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Persistence of Ebola virus after the end of widespread transmission in Liberia: an outbreak report

Outbreak response efforts for the 2014–15 Ebola virus disease epidemic in west Africa brought widespread transmission to an end. However, subsequent clusters of infection have occurred in the region. An Ebola virus disease cluster in Liberia in November, 2015, that was identified after a 15-year-old... Full description

Journal Title: The Lancet infectious diseases 2018, Vol.18 (9), p.1015-1024
Main Author: Dokubo, Emily Kainne
Other Authors: Wendland, Annika , Mate, Suzanne E , Ladner, Jason T , Hamblion, Esther L , Raftery, Philomena , Blackley, David J , Laney, A Scott , Mahmoud, Nuha , Wayne-Davies, Gloria , Hensley, Lisa , Stavale, Eric , Fakoli, Lawrence , Gregory, Christopher , Chen, Tai-Ho , Koryon, Augustine , Roth Allen, Denise , Mann, Jennifer , Hickey, Andrew , Saindon, John , Badini, Mehboob , Baller, April , Clement, Peter , Bolay, Fatorma , Wapoe, Yatta , Wiley, Michael R , Logue, James , Dighero-Kemp, Bonnie , Higgs, Elizabeth , Gasasira, Alex , Williams, Desmond E , Dahn, Bernice , Kateh, Francis , Nyenswah, Tolbert , Palacios, Gustavo , Fallah, Mosoka P
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: United States: Elsevier Ltd
ID: ISSN: 1473-3099
Link: https://www.ncbi.nlm.nih.gov/pubmed/30049622
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title: Persistence of Ebola virus after the end of widespread transmission in Liberia: an outbreak report
format: Article
creator:
  • Dokubo, Emily Kainne
  • Wendland, Annika
  • Mate, Suzanne E
  • Ladner, Jason T
  • Hamblion, Esther L
  • Raftery, Philomena
  • Blackley, David J
  • Laney, A Scott
  • Mahmoud, Nuha
  • Wayne-Davies, Gloria
  • Hensley, Lisa
  • Stavale, Eric
  • Fakoli, Lawrence
  • Gregory, Christopher
  • Chen, Tai-Ho
  • Koryon, Augustine
  • Roth Allen, Denise
  • Mann, Jennifer
  • Hickey, Andrew
  • Saindon, John
  • Badini, Mehboob
  • Baller, April
  • Clement, Peter
  • Bolay, Fatorma
  • Wapoe, Yatta
  • Wiley, Michael R
  • Logue, James
  • Dighero-Kemp, Bonnie
  • Higgs, Elizabeth
  • Gasasira, Alex
  • Williams, Desmond E
  • Dahn, Bernice
  • Kateh, Francis
  • Nyenswah, Tolbert
  • Palacios, Gustavo
  • Fallah, Mosoka P
subjects:
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Clusters
  • Disease control
  • Disease Outbreaks - prevention & control
  • Disease Outbreaks - statistics & numerical data
  • Disease transmission
  • Ebola virus
  • Ebola virus infections
  • Ebolavirus
  • Epidemics
  • Epidemics - prevention & control
  • Epidemics - statistics & numerical data
  • Epidemiology
  • Female
  • Genomes
  • Haplotypes
  • Health aspects
  • Hemorrhagic Fever, Ebola - epidemiology
  • Hemorrhagic Fever, Ebola - prevention & control
  • Hemorrhagic Fever, Ebola - transmission
  • Humans
  • Immunoglobulins
  • Infant
  • Infections
  • Liberia - epidemiology
  • Male
  • Medical laboratories
  • Middle Aged
  • Outbreaks
  • Phylogeny
  • Prevention
  • Serology
  • Studies
  • Viral diseases
  • Virus diseases
  • Viruses
ispartof: The Lancet infectious diseases, 2018, Vol.18 (9), p.1015-1024
description: Outbreak response efforts for the 2014–15 Ebola virus disease epidemic in west Africa brought widespread transmission to an end. However, subsequent clusters of infection have occurred in the region. An Ebola virus disease cluster in Liberia in November, 2015, that was identified after a 15-year-old boy tested positive for Ebola virus infection in Monrovia, raised the possibility of transmission from a persistently infected individual. Case investigations were done to ascertain previous contact with cases of Ebola virus disease or infection with Ebola virus. Molecular investigations on blood samples explored a potential linkage between Ebola virus isolated from cases in this November, 2015, cluster and epidemiologically linked cases from the 2014–15 west African outbreak, according to the national case database. The cluster investigated was the family of the index case (mother, father, three siblings). Ebola virus genomes assembled from two cases in the November, 2015, cluster, and an epidemiologically linked Ebola virus disease case in July, 2014, were phylogenetically related within the LB5 sublineage that circulated in Liberia starting around August, 2014. Partial genomes from two additional individuals, one from each cluster, were also consistent with placement in the LB5 sublineage. Sequencing data indicate infection with a lineage of the virus from a former transmission chain in the country. Based on serology and epidemiological and genomic data, the most plausible scenario is that a female case in the November, 2015, cluster survived Ebola virus disease in 2014, had viral persistence or recurrent disease, and transmitted the virus to three family members a year later. Investigation of the source of infection for the November, 2015, cluster provides evidence of Ebola virus persistence and highlights the risk for outbreaks after interruption of active transmission. These findings underscore the need for focused prevention efforts among survivors and sustained capacity to rapidly detect and respond to new Ebola virus disease cases to prevent recurrence of a widespread outbreak. US Centers for Disease Control and Prevention, Defense Threat Reduction Agency, and WHO.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1473-3099
fulltext: fulltext
issn:
  • 1473-3099
  • 1474-4457
url: Link


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titlePersistence of Ebola virus after the end of widespread transmission in Liberia: an outbreak report
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creatorDokubo, Emily Kainne ; Wendland, Annika ; Mate, Suzanne E ; Ladner, Jason T ; Hamblion, Esther L ; Raftery, Philomena ; Blackley, David J ; Laney, A Scott ; Mahmoud, Nuha ; Wayne-Davies, Gloria ; Hensley, Lisa ; Stavale, Eric ; Fakoli, Lawrence ; Gregory, Christopher ; Chen, Tai-Ho ; Koryon, Augustine ; Roth Allen, Denise ; Mann, Jennifer ; Hickey, Andrew ; Saindon, John ; Badini, Mehboob ; Baller, April ; Clement, Peter ; Bolay, Fatorma ; Wapoe, Yatta ; Wiley, Michael R ; Logue, James ; Dighero-Kemp, Bonnie ; Higgs, Elizabeth ; Gasasira, Alex ; Williams, Desmond E ; Dahn, Bernice ; Kateh, Francis ; Nyenswah, Tolbert ; Palacios, Gustavo ; Fallah, Mosoka P
creatorcontribDokubo, Emily Kainne ; Wendland, Annika ; Mate, Suzanne E ; Ladner, Jason T ; Hamblion, Esther L ; Raftery, Philomena ; Blackley, David J ; Laney, A Scott ; Mahmoud, Nuha ; Wayne-Davies, Gloria ; Hensley, Lisa ; Stavale, Eric ; Fakoli, Lawrence ; Gregory, Christopher ; Chen, Tai-Ho ; Koryon, Augustine ; Roth Allen, Denise ; Mann, Jennifer ; Hickey, Andrew ; Saindon, John ; Badini, Mehboob ; Baller, April ; Clement, Peter ; Bolay, Fatorma ; Wapoe, Yatta ; Wiley, Michael R ; Logue, James ; Dighero-Kemp, Bonnie ; Higgs, Elizabeth ; Gasasira, Alex ; Williams, Desmond E ; Dahn, Bernice ; Kateh, Francis ; Nyenswah, Tolbert ; Palacios, Gustavo ; Fallah, Mosoka P
descriptionOutbreak response efforts for the 2014–15 Ebola virus disease epidemic in west Africa brought widespread transmission to an end. However, subsequent clusters of infection have occurred in the region. An Ebola virus disease cluster in Liberia in November, 2015, that was identified after a 15-year-old boy tested positive for Ebola virus infection in Monrovia, raised the possibility of transmission from a persistently infected individual. Case investigations were done to ascertain previous contact with cases of Ebola virus disease or infection with Ebola virus. Molecular investigations on blood samples explored a potential linkage between Ebola virus isolated from cases in this November, 2015, cluster and epidemiologically linked cases from the 2014–15 west African outbreak, according to the national case database. The cluster investigated was the family of the index case (mother, father, three siblings). Ebola virus genomes assembled from two cases in the November, 2015, cluster, and an epidemiologically linked Ebola virus disease case in July, 2014, were phylogenetically related within the LB5 sublineage that circulated in Liberia starting around August, 2014. Partial genomes from two additional individuals, one from each cluster, were also consistent with placement in the LB5 sublineage. Sequencing data indicate infection with a lineage of the virus from a former transmission chain in the country. Based on serology and epidemiological and genomic data, the most plausible scenario is that a female case in the November, 2015, cluster survived Ebola virus disease in 2014, had viral persistence or recurrent disease, and transmitted the virus to three family members a year later. Investigation of the source of infection for the November, 2015, cluster provides evidence of Ebola virus persistence and highlights the risk for outbreaks after interruption of active transmission. These findings underscore the need for focused prevention efforts among survivors and sustained capacity to rapidly detect and respond to new Ebola virus disease cases to prevent recurrence of a widespread outbreak. US Centers for Disease Control and Prevention, Defense Threat Reduction Agency, and WHO.
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languageeng
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subjectAdolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Clusters ; Disease control ; Disease Outbreaks - prevention & control ; Disease Outbreaks - statistics & numerical data ; Disease transmission ; Ebola virus ; Ebola virus infections ; Ebolavirus ; Epidemics ; Epidemics - prevention & control ; Epidemics - statistics & numerical data ; Epidemiology ; Female ; Genomes ; Haplotypes ; Health aspects ; Hemorrhagic Fever, Ebola - epidemiology ; Hemorrhagic Fever, Ebola - prevention & control ; Hemorrhagic Fever, Ebola - transmission ; Humans ; Immunoglobulins ; Infant ; Infections ; Liberia - epidemiology ; Male ; Medical laboratories ; Middle Aged ; Outbreaks ; Phylogeny ; Prevention ; Serology ; Studies ; Viral diseases ; Virus diseases ; Viruses
ispartofThe Lancet infectious diseases, 2018, Vol.18 (9), p.1015-1024
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18Hickey, Andrew
19Saindon, John
20Badini, Mehboob
21Baller, April
22Clement, Peter
23Bolay, Fatorma
24Wapoe, Yatta
25Wiley, Michael R
26Logue, James
27Dighero-Kemp, Bonnie
28Higgs, Elizabeth
29Gasasira, Alex
30Williams, Desmond E
31Dahn, Bernice
32Kateh, Francis
33Nyenswah, Tolbert
34Palacios, Gustavo
35Fallah, Mosoka P
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descriptionOutbreak response efforts for the 2014–15 Ebola virus disease epidemic in west Africa brought widespread transmission to an end. However, subsequent clusters of infection have occurred in the region. An Ebola virus disease cluster in Liberia in November, 2015, that was identified after a 15-year-old boy tested positive for Ebola virus infection in Monrovia, raised the possibility of transmission from a persistently infected individual. Case investigations were done to ascertain previous contact with cases of Ebola virus disease or infection with Ebola virus. Molecular investigations on blood samples explored a potential linkage between Ebola virus isolated from cases in this November, 2015, cluster and epidemiologically linked cases from the 2014–15 west African outbreak, according to the national case database. The cluster investigated was the family of the index case (mother, father, three siblings). Ebola virus genomes assembled from two cases in the November, 2015, cluster, and an epidemiologically linked Ebola virus disease case in July, 2014, were phylogenetically related within the LB5 sublineage that circulated in Liberia starting around August, 2014. Partial genomes from two additional individuals, one from each cluster, were also consistent with placement in the LB5 sublineage. Sequencing data indicate infection with a lineage of the virus from a former transmission chain in the country. Based on serology and epidemiological and genomic data, the most plausible scenario is that a female case in the November, 2015, cluster survived Ebola virus disease in 2014, had viral persistence or recurrent disease, and transmitted the virus to three family members a year later. Investigation of the source of infection for the November, 2015, cluster provides evidence of Ebola virus persistence and highlights the risk for outbreaks after interruption of active transmission. These findings underscore the need for focused prevention efforts among survivors and sustained capacity to rapidly detect and respond to new Ebola virus disease cases to prevent recurrence of a widespread outbreak. US Centers for Disease Control and Prevention, Defense Threat Reduction Agency, and WHO.
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titlePersistence of Ebola virus after the end of widespread transmission in Liberia: an outbreak report
authorDokubo, Emily Kainne ; Wendland, Annika ; Mate, Suzanne E ; Ladner, Jason T ; Hamblion, Esther L ; Raftery, Philomena ; Blackley, David J ; Laney, A Scott ; Mahmoud, Nuha ; Wayne-Davies, Gloria ; Hensley, Lisa ; Stavale, Eric ; Fakoli, Lawrence ; Gregory, Christopher ; Chen, Tai-Ho ; Koryon, Augustine ; Roth Allen, Denise ; Mann, Jennifer ; Hickey, Andrew ; Saindon, John ; Badini, Mehboob ; Baller, April ; Clement, Peter ; Bolay, Fatorma ; Wapoe, Yatta ; Wiley, Michael R ; Logue, James ; Dighero-Kemp, Bonnie ; Higgs, Elizabeth ; Gasasira, Alex ; Williams, Desmond E ; Dahn, Bernice ; Kateh, Francis ; Nyenswah, Tolbert ; Palacios, Gustavo ; Fallah, Mosoka P
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26Immunoglobulins
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30Male
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7Laney, A Scott
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27Dighero-Kemp, Bonnie
28Higgs, Elizabeth
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32Kateh, Francis
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abstractOutbreak response efforts for the 2014–15 Ebola virus disease epidemic in west Africa brought widespread transmission to an end. However, subsequent clusters of infection have occurred in the region. An Ebola virus disease cluster in Liberia in November, 2015, that was identified after a 15-year-old boy tested positive for Ebola virus infection in Monrovia, raised the possibility of transmission from a persistently infected individual. Case investigations were done to ascertain previous contact with cases of Ebola virus disease or infection with Ebola virus. Molecular investigations on blood samples explored a potential linkage between Ebola virus isolated from cases in this November, 2015, cluster and epidemiologically linked cases from the 2014–15 west African outbreak, according to the national case database. The cluster investigated was the family of the index case (mother, father, three siblings). Ebola virus genomes assembled from two cases in the November, 2015, cluster, and an epidemiologically linked Ebola virus disease case in July, 2014, were phylogenetically related within the LB5 sublineage that circulated in Liberia starting around August, 2014. Partial genomes from two additional individuals, one from each cluster, were also consistent with placement in the LB5 sublineage. Sequencing data indicate infection with a lineage of the virus from a former transmission chain in the country. Based on serology and epidemiological and genomic data, the most plausible scenario is that a female case in the November, 2015, cluster survived Ebola virus disease in 2014, had viral persistence or recurrent disease, and transmitted the virus to three family members a year later. Investigation of the source of infection for the November, 2015, cluster provides evidence of Ebola virus persistence and highlights the risk for outbreaks after interruption of active transmission. These findings underscore the need for focused prevention efforts among survivors and sustained capacity to rapidly detect and respond to new Ebola virus disease cases to prevent recurrence of a widespread outbreak. US Centers for Disease Control and Prevention, Defense Threat Reduction Agency, and WHO.
copUnited States
pubElsevier Ltd
pmid30049622
doi10.1016/S1473-3099(18)30417-1