#Ebola virus disease in #children in #Conakry and Coyah #ETCs and #risk #factors associated with death (Med Mal Infect., abstract)

[Source: US National Library of Medicine, full page: (LINKLINK). Abstract, edited.]

Med Mal Infect. 2019 Dec 21. pii: S0399-077X(19)31077-7. doi: 10.1016/j.medmal.2019.12.001. [Epub ahead of print]

Ebola virus disease in children in Conakry and Coyah Ebola treatment centers and risk factors associated with death.

Sow MS1, Sow DC2, Diallo ML3, Kassé D3, Sylla K2, Camara A4, Djiro SD5, Diallo MOS2, Bah EI2, Bah I2, Diallo MP3.

Author information: 1 Service des maladies infectieuses et tropicales de l’hôpital National de Donka. Electronic address: smsaliou@gmail.com. 2 Service des maladies infectieuses et tropicales de l’hôpital National de Donka. 3 Service de pédiatrie de l’hôpital National de Donka. 4 Chaire de santé publique. 5 Registre des cancers de Guinée, Guinea.

 

Abstract

OBJECTIVE:

To study Ebola virus disease (EVD) in children aged 15 years and below, and to identify risk factors associated with death.

PATIENTS AND METHODS:

Retrospective, multicenter, descriptive, and analytical study of files of children aged 15 years and below in Ebola treatment centers (ETC) of Donka from March 2014 to May 2015. We included all files of children aged 15 years and below hospitalized for EVD in the two ETCs.

RESULTS:

A total of 739 patients hospitalized in both ETCs, 146 children aged 15 years and below (20%) were registered during the study period. The mean age of children was 6.73±4.26 years. Most children were aged above five years (65.8%) and the mean time to consultation was 4.34±3.21 days. The main clinical signs were asthenia (78.8%), fever (75.3%), anorexia (53.4%), headache (45.9%), vomiting (41.8%), abdominal pain (29.5%), and diarrhea (28.8%). The case fatality was 48%, including 54.3% in Coyah and 45% in Conakry. Older age (aOR=0.83, 95% CI [0.76-0.95]), fever (aOR=3.28, 95% CI [1.22-8.87]), diarrhea (aOR=2.98, 95% CI [1.19-4.48]), and hemorrhage (aOR=3.13, 95% CI [1.00-10.38]) were independently associated with death due to EVD.

CONCLUSION:

EVD remains serious especially in children, with high case fatality. Risk factors independently associated with death were young age, diarrhea, hemorrhage, and fever. Particular attention to these risk factors and vaccination will contribute to improving the prognosis of EVD in children.

Copyright © 2019 Elsevier Masson SAS. All rights reserved.

KEYWORDS: Children; Ebola; Ebola treatment center

PMID: 31874716 DOI: 10.1016/j.medmal.2019.12.001

Keywords: Ebola; Guinea; Pediatrics.

——

#Serological Evidence of #Exposure to #Ebolaviruses in Domestic #Pigs from #Guinea (Tranbsound Emerg Dis., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Transbound Emerg Dis. 2019 Oct 18. doi: 10.1111/tbed.13391. [Epub ahead of print]

Serological Evidence of Exposure to Ebolaviruses in Domestic Pigs from Guinea.

Fischer K1, Camara A2, Troupin C2, Fehling SK3, Strecker T3, Groschup MH1, Tordo N2, Diederich S1.

Author information: 1 Friedrich-Loeffler-Institut, Institute of Novel and Emerging Infectious Diseases, Greifswald – Insel Riems, Germany. 2 Institut Pasteur de Guineé, Conakry, Guinea. 3 Institute of Virology, Philipps University of Marburg, Marburg, Germany.

 

Abstract

The genus Ebolavirus comprises several virus species with zoonotic potential and varying pathogenicity for humans. Ebolaviruses are considered to circulate in wildlife with occasional spillover events into the human population which then often leads to severe disease outbreaks. Several studies indicate a significant role of bats as reservoir hosts in the ebolavirus ecology. However, pigs from the Philippines have been found to be naturally infected with Reston virus (RESTV), an ebolavirus that is thought to only cause asymptomatic infections in humans. The recent report of ebolavirus-specific antibodies in pigs from Sierra Leone further supports natural infection of pigs with ebolaviruses. However, susceptibility of pigs to highly pathogenic Ebola virus (EBOV) was only shown under experimental settings and evidence for natural infection of pigs with EBOV is currently lacking. Between October and December 2017, we collected 308 serum samples from pigs in Guinea, West Africa, and tested for the presence of ebolavirus-specific antibodies with different serological assays. Besides reactivity to EBOV nucleoproteins in ELISA and Western Blot for 19 (6.2%) and 13 (4.2%) samples respectively, four sera recognized Sudan virus (SUDV) NP in Western blot. Furthermore, four samples specifically detected EBOV or SUDV glycoprotein (GP) in an indirect immunofluorescence assay under native conditions. Virus neutralization assay based on EBOV (Mayinga isolate) revealed five weakly neutralizing sera. The finding of (cross-) reactive and weakly neutralizing antibodies suggests the exposure of pigs from Guinea to ebolaviruses or ebola-like viruses with their pathogenicity as well as their zoonotic potential remaining unknown. Future studies should investigate whether pigs can act as an amplifying host for ebolaviruses and whether there is a risk for spillover events.

© 2019 Blackwell Verlag GmbH.

KEYWORDS: ELISA; Ebola; West Africa; antibodies; ebolaviruses; neutralization test; pigs; serology

PMID: 31627257 DOI: 10.1111/tbed.13391

Keywords: Ebola; Sudan Virus; Serology; Seroprevalence; Pigs; Guinea.

——-

Subsequent #mortality in #survivors of #Ebola virus disease in #Guinea: a nationwide retrospective cohort study (Lancet Infect Dis., abstract)

[Source: The Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]

Subsequent mortality in survivors of Ebola virus disease in Guinea: a nationwide retrospective cohort study

Mory Keita, MD, Boubacar Diallo, MD, Samuel Mesfin, BSc, Abdourahmane Marega, PharmD, Koumpingnin Yacouba Nebie, MD, N’Faly Magassouba, PhD, Ahmadou Barry, MD, Seydou Coulibaly, MD, Boubacar Barry, BSc, Mamadou Oury Baldé, MD, Raymond Pallawo, MD, Sadou Sow, MPH, Prof Alpha Oumar Bah, MD, Mamadou Saliou Balde, MD, Steven Van Gucht, PhD, Prof Mandy Kader Kondé, PhD, Amadou Bailo Diallo, MD, Mamoudou Harouna Djingarey, MD, Ibrahima Socé Fall, PhD, Pierre Formenty, DVM, Prof Judith R Glynn, PhD, Lorenzo Subissi, PhD

Published: September 04, 2019 / DOI: https://doi.org/10.1016/S1473-3099(19)30313-5

 

Summary

Background

A record number of people survived Ebola virus infection in the 2013–16 outbreak in west Africa, and the number of survivors has increased after subsequent outbreaks. A range of post-Ebola sequelae have been reported in survivors, but little is known about subsequent mortality. We aimed to investigate subsequent mortality among people discharged from Ebola treatment units.

Methods

From Dec 8, 2015, Surveillance Active en ceinture, the Guinean national survivors’ monitoring programme, attempted to contact and follow-up all survivors of Ebola virus disease who were discharged from Ebola treatment units. Survivors were followed up until Sept 30, 2016, and deaths up to this timepoint were recorded. Verbal autopsies were done to gain information about survivors of Ebola virus disease who subsequently died from their closest family members. We calculated the age-standardised mortality ratio compared with the general Guinean population, and assessed risk factors for mortality using survival analysis and a Cox proportional hazards regression model.

Findings

Of the 1270 survivors of Ebola virus disease who were discharged from Ebola treatment units in Guinea, information was retrieved for 1130 (89%). Compared with the general Guinean population, survivors of Ebola virus disease had a more than five-times increased risk of mortality up to Dec 31, 2015 (age-standardised mortality ratio 5·2 [95% CI 4·0–6·8]), a mean of 1 year of follow-up after discharge. Thereafter (ie, from Jan 1–Sept 30, 2016), mortality did not differ between survivors of Ebola virus disease and the general population. (0·6 [95% CI 0·2–1·4]). Overall, 59 deaths were reported, and the cause of death was tentatively attributed to renal failure in 37 cases, mostly on the basis of reported anuria. Longer stays (ie, equal to or longer than the median stay) in Ebola treatment units were associated with an increased risk of late death compared with shorter stays (adjusted hazard ratio 2·62 [95% CI 1·43–4·79]).

Interpretation

Mortality was high in people who recovered from Ebola virus disease and were discharged from Ebola treatment units in Guinea. The finding that survivors who were hospitalised for longer during primary infection had an increased risk of death, could help to guide current and future survivors’ programmes and in the prioritisation of funds in resource-constrained settings. The role of renal failure in late deaths after recovery from Ebola virus disease should be investigated.

Funding

WHO, International Medical Corps, and the Guinean Red Cross.

Keywords: Ebola; Ebola-Makona; Post Ebola Virus Disease Syndrome; Guinea.

——

#CFR #estimates for the 2013 – 2016 West #African #Ebola #epidemic: application of Boosted Regression Trees for imputation (Clin Infect Dis., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Clin Infect Dis. 2019 Jul 22. pii: ciz678. doi: 10.1093/cid/ciz678. [Epub ahead of print]

Case fatality ratio estimates for the 2013 – 2016 West African Ebola epidemic: application of Boosted Regression Trees for imputation.

Forna A1, Nouvellet P1,2, Dorigatti I1, Donnelly CA1,3.

Author information: 1 MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom. 2 School of Life Sciences, University of Sussex, Brighton, UK. 3 Department of Statistics, University of Oxford, Oxford, UK.

 

Abstract

BACKGROUND:

The 2013-2016 West African Ebola epidemic has been the largest to date with more than 11,000 deaths in the affected countries. The data collected have provided more insight than ever before into the case fatality ratio (CFR) and how it varies with age and other characteristics. However, the accuracy and precision of the naïve CFR remain limited because 44% of survival outcomes were unreported.

METHODS:

Using a Boosted Regression Tree (BRT) model, we imputed survival outcomes (i.e. survival or death) when unreported, corrected for model imperfection to estimate the CFR without imputation, with imputation and adjusted with imputation. The method allowed us to further identify and explore relevant clinical and demographic predictors of the CFR.

RESULTS:

The out-of-sample performances of our model were good: sensitivity=69.7% (95% CI 52.5%-75.6%), specificity=69.8% (95% CI 54.1%-75.6%), percentage correctly classified=69.9% (95% CI 53.7%-75.5%) and area under the ROC curve= 76.0% (95% CI 56.8%-82.1%). The adjusted CFR estimates for the 2013-2016 West African epidemic were 82.8% (95% CI 45%.6-85.6%) overall and 89.1% (95% CI 40.8%-91.6%) , 65.6% (95% CI 61.3%-69.6%) and 79.2% (95% CI 45.4-84.1) for Sierra Leone, Guinea and Liberia, respectively. We found that district, hospitalisation status, age, case classification and quarter explained 93.6% of the variance in the naïve CFR.

CONCLUSIONS:

The adjusted CFR estimates improved the naïve CFR estimates obtained without imputation and were more representative. Used in conjunction with other resources, adjusted estimates will inform public health contingency planning for future Ebola epidemic, and help better allocate resources and evaluate the effectiveness of future inventions.

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.

KEYWORDS: Imputation; Infectious Disease Epidemiology; Machine Learning; Survival; Viral Haemorrhagic Disease

PMID: 31328221 DOI: 10.1093/cid/ciz678

Keywords: Ebola; West Africa.

——

#Bombali Virus in Mops condylurus #Bats, #Guinea (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 9—September 2019 / Research Letter

Bombali Virus in Mops condylurus Bats, Guinea

Lyudmila S. Karan, Marat T. Makenov, Mikhail G. Korneev, Noumany Sacko, Sanaba Boumbaly, Sergey A. Yakovlev, Kerfalla Kourouma, Roman B. Bayandin, Anastasiya V. Gladysheva, Andrey V. Shipovalov, Irina A. Yurganova, Yana E. Grigorieva, Marina V. Fedorova, Svetlana A. Scherbakova, Vladimir V. Kutyrev, Alexander P. Agafonov, Renat A. Maksyutov, German A. Shipulin, Viktor V. Maleev, Mamadou Boiro, Vasiliy G. Akimkin, and Anna Y. Popova

Author affiliations: Central Research Institute of Epidemiology, Moscow, Russia (L.S. Karan, M.T. Makenov, Y.A. Grigorieva, M.V. Fedorova, V.V. Maleev, V.G. Akimkin); Russian Research Anti-Plague Institute, Saratov, Russia (M.G. Korneev, S.A. Yakovlev, S.A. Scherbakova, V.V. Kutyrev); International Center for Research of Tropical Infections in Guinea, N’Zerekore, Guinea (N. Sacko, S. Boumbaly); Research Institute of Applied Biology of Guinea, Kindia, Guinea (N. Sacko, S. Boumbaly, K. Kourouma, M. Boiro); State Research Center of Virology and Biotechnology VECTOR, Kol’tsovo, Russia (R.B. Bayandin, A.V. Gladysheva, A.V. Shipovalov, I.A. Yurganova, A.P. Agafonov, R.A. Maksyutov); Center of Strategical Planning and Biomedical Health Risks Management, Moscow (G.A. Shipulin); Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, Moscow (A.Y. Popova)

 

Abstract

In 2018, a previously unknown Ebola virus, Bombali virus, was discovered in Sierra Leone. We describe detection of Bombali virus in Guinea. We found viral RNA in internal organs of 3 Angolan free-tailed bats (Mops condylurus) trapped in the city of N’Zerekore and in a nearby village.

Keywords: Ebola; Ebola-Bombali; Bats; Guinea.

——

#Laboratory #findings, compassionate use of #favipiravir, and outcome in patients with #Ebola virus disease, #Guinea, 2015 – a retrospective observational study (J Infect Dis., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Infect Dis. 2019 Feb 21. pii: jiz078. doi: 10.1093/infdis/jiz078. [Epub ahead of print]

Laboratory findings, compassionate use of favipiravir, and outcome in patients with Ebola virus disease, Guinea, 2015 – a retrospective observational study.

Kerber R1,2,3, Lorenz E1,3, Duraffour S1,2,3, Sissoko D4,5, Rudolf M1,2,3, Jaeger A1,3, Cisse SD6, Camara AM6, Miranda O7, Castro CM7, Akoi Bore J2,6, Raymond Koundouno F2,6, Repits J2,8, Afrough B2,9, Becker-Ziaja B1,2,3, Hinzmann J2,10, Mertens M2,3,11, Vitoriano I2,9, Hugh Logue C2,9, Böttcher JP2,10, Pallasch E1,2,3, Sachse A2,10, Bah A2,12, Cabeza-Cabrerizo M2, Nitzsche K2, Kuisma E2,9, Michel J2,10, Holm T1,2,3, Gayle Zekeng E2, Cowley LA2,13,14, Garcia-Dorival I2,15, Hetzelt N2,10, Josef Baum JH1,2, Portmann J2,16, Carter L2,17,18, Yenamaberhan RL1,2, Camino A2, Enkirch T2,19, Singethan K2,20, Meisel S1,2, Mazzarelli A2,21, Kosgei A2,22, Kafetzopoulou L2,23, Rickett NY2,15, Patrono LV1,2, Ghebreghiorghis L2,10, Arnold U2,10, Colin G4,5,24, Juchet S4,5,24, Marchal CL4, Kolie JS25, Beavogui AH25, Wurr S1,2,3, Bockholt S1,2,3, Krumkamp R1,3, May J1,3, Stoecker K2,3,26, Fleischmann E2,3,26, Ippolito G2,21, W Carroll M2,9,27, Koivogui L28, Magassouba N29, Keita S6, Gurry C18, Drury P18, Diallo B30, Formenty P18, Wölfel R2,3,26, Caro AD2,21, Gabriel M1,2,3, Anglaret X4,5,24, Malvy D4,5, Günther S1,2,3.

Author information: 1 Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany. 2 The European Mobile Laboratory Consortium, Hamburg, Germany. 3 German Centre for Infection Research (DZIF), Germany. 4 INSERM U1219, Bordeaux University, Bordeaux, France. 5 Bordeaux University Hospital, Bordeaux, France. 6 Ministry of Health Guinea, Conakry, Guinea. 7 Hospital Militar Central Dr. Carlos J. Finlay, Havana, Cuba. 8 Janssen-Cilag, Sollentuna, Sweden. 9 Public Health England, Porton Down, Salisbury, United Kingdom. 10 Robert Koch Institute, Berlin, Germany. 11 Friedrich Loeffler Institute, Federal Research Institute for Animal Health, Greifswald, Insel Riems, Germany. 12 Swiss Tropical and Public Health Institute, Basel, Switzerland. 13 Public Health England, London, United Kingdom. 14 The Milner Centre for Evolution, University of Bath, Bath, United Kingdom. 15 Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom. 16 Federal Office for Civil Protection, Spiez Laboratory, Spiez, Switzerlands. 17 University College London, London, United Kingdom. 18 World Health Organization, Geneva, Switzerland. 19 Paul-Ehrlich-Institut, Division of Veterinary Medicine, Langen, Germany. 20 Institute of Virology, Technische Universität München, Munich, Germany. 21 National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Rome, Italy. 22 Kenya Medical Research Institute, Nairobi, Kenya. 23 KU Leuven – University of Leuven, Rega Institute for Medical Research, Leuven, Belgium. 24 PAC-CI, ANRS Research Site, Treichville University Hospital, Abidjan, Côte d’Ivoire. 25 Centre de Recherche en Santé Rurale, Maférinya, Guinea. 26 Bundeswehr Institute of Microbiology, Munich, Germany. 27 University of Southampton, South General Hospital, Southampton, United Kingdom. 28 Institut National de Santé Publique, Conakry, Guinea. 29 Université Gamal Abdel Nasser de Conakry, Laboratoire des Fièvres Hémorragiques en Guinée, Conakry, Guinea. 30 World Health Organization, Conakry, Guinea.

 

Abstract

BACKGROUND:

In 2015, the laboratory at the Ebola treatment center in Coyah, Guinea, confirmed Ebola virus disease (EVD) in 286 patients. Cycle threshold (Ct) in the Ebola virus RT-PCR and 13 blood chemistry parameters were measured on admission and during hospitalization. Favipiravir treatment was offered to EVD patients on compassionate use basis.

METHODS:

To reduce biases in the raw field data, we carefully selected 163 of the 286 EVD patients for a retrospective study to assess associations between potential risk factors, alterations in blood chemistry, favipiravir treatment, and outcome.

RESULTS:

The case fatality rate in favipiravir-treated patients was lower than in untreated patients (31/73 [42.5%] vs. 52/90 [57.8%], p = 0.053 in univariate analysis). In the multivariate regression analysis, higher Ct value and younger age were associated with survival (p <0.001), while favipiravir treatment showed no statistically significant effect (p = 0.11). However, Kaplan-Meier analysis indicated a longer survival time in the favipiravir-treated group (p = 0.015). The study also showed characteristic changes in blood chemistry in fatal cases vs. survivors.

CONCLUSIONS:

Consistent with the JIKI trial, this retrospective study reveals a trend toward improved survival in favipiravir-treated patients; however, the effect was not statistically significant except for survival time.

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.

KEYWORDS: Ebola virus disease; Epidemic; Favipiravir; Filovirus; Guinea; Mobile laboratory

PMID: 30788508 DOI: 10.1093/infdis/jiz078

Keywords: Ebola; Ebola-Makona; Guinea; Antivirals; Favipiravir.

——

#Prevalence of #infection among #asymptomatic and #paucisymptomatic #contact persons exposed to #Ebola virus in #Guinea: a retrospective, cross-sectional observational study (Lancet Infect Dis., abstract)

[Source: The Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]

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

Mamadou Saliou Kalifa Diallo, MSc *, Muriel Rabilloud, PhD *, Prof Ahidjo Ayouba, PhD *, Prof Abdoulaye Touré, PhD *, Guillaume Thaurignac, MSc, Alpha Kabinet Keita, PhD, Christelle Butel, MSc., Cécé Kpamou, MSc, Thierno Alimou Barry, MD, Mariama Djouldé Sall, MD, Ibrahima Camara, MSc, Sandrine Leroy, PhD, Prof Philippe Msellati, PhD, Prof René Ecochard, PhD, Prof Martine Peeters, PhD, Prof Mamadou Saliou Sow, PhD, Prof Eric Delaporte, PhD, Prof Jean-François Etard, PhD  on behalf of theContactebogui Study Group †

Published: February 11, 2019 / DOI: https://doi.org/10.1016/S1473-3099(18)30649-2

 

Summary

Background

The prevalence of Ebola virus infection among people who have been in contact with patients with Ebola virus disease remains unclear, but is essential to understand the dynamics of transmission. This study aimed to identify risk factors for seropositivity and to estimate the prevalence of Ebola virus infection in unvaccinated contact persons.

Methods

In this retrospective, cross-sectional observational study, we recruited individuals between May 12, 2016, and Sept 8, 2017, who had been in physical contact with a patient with Ebola virus disease, from four medical centres in Guinea (Conakry, Macenta, N’zérékoré, and Forécariah). Contact persons had to be 7 years or older and not diagnosed with Ebola virus disease. Participants were selected through the Postebogui survivors’ cohort. We collected self-reported information on exposure and occurrence of symptoms after exposure using a questionnaire, and tested antibody response against glycoprotein, nucleoprotein, and 40-kDa viral protein of Zaire Ebola virus by taking a blood sample. The prevalence of Ebola virus infection was estimated with a latent class model.

Findings

1721 contact persons were interviewed and given blood tests, 331 of whom reported a history of vaccination so were excluded, resulting in a study population of 1390. Symptoms were reported by 216 (16%) contact persons. The median age of participants was 26 years (range 7–88) and 682 (49%) were male. Seropositivity was identified in 18 (8·33%, 95% CI 5·01–12·80) of 216 paucisymptomatic contact persons and 39 (3·32%, 5·01–12·80) of 1174 (2–4) asymptomatic individuals (p=0·0021). Seropositivity increased with participation in burial rituals (adjusted odds ratio [aOR] 2·30, 95% CI 1·21–4·17; p=0·0079) and exposure to blood or vomit (aOR 2·15, 1·23–3·91; p=0·0090). Frequency of Ebola virus infection varied from 3·06% (95% CI 1·84–5·05) in asymptomatic contact persons who did not participate in burial rituals to 5·98% (2·81–8·18) in those who did, and from 7·17% (3·94–9·09) in paucisymptomatic contact persons who did not participate in burial rituals to 17·16% (12·42–22·31) among those who did.

Interpretation

This study provides a new assessment of the prevalence of Ebola virus infection among contact persons according to exposure, provides evidence for the occurrence of paucisymptomatic cases, and reinforces the importance of closely monitoring at-risk contact persons.

Funding

Institut National de la Santé et de la Recherche Médicale, Reacting, the French Ebola Task Force, Institut de Recherche pour le Développement, and Montpellier University Of Excellence-University of Montpellier.

Keywords: Ebola; Guinea; Seroprevalence.

——

#Immune #parameters and outcomes during #Ebola virus disease (JCI Insight., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

JCI Insight. 2019 Jan 10;4(1). pii: 125106. doi: 10.1172/jci.insight.125106. [Epub ahead of print]

Immune parameters and outcomes during Ebola virus disease.

Reynard S1, Journeaux A1, Gloaguen E2, Schaeffer J1, Varet H3, Pietrosemoli N3, Mateo M1, Baillet N1, Laouenan C2,4, Raoul H5, Mullaert J2, Baize S1.

Author information: 1 Unité de Biologie des Infections Virales Emergentes, Institut Pasteur, Centre International de Recherche en Infectiologie, Université Lyon I, INSERM, CNRS, ENS Lyon, Lyon, France. 2 Infection Antimicrobials Modelling Evolution, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France. 3 Institut Pasteur, Hub Bioinformatique et Biostatistique, Centre de Bioinformatique, Biostatistique et Biologie Intégrative, C3BI, USR 3756 IP CNRS, Paris, France. 4 Assistance Publique – Hôpitaux de Paris, Hôpital Bichat Claude Bernard, Paris, France. 5 Laboratoire P4 Jean Mérieux-INSERM, INSERM, Lyon, France.

 

Abstract

BACKGROUND:

The West African Ebola virus epidemic from 2014-2016 highlighted the lack of knowledge about the pathogenicity of the virus and the factors responsible for outcome. A performant and rapid diagnosis is of crucial importance, as is overcoming the difficulty of providing high-quality patient management during such an extensive outbreak. Here, we propose to study the role of the immune mediators during Ebola virus disease and to define some molecules of importance in the outcome.

METHODS:

Plasma from Guinean patients sampled during the outbreak were analyzed using RT-qPCR, magnetic bead assay, ELISA, and high-quality statistical analyses. We also performed a transcriptomic analysis in leukocytes samples. Therefore, we deeply characterized the immune responses involved in Ebola virus disease.

RESULTS:

We evaluated the immune patterns depending on the outcome of the disease. Survivors presented an efficient and well-balanced immune response, whereas fatalities were characterized by an intense inflammatory response, overexpression of multiple cytokines, and a “chemokine storm.” The plasma concentration of most of the parameters tested increased until death. Statistical analyses also allowed us to define a panel of markers highly predictive of outcome.

CONCLUSION:

The immune response observed in fatalities was highly similar to that characterizing septic shock syndrome. Our results suggest that immune responses can play a major pathogenic role during severe Ebola virus infection and argue in favor of therapeutic approaches that act on both viral replication and the induction of shock syndrome.

FUNDING:

French Ministry of Foreign Affairs, the Agence Française de Développement, and the Institut Pasteur.

KEYWORDS: Chemokines; Cytokines; Infectious disease; Innate immunity; Virology

PMID: 30626757 DOI: 10.1172/jci.insight.125106

Keywords: Ebola; Immunology.

——

#Survey of #Ebola Viruses in Frugivorous and Insectivorous #Bats in #Guinea, #Cameroon, and the #DRC, 2015–2017 (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 24, Number 12—December 2018 / Research

Survey of Ebola Viruses in Frugivorous and Insectivorous Bats in Guinea, Cameroon, and the Democratic Republic of the Congo, 2015–2017

Helene M. De Nys1, Placide Mbala Kingebeni1, Alpha K. Keita1, Christelle Butel, Guillaume Thaurignac, Christian-Julian Villabona-Arenas, Thomas Lemarcis, Mare Geraerts, Nicole Vidal, Amandine Esteban, Mathieu Bourgarel, François Roger, Fabian Leendertz, Ramadan Diallo, Simon-Pierre Ndimbo-Kumugo, Justus Nsio-Mbeta, Nikki Tagg, Lamine Koivogui, Abdoulaye Toure, Eric Delaporte, Steve Ahuka-Mundeke, Jean-Jacques Muyembe Tamfum, Eitel Mpoudi-Ngole, Ahidjo Ayouba2, and Martine Peeters2

Author affiliations: TransVIHMI of Institut de Recherche pour le Développement, Institut National de la Santé et de la Recherche Médicale and University of Montpellier, Montpellier, France (H.M. De Nys, P. Mbala Kingebeni, A.K. Keita, C. Butel, G. Thaurignac, C.-J. Villabona-Arenas, T. Lemarcis, M. Geraerts, N. Vidal, A. Esteban, M. Bourgarel, F. Roger, A. Toure, E. Delaporte, A. Ayouba, M. Peeters); National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo (P. Mbala Kingebeni, S.P. Ndimbo-Kumugo, S. Ahuka-Mundeke, J.-J. Muyembe Tamfum); Cliniques Universitaires de Kinshasa, Kinshasa (P. Mbala Kingebeni, S. Ahuka-Mundeke, J.-J. Muyembe Tamfum); Centre de Recherche et de Formation en Infectiologie de Guinée, Conakry, Guinea (A.K. Keita, A. Toure); Robert Koch-Institute, Berlin, Germany (F. Leendertz); Ministère de l’Elevage et des Productions Animales, Conakry (R. Diallo); Direction de Lutte contre la Maladie, Kinshasa (J. Nsio-Mbeta); Royal Zoological Society of Antwerp, Antwerp, Belgium (N. Tagg); Université de Conakry, Conakry (L. Koivogui); Institut National de Sante Publique, Conakry (A. Toure); Institut de Recherches Médicales et d’Études des Plantes Médicinales, Yaoundé, Cameroon (E. Mpoudi-Ngole); Cameroon Institut de Recherche pout le Développement, Yaoundé (E. Mpoudi-Ngole)

 

Abstract

To clarify the role of bats in the ecology of Ebola viruses, we assessed the prevalence of Ebola virus antibodies in a large-scale sample of bats collected during 2015–2017 from countries in Africa that have had previous Ebola outbreaks (Guinea, the Democratic Republic of the Congo) or are at high risk for outbreaks (Cameroon). We analyzed 4,022 blood samples of bats from >12 frugivorous and 27 insectivorous species; 2–37 (0.05%–0.92%) bats were seropositive for Zaire and 0–30 (0%–0.75%) bats for Sudan Ebola viruses. We observed Ebola virus antibodies in 1 insectivorous bat genus and 6 frugivorous bat species. Certain bat species widespread across Africa had serologic evidence of Zaire and Sudan Ebola viruses. No viral RNA was detected in the subset of samples tested (n = 665). Ongoing surveillance of bats and other potential animal reservoirs are required to predict and prepare for future outbreaks.

Keywords: Ebolavirus; Sudan Virus; Ebola Zaire; Bats; Guinea; DRC; Cameroon.

——

#Safety of the rVSV #ZEBOV #vaccine against #Ebola Zaire among frontline #workers in #Guinea (Vaccine, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Vaccine. 2018 Sep 25. pii: S0264-410X(18)31246-5. doi: 10.1016/j.vaccine.2018.09.009. [Epub ahead of print]

Safety of the rVSV ZEBOV vaccine against Ebola Zaire among frontline workers in Guinea.

Juan-Giner A1, Tchaton M1, Jemmy JP2, Soumah A1, Boum Y1, Faga EM2, Cisse M3, Grais RF4.

Author information: 1 Epicentre, 8 rue Saint Sabin, 75011 Paris, France. 2 Médecins Sans Frontières-Operational Center, Belgium. 3 Centre Hospital-Universitaire de Donka, Conakry, Guinea. 4 Epicentre, 8 rue Saint Sabin, 75011 Paris, France. Electronic address: Rebecca.Grais@epicentre.msf.org.

 

Abstract

BACKGROUND:

As part of the ring vaccination trial in Guinea, Front Line Workers were invited to participate in a sub-study to provide additional information on the immunogenicity and safety of rVSVΔG/ZEBOV-GP. Here we summarize the information on the safety follow-up.

METHODS:

An open-label, non-randomized, immunogenicity evaluation of one dose of rVSVΔG/ZEBOV-GP was conducted in Conakry, Guinea between March 2015 and July 2016. Front-line workers refusing vaccination were invited to participate as a control group. Participants were followed for 3 months with a subset followed-up for 6 months after vaccination. Women becoming pregnant during the follow-up were followed until pregnancy outcome. Solicited and unsolicited adverse events were monitored at each contact with participants using standardized study forms.

RESULTS:

2016 vaccinated participants and 99 controls were included in the safety cohort. On the 3 days post-vaccination visit adverse events were very common, with over 70% of participants reporting at least one adverse event. The most frequently reported symptoms were headache, fatigue, arthralgia, subjective fever and myalgia. Among participants that completed fever diaries (n = 887), post-vaccination fever was reported by 15.22%. Comparing to the unvaccinated group, local reaction, fatigue, headache, arthralgia, myalgia and subjective fever occurring within the first 3 days post-vaccination were statistically significantly different in the vaccinated group compared to the unvaccinated. A total of 8 Serious Adverse Events were identified during follow-up. 2 SAEs were related to pregnancy.

CONCLUSIONS:

Results confirm that adverse events 3 days after vaccination with the rVSV candidate vaccine are common. The occurrence of fever is of particular concern in the context of ongoing Ebola transmission. Additional studies should address important data gaps regarding the use of the vaccine in pregnancy and other vulnerable populations.

Copyright © 2018. Published by Elsevier Ltd.

KEYWORDS: Ebola virus disease; Guinea; Health-care workers; Safety; Surveillance; rVSV vaccine

PMID: 30266489 DOI: 10.1016/j.vaccine.2018.09.009

Keywords: Ebola; Vaccines; Guinea; Drugs Safety.

——