scholarly journals A retrospective cohort investigation of seroprevalence of Marburg virus and ebolaviruses in two different ecological zones in Uganda

2020 ◽  
Author(s):  
Luke Nyakarahuka ◽  
Ilana J. Schafer ◽  
Stephen Balinandi ◽  
Sophia Mulei ◽  
Alex Tumusiime ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gold Mining ◽  
Ebola Virus ◽  
Virus Disease ◽  
Marburg Virus ◽  
Igg Antibodies ◽  
Mining Communities ◽  
Ecological Zones ◽  
Increased Risk ◽  
Western Uganda

Abstract Background Uganda has experienced seven Ebola Virus Disease (EVD) outbreaks and four Marburg Virus disease (MVD) outbreaks between 2000 and 2019. We investigated the seroprevalence and risk factors for Marburg virus and ebolaviruses infections in gold mining communities around Kitaka gold mine in Western Uganda, and compared them to non-mining communities in Central UgandaMethods A questionnaire was administered and human blood samples were collected from three exposed groups in Western Uganda (gold miners, and household members of miners, non-miners living within 50 km of Kitaka mine). Controls were community members in Central Uganda far away from any gold mining activity which we considered as low-risk groups or ‘unexposed’ to filovirus infection. ELISA technique was used to analyse samples, detecting IgG antibodies against Marburg virus and ebolaviruses (filovirus).Results Miners in western Uganda were 4.8 times more likely to be seropositive compared to the non-exposed group in central Uganda (RR=4.8, 95%CI 1.3-17.9). Overall, filovirus seropositivity was 2.6% (19/724) of which 2.5% (18/724) was to Sudan virus, 0.1% (1/724) was to Bundibugyo virus, and 0.1% (1/724) to Marburg virus. One individual had IgG antibodies reactive to both Sudan virus and Bundibugyo virus. The risk factors for seropositivity to Sudan virus identified included mining (aOR=3.4, 1.3-8.5), male sex (3.1, 1.01 - 9.5), going inside mines (3.1, 1.2 - 8.2), cleaning corpses (3.1, 1.04 - 9.1) and contact with suspect filovirus cases (3.9, 1.04 -14.5).Conclusions These findings indicate that filovirus outbreaks may go undetected in Uganda and people involved in artisan gold mining or living close to mines and/or caves are more likely to be exposed to infection with either Marburg virus or ebolaviruses, likely due to increased risk of exposure to bats. This calls for active surveillance in known high-risk areas for early detection and response to prevent filovirus epidemics.

scholarly journals A retrospective cohort investigation of seroprevalence of Marburg virus and ebolaviruses in two different ecological zones in Uganda

2020 ◽  
Author(s):  
Luke Nyakarahuka ◽  
Ilana J. Schafer ◽  
Stephen Balinandi ◽  
Sophia Mulei ◽  
Alex Tumusiime ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Gold Mining ◽  
Virus Disease ◽  
Marburg Virus ◽  
Control Group ◽  
Igg Antibodies ◽  
Mining Communities ◽  
Risk Areas ◽  
Western Uganda

Abstract Background: Uganda has experienced seven Ebola Virus Disease (EVD) outbreaks and four Marburg Virus disease (MVD) outbreaks between 2000 and 2019. We investigated the seroprevalence and risk factors for Marburg virus and ebolaviruses in gold mining communities around Kitaka gold mine in Western Uganda, and compared them to non-mining communities in Central Uganda.Methods: A questionnaire was administered and human blood samples were collected from three exposure groups in Western Uganda (gold miners, household members of miners, non-miners living within 50 km of Kitaka mine). The unexposed controls group sampled was community members in Central Uganda far away from any gold mining activity which we considered as low-risk for filovirus infection. ELISA serology was used to analyse samples, detecting IgG antibodies against Marburg virus and ebolaviruses (filoviruses). Data was analysed in STATA software using risk ratios and odds ratios. Results: Miners in western Uganda were 5.4 times more likely to be filovirus seropositive compared to the control group in central Uganda (RR=5.4; 95% CI 1.5 – 19.7) whereas people living in high-risk areas in Ibanda and Kamwenge disricts were 3.6 more likely to be seropositive compared to control group in Luweeero district (RR=3.6; 95% CI 1.1 – 12.2) . Among all participants, filovirus seropositivity was 2.6% (19/724) of which 2.5% (18/724) was to Sudan virus and 0.1 % (1/724) to Marburg virus. One individual seropositive for Sudan virus also had IgG antibodies reactive to Bundibugyo virus. The risk factors for filovirus seropositivity identified included mining (AOR=3.4; 95% CI 1.3-8.5), male sex (AOR=3.1; 95% CI 1.01 - 9.5), going inside mines (AOR=3.1; 95% CI 1.2 - 8.2), cleaning corpses (AOR=3.1; 95% CI 1.04 - 9.1) and contact with suspect filovirus cases (AOR=3.9, 95% CI 1.04 -14.5). Conclusions: These findings indicate that filovirus outbreaks may go undetected in Uganda and people involved in artisan gold mining are more likely to be exposed to infection with either Marburg virus or ebolaviruses, likely due to increased risk of exposure to bats. This calls for active surveillance in known high-risk areas for early detection and response to prevent filovirus epidemics.

scholarly journals Contact tracing performance during the Ebola virus disease outbreak in Kenema district, Sierra Leone

2017 ◽  
Vol 372 (1721) ◽  
pp. 20160300 ◽  
Author(s):  
Mikiko Senga ◽  
Alpha Koi ◽  
Lina Moses ◽  
Nadia Wauquier ◽  
Philippe Barboza ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Contact Line ◽  
Ebola Virus ◽  
Virus Disease ◽  
The Body ◽  
Physical Contact ◽  
Ebola Virus Disease ◽  
Contact Tracing ◽  
Retrospective Data Analysis ◽  
Increased Risk

Contact tracing in an Ebola virus disease (EVD) outbreak is the process of identifying individuals who may have been exposed to infected persons with the virus, followed by monitoring for 21 days (the maximum incubation period) from the date of the most recent exposure. The goal is to achieve early detection and isolation of any new cases in order to prevent further transmission. We performed a retrospective data analysis of 261 probable and confirmed EVD cases in the national EVD database and 2525 contacts in the Contact Line Lists in Kenema district, Sierra Leone between 27 April and 4 September 2014 to assess the performance of contact tracing during the initial stage of the outbreak. The completion rate of the 21-day monitoring period was 89% among the 2525 contacts. However, only 44% of the EVD cases had contacts registered in the Contact Line List and 6% of probable or confirmed cases had previously been identified as contacts. Touching the body fluids of the case and having direct physical contact with the body of the case conferred a 9- and 20-fold increased risk of EVD status, respectively. Our findings indicate that incompleteness of contact tracing led to considerable unmonitored transmission in the early months of the epidemic. To improve the performance of early outbreak contact tracing in resource poor settings, our results suggest the need for prioritized contact tracing after careful risk assessment and better alignment of Contact Line Listing with case ascertainment and investigation. This article is part of the themed issue ‘The 2013–2016 West African Ebola epidemic: data, decision-making and disease control’.

scholarly journals 411. Does an Early Cytokine Response During Ebola Virus Disease Improve the Duration of Survival in Rhesus Macaques?

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S208-S208
Author(s):  
Paul W Blair ◽  
Karen A O Martins ◽  
Keshtkar-Jahromi Maryam ◽  
Mark G Kortepeter ◽  
Keebaugh Michael ◽  
...  
Keyword(s):  
Ebola Virus ◽  
Cox Regression ◽  
Virus Disease ◽  
Rhesus Macaques ◽  
Early Death ◽  
Ebola Virus Disease ◽  
Cytokine Release ◽  
Time To Death ◽  
Post Exposure ◽  
Increased Risk

Abstract Background Ebola virus disease results in a severe cytokine release resulting in organ failure and disseminated intravascular coagulation, often leading to death. An early post-exposure immune response may improve outcomes but that remains poorly characterized. Therefore, we evaluated select serum cytokine markers of immune activation in nonhuman primates (NHPs) for their association with duration of survival. Methods This was a post-hoc analysis of an interventional supportive care NHP study in which 13 rhesus macaques were inoculated intramuscularly with a target dose of 1000 PFU Zaire ebolavirus (Kikwit). We measured cytokines with a Luminex MAGPIX panel at baseline and daily starting day 3 post-exposure until euthanasia. Based on human clinical data, 10 cytokines and proteins were included in our analysis: IL-1ra, IL-6, IL-10, GM-CSF, MCP-1, MIP-1α, MIP-1β, IFN-γ, TNF-α, and C-reactive protein levels. After NHPs were divided into two groups by k-means clustering, we developed Kaplan–Meier curves for time to death (Figure 1). We visually explored Pearson’s correlation and kinetics of serum cytokines and log10viral load (Figure 1; Figure 2). We fitted cox regression models with each cytokine to evaluate the risk of early disease for each cytokine log10 level or log2-fold change. We performed a sensitivity analysis for MIP-1β centering the data at dpe 0. Results Among NHPs with temperature data, 83% (N = 10) developed fevers (>3 SD baseline) from dpe 3 to 4.The macrophage markerMIP-1β was associated with an increased risk of early death (per log10pg/mL increase, HR= 52.83 at dpe 3, adjusted P = 0.045). Surprisingly, this association was also observed at dpe 0 (HR= 36.88 at dpe 0, adjusted P = 0.044). Other cytokine levels or changes were not associated with an increased hazard of death. Conclusion Our findings did not support a role for early systemic cytokine release in improving survival. However, elevated baseline levels of the MIP-1β may predispose NHPs to early death from EVD. This finding could represent a target for therapeutic strategies and should be further researched. Disclosures All authors: No reported disclosures.

scholarly journals Macaque Monoclonal Antibodies Targeting Novel Conserved Epitopes within Filovirus Glycoprotein

2015 ◽  
Vol 90 (1) ◽  
pp. 279-291 ◽  
Author(s):  
Zhen-Yong Keck ◽  
Sven G. Enterlein ◽  
Katie A. Howell ◽  
Hong Vu ◽  
Sergey Shulenin ◽  
...  
Keyword(s):  
Monoclonal Antibodies ◽  
Nonhuman Primates ◽  
Ebola Virus ◽  
Virus Disease ◽  
Protective Efficacy ◽  
Hemorrhagic Fever ◽  
Marburg Virus ◽  
Human Pathogens ◽  
Content Type ◽  
The Core

ABSTRACTFiloviruses cause highly lethal viral hemorrhagic fever in humans and nonhuman primates. Current immunotherapeutic options for filoviruses are mostly specific to Ebola virus (EBOV), although other members ofFiloviridaesuch as Sudan virus (SUDV), Bundibugyo virus (BDBV), and Marburg virus (MARV) have also caused sizeable human outbreaks. Here we report a set of pan-ebolavirus and pan-filovirus monoclonal antibodies (MAbs) derived from cynomolgus macaques immunized repeatedly with a mixture of engineered glycoproteins (GPs) and virus-like particles (VLPs) for three different filovirus species. The antibodies recognize novel neutralizing and nonneutralizing epitopes on the filovirus glycoprotein, including conserved conformational epitopes within the core regions of the GP1 subunit and a novel linear epitope within the glycan cap. We further report the first filovirus antibody binding to a highly conserved epitope within the fusion loop of ebolavirus and marburgvirus species. One of the antibodies binding to the core GP1 region of all ebolavirus species and with lower affinity to MARV GP cross neutralized both SUDV and EBOV, the most divergent ebolavirus species. In a mouse model of EBOV infection, this antibody provided 100% protection when administered in two doses and partial, but significant, protection when given once at the peak of viremia 3 days postinfection. Furthermore, we describe novel cocktails of antibodies with enhanced protective efficacy compared to individual MAbs. In summary, the present work describes multiple novel, cross-reactive filovirus epitopes and innovative combination concepts that challenge the current therapeutic models.IMPORTANCEFiloviruses are among the most deadly human pathogens. The 2014-2015 outbreak of Ebola virus disease (EVD) led to more than 27,000 cases and 11,000 fatalities. While there are five species ofEbolavirusand several strains of marburgvirus, the current immunotherapeutics primarily target Ebola virus. Since the nature of future outbreaks cannot be predicted, there is an urgent need for therapeutics with broad protective efficacy against multiple filoviruses. Here we describe a set of monoclonal antibodies cross-reactive with multiple filovirus species. These antibodies target novel conserved epitopes within the envelope glycoprotein and exhibit protective efficacy in mice. We further present novel concepts for combination of cross-reactive antibodies against multiple epitopes that show enhanced efficacy compared to monotherapy and provide complete protection in mice. These findings set the stage for further evaluation of these antibodies in nonhuman primates and development of effective pan-filovirus immunotherapeutics for use in future outbreaks.

scholarly journals ECG CHANGES IN PATIENTS WITH COVID-19 – A RETROSPECTIVE OBSERVATIONAL STUDY AT A TERTIARY CARE HOSPITAL IN CHENNAI

2021 ◽  
pp. 5-7
Author(s):  
A .Shaik Sulaiman Meeran ◽  
T. Balaji ◽  
P. Raja ◽  
Kiran Chandramohan
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Virus Disease ◽  
Tertiary Care ◽  
P Wave ◽  
Retrospective Observational Study ◽  
Care Hospital ◽  
Icu Admission ◽  
Corona Virus ◽  
Increased Risk

Background:A global outbreak of corona virus disease, caused by severe respiratory corona virus 2, has emerged since December 2019. However electrocardiographic manifestations of patients with COVID-19 have not been fully described. We aim to investigate ECG characteristics in COVID-19 patients and risk factors of ICU admission Methods:This retrospective observational study included the patients with COVID-19 at the Government Kilpauk Medical College, Chennai between June 1st and 31st, 2020. Demographic, clinical and ECG characteristics were collected and comparison were made between ICU and non ICU admission groups. Logistic regression was used to identify risk factors of ICU admission Results:Among the 159 patients included ST-T abnormalities were the most common ECG feature followed by arrhythmias. Compared with non ICU group, the ICU group showed higher heart rate and P wave duration and was more frequently associated with CVD, ST-T abnormalities, arrythmias, QTc prolongation and pathological Q waves. ST-T abnormalities and history of CVD were associated with increased risk of ICU admission Conclusion:COVID-19 is frequently related to cardiovascular manifestations including ECG abnormalities and cardiovascular comorbidities. ST-T abnormalities and CVD at admission were associated with increased odds of ICU admission

scholarly journals Offering patients more: how the West Africa Ebola outbreak can shape innovation in therapeutic research for emerging and epidemic infections

2017 ◽  
Vol 372 (1721) ◽  
pp. 20160294 ◽  
Author(s):  
Amanda M. Rojek ◽  
Peter W. Horby
Keyword(s):  
West Africa ◽  
Ebola Virus ◽  
Virus Disease ◽  
Nipah Virus ◽  
Emerging Infectious Diseases ◽  
Disease Outbreaks ◽  
International Travel ◽  
Marburg Virus ◽  
World Health ◽  
The West

Although, after an epidemic of over 28 000 cases, there are still no licensed treatments for Ebola virus disease (EVD), significant progress was made during the West Africa outbreak. The pace of pre-clinical development was exceptional and a number of therapeutic clinical trials were conducted in the face of considerable challenges. Given the on-going risk of emerging infectious disease outbreaks in an era of unprecedented population density, international travel and human impact on the environment it is pertinent to focus on improving the research and development landscape for treatments of emerging and epidemic-prone infections. This is especially the case since there are no licensed therapeutics for some of the diseases considered by the World Health Organization as most likely to cause severe outbreaks—including Middle East respiratory syndrome coronavirus, Marburg virus, Crimean Congo haemorrhagic fever and Nipah virus. EVD, therefore, provides a timely exemplar to discuss the barriers, enablers and incentives needed to find effective treatments in advance of health emergencies caused by emerging infectious diseases. This article is part of the themed issue ‘The 2013–2016 West African Ebola epidemic: data, decision-making and disease control’.

Ebola and Other Filoviruses

2018 ◽  
Author(s):  
Lisa M. Bebell
Keyword(s):  
Ebola Virus ◽  
Inflammatory Responses ◽  
Virus Disease ◽  
Treatment Strategies ◽  
Disease Outbreaks ◽  
Marburg Virus ◽  
Residual Effects ◽  
Long Term Outcomes ◽  
Pediatric Vaccination

Congenital and pediatric Ebola virus disease (EVD) and Marburg virus disease (MVD) are severe, even lethal infections. Historically, children have been underrepresented in filovirus disease outbreaks, and evidence-based treatment strategies are lacking. Existing data suggest that case fatalities are highest among children under four years of age, which is partially explained by higher virus concentrations in young children. Prevention and aggressive resuscitation, nutrition, and supportive care are the mainstays of management until filovirus-specific therapies can be developed. Differences in pediatric immune and inflammatory responses may necessitate unique approaches to pediatric vaccination and treatment. There are minimal safety or immunogenicity data in children, a crucial knowledge gap that must be addressed in future trials. Studying pediatric survivors of the 2014–2016 West Africa EVD outbreak will provide much-needed data on long-term outcomes and residual effects of filovirus disease while we await effective filovirus-specific vaccines and therapies.

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

2020 ◽  
Vol 50 (7) ◽  
pp. 562-566 ◽  
Author(s):  
M.S. Sow ◽  
D.C. Sow ◽  
M.L. Diallo ◽  
D. Kassé ◽  
K. Sylla ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ebola Virus ◽  
Virus Disease ◽  
Ebola Virus Disease ◽  
Factors Associated

Viral Haemorrhagic Fevers and Malaria Co-Infections Among Febrile Patients Seeking Health Care in Tanzania

2021 ◽  
Author(s):  
Sima Rugarabamu ◽  
Susan F. Rumisha ◽  
Gaspary O. Mwanyika ◽  
Calvin Sindato ◽  
Hee-Young Lim ◽  
...  
Keyword(s):  
Health Care ◽  
Ebola Virus ◽  
Virus Disease ◽  
Marburg Virus ◽  
Immunoglobulin M ◽  
Sub Saharan Africa ◽  
Infection Prevalence ◽  
Haemorrhagic Fever ◽  
Rapid Diagnostics ◽  
Valley Fever

Abstract Background: In recent years there have been reports of viral haemorrhagic fever (VHF) epidemics in Sub-Saharan Africa where malaria is endemic. VHF and malaria have overlapping clinical presentations making differential diagnosis a challenge. The objective of this study was to determine the prevalence of selected zoonotic VHFs and malaria co-infections among febrile patients seeking health care in Tanzania. Methods: This facility-based cross-section study was carried out in Buhigwe, Kalambo, Kyela, Kilindi, Kinondoni, Kondoa, Mvomero, and Ukerewe districts in Tanzania. The study involved febrile patients seeking health care from primary healthcare facilities. Blood samples were collected and tested for infections due to malaria, Crimean-Congo haemorrhagic fever (CCHF), Ebola virus disease (EVD), Marburg virus disease (MVD), Rift Valley fever (RVF) and yellow fever (YF). Malaria infections were tested using rapid diagnostics tests while exposure to VHFs was determined by screening for immunoglobulin M antibodies using commercial enzyme-linked immunosorbent assays. Results: A total of 308 participants (mean age=35±18.9 years) were involved in the study. Of these, 54 (17.5%) had malaria infection and 15 (4.8%) were positive for IgM antibodies against VHFs (RVF=8; CCHF=2; EBV=3; MBV=1; YF=1). Six (1.9%) individuals had both VHF (RVF=2; CCHF=1; EVD=2; MVD=1) and malaria infections. The highest co-infection prevalence (0.6%), was observed among individuals aged 46-60 years (p<0.05). District was significantly associated with co-infection (p<0.05) with the highest prevalence recorded in Buhigwe (1.2%) followed by Kinondoni (0.9%) districts. Headache (100%) and muscle, bone, back and joint pains (83.3%) were the most significant complaints among those infected with both VHFs and malaria (p=0.001). Conclusions: Co-infections of VHF and malaria are prevalent in Tanzania and affect more the older than the younger population. Since the overlapping symptoms in co-infected individuals may challenge accurate diagnosis, adequate laboratory diagnosis should be emphasized in the management of febrile illnesses.

Doctors’ Knowledge of Viral Haemorrhagic Fevers

2015 ◽  
Vol 14 (2) ◽  
pp. 47-52
Author(s):  
Clifford Lisk ◽  
◽  
Luke Snell ◽  
Michael Haji-Coll ◽  
Jayne Ellis ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
At Risk ◽  
West Africa ◽  
Ebola Virus ◽  
Healthcare Professionals ◽  
Virus Disease ◽  
Ebola Virus Disease ◽  
Poor Knowledge ◽  
Online Study

Viral Haemorrhagic Fevers (VHF) such as Ebola Virus Disease (EVD) are of increasing concern of increasing concern to clinicians and public heath bodies across Europe and America due to the on-going epidemic in West Africa. We conducted an online study to assess clinicians’ knowledge of VHF across six hospital sites in London. This showed suboptimal knowledge of Public Health England guidance, EVD epidemiology and the risk factors for acquiring VHF. Knowledge about VHF was dependent on seniority of grade with the most junior grade of doctors performing worse in several areas of the survey. Poor knowledge raises concerns that those at risk of VHF will be inappropriately risk stratified and managed. Education of doctors and other healthcare professionals about VHF is necessary to address these knowledge gaps.

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