From the Journals

Ebola research update: January-February 2017


 

The struggle to defeat Ebola virus disease continues globally, although it may not always make the headlines. To catch up on what you may have missed, here are some notable news items and journal articles published over the past few weeks that are worth a second look.

Italian researchers observed the presence of total Ebola virus RNA and replication markers in specimens of the lower respiratory tract, even after viral clearance from plasma, suggesting possible local replication.

CDC/Daniel J. DeNoon
A case study in the Journal of Infectious Diseases described the first neonate documented to have survived congenital infection with Ebola virus. The child was treated with monoclonal antibodies (ZMapp), a buffy coat transfusion from an Ebola survivor, and the broad-spectrum antiviral GS-5734.

Researchers have identified a mechanism that appears to represent one way that host cells have evolved to outsmart infection by Ebola and other viruses, according to a study in PLOS Pathogens.

Post–Ebola virus disease symptoms can remain long after recovery and long-term viral persistence in semen is confirmed, according to a study in Lancet Infectious Diseases. The authors say the results justify calls for regular check-ups of survivors at least 18 months after recovery.

A new mouse model of early Ebola virus infection may show how early immune responses can affect the development of Ebola virus disease, according to a study in Cell Reports, and identify protective immune responses as targets for developing human Ebola virus therapeutics.

The addition of disease surveillance officers in Kambia, Sierra Leone, enabled public health officials to provide a more timely response to Ebola virus alerts as well as conduct active case searching throughout the district, according to a report in MMWR, which investigators said was associated with earlier detection and a decline in number of new Ebola virus disease cases recorded.

A study published in PLOS Neglected Tropical Diseases proposed highly predictive and easy-to-use prognostic tools that stratify the risk of Ebola virus disease mortality at or after Ebola virus disease triage.

According to a study published in the Journal of Human Lactation, donor human milk processed at nonprofit milk banks is safe from Ebola and Marburg viruses because the viruses are safely inactivated in human milk by standard North American pasteurization techniques.

A recent study found that the 2014-2015 West Africa Ebola epidemic was largely driven and sustained by “superspreadings” that were ubiquitous throughout the outbreak, and that age is an important demographic predictor for superspreading. The authors said their results highlight the importance of control measures targeted at potential superspreaders and enhance understanding of causes and consequences of superspreading for Ebola virus.

Ebola, and more recently Zika and yellow fever, have demonstrated that the world does not yet have a reliable or robust global system for preventing, detecting, and responding to disease outbreaks, according to an analysis in BMJ.

Ebola virus strains can be generated that replicate and cause disease within new host rodent species, according to a bioinformatics study, raising concerns that few mutations may result in novel human pathogenic Ebola viruses.

A study in Sierra Leone using a new highly specific and sensitive assay found that asymptomatic infection with Ebola virus was uncommon despite high exposure. The authors said “low prevalence suggests asymptomatic infection contributes little to herd immunity in Ebola, and even if infectious, would account for few transmissions.”

Malaria parasite coinfection was common in patients presenting to Ebola Treatment Units in Sierra Leone, according to a study in The Lancet Infectious Diseases, and conferred an increased mortality risk in patients infected with Ebola virus, supporting empirical malaria treatment in Ebola Treatment Units. The authors said high mortality among patients without Ebola virus disease or malaria suggests expanded testing and treatment might improve care in future Ebola epidemics.

On Twitter @richpizzi

Recommended Reading

Guidelines for diagnosing TB in adults, children
MDedge Infectious Disease
Ebola research update: December 2016
MDedge Infectious Disease
SOFA score may be best to identify sepsis in the ICU
MDedge Infectious Disease
Watch for cutaneous manifestations of tropical infectious diseases
MDedge Infectious Disease
Chikungunya arthritis symptoms reduced with immunomodulatory drugs
MDedge Infectious Disease
Lower C. difficile mortality with vancomycin than metronidazole
MDedge Infectious Disease
Crusted scabies outbreak: How much prophylaxis?
MDedge Infectious Disease
Vitamin D reduces respiratory infection risk
MDedge Infectious Disease
Increased schizophrenia, affective disorder risks associated with infections
MDedge Infectious Disease
VIDEO: Infectious enteritis quadrupled short-term risk of IBS
MDedge Infectious Disease