Minimally Symptomatic Infection in an Ebola 'Hotspot': A Cross-Sectional Serosurvey.
Minimally Symptomatic Infection in an Ebola 'Hotspot': A Cross-Sectional Serosurvey.
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DOI：
10.1371/journal.pntd.0005087
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发表时间：
2016-11
影响因子：
3.8
通讯作者：
Farmer PE
中科院分区：
文献类型：
--
作者：
Richardson ET;Kelly JD;Barrie MB;Mesman AW;Karku S;Quiwa K;Marsh RH;Koedoyoma S;Daboh F;Barron KP;Grady M;Tucker E;Dierberg KL;Rutherford GW;Barry M;Jones JH;Murray MB;Farmer PE
埃博拉病毒（EBOV）感染症状轻微的证据有限。在2013 - 2016年西非疫情期间，人们认为它与已发表的干预效果模型或预测在流行病学上无关。为了提高我们对埃博拉病毒在人类中的传播动力学的认识，我们在一个公认的“热点”地区调查了报告埃博拉病毒病病例的隔离接触者中出现症状轻微的埃博拉病毒感染。“从2015年10月到2016年1月，我们在塞拉利昂科诺区的Sukudu进行了横断面血清调查。从187名研究参与者、132名阴性对照者（以前接触埃博拉病毒的可能性较低的个体）和30名阳性对照者（埃博拉病毒病幸存者）中收集了血液样本。采用Alpha诊断国际ELISA试剂盒检测IgG对埃博拉糖蛋白和核蛋白的反应，血浆稀释比例为1:20 00。在ChroMate 4300微孔板读取仪上，在450 nm处读取光密度（在630nm处减去OD以使孔背景归一化）。抗gp酶联免疫吸附试验的临界值为4.7 U/mL，区分阳性和阴性对照的敏感性为96.7%，特异性为97.7%。我们确定了14名血清学阳性个体，但已知他们患有埃博拉病毒病。14名血清阳性个体中有两人在隔离期间仅报告发烧，其余12人在隔离期间否认有任何体征或症状。通过使用ELISA测量扎伊尔埃博拉病毒抗体浓度，我们在塞拉利昂的一个“热点”村庄发现了大量以前未发现的埃博拉病毒感染个体，大约在该村暴发一年后。研究结果进一步证明，埃博拉与许多其他病毒感染一样，具有一系列临床表现，包括轻微症状感染。这些数据还表明，在疫情期间，很大一部分埃博拉传播事件可能未被发现。需要进一步的研究来了解以前未被发现的EBOV感染个体传播的潜在风险和临床后遗症。2013 - 2016年西非埃博拉疫情报告病例超过2.8万例，是有记录以来规模最大、持续时间最长的疫情。这项研究进一步证明，埃博拉病毒与其他病毒一样，会引起一系列临床表现，其中可能包括轻微症状感染。研究结果还表明，在最近的疫情中，西非埃博拉病毒的许多人际传播事件可能未被发现。这对埃博拉病毒疾病存活的定义、传播链的描述以及未来的疫苗研究具有重要意义。
Evidence for minimally symptomatic Ebola virus (EBOV) infection is limited. During the 2013–16 outbreak in West Africa, it was not considered epidemiologically relevant to published models or projections of intervention effects. In order to improve our understanding of the transmission dynamics of EBOV in humans, we investigated the occurrence of minimally symptomatic EBOV infection in quarantined contacts of reported Ebola virus disease cases in a recognized ‘hotspot.’ We conducted a cross-sectional serosurvey in Sukudu, Kono District, Sierra Leone, from October 2015 to January 2016. A blood sample was collected from 187 study participants, 132 negative controls (individuals with a low likelihood of previous exposure to Ebola virus), and 30 positive controls (Ebola virus disease survivors). IgG responses to Ebola glycoprotein and nucleoprotein were measured using Alpha Diagnostic International ELISA kits with plasma diluted at 1:200. Optical density was read at 450 nm (subtracting OD at 630nm to normalize well background) on a ChroMate 4300 microplate reader. A cutoff of 4.7 U/mL for the anti-GP ELISA yielded 96.7% sensitivity and 97.7% specificity in distinguishing positive and negative controls. We identified 14 seropositive individuals not known to have had Ebola virus disease. Two of the 14 seropositive individuals reported only fever during quarantine while the remaining 12 denied any signs or symptoms during quarantine. By using ELISA to measure Zaire Ebola virus antibody concentrations, we identified a significant number of individuals with previously undetected EBOV infection in a ‘hotspot’ village in Sierra Leone, approximately one year after the village outbreak. The findings provide further evidence that Ebola, like many other viral infections, presents with a spectrum of clinical manifestations, including minimally symptomatic infection. These data also suggest that a significant portion of Ebola transmission events may have gone undetected during the outbreak. Further studies are needed to understand the potential risk of transmission and clinical sequelae in individuals with previously undetected EBOV infection. With over 28,000 reported cases, the 2013–16 West African Ebola virus disease epidemic is the largest and longest on record. This study provides further evidence that Ebola, like other viruses, causes a spectrum of clinical manifestations that may include minimally symptomatic infection. The findings also suggest that many episodes of human-to-human transmission of Ebola virus in West Africa may have gone undetected in the recent outbreak. This has implications for the definition of Ebola virus disease survivorship, delineation of transmission chains, and future vaccine studies.
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DOI：
10.1056/nejmoa1411100
发表时间：
2014-10-16
期刊：
The New England journal of medicine
影响因子：
--
作者：
WHO Ebola Response Team;Aylward B;Barboza P;Bawo L;Bertherat E;Bilivogui P;Blake I;Brennan R;Briand S;Chakauya JM;Chitala K;Conteh RM;Cori A;Croisier A;Dangou JM;Diallo B;Donnelly CA;Dye C;Eckmanns T;Ferguson NM;Formenty P;Fuhrer C;Fukuda K;Garske T;Gasasira A;Gbanyan S;Graaff P;Heleze E;Jambai A;Jombart T;Kasolo F;Kadiobo AM;Keita S;Kertesz D;Koné M;Lane C;Markoff J;Massaquoi M;Mills H;Mulba JM;Musa E;Myhre J;Nasidi A;Nilles E;Nouvellet P;Nshimirimana D;Nuttall I;Nyenswah T;Olu O;Pendergast S;Perea W;Polonsky J;Riley S;Ronveaux O;Sakoba K;Santhana Gopala Krishnan R;Senga M;Shuaib F;Van Kerkhove MD;Vaz R;Wijekoon Kannangarage N;Yoti Z
通讯作者：
Yoti Z
影响因子：
168.9
作者：
Broadhurst, Mara Jana;Kelly, John Daniel;Pollock, Nira R.
通讯作者：
Pollock, Nira R.
影响因子：
11.8
作者：
Farmer, P
通讯作者：
Farmer, P
影响因子：
6.4
作者：
Ksiazek, TG;Rollin, PE;Peters, CJ
通讯作者：
Peters, CJ
影响因子：
6.4
作者：
Heffernan, RT;Pambo, B;Ryder, RW
通讯作者：
Ryder, RW