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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Meta Djomsi D, Lacroix A, Soumah AK, Kinganda Lusamaki E, Mesdour A, Raulino R, Esteban A, Ndong Bass I, Mba Djonzo FA, Goumou S, Ndimbo-Kimugu SP, Lempu G, Mbala Kingebeni P, Bamuleka DM, Likofata J, Muyembe Tamfum JJ, Toure A, Mpoudi Ngole E, Kouanfack C, Delaporte E, Keita AK, Ahuka-Mundeke S, Ayouba A, Peeters M. Coronaviruses Are Abundant and Genetically Diverse in West and Central African Bats, including Viruses Closely Related to Human Coronaviruses. Viruses 2023; 15:337. [PMID: 36851551 PMCID: PMC9967053 DOI: 10.3390/v15020337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/19/2023] [Accepted: 01/23/2023] [Indexed: 01/27/2023] Open
Abstract
Bats are at the origin of human coronaviruses, either directly or via an intermediate host. We tested swabs from 4597 bats (897 from the Democratic Republic of Congo (DRC), 2191 from Cameroon and 1509 from Guinea) with a broadly reactive PCR in the RdRp region. Coronaviruses were detected in 903 (19.6%) bats and in all species, with more than 25 individuals tested. The highest prevalence was observed in Eidolon helvum (239/733; 39.9%) and Rhinolophus sp. (306/899; 34.1%), followed by Hipposideros sp. (61/291; 20.9%). Frugivorous bats were predominantly infected with beta coronaviruses from the Nobecovirus subgenus (93.8%), in which at least 6 species/genus-specific subclades were observed. In contrast, insectivorous bats were infected with beta-coronaviruses from different subgenera (Nobecovirus (8.5%), Hibecovirus (32.8%), Merbecovirus (0.5%) and Sarbecovirus (57.6%)) and with a high diversity of alpha-coronaviruses. Overall, our study shows a high prevalence and genetic diversity of coronaviruses in bats and illustrates that Rhinolophus bats in Africa are infected at high levels with the Sarbecovirus subgenus, to which SARS-CoV-2 belongs. It is important to characterize in more detail the different coronavirus lineages from bats for their potential to infect human cells, their evolution and to study frequency and modes of contact between humans and bats in Africa.
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Affiliation(s)
- Dowbiss Meta Djomsi
- Centre de Recherche sur les Maladies Emergentes et Réémergentes (CREMER), Yaounde P.O. Box 1857, Cameroon
| | - Audrey Lacroix
- TransVIHMI, University of Montpellier, Institut de Recherche pour le Développement, INSERM, 34394 Montpellier, France
| | - Abdoul Karim Soumah
- Centre de Recherche et de Formation en Infectiologie de Guinée (CERFIG), Gamal Abdel Nasser University (UGANC), Conakry BP6629, Guinea
| | - Eddy Kinganda Lusamaki
- National Institute of Biomedical Research (INRB), Kinshasa P.O. Box 1197, Democratic Republic of Congo
| | - Asma Mesdour
- TransVIHMI, University of Montpellier, Institut de Recherche pour le Développement, INSERM, 34394 Montpellier, France
| | - Raisa Raulino
- TransVIHMI, University of Montpellier, Institut de Recherche pour le Développement, INSERM, 34394 Montpellier, France
| | - Amandine Esteban
- TransVIHMI, University of Montpellier, Institut de Recherche pour le Développement, INSERM, 34394 Montpellier, France
| | - Innocent Ndong Bass
- Centre de Recherche sur les Maladies Emergentes et Réémergentes (CREMER), Yaounde P.O. Box 1857, Cameroon
| | | | - Souana Goumou
- Centre de Recherche et de Formation en Infectiologie de Guinée (CERFIG), Gamal Abdel Nasser University (UGANC), Conakry BP6629, Guinea
| | | | - Guy Lempu
- National Institute of Biomedical Research (INRB), Kinshasa P.O. Box 1197, Democratic Republic of Congo
| | - Placide Mbala Kingebeni
- National Institute of Biomedical Research (INRB), Kinshasa P.O. Box 1197, Democratic Republic of Congo
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa P.O. Box 1197, Democratic Republic of Congo
| | - Daniel Mukadi Bamuleka
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa P.O. Box 1197, Democratic Republic of Congo
- Institut National de Recherche Biomédicale (INRB), Kinshasa P.O. Box 1197, Democratic Republic of Congo
| | - Jacques Likofata
- Laboratoire Provincial de Mbandaka, Mbandaka, Democratic Republic of Congo
| | - Jean-Jacques Muyembe Tamfum
- National Institute of Biomedical Research (INRB), Kinshasa P.O. Box 1197, Democratic Republic of Congo
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa P.O. Box 1197, Democratic Republic of Congo
| | - Abdoulaye Toure
- Centre de Recherche et de Formation en Infectiologie de Guinée (CERFIG), Gamal Abdel Nasser University (UGANC), Conakry BP6629, Guinea
- Department of Public Health, Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University (UGANC), Conakry P.O. Box 1147, Guinea
| | - Eitel Mpoudi Ngole
- Centre de Recherche sur les Maladies Emergentes et Réémergentes (CREMER), Yaounde P.O. Box 1857, Cameroon
| | - Charles Kouanfack
- Centre de Recherche sur les Maladies Emergentes et Réémergentes (CREMER), Yaounde P.O. Box 1857, Cameroon
| | - Eric Delaporte
- TransVIHMI, University of Montpellier, Institut de Recherche pour le Développement, INSERM, 34394 Montpellier, France
| | - Alpha Kabinet Keita
- TransVIHMI, University of Montpellier, Institut de Recherche pour le Développement, INSERM, 34394 Montpellier, France
- Centre de Recherche et de Formation en Infectiologie de Guinée (CERFIG), Gamal Abdel Nasser University (UGANC), Conakry BP6629, Guinea
- Department of Public Health, Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University (UGANC), Conakry P.O. Box 1147, Guinea
| | - Steve Ahuka-Mundeke
- National Institute of Biomedical Research (INRB), Kinshasa P.O. Box 1197, Democratic Republic of Congo
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa P.O. Box 1197, Democratic Republic of Congo
| | - Ahidjo Ayouba
- TransVIHMI, University of Montpellier, Institut de Recherche pour le Développement, INSERM, 34394 Montpellier, France
| | - Martine Peeters
- TransVIHMI, University of Montpellier, Institut de Recherche pour le Développement, INSERM, 34394 Montpellier, France
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Lucas A, Kumakamba C, Lange CE, Obel E, Miningue G, Likofata J, Gillis A, LeBreton M, McIver DJ, Euren J, Kreuder Johnson C, Goldstein T, Muyembe-Tamfum JJ, Saylors K. Serology and Behavioral Perspectives on Ebola Virus Disease Among Bushmeat Vendors in Equateur, Democratic Republic of the Congo, After the 2018 Outbreak. Open Forum Infect Dis 2020; 7:ofaa295. [PMID: 32855984 PMCID: PMC7443109 DOI: 10.1093/ofid/ofaa295] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 07/11/2020] [Indexed: 12/01/2022] Open
Abstract
After the 2018 Ebola outbreak in Equateur Province, Democratic Republic of the Congo, we conducted behavioral interviews and collected samples from bushmeat vendors and primates in Mbandaka to test for evidence of Ebola virus exposure. Although participants indicated being aware of Ebola, they did not consider themselves at occupational risk for infection. We found antibodies against Zaire ebolavirus in one participant despite no reported history of disease or contact with infected individuals. Our data underline concerns of possible subclinical or undiagnosed Ebola virus infections and the importance and challenges of risk communication to populations who are occupationally exposed to bushmeat. Following the 2018 Ebola outbreak in Equateur Province, Democratic Republic of the Congo, bushmeat vendors interviewed in Mbandaka indicated being aware of Ebola, but did not consider themselves at occupational risk. Antibodies against Zaire ebolavirus were detected in one participant.
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Affiliation(s)
| | | | | | - Erby Obel
- Metabiota Inc, Kinshasa, Democratic Republic of the Congo
| | - Guy Miningue
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Jacques Likofata
- Mbandaka Laboratory, Ministry of Health, Mbandaka, Democratic Republic of the Congo
| | | | | | | | - Jason Euren
- Metabiota Inc, San Francisco, California, USA
| | - Christine Kreuder Johnson
- One Health Institute, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Tracey Goldstein
- One Health Institute, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Jean J Muyembe-Tamfum
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
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Mbala-Kingebeni P, Villabona-Arenas CJ, Vidal N, Likofata J, Nsio-Mbeta J, Makiala-Mandanda S, Mukadi D, Mukadi P, Kumakamba C, Djokolo B, Ayouba A, Delaporte E, Peeters M, Muyembe Tamfum JJ, Ahuka-Mundeke S. Rapid Confirmation of the Zaire Ebola Virus in the Outbreak of the Equateur Province in the Democratic Republic of Congo: Implications for Public Health Interventions. Clin Infect Dis 2020; 68:330-333. [PMID: 29961823 PMCID: PMC6321851 DOI: 10.1093/cid/ciy527] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 06/27/2018] [Indexed: 12/22/2022] Open
Abstract
Ten days after the declaration of the Ebola outbreak in the Democratic Republic of Congo, rapid identification of the species Zaire Ebola virus using partial gene amplification and nanopore sequencing backed up the use of the recombinant vesicular stomatitis virus–Zaire Ebola virus vaccine in the recommended ring vaccination strategy.
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Affiliation(s)
- Placide Mbala-Kingebeni
- National Institute of Biomedical Research, Cliniques Universitaires de Kinshasa, Democratic Republic of Congo.,Service de Microbiologie, Cliniques Universitaires de Kinshasa, Democratic Republic of Congo.,Recherches translationelles sur le virus de l'immunodéficience et les maladies infectieuses, Institut de Recherche pour le Développement, University of Montpellier, Institut national de la santé et de la recherche médicale, France
| | - Christian-Julian Villabona-Arenas
- Recherches translationelles sur le virus de l'immunodéficience et les maladies infectieuses, Institut de Recherche pour le Développement, University of Montpellier, Institut national de la santé et de la recherche médicale, France
| | - Nicole Vidal
- Recherches translationelles sur le virus de l'immunodéficience et les maladies infectieuses, Institut de Recherche pour le Développement, University of Montpellier, Institut national de la santé et de la recherche médicale, France
| | | | | | - Sheila Makiala-Mandanda
- National Institute of Biomedical Research, Cliniques Universitaires de Kinshasa, Democratic Republic of Congo.,Service de Microbiologie, Cliniques Universitaires de Kinshasa, Democratic Republic of Congo
| | - Daniel Mukadi
- National Institute of Biomedical Research, Cliniques Universitaires de Kinshasa, Democratic Republic of Congo.,Service de Microbiologie, Cliniques Universitaires de Kinshasa, Democratic Republic of Congo
| | - Patrick Mukadi
- National Institute of Biomedical Research, Cliniques Universitaires de Kinshasa, Democratic Republic of Congo.,Service de Microbiologie, Cliniques Universitaires de Kinshasa, Democratic Republic of Congo
| | - Charles Kumakamba
- National Institute of Biomedical Research, Cliniques Universitaires de Kinshasa, Democratic Republic of Congo.,6Metabiota Inc., Kinshasa, Democratic Republic of Congo
| | | | - Ahidjo Ayouba
- Recherches translationelles sur le virus de l'immunodéficience et les maladies infectieuses, Institut de Recherche pour le Développement, University of Montpellier, Institut national de la santé et de la recherche médicale, France
| | - Eric Delaporte
- Recherches translationelles sur le virus de l'immunodéficience et les maladies infectieuses, Institut de Recherche pour le Développement, University of Montpellier, Institut national de la santé et de la recherche médicale, France
| | - Martine Peeters
- Recherches translationelles sur le virus de l'immunodéficience et les maladies infectieuses, Institut de Recherche pour le Développement, University of Montpellier, Institut national de la santé et de la recherche médicale, France
| | - Jean-Jacques Muyembe Tamfum
- National Institute of Biomedical Research, Cliniques Universitaires de Kinshasa, Democratic Republic of Congo.,Service de Microbiologie, Cliniques Universitaires de Kinshasa, Democratic Republic of Congo
| | - Steve Ahuka-Mundeke
- National Institute of Biomedical Research, Cliniques Universitaires de Kinshasa, Democratic Republic of Congo.,Service de Microbiologie, Cliniques Universitaires de Kinshasa, Democratic Republic of Congo
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6
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Mbala-Kingebeni P, Pratt CB, Wiley MR, Diagne MM, Makiala-Mandanda S, Aziza A, Di Paola N, Chitty JA, Diop M, Ayouba A, Vidal N, Faye O, Faye O, Karhemere S, Aruna A, Nsio J, Mulangu F, Mukadi D, Mukadi P, Kombe J, Mulumba A, Duraffour S, Likofata J, Pukuta E, Caviness K, Bartlett ML, Gonzalez J, Minogue T, Sozhamannan S, Gross SM, Schroth GP, Kuhn JH, Donaldson EF, Delaporte E, Sanchez-Lockhart M, Peeters M, Muyembe-Tamfum JJ, Alpha Sall A, Palacios G, Ahuka-Mundeke S. 2018 Ebola virus disease outbreak in Équateur Province, Democratic Republic of the Congo: a retrospective genomic characterisation. Lancet Infect Dis 2019; 19:641-647. [PMID: 31000465 DOI: 10.1016/s1473-3099(19)30124-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 02/09/2019] [Accepted: 02/15/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND The 2018 Ebola virus disease (EVD) outbreak in Équateur Province, Democratic Republic of the Congo, began on May 8, and was declared over on July 24; it resulted in 54 documented cases and 33 deaths. We did a retrospective genomic characterisation of the outbreak and assessed potential therapeutic agents and vaccine (medical countermeasures). METHODS We used target-enrichment sequencing to produce Ebola virus genomes from samples obtained in the 2018 Équateur Province outbreak. Combining these genomes with genomes associated with known outbreaks from GenBank, we constructed a maximum-likelihood phylogenetic tree. In-silico analyses were used to assess potential mismatches between the outbreak strain and the probes and primers of diagnostic assays and the antigenic sites of the experimental rVSVΔG-ZEBOV-GP vaccine and therapeutics. An in-vitro flow cytometry assay was used to assess the binding capability of the individual components of the monoclonal antibody cocktail ZMapp. FINDINGS A targeted sequencing approach produced 16 near-complete genomes. Phylogenetic analysis of these genomes and 1011 genomes from GenBank revealed a distinct cluster, confirming a new Ebola virus variant, for which we propose the name "Tumba". This new variant appears to have evolved at a slower rate than other Ebola virus variants (0·69 × 10-3 substitutions per site per year with "Tumba" vs 1·06 × 10-3 substitutions per site per year without "Tumba"). We found few sequence mismatches in the assessed assay target regions and antigenic sites. We identified nine amino acid changes in the Ebola virus surface glycoprotein, of which one resulted in reduced binding of the 13C6 antibody within the ZMapp cocktail. INTERPRETATION Retrospectively, we show the feasibility of using genomics to rapidly characterise a new Ebola virus variant within the timeframe of an outbreak. Phylogenetic analysis provides further indications that these variants are evolving at differing rates. Rapid in-silico analyses can direct in-vitro experiments to quickly assess medical countermeasures. FUNDING Defense Biological Product Assurance Office.
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Affiliation(s)
- Placide Mbala-Kingebeni
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; TransVIHMI, Institut de Recherche pour le Développement, Institut National de la Santé et de la Recherche Médicale, Université de Montpellier, Montpellier, France; Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Catherine B Pratt
- Center for Genome Sciences, US Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA; College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Michael R Wiley
- Center for Genome Sciences, US Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA; College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Sheila Makiala-Mandanda
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Amuri Aziza
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Nicholas Di Paola
- Center for Genome Sciences, US Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Joseph A Chitty
- Center for Genome Sciences, US Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | | | - Ahidjo Ayouba
- TransVIHMI, Institut de Recherche pour le Développement, Institut National de la Santé et de la Recherche Médicale, Université de Montpellier, Montpellier, France
| | - Nicole Vidal
- TransVIHMI, Institut de Recherche pour le Développement, Institut National de la Santé et de la Recherche Médicale, Université de Montpellier, Montpellier, France
| | | | - Oumar Faye
- Institut Pasteur de Dakar, Dakar, Senegal
| | - Stormy Karhemere
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Aaron Aruna
- Direction Générale de Lutte contre la Maladie, Kinshasa, Democratic Republic of the Congo
| | - Justus Nsio
- Direction Générale de Lutte contre la Maladie, Kinshasa, Democratic Republic of the Congo
| | - Felix Mulangu
- Direction Générale de Lutte contre la Maladie, Kinshasa, Democratic Republic of the Congo
| | - Daniel Mukadi
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Patrick Mukadi
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - John Kombe
- Direction Générale de Lutte contre la Maladie, Kinshasa, Democratic Republic of the Congo
| | - Anastasie Mulumba
- Monsieur le Représentant de l'Organisation Mondiale de la Santé, Democratic Republic of the Congo
| | - Sophie Duraffour
- Monsieur le Représentant de l'Organisation Mondiale de la Santé, Democratic Republic of the Congo; Bernhard-Nocht-Institut für Tropenmedizin, Hamburg, Germany
| | - Jacques Likofata
- Laboratoire Provinciale, Mbandaka, Democratic Republic of the Congo
| | - Elisabeth Pukuta
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Katie Caviness
- Center for Genome Sciences, US Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Maggie L Bartlett
- Center for Genome Sciences, US Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA; Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Jeanette Gonzalez
- Center for Genome Sciences, US Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Timothy Minogue
- Diagnostics Services Division, US Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Shanmuga Sozhamannan
- Defense Biological Product Assurance Office, Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense-Joint Project Management Office for Guardian, Frederick, MD, USA; Logistics Management Institute, Tysons, VA, USA
| | | | | | - Jens H Kuhn
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, MD, USA
| | - Eric F Donaldson
- Division of Antiviral Products, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Eric Delaporte
- TransVIHMI, Institut de Recherche pour le Développement, Institut National de la Santé et de la Recherche Médicale, Université de Montpellier, Montpellier, France
| | - Mariano Sanchez-Lockhart
- Center for Genome Sciences, US Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA; Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Martine Peeters
- TransVIHMI, Institut de Recherche pour le Développement, Institut National de la Santé et de la Recherche Médicale, Université de Montpellier, Montpellier, France
| | - Jean-Jacques Muyembe-Tamfum
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | | | - Gustavo Palacios
- Center for Genome Sciences, US Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA.
| | - Steve Ahuka-Mundeke
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo; Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
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7
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Nolen LD, Osadebe L, Katomba J, Likofata J, Mukadi D, Monroe B, Doty J, Hughes CM, Kabamba J, Malekani J, Bomponda PL, Lokota JI, Balilo MP, Likafi T, Lushima RS, Ilunga BK, Nkawa F, Pukuta E, Karhemere S, Tamfum JJM, Nguete B, Wemakoy EO, McCollum AM, Reynolds MG. Extended Human-to-Human Transmission during a Monkeypox Outbreak in the Democratic Republic of the Congo. Emerg Infect Dis 2018; 22:1014-21. [PMID: 27191380 PMCID: PMC4880088 DOI: 10.3201/eid2206.150579] [Citation(s) in RCA: 163] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
During the outbreak, 50% of household members living with an infected person developed symptom of monkeypox infection. A 600-fold increase in monkeypox cases occurred in the Bokungu Health Zone of the Democratic Republic of the Congo during the second half of 2013; this increase prompted an outbreak investigation. A total of 104 possible cases were reported from this health zone; among 60 suspected cases that were tested, 50 (48.1%) cases were confirmed by laboratory testing, and 10 (9.6%) tested negative for monkeypox virus (MPXV) infection. The household attack rate (i.e., rate of persons living with an infected person that develop symptoms of MPXV infection) was 50%. Nine families showed >1 transmission event, and >6 transmission events occurred within this health zone. Mean incubation period was 8 days (range 4–14 days). The high attack rate and transmission observed in this study reinforce the importance of surveillance and rapid identification of monkeypox cases. Community education and training are needed to prevent transmission of MPXV infection during outbreaks.
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8
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Nolen LD, Osadebe L, Katomba J, Likofata J, Mukadi D, Monroe B, Doty J, Kalemba L, Malekani J, Kabamba J, Bomponda PL, Lokota JI, Balilo MP, Likafi T, Lushima RS, Tamfum JJM, Okitolonda EW, McCollum AM, Reynolds MG. Introduction of Monkeypox into a Community and Household: Risk Factors and Zoonotic Reservoirs in the Democratic Republic of the Congo. Am J Trop Med Hyg 2015; 93:410-5. [PMID: 26013374 PMCID: PMC4530773 DOI: 10.4269/ajtmh.15-0168] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 04/02/2015] [Indexed: 11/07/2022] Open
Abstract
An increased incidence of monkeypox (MPX) infections in the Democratic Republic of the Congo was noted by the regional surveillance system in October 2013. Little information exists regarding how MPX is introduced into the community and the factors associated with transmission within the household. Sixty-eight wild animals were collected and tested for Orthopoxvirus. Two of three rope squirrels (Funisciurus sp.) were positive for antibodies to Orthopoxviruses; however, no increased risk was associated with the consumption or preparation of rope squirrels. A retrospective cohort investigation and a case-control investigation were performed to identify risk factors affecting the introduction of monkeypox virus (MPXV) into the community and transmission within the home. School-age males were the individuals most frequently identified as the first person infected in the household and were the group most frequently affected overall. Risk factors of acquiring MPXV in a household included sleeping in the same room or bed, or using the same plate or cup as the primary case. There was no significant risk associated with eating or processing of wild animals. Activities associated with an increased risk of MPXV transmission all have potential for virus exposure to the mucosa.
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Affiliation(s)
- Leisha Diane Nolen
- U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo
| | - Lynda Osadebe
- U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo
| | - Jacques Katomba
- U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo
| | - Jacques Likofata
- U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo
| | - Daniel Mukadi
- U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo
| | - Benjamin Monroe
- U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo
| | - Jeffrey Doty
- U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo
| | - Lem's Kalemba
- U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo
| | - Jean Malekani
- U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo
| | - Joelle Kabamba
- U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo
| | - Pierre Lokwa Bomponda
- U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo
| | - Jules Inonga Lokota
- U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo
| | - Marcel Pie Balilo
- U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo
| | - Toutou Likafi
- U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo
| | - Robert Shongo Lushima
- U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo
| | - Jean-Jacques Muyembe Tamfum
- U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo
| | - Emile Wemakoy Okitolonda
- U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo
| | - Andrea M McCollum
- U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo
| | - Mary G Reynolds
- U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo
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