The Experts below are selected from a list of 1488 Experts worldwide ranked by ideXlab platform
Pierre E Rollin - One of the best experts on this subject based on the ideXlab platform.
-
Emerging Infections 6 - Responding to Epidemics of Ebola Hemorrhagic Fever: Progress and Lessons Learned from Recent Outbreaks in Uganda, Gabon, and Congo
Emerging Infections 6, 2014Co-Authors: Daniel G Bausch, Pierre E RollinAbstract:Ebola Hemorrhagic Fever (EHF) is caused by viruses of the genus Ebolavirus of the Filoviridae family. Except for a laboratory-acquired case in England in 1976, human cases of EHF have been noted exclusively in sub-Saharan Africa. Five years after the Kikwit outbreak, the 2000–2001 outbreak in Gulu, Uganda, was the largest outbreak of EHF recorded to date. Analysis of this epidemic, as well as the more recent events in Gabon and Congo, will no doubt further our understanding of EHF. While awaiting more formal presentations of the scientific data, these outbreaks provide the opportunity to reflect on the progress in the domain of EHF since 1995, to speculate on the future, and to reassess needs. The sporadic nature of EHF cases and the difficulty in isolating them when they occur limited the health care worker exposures in the most recent outbreak in Gabon and Congo. The few field surveys undertaken since the Kikwit outbreak have yielded either negative or controversial results, with the latter consisting of a report of the identification of Ebola virus sequences by polymerase chain reaction (PCR) and the observation of virus-like nucleocapsids by electron microscopy in rodents and shrews in the Central African Republic, but without the actual isolation of Ebola virus.
-
Ebola Hemorrhagic Fever: Novel Biomarker Correlates of Clinical Outcome
The Journal of infectious diseases, 2014Co-Authors: Anita K Mcelroy, Timothy D Flietstra, Jonathan S Towner, Pierre E Rollin, Bobbie R. Erickson, Stuart T. Nichol, Christina F. SpiropoulouAbstract:Ebola Hemorrhagic Fever (EHF) outbreaks occur sporadically in Africa and result in high rates of death. The 2000-2001 outbreak of Sudan virus-associated EHF in the Gulu district of Uganda led to 425 cases, of which 216 were laboratory confirmed, making it the largest EHF outbreak on record. Serum specimens from this outbreak had been preserved in liquid nitrogen from the time of collection and were available for analysis. Available samples were tested using a series of multiplex assays to measure the concentrations of 55 biomarkers. The data were analyzed to identify statistically significant associations between the tested biomarkers and Hemorrhagic manifestations, viremia, and/or death. Death, hemorrhage, and viremia were independently associated with elevated levels of several chemokines and cytokines. Death and hemorrhage were associated with elevated thrombomodulin and ferritin levels. Hemorrhage was also associated with elevated levels of soluble intracellular adhesion molecule. Viremia was independently associated with elevated levels of tissue factor and tissue plasminogen activator. Finally, samples from nonfatal cases had higher levels of sCD40L. These novel associations provide a better understanding of EHF pathophysiology and a starting point for researching new potential targets for therapeutic interventions. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.
-
Ebola Hemorrhagic Fever: novel biomarker correlates of clinical outcome.
The Journal of infectious diseases, 2014Co-Authors: Anita K Mcelroy, Timothy D Flietstra, Jonathan S Towner, Pierre E Rollin, Bobbie R. Erickson, Stuart T. Nichol, Christina F. SpiropoulouAbstract:BACKGROUND: Ebola Hemorrhagic Fever (EHF) outbreaks occur sporadically in Africa and result in high rates of death. The 2000-2001 outbreak of Sudan virus-associated EHF in the Gulu district of Uganda led to 425 cases, of which 216 were laboratory confirmed, making it the largest EHF outbreak on record. Serum specimens from this outbreak had been preserved in liquid nitrogen from the time of collection and were available for analysis.\n\nMETHODS: Available samples were tested using a series of multiplex assays to measure the concentrations of 55 biomarkers. The data were analyzed to identify statistically significant associations between the tested biomarkers and Hemorrhagic manifestations, viremia, and/or death.\n\nRESULTS: Death, hemorrhage, and viremia were independently associated with elevated levels of several chemokines and cytokines. Death and hemorrhage were associated with elevated thrombomodulin and ferritin levels. Hemorrhage was also associated with elevated levels of soluble intracellular adhesion molecule. Viremia was independently associated with elevated levels of tissue factor and tissue plasminogen activator. Finally, samples from nonfatal cases had higher levels of sCD40L.\n\nCONCLUSIONS: These novel associations provide a better understanding of EHF pathophysiology and a starting point for researching new potential targets for therapeutic interventions.
-
Reemerging Sudan Ebola virus disease in Uganda, 2011
Emerging Infectious Diseases, 2012Co-Authors: Adam Macneil, Edward Mbidde, Roger Downing, Stephen Balinandi, Joseph Francis Wamala, Trevor Shoemaker, Shelley Campbell, Julius J Lutwama, Pierre E Rollin, Laura K. Mcmullan, Ute Ströeher, Stuart T. NicholAbstract:Two large outbreaks of Ebola Hemorrhagic Fever occurred in Uganda in 2000 and 2007. In May 2011, we identified a single case of Sudan Ebola virus disease in Luwero District. The establishment of a permanent in-country laboratory and cooperation between international public health entities facilitated rapid outbreak response and control activities.
-
Proportion of deaths and clinical features in Bundibugyo Ebola virus infection, Uganda
Emerging Infectious Diseases, 2010Co-Authors: Adam Macneil, Deborah L. Cannon, Roger Downing, Joseph Francis Wamala, Thomas G. G Ksiazek, Zachary Reed, Julius J Lutwama, Sam Okware, Jonathan S Towner, Eileen C. Farnon, Jordan W. Tappero, Stuart T. Nichol, Pierre E RollinAbstract:The first known Ebola Hemorrhagic Fever (EHF) outbreak caused by Bundibugyo Ebola virus occurred in Bundibugyo District, Uganda, in 2007. Fifty-six cases of EHF were laboratory confirmed. Although signs and symptoms were largely nonspecific and similar to those of EHF outbreaks caused by Zaire and Sudan Ebola viruses, proportion of deaths among those infected was lower (?40%).
Stuart T. Nichol - One of the best experts on this subject based on the ideXlab platform.
-
Ebola Hemorrhagic Fever: Novel Biomarker Correlates of Clinical Outcome
The Journal of infectious diseases, 2014Co-Authors: Anita K Mcelroy, Timothy D Flietstra, Jonathan S Towner, Pierre E Rollin, Bobbie R. Erickson, Stuart T. Nichol, Christina F. SpiropoulouAbstract:Ebola Hemorrhagic Fever (EHF) outbreaks occur sporadically in Africa and result in high rates of death. The 2000-2001 outbreak of Sudan virus-associated EHF in the Gulu district of Uganda led to 425 cases, of which 216 were laboratory confirmed, making it the largest EHF outbreak on record. Serum specimens from this outbreak had been preserved in liquid nitrogen from the time of collection and were available for analysis. Available samples were tested using a series of multiplex assays to measure the concentrations of 55 biomarkers. The data were analyzed to identify statistically significant associations between the tested biomarkers and Hemorrhagic manifestations, viremia, and/or death. Death, hemorrhage, and viremia were independently associated with elevated levels of several chemokines and cytokines. Death and hemorrhage were associated with elevated thrombomodulin and ferritin levels. Hemorrhage was also associated with elevated levels of soluble intracellular adhesion molecule. Viremia was independently associated with elevated levels of tissue factor and tissue plasminogen activator. Finally, samples from nonfatal cases had higher levels of sCD40L. These novel associations provide a better understanding of EHF pathophysiology and a starting point for researching new potential targets for therapeutic interventions. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.
-
Ebola Hemorrhagic Fever: novel biomarker correlates of clinical outcome.
The Journal of infectious diseases, 2014Co-Authors: Anita K Mcelroy, Timothy D Flietstra, Jonathan S Towner, Pierre E Rollin, Bobbie R. Erickson, Stuart T. Nichol, Christina F. SpiropoulouAbstract:BACKGROUND: Ebola Hemorrhagic Fever (EHF) outbreaks occur sporadically in Africa and result in high rates of death. The 2000-2001 outbreak of Sudan virus-associated EHF in the Gulu district of Uganda led to 425 cases, of which 216 were laboratory confirmed, making it the largest EHF outbreak on record. Serum specimens from this outbreak had been preserved in liquid nitrogen from the time of collection and were available for analysis.\n\nMETHODS: Available samples were tested using a series of multiplex assays to measure the concentrations of 55 biomarkers. The data were analyzed to identify statistically significant associations between the tested biomarkers and Hemorrhagic manifestations, viremia, and/or death.\n\nRESULTS: Death, hemorrhage, and viremia were independently associated with elevated levels of several chemokines and cytokines. Death and hemorrhage were associated with elevated thrombomodulin and ferritin levels. Hemorrhage was also associated with elevated levels of soluble intracellular adhesion molecule. Viremia was independently associated with elevated levels of tissue factor and tissue plasminogen activator. Finally, samples from nonfatal cases had higher levels of sCD40L.\n\nCONCLUSIONS: These novel associations provide a better understanding of EHF pathophysiology and a starting point for researching new potential targets for therapeutic interventions.
-
Reemerging Sudan Ebola virus disease in Uganda, 2011
Emerging Infectious Diseases, 2012Co-Authors: Adam Macneil, Edward Mbidde, Roger Downing, Stephen Balinandi, Joseph Francis Wamala, Trevor Shoemaker, Shelley Campbell, Julius J Lutwama, Pierre E Rollin, Laura K. Mcmullan, Ute Ströeher, Stuart T. NicholAbstract:Two large outbreaks of Ebola Hemorrhagic Fever occurred in Uganda in 2000 and 2007. In May 2011, we identified a single case of Sudan Ebola virus disease in Luwero District. The establishment of a permanent in-country laboratory and cooperation between international public health entities facilitated rapid outbreak response and control activities.
-
Proportion of deaths and clinical features in Bundibugyo Ebola virus infection, Uganda
Emerging Infectious Diseases, 2010Co-Authors: Adam Macneil, Deborah L. Cannon, Roger Downing, Joseph Francis Wamala, Thomas G. G Ksiazek, Zachary Reed, Julius J Lutwama, Sam Okware, Jonathan S Towner, Eileen C. Farnon, Jordan W. Tappero, Stuart T. Nichol, Pierre E RollinAbstract:The first known Ebola Hemorrhagic Fever (EHF) outbreak caused by Bundibugyo Ebola virus occurred in Bundibugyo District, Uganda, in 2007. Fifty-six cases of EHF were laboratory confirmed. Although signs and symptoms were largely nonspecific and similar to those of EHF outbreaks caused by Zaire and Sudan Ebola viruses, proportion of deaths among those infected was lower (?40%).
-
Laboratory diagnosis of Ebola Hemorrhagic Fever during an outbreak in Yambio, Sudan, 2004.
The Journal of infectious diseases, 2007Co-Authors: Clayton O. O Onyango, Mike Bell, Jonathan S Towner, William J. Bellini, Kevin M De Cock, Dominique Legros, Thomas G. G Ksiazek, Pierre Formenty, Peter M. M Tukei, Thomas Grein, Victor O. O Ofula, Abdullahi Ahmed, Rodney L. L Coldren, Samson L. L Konongoi, Rosemary C. C Sang, Martin L. L Opoka, Stuart T. Nichol, Pierre E RollinAbstract:Between the months of April and June 2004, an Ebola Hemorrhagic Fever (EHF) outbreak was reported in Yambio county, southern Sudan. Blood samples were collected from a total of 36 patients with suspected EHF and were tested by enzyme-linked immunosorbent assay (ELISA) for immunoglobulin G and M antibodies, antigen ELISA, and reverse-transcription polymerase chain reaction (PCR) of a segment of the Ebolavirus (EBOV) polymerase gene. A total of 13 patients were confirmed to be infected with EBOV. In addition, 4 fatal cases were classified as probable cases, because no samples were collected. Another 12 patients were confirmed to have acute measles infection during the same period that EBOV was circulating. Genetic analysis of PCR-positive samples indicated that the virus was similar to but distinct from Sudan EBOV Maleo 1979. In response, case management, social mobilization, and follow-up of contacts were set up as means of surveillance. The outbreak was declared to be over on 7 August 2004.
David L. Heymann - One of the best experts on this subject based on the ideXlab platform.
-
The reemergence of Ebola Hemorrhagic Fever, Democratic Republic of the Congo, 1995. Commission de Lutte contre les Epidémies à Kikwit.
The Journal of infectious diseases, 1999Co-Authors: Ali S. Khan, Bernard Le Guenno, Barbara Kerstiens, Yon Fleerackers, Peter H Kilmarx, F K Tshioko, Genevieve Rodier, Pierre Nabeth, David L. Heymann, Okumi NkukuAbstract:In May 1995, an international team characterized and contained an outbreak of Ebola Hemorrhagic Fever (EHF) in Kikwit, Democratic Republic of the Congo. Active surveillance was instituted using several methods, including house-to-house search, review of hospital and dispensary logs, interview of health care personnel, retrospective contact tracing, and direct follow-up of suspect cases. In the field, a clinical case was defined as Fever and Hemorrhagic signs, Fever plus contact with a case-patient, or Fever plus at least 3 of 10 symptoms. A total of 315 cases of EHF, with an 81% case fatality, were identified, excluding 10 clinical cases with negative laboratory results. The earliest documented case-patient had onset on 6 January, and the last case-patient died on 16 July. Eighty cases (25%) occurred among health care workers. Two individuals may have been the source of infection for >50 cases. The outbreak was terminated by the initiation of barrier-nursing techniques, health education efforts, and rapid identification of cases.
-
the reemergence of Ebola Hemorrhagic Fever democratic republic of the congo 1995
The Journal of Infectious Diseases, 1999Co-Authors: Ali S. Khan, Kweteminga F Tshioko, Bernard Le Guenno, Barbara Kerstiens, Yon Fleerackers, Peter H Kilmarx, Genevieve Rodier, Pierre Nabeth, David L. Heymann, Okumi NkukuAbstract:In May 1995, an international team characterized and contained an outbreak of Ebola Hemorrhagic Fever (EHF) in Kikwit, Democratic Republic of the Congo. Active surveillance was instituted using several methods, including house-to-house search, review of hospital and dispensary logs, interview of health care personnel, retrospective contact tracing, and direct follow-up of suspect cases. In the field, a clinical case was defined as Fever and Hemorrhagic signs, Fever plus contact with a case-patient, or Fever plus at least 3 of 10 symptoms. A total of 315 cases of EHF, with an 81% case fatality, were identified, excluding 10 clinical cases with negative laboratory results. The earliest documented case-patient had onset on 6 January, and the last case-patient died on 16 July. Eighty cases (25%) occurred among health care workers. Two individuals may have been the source of infection for >50 cases. The outbreak was terminated by the initiation of barrier-nursing techniques, health education efforts, and rapid identification of cases.
-
Ebola Hemorrhagic Fever: Lessons from Kikwit, Democratic Republic of the Congo
The Journal of Infectious Diseases, 1999Co-Authors: David L. Heymann, Deo Barakamfitiye, Mark Szczeniowski, Jean-jacques Muyembe-tamfum, Okwo Bele, Guenael RodierAbstract:The outbreak of Ebola Hemorrhagic Fever in Kikwit, Democratic Republic of the Congo, clearly signaled an end to the days when physicians and researchers could work in relative obscurity on problems of international importance, and it provided many lessons to the international public health and scientific communities. In particular, the outbreak signaled a need for stronger infectious disease surveillance and control worldwide, for improved international preparedness to provide support when similar outbreaks occur, and for accommodating the needs of the press in providing valid information. A need for more broad-based international health regulations and electronic information systems within the World Health Organization also became evident, as did the realization that there are new and more diverse partners able to rapidly respond to international outbreaks. Finally, a need for continued and coordinated Ebola research was identified, especially as concerns development of simple and valid diagnostic tests, better patient management procedures, and identification of the natural reservoir.
-
Ebola between outbreaks: intensified Ebola Hemorrhagic Fever surveillance in the Democratic Republic of the Congo, 1981-1985.
The Journal of infectious diseases, 1999Co-Authors: Z Jezek, M Y Szczeniowski, J J Muyembe-tamfum, J B Mccormick, David L. HeymannAbstract:Surveillance for Ebola Hemorrhagic Fever was conducted in the Democratic Republic of the Congo from 1981 to 1985 to estimate the incidence of human infection. Persons who met the criteria of one of three different case definitions were clinically evaluated, and blood was obtained for antibody confirmation by IFA. Contacts of each case and 4 age- and sex-matched controls were also clinically examined and tested for immunofluorescent antibody. Twenty-one cases of Ebola infection (persons with an antibody titer of > or = 1:64, or lower if they fit the clinical case definition) were identified, with a maximum 1-year incidence of 9 and a case fatality rate of 43%. Cases occurred throughout the year, but most (48%) occurred early in the rainy season. Fifteen percent of contacts had antibody titers > or =1:64 to Ebola virus, compared with 1% of controls (P < .0001). Results suggest that Ebola virus periodically emerges from nature to infect humans, that person-to-person transmission is relatively limited, and that amplification to large epidemics is unusual.
-
Ebola between Outbreaks: Intensified Ebola Hemorrhagic Fever Surveillance in the Democratic Republic of the Congo, 1981–1985
The Journal of Infectious Diseases, 1999Co-Authors: Z Jezek, M Y Szczeniowski, J J Muyembe-tamfum, J B Mccormick, David L. HeymannAbstract:Surveillance for Ebola Hemorrhagic Fever was conducted in the Democratic Republic of the Congo from 1981 to 1985 to estimate the incidence of human infection. Persons who met the criteria of one of three different case definitions were clinically evaluated, and blood was obtained for antibody confirmation by IFA. Contacts of each case and 4 age- and sex-matched controls were also clinically examined and tested for immunofluorescent antibody. Twenty-one cases of Ebola infection (persons with an antibody titer of > or = 1:64, or lower if they fit the clinical case definition) were identified, with a maximum 1-year incidence of 9 and a case fatality rate of 43%. Cases occurred throughout the year, but most (48%) occurred early in the rainy season. Fifteen percent of contacts had antibody titers > or =1:64 to Ebola virus, compared with 1% of controls (P < .0001). Results suggest that Ebola virus periodically emerges from nature to infect humans, that person-to-person transmission is relatively limited, and that amplification to large epidemics is unusual.
Pierre Formenty - One of the best experts on this subject based on the ideXlab platform.
-
Laboratory diagnosis of Ebola Hemorrhagic Fever during an outbreak in Yambio, Sudan, 2004.
The Journal of infectious diseases, 2007Co-Authors: Clayton O. O Onyango, Mike Bell, Jonathan S Towner, William J. Bellini, Kevin M De Cock, Dominique Legros, Thomas G. G Ksiazek, Pierre Formenty, Peter M. M Tukei, Thomas Grein, Victor O. O Ofula, Abdullahi Ahmed, Rodney L. L Coldren, Samson L. L Konongoi, Rosemary C. C Sang, Martin L. L Opoka, Stuart T. Nichol, Pierre E RollinAbstract:Between the months of April and June 2004, an Ebola Hemorrhagic Fever (EHF) outbreak was reported in Yambio county, southern Sudan. Blood samples were collected from a total of 36 patients with suspected EHF and were tested by enzyme-linked immunosorbent assay (ELISA) for immunoglobulin G and M antibodies, antigen ELISA, and reverse-transcription polymerase chain reaction (PCR) of a segment of the Ebolavirus (EBOV) polymerase gene. A total of 13 patients were confirmed to be infected with EBOV. In addition, 4 fatal cases were classified as probable cases, because no samples were collected. Another 12 patients were confirmed to have acute measles infection during the same period that EBOV was circulating. Genetic analysis of PCR-positive samples indicated that the virus was similar to but distinct from Sudan EBOV Maleo 1979. In response, case management, social mobilization, and follow-up of contacts were set up as means of surveillance. The outbreak was declared to be over on 7 August 2004.
-
Trigger events: enviroclimatic coupling of Ebola Hemorrhagic Fever outbreaks.
The American Journal of Tropical Medicine and Hygiene, 2004Co-Authors: Jorge E. Pinzon, James M. Wilson, Compton J. Tucker, Ray R. Arthur, Peter B. Jahrling, Pierre FormentyAbstract:We use spatially continuous satellite data as a correlate of precipitation within tropical Africa and show that the majority of documented Ebola Hemorrhagic Fever outbreaks were closely associated with sharply drier conditions at the end of the rainy season. We propose that these trigger events may enhance transmission of Ebola virus from its cryptic reservoir to humans. These findings suggest specific directions to help understand the sylvatic cycle of the virus and may provide early warning tools to detect possible future outbreaks of this enigmatic disease.
Thomas G. G Ksiazek - One of the best experts on this subject based on the ideXlab platform.
-
Proportion of deaths and clinical features in Bundibugyo Ebola virus infection, Uganda
Emerging Infectious Diseases, 2010Co-Authors: Adam Macneil, Deborah L. Cannon, Roger Downing, Joseph Francis Wamala, Thomas G. G Ksiazek, Zachary Reed, Julius J Lutwama, Sam Okware, Jonathan S Towner, Eileen C. Farnon, Jordan W. Tappero, Stuart T. Nichol, Pierre E RollinAbstract:The first known Ebola Hemorrhagic Fever (EHF) outbreak caused by Bundibugyo Ebola virus occurred in Bundibugyo District, Uganda, in 2007. Fifty-six cases of EHF were laboratory confirmed. Although signs and symptoms were largely nonspecific and similar to those of EHF outbreaks caused by Zaire and Sudan Ebola viruses, proportion of deaths among those infected was lower (?40%).
-
Laboratory diagnosis of Ebola Hemorrhagic Fever during an outbreak in Yambio, Sudan, 2004.
The Journal of infectious diseases, 2007Co-Authors: Clayton O. O Onyango, Mike Bell, Jonathan S Towner, William J. Bellini, Kevin M De Cock, Dominique Legros, Thomas G. G Ksiazek, Pierre Formenty, Peter M. M Tukei, Thomas Grein, Victor O. O Ofula, Abdullahi Ahmed, Rodney L. L Coldren, Samson L. L Konongoi, Rosemary C. C Sang, Martin L. L Opoka, Stuart T. Nichol, Pierre E RollinAbstract:Between the months of April and June 2004, an Ebola Hemorrhagic Fever (EHF) outbreak was reported in Yambio county, southern Sudan. Blood samples were collected from a total of 36 patients with suspected EHF and were tested by enzyme-linked immunosorbent assay (ELISA) for immunoglobulin G and M antibodies, antigen ELISA, and reverse-transcription polymerase chain reaction (PCR) of a segment of the Ebolavirus (EBOV) polymerase gene. A total of 13 patients were confirmed to be infected with EBOV. In addition, 4 fatal cases were classified as probable cases, because no samples were collected. Another 12 patients were confirmed to have acute measles infection during the same period that EBOV was circulating. Genetic analysis of PCR-positive samples indicated that the virus was similar to but distinct from Sudan EBOV Maleo 1979. In response, case management, social mobilization, and follow-up of contacts were set up as means of surveillance. The outbreak was declared to be over on 7 August 2004.
-
Rapid diagnosis of Ebola Hemorrhagic Fever by reverse transcription-PCR in an outbreak setting and assessment of patient viral load as a predictor of outcome.
Journal of virology, 2004Co-Authors: Jonathan S Towner, Sharon M Crary, William F Lee, Mathew Lukwiya, Roger Downing, Martin Vincent, Daniel G Bausch, Thomas G. G Ksiazek, Christina F. Spiropoulou, Felix Kaducu, Pierre E Rollin, Anthony Sanchez, Stuart T. NicholAbstract:The largest outbreak on record of Ebola Hemorrhagic Fever (EHF) occurred in Uganda from August 2000 to January 2001. The outbreak was centered in the Gulu district of northern Uganda, with secondary transmission to other districts. After the initial diagnosis of Sudan Ebolavirus by the National Institute for Virology in Johannesburg, South Africa, a temporary diagnostic laboratory was established within the Gulu district at St. Mary's Lacor Hospital. The laboratory used antigen capture and reverse transcription-PCR (RT-PCR) to diagnose Sudan Ebolavirus infection in suspect patients. The RT-PCR and antigen-capture diagnostic assays proved very effective for detecting Ebolavirus in patient serum, plasma, and whole blood. In samples collected very early in the course of infection, the RT-PCR assay could detect Ebolavirus 24 to 48 h prior to detection by antigen capture. More than 1,000 blood samples were collected, with multiple samples obtained from many patients throughout the course of infection. Real-time quantitative RT-PCR was used to determine the viral load in multiple samples from patients with fatal and nonfatal cases, and these data were correlated with the disease outcome. RNA copy levels in patients who died averaged 2 log(10) higher than those in patients who survived. Using clinical material from multiple EHF patients, we sequenced the variable region of the glycoprotein. This Sudan Ebolavirus strain was not derived from either the earlier Boniface (1976) or Maleo (1979) strain, but it shares a common ancestor with both. Furthermore, both sequence and epidemiologic data are consistent with the outbreak having originated from a single introduction into the human population.
-
long term disease surveillance in bandundu region democratic republic of the congo a model for early detection and prevention of Ebola Hemorrhagic Fever
The Journal of Infectious Diseases, 1999Co-Authors: Ethleen Lloyd, Mpia Ado Bwaka, Philippe Calain, Kweteminga F Tshioko, Kader M Konde, Thomas G. G Ksiazek, Sherif R Zaki, Wun-ju Shieh, Pierre E Rollin, Eric VerchuerenAbstract:After the large-scale outbreak of Ebola Hemorrhagic Fever (EHF) in Bandundu region, Democratic Republic of the Congo, a program was developed to help detect and prevent future outbreaks of EHF in the region. The long-term surveillance and prevention strategy is based on early recognition by physicians, immediate initiation of enhanced barrier-nursing practices, and the use of an immunohistochemical diagnostic test performed on formalin-fixed skin specimens of patients who die of suspected viral Hemorrhagic Fever. The program was implemented in September 1995 during a 4-day workshop with 28 local physicians representing 17 of 22 health zones in the region. Specimen collection kits were distributed to clinics in participating health zones, and a follow-up evaluation was conducted after 6 months. The use of a formalin-fixed skin specimen for laboratory confirmation of EHF can provide an appropriate method for EHF surveillance when linked with physician training, use of viral Hemorrhagic Fever isolation precautions, and follow-up investigation.
-
clinical virology of Ebola Hemorrhagic Fever ehf virus virus antigen and igg and igm antibody findings among ehf patients in kikwit democratic republic of the congo 1995
The Journal of Infectious Diseases, 1999Co-Authors: Thomas G. G Ksiazek, Ali S. Khan, Pierre E Rollin, R Swanepoel, A J Williams, David S Bressler, Mary Lane Martin, F J Burt, P A Leman, Alexander K RoweAbstract:Ebola Hemorrhagic Fever (EHF) patients treated at Kikwit General Hospital during the 1995 outbreak were tested for viral antigen, IgG and IgM antibody, and infectious virus. Viral antigen could be detected in virtually all patients during the acute phase of illness, while antibody was not always detectable before death. Virus was also isolated from patients during the course of their febrile illness, but attempts to quantify virus in Vero E6 cells by standard plaque assay were often unsuccessful. IgG and IgM antibody appeared at approximately the same time after disease onset (8-10 days), but IgM persisted for a much shorter period among the surviving convalescent patients. IgG antibody was detectable in surviving patients through about 2 years after onset, the latest time that samples were obtained. Detection of Ebola virus antigens or virus isolation appears to be the most reliable means of diagnosis for patients with suspected acute EHF, since patients with this often-fatal disease (80% mortality) may not develop detectable antibodies before death.