Ebola Virus Disease in the Democratic Republic of Congo
Ebola Virus Disease in the Democratic Republic of Congo
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DOI：
10.1056/nejmoa1411099
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发表时间：
2014-11-27
影响因子：
158.5
通讯作者：
Leroy, Eric M.
中科院分区：
文献类型：
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作者：
Maganga, Gael D.;Kapetshi, Jimmy;Leroy, Eric M.
据报道，第七次埃博拉病毒病（EVD）在赤道非洲国家刚果（DRC）爆发始于2014年7月26日，另一场大规模的EVD疫情继续在西非蔓延。EVD在赤道和西非的同时报告提出了一个问题，这两次疫情是否是linked.METHODSWe从刚果民主共和国的患者获得的数据，使用标准的世界卫生组织的临床调查形式的病毒性出血热。患者被分类为疑似、很可能或确诊的EVD或非EVD疾病。采集血样用于聚合酶链反应诊断、病毒分离、测序和系统发育分析。疫情始于赤道省博伊特镇附近的Inkananeo村，并已局限于该省。2014年7月26日至10月7日期间，共报告了69例疑似、可能或确诊病例，包括8例卫生保健工作者病例，49例死亡。截至10月7日，自疫情爆发以来，已有大约六代EVD病例。报告的每周病例发生率在8月17日和24日的几周达到峰值，此后急剧下降。基因组测序显示埃博拉病毒（EBOV，扎伊尔种）是这次疫情的原因。在这次暴发中分离的EBOV的编码全基因组序列显示，与1995年刚果民主共和国基奎特暴发的最密切相关的变异株的同一性为99.2%，与1995年刚果民主共和国基奎特暴发的最密切相关的变异株的同一性为96.8%。结论：刚果民主共和国目前的EVD疫情具有与赤道地区以前EVD疫情相似的临床和流行病学特征。非洲病原体是当地的EBOV变异体，这次疫情的人畜共患病起源与2014年西非疫情不同。
BACKGROUNDThe seventh reported outbreak of Ebola virus disease (EVD) in the equatorial African country of the Democratic Republic of Congo (DRC) began on July 26, 2014, as another large EVD epidemic continued to spread in West Africa. Simultaneous reports of EVD in equatorial and West Africa raised the question of whether the two outbreaks were linked.METHODSWe obtained data from patients in the DRC, using the standard World Health Organization clinical-investigation form for viral hemorrhagic fevers. Patients were classified as having suspected, probable, or confirmed EVD or a non-EVD illness. Blood samples were obtained for polymerase-chain-reaction-based diagnosis, viral isolation, sequencing, and phylogenetic analysis.RESULTSThe outbreak began in Inkanamongo village in the vicinity of Boende town in Equateur province and has been confined to that province. A total of 69 suspected, probable, or confirmed cases were reported between July 26 and October 7, 2014, including 8 cases among health care workers, with 49 deaths. As of October 7, there have been approximately six generations of cases of EVD since the outbreak began. The reported weekly case incidence peaked in the weeks of August 17 and 24 and has since fallen sharply. Genome sequencing revealed Ebola virus (EBOV, Zaire species) as the cause of this outbreak. A coding-complete genome sequence of EBOV that was isolated during this outbreak showed 99.2% identity with the most closely related variant from the 1995 outbreak in Kikwit in the DRC and 96.8% identity to EBOV variants that are currently circulating in West Africa.CONCLUSIONSThe current EVD outbreak in the DRC has clinical and epidemiologic characteristics that are similar to those of previous EVD outbreaks in equatorial Africa. The causal agent is a local EBOV variant, and this outbreak has a zoonotic origin different from that in the 2014 epidemic in West Africa.