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Outbreak of new Ebola, most likely caused by a person infected 5 years ago | Science

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The Ebola virus can cause latent infections in survivors and cause new outbreaks.

National Institute of Allergy and Infectious Diseases / National Institute of Health Sciences / Flickr (CC BY-NC 2.0)

Along Kai Kupfer Schmidt

The outbreak of Sierra Leone’s hemorrhagic fever in Guinea, which has killed at least 18 people and killed 9 people so far, stirs up the difficult memories of the devastating epidemic that struck West African countries between 2013 and 2016. More than 11,000 people have died along with Liberia and Sierra Leone. ..

But trauma may not be the only persistence. The virus that caused the new outbreak is almost the same as the strain found 5-6 years ago, and genome analysis by three independent research groups shows that the virus is always lurking in epidemic survivors. It suggests that. “This is pretty shocking,” says Georgetown University virologist Angela Rasmussen. “Ebola virus is not a herpesvirus” — it is known to cause long-term infections — “and generally RNA viruses do not hang around at all, just not replicating.”

Scientists knew that the Ebola virus could last for a long time in the human body. The 2016 revival in Guinea began with survivors The person who shed the virus with his semen More than 500 days after his infection, he infected his partner through sexual intercourse. “But it’s horrifying and new that a new outbreak begins five years after the epidemic ends,” said three teams studying survivors of Ebola at the University of Montpellier’s infectious disease specialist. Although outbreaks of Ebola survivors ignited are still very rare, according to De Laporte, the findings raise difficult questions about how to prevent Ebola survivors without further stigma.

The current outbreak in Guinea was detected after the death of a 51-year-old nurse, who was first diagnosed with typhoid fever and malaria, in late January. Some people who attended her funeral became ill, including members of her family and the traditional therapist who treated her, four of whom died. Researchers suspected that Ebola caused all deaths and found the virus in the blood of a nurse’s husband in early February. The outbreak of Ebola was officially declared on February 13, and nurses could be probands.

The Guinea Infectious Diseases Research and Training Center (CERFIG) and the National Institute for Hemorrhagic Fever are reading the viral genome from four patients each. Researchers at the Pasteur Institute in Dakar, Senegal, have sequenced two genomes. To three Post Today, on the website virological.org, the group agrees that the outbreak was caused by a species of Macona strain called. Zaire Ebola virus, Just like the fads of the past. The phylogenetic tree shows that the new virus is between the 2013-16 epidemic virus samples.

Until recently, scientists assumed that an epidemic of Ebola would begin when the virus caused the species to jump from an animal host to a human. In theory, it could have happened in Guinea, says Stephan Günther, a virologist at the Bernhardnocht Institute for Tropical Medicine, who worked with one of the three teams. But given the similarities between epidemic and new viruses, “it must be incredibly unlikely.”

External scientists agree, but say that Ebola has not been proven to be dormant alone for five years. “From the tree, we’ll conclude that it’s a virus that somehow survived in the area and is probably a survivor,” says Dan Bausch, a veteran of several Ebola heads of public health in the United Kingdom. .. Prompt support team. However, Bausch adds that it is difficult to rule out scenarios such as the chain of unrecognized small human-to-human transmissions. “For example, a survivor in 2014 infects his wife a few years after recovery, infects another man, survives, carries the virus. For several years, then infects another woman, and then dies. Seen by nurses “-proband of a new outbreak.

Although the nurse herself is not known to be a survivor, she may have come into contact with the survivor personally or through work, or she was infected with few symptoms many years ago. there is a possibility. “Understanding exactly what happened is one of the biggest problems right now,” says Bausch.

Another outbreak of Ebola, which is ongoing in North Kivu, the Democratic Republic of the Congo, was also initiated by an infection from someone who was infected during a previous outbreak, Delaporte said. (Survivors tested twice negative for Ebola after becoming ill in 2020.) In summary, suggesting that humans are as likely to be a new source of Ebola as wildlife. I am. “This is clearly a new paradigm for how these outbreaks begin.” Fabian Leendertz, a wildlife veterinarian involved in sequencing, said that each eruption of Ebola was due to increased mobility and other factors. As they grow larger and have more survivors, the chances of an outbreak caused by a survivor can be even higher.

This is clearly a new paradigm about how these outbreaks begin.

University of Montpellier, Eric de la Porte

The case raises important new research issues, says Bausch: “How do we need to change our response to escape the outbreak-response-reintroduction-occurrence cycle?” He asks. “Can new treatments be used to get rid of the virus from survivors?”

But the most pressing question is what these results mean for survivors of Ebola, who are already facing many challenges. Many people not only lose friends and family from the virus, but also suffer from long-term sequelae such as muscle aches and eye problems.in the investigation Published in February, Delaporte found that about half of Guinea’s more than 800 Ebola survivors still report symptoms two and four years after their illness.

In addition to this, survivors face intense stigma. Frederick Le Marsis, a social anthropologist at the Lyon Higher Normal School and the French Institute for Development, said in the aftermath of this epidemic, including claims that survivors sold their families to international organizations to save them. He states that many conspiracy theories have swirled. Someone who works in Guinea. According to him, only one man survived in the family of eleven, and no one wanted to work with him when he returned. “He was considered an unreliable person.” The news that survivors were likely to have touched on the current outbreak could cause further problems for survivors, says Le Marsis. .. Will they be kicked out of their families and communities? “

Virologist Alpha Keita, who led the sequencing work at CERFIG, has been stigmatized and even worried about violence against survivors since the first surprising results a week ago. One of the important messages to the public is that some people infected with Ebola have few symptoms. “So don’t blame the survivors of Ebola. You don’t know you’re not a survivor,” says Keita.

Bausch + Lomb wants an educational campaign to explain that unprotected sex with survivors of Ebola can pose a risk, but causal relationships such as handshakes and collaboration do not pose a risk. And medical monitoring of survivors is needed, but it’s not just about testing them for the Ebola virus, he says. “We need to be aware of and support all other physical, mental and social challenges facing survivors and their families.” Importantly, “survivors, another outbreak.” It’s not just about treating hot potatoes as a risk to start. ” According to Le Marcis, if all patients with fever and diarrhea need to be considered potential cases of Ebola, it also poses a challenge to the national health care system.

Fortunately, Ebola vaccines and treatments have become available in recent years. Already, the contacts of thousands of new Ebola patients, and those contacts, have been vaccinated. Healthcare workers are also vaccinated. Vaccination of survivors may even help eliminate latent infections, Rasmussen says. And now, the fact that virus samples have been sequenced in Guinea shows that the country’s scientific capabilities have improved. “Seven years ago, when the epidemic began, there was no infrastructure in Guinea to do this.”

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