapple with Ebola amid the COVID-19 crisis in DRC successfully.
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Affiliation(s)
| | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh.,Division of Infectious Diseases, The Red-Green Research Centre, BICCB, Dhaka, Bangladesh
| | - Zohra Kazmi
- Jinnah Medical and Dental College, Karachi, Pakistan
| | | | - Abdullahi Tunde Aborode
- Healthy Africans Platform, Research and Development, Ibadan, Nigeria.,West African Academy of Public Health, Research and Development, Abuja, Nigeria
| | - Shoaib Ahmad
- Department of Surgery, District Head Quarters Teaching Hospital, Faisalabad, Pakistan
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49
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Kitamura K, Shimizu H. The Molecular Evolution of Type 2 Vaccine-Derived Polioviruses in Individuals with Primary Immunodeficiency Diseases. Viruses 2021; 13:v13071407. [PMID: 34372613 PMCID: PMC8310373 DOI: 10.3390/v13071407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 07/17/2021] [Accepted: 07/17/2021] [Indexed: 12/28/2022] Open
Abstract
The oral poliovirus vaccine (OPV), which prevents person-to-person transmission of poliovirus by inducing robust intestinal immunity, has been a crucial tool for global polio eradication. However, polio outbreaks, mainly caused by type 2 circulating vaccine-derived poliovirus (cVDPV2), are increasing worldwide. Meanwhile, immunodeficiency-associated vaccine-derived poliovirus (iVDPV) is considered another risk factor during the final stage of global polio eradication. Patients with primary immunodeficiency diseases are associated with higher risks for long-term iVDPV infections. Although a limited number of chronic iVDPV excretors were reported, the recent identification of a chronic type 2 iVDPV (iVDPV2) excretor in the Philippines highlights the potential risk of inapparent iVDPV infection for expanding cVDPV outbreaks. Further research on the genetic characterizations and molecular evolution of iVDPV2, based on comprehensive iVDPV surveillance, will be critical for elucidating the remaining risk of iVDPV2 during the post-OPV era.
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50
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Lacroix A, Mbala Kingebeni P, Ndimbo Kumugo SP, Lempu G, Butel C, Serrano L, Vidal N, Thaurignac G, Esteban A, Mukadi Bamuleka D, Likofata J, Delaporte E, Muyembe Tamfum JJ, Ayouba A, Peeters M, Ahuka Mundeke S. Investigating the Circulation of Ebola Viruses in Bats during the Ebola Virus Disease Outbreaks in the Equateur and North Kivu Provinces of the Democratic Republic of Congo from 2018. Pathogens 2021; 10:pathogens10050557. [PMID: 34064424 PMCID: PMC8147758 DOI: 10.3390/pathogens10050557] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/28/2021] [Accepted: 04/30/2021] [Indexed: 02/04/2023] Open
Abstract
With 12 of the 31 outbreaks, the Democratic Republic of Congo (DRC) is highly affected by Ebolavirus disease (EVD). To better understand the role of bats in the ecology of Ebola viruses, we conducted surveys in bats during two recent EVD outbreaks and in two areas with previous outbreaks. Dried blood spots were tested for antibodies to ebolaviruses and oral and rectal swabs were screened for the presence of filovirus using a broadly reactive semi-nested RT-PCR. Between 2018 and 2020, 892 (88.6%) frugivorous and 115 (11.4%) insectivorous bats were collected. Overall, 11/925 (1.2%) to 100/925 (10.8%) bats showed antibodies to at least one Ebolavirus antigen depending on the positivity criteria. Antibodies were detected in fruit bats from the four sites and from species previously documented to harbor Ebola antibodies or RNA. We tested for the first time a large number of bats during ongoing EVD outbreaks in DRC, but no viral RNA was detected in the 676 sampled bats. Our study illustrates the difficulty to document the role of bats as a source of Ebolaviruses as they might clear quickly the virus. Given the increasing frequency of EVD outbreaks, more studies on the animal reservoir are urgently needed.
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Affiliation(s)
- Audrey Lacroix
- TransVIHMI (Recherches Translationnelles sur VIH et Maladies Infectieuses), Université de Montpellier, Institut de Recherche pour le Développement, INSERM, 34394 Montpellier, France; (A.L.); (C.B.); (L.S.); (N.V.); (G.T.); (A.E.); (E.D.); (A.A.)
| | - Placide Mbala Kingebeni
- Institut National de Recherche Biomédicale (INRB), 1197 Kinshasa, Democratic Republic of the Congo; (P.M.K.); (S.P.N.K.); (G.L.); (J.-J.M.T.)
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, 1197 Kinshasa, Democratic Republic of the Congo;
| | - Simon Pierre Ndimbo Kumugo
- Institut National de Recherche Biomédicale (INRB), 1197 Kinshasa, Democratic Republic of the Congo; (P.M.K.); (S.P.N.K.); (G.L.); (J.-J.M.T.)
| | - Guy Lempu
- Institut National de Recherche Biomédicale (INRB), 1197 Kinshasa, Democratic Republic of the Congo; (P.M.K.); (S.P.N.K.); (G.L.); (J.-J.M.T.)
| | - Christelle Butel
- TransVIHMI (Recherches Translationnelles sur VIH et Maladies Infectieuses), Université de Montpellier, Institut de Recherche pour le Développement, INSERM, 34394 Montpellier, France; (A.L.); (C.B.); (L.S.); (N.V.); (G.T.); (A.E.); (E.D.); (A.A.)
| | - Laetitia Serrano
- TransVIHMI (Recherches Translationnelles sur VIH et Maladies Infectieuses), Université de Montpellier, Institut de Recherche pour le Développement, INSERM, 34394 Montpellier, France; (A.L.); (C.B.); (L.S.); (N.V.); (G.T.); (A.E.); (E.D.); (A.A.)
| | - Nicole Vidal
- TransVIHMI (Recherches Translationnelles sur VIH et Maladies Infectieuses), Université de Montpellier, Institut de Recherche pour le Développement, INSERM, 34394 Montpellier, France; (A.L.); (C.B.); (L.S.); (N.V.); (G.T.); (A.E.); (E.D.); (A.A.)
| | - Guillaume Thaurignac
- TransVIHMI (Recherches Translationnelles sur VIH et Maladies Infectieuses), Université de Montpellier, Institut de Recherche pour le Développement, INSERM, 34394 Montpellier, France; (A.L.); (C.B.); (L.S.); (N.V.); (G.T.); (A.E.); (E.D.); (A.A.)
| | - Amandine Esteban
- TransVIHMI (Recherches Translationnelles sur VIH et Maladies Infectieuses), Université de Montpellier, Institut de Recherche pour le Développement, INSERM, 34394 Montpellier, France; (A.L.); (C.B.); (L.S.); (N.V.); (G.T.); (A.E.); (E.D.); (A.A.)
| | - Daniel Mukadi Bamuleka
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, 1197 Kinshasa, Democratic Republic of the Congo;
- Institut National de Recherche Biomédicale (INRB), Goma, Democratic Republic of the Congo
| | - Jacques Likofata
- Laboratoire Provincial de Mbandaka, Equateur, Democratic Republic of the Congo;
| | - Eric Delaporte
- TransVIHMI (Recherches Translationnelles sur VIH et Maladies Infectieuses), Université de Montpellier, Institut de Recherche pour le Développement, INSERM, 34394 Montpellier, France; (A.L.); (C.B.); (L.S.); (N.V.); (G.T.); (A.E.); (E.D.); (A.A.)
| | - Jean-Jacques Muyembe Tamfum
- Institut National de Recherche Biomédicale (INRB), 1197 Kinshasa, Democratic Republic of the Congo; (P.M.K.); (S.P.N.K.); (G.L.); (J.-J.M.T.)
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, 1197 Kinshasa, Democratic Republic of the Congo;
| | - Ahidjo Ayouba
- TransVIHMI (Recherches Translationnelles sur VIH et Maladies Infectieuses), Université de Montpellier, Institut de Recherche pour le Développement, INSERM, 34394 Montpellier, France; (A.L.); (C.B.); (L.S.); (N.V.); (G.T.); (A.E.); (E.D.); (A.A.)
| | - Martine Peeters
- TransVIHMI (Recherches Translationnelles sur VIH et Maladies Infectieuses), Université de Montpellier, Institut de Recherche pour le Développement, INSERM, 34394 Montpellier, France; (A.L.); (C.B.); (L.S.); (N.V.); (G.T.); (A.E.); (E.D.); (A.A.)
- Correspondence: (M.P.); (S.A.M.)
| | - Steve Ahuka Mundeke
- Institut National de Recherche Biomédicale (INRB), 1197 Kinshasa, Democratic Republic of the Congo; (P.M.K.); (S.P.N.K.); (G.L.); (J.-J.M.T.)
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, 1197 Kinshasa, Democratic Republic of the Congo;
- Correspondence: (M.P.); (S.A.M.)
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