Overview of latest articles and publications on ebola in PubMed. PubMed is a service of the US National Library of Medicine that includes over 18 million citations from MEDLINE and other life science journals.
- Interrogating resilience in health systems development.
Interrogating resilience in health systems development. [Journal Article]Health Policy Plan 2017 Sep 23.HPvan de Pas R, Ashour M, Kapilashrami A, et al. The Fourth Global Symposium on Health Systems Research was themed around 'Resilient and responsive health systems for a changing world.' This commentary is the outcome of a panel discussion at the symp...Publisher Full TextThe Fourth Global Symposium on Health Systems Research was themed around 'Resilient and responsive health systems for a changing world.' This commentary is the outcome of a panel discussion at the symposium in which the resilience discourse and its use in health systems development was critically interrogated. The 2014-15 Ebola outbreak in West-Africa added momentum for the wider adoption of resilient health systems as a crucial element to prepare for and effectively respond to crisis. The growing salience of resilience in development and health systems debates can be attributed in part to development actors and philanthropies such as the Rockefeller Foundation. Three concerns regarding the application of resilience to health systems development are discussed: (1) the resilience narrative overrules certain democratic procedures and priority setting in public health agendas by 'claiming' an exceptional policy space; (2) resilience compels accepting and maintaining the status quo and excludes alternative imaginations of just and equitable health systems including the socio-political struggles required to attain those; and (3) an empirical case study from Gaza makes the case that resilience and vulnerability are symbiotic with each other rather than providing a solution for developing a strong health system. In conclusion, if the normative aim of health policies is to build sustainable, universally accessible, health systems then resilience is not the answer. The current threats that health systems face demand us to imagine beyond and explore possibilities for global solidarity and justice in health.
- The Crux of Ebola Diagnostics.
The Crux of Ebola Diagnostics. [Journal Article]J Infect Dis 2017 Sep 23.JIStrong JE, Feldmann H Publisher Full Text
- Rapid determination of ebolavirus infectivity in clinical samples using a novel reporter cell line.
Rapid determination of ebolavirus infectivity in clinical samples using a novel reporter cell line. [Journal Article]J Infect Dis 2017 Sep 23.JIKainulainen MH, Nichol ST, Albariño CG, et al. Modern ebolavirus diagnostics rely primarily on qRT-PCR, a sensitive method to detect viral genetic material in the acute phase of the disease. However, qRT-PCR does not confirm presence of infectious ...Publisher Full TextModern ebolavirus diagnostics rely primarily on qRT-PCR, a sensitive method to detect viral genetic material in the acute phase of the disease. However, qRT-PCR does not confirm presence of infectious virus, presenting limitations in patient and outbreak management. Attempts to isolate infectious virus rely on in vivo or basic cell culture approaches, which prohibit rapid results and screening. Here we present a novel reporter cell line capable of detecting live ebolaviruses. These cells permit sensitive large-scale screening and titration of infectious virus in experimental and clinical samples, independent of ebolavirus species and variant.
- Review of computational methods for virus-host protein interaction prediction: a case study on novel Ebola-human interactions.
Review of computational methods for virus-host protein interaction prediction: a case study on novel Ebola-human interactions. [Journal Article]Brief Funct Genomics 2017 Sep 26.BFHalder AK, Dutta P, Kundu M, et al. Identification of potential virus-host interactions is useful and vital to control the highly infectious virus-caused diseases. This may contribute toward development of new drugs to treat the viral in...Publisher Full TextIdentification of potential virus-host interactions is useful and vital to control the highly infectious virus-caused diseases. This may contribute toward development of new drugs to treat the viral infections. Recently, database records of clinically and experimentally validated interactions between a small set of human proteins and Ebola virus (EBOV) have been published. Using the information of the known human interaction partners of EBOV, our main objective is to identify a set of proteins that may interact with EBOV proteins. Here, we first review the state-of-the-art, computational methods used for prediction of novel virus-host interactions for infectious diseases followed by a case study on EBOV-human interactions. The assessment result shows that the predicted human host proteins are highly similar with known human interaction partners of EBOV in the context of structure and semantics and are responsible for similar biochemical activities, pathways and host-pathogen relationships.
- Vibrio vulnificus - new insights into a deadly opportunistic pathogen.
Vibrio vulnificus - new insights into a deadly opportunistic pathogen. [Journal Article]Environ Microbiol 2017 Oct 13.EMBaker-Austin C, Oliver JD Vibrio vulnificus is a Gram-negative aquatic bacterium first isolated by the United States (US) Centers for Disease Control and Prevention (CDC) in 1964. This bacterium is part of the normal microbiota...Publisher Full TextVibrio vulnificus is a Gram-negative aquatic bacterium first isolated by the United States (US) Centers for Disease Control and Prevention (CDC) in 1964. This bacterium is part of the normal microbiota of estuarine waters and occurs in high numbers in molluscan shellfish around the world, particularly in warmer months. Infections in humans are derived from consumption of seafood produce and from water exposure. V. vulnificus is a striking and enigmatic human pathogen, yet many aspects related to its biology, genomics, virulence capabilities and epidemiology remain elusive and poorly understood. This pathogen is responsible for over 95% of seafood-related deaths in the USA, and carries the highest fatality rate of any food-borne pathogen. Indeed, infections associated with this pathogen that progress to primary septicaemia have a similar case fatality rate to category BSL 3 and 4 pathogens, such as anthrax, bubonic plague, Ebola, and Marburg fever. Interestingly, V. vulnificus infections disproportionately affect males (∼85% of cases) and older patients (> 40 years), especially those with underlying conditions such as liver diseases, diabetes and immune disorders. New insights from molecular studies and comparative genomic approaches have offered tantalising insights into this pathogen. A recent increase and geographical spread in reported infections, in particular wound cases, underlines the growing international importance of V. vulnificus, particularly in the context of coastal warming. We outline and explore here a range of current data gaps regarding this important pathogen, and provide some current thoughts on approaches to elucidate key aspects associated with this bacterium. This article is protected by copyright. All rights reserved.
- Role of contact tracing in containing the 2014 Ebola outbreak: a review.
Role of contact tracing in containing the 2014 Ebola outbreak: a review. [Journal Article]Afr Health Sci 2017 Mar; 17(1):225-236.AHSaurabh S, Prateek S The strategy of contact tracing has a great potential to significantly reduce the incidence of cases of Ebola virus disease. However, its success is eventually determined by the level of trust between ...PMC Free Full TextThe 2014 outbreak of Ebola virus disease which emerged in the month of March in the year 2014 in Guinea has been declared as a public health emergency of international concern.The objectives of the review article are to assess the role of contact tracing in the Ebola outbreak and to identify the challenges faced by the health workers while performing contact tracing.An extensive search of all materials related to the Ebola outbreak and contact tracing was carried out in PubMed, Medline, World Health Organization website and Google Scholar search engines. Keywords used in the search included Ebola virus disease, West-Africa, contact tracing, World Health Organization. Overall 60 articles were selected and included in the discussion.Contact tracing is an important strategy in epidemiology and refers to the identification and diagnosis of those individuals who have come in contact with an infected person. It ultimately aims to reduce the time span required to detect and treat a case of an infectious disease and hence significantly minimize the risk of transmission to the subsequent susceptible individuals. In-fact, contact tracing continues to remain an important measure, as it aids the epidemiologist in containing the infection.The strategy of contact tracing has a great potential to significantly reduce the incidence of cases of Ebola virus disease. However, its success is eventually determined by the level of trust between the community and the public health system and the quality of the diagnostic & treatment services.
- A rapid bio-optical sensor for diagnosing Q fever in clinical specimens.
A rapid bio-optical sensor for diagnosing Q fever in clinical specimens. [Journal Article]J Biophotonics 2017 Oct 10.JBKoo B, Jin CE, Park SY, et al. Recent zoonotic outbreaks, such as Zika, Middle East Respiratory Syndrome, and Ebola, have highlighted the need for rapid and accurate diagnostic assays that can be used to aid pathogen control. Q-feve...Publisher Full TextRecent zoonotic outbreaks, such as Zika, Middle East Respiratory Syndrome, and Ebola, have highlighted the need for rapid and accurate diagnostic assays that can be used to aid pathogen control. Q-fever is a zoonotic disease caused by the transmission of Coxiella burnetii that can cause serious illness in humans via aerosols and is considered a potential bioterrorism agent. However the existing assays are not suitable for the detection of this pathogen due to its low levels in real samples. We here describe a rapid bio-optical sensor for the accurate detection of Q fever and validate its clinical utility. By combining a bio-optical sensor, that transduces the presence of the target DNA based on binding-induced changes in the refractive index on the waveguide surface in a label-free and real-time manner, with isothermal DNA amplification, this new diagnostic tool offers a rapid (<20 min) one-step DNA amplification/detection method. We confirmed the clinical sensitivity (> 90%) of the bio-optical sensor by detecting C. burnetii in 11 formalin-fixed, paraffin-embedded liver biopsy samples from acute Q-fever hepatitis patients and in 16 blood plasma samples from patients in which Q-fever is the cause of fever of unknown origin.>
- Intracellular Crosslinking of Filoviral Nucleoproteins with Xintrabodies Restricts Viral Packaging.
Intracellular Crosslinking of Filoviral Nucleoproteins with Xintrabodies Restricts Viral Packaging. [Journal Article]Front Immunol 2017.:1197.FIDarling TL, Sherwood LJ, Hayhurst A Viruses assemble large macromolecular repeat structures that become part of the infectious particles or virions. Ribonucleocapsids (RNCs) of negative strand RNA viruses are a prime example where repeti...Viruses assemble large macromolecular repeat structures that become part of the infectious particles or virions. Ribonucleocapsids (RNCs) of negative strand RNA viruses are a prime example where repetition of nucleoprotein (NP) along the genome creates a core polymeric helical scaffold that accommodates other nucleocapsid proteins including viral polymerase. The RNCs are transported through the cytosol for packaging into virions through association with viral matrix proteins at cell membranes. We hypothesized that RNC would be ideal targets for crosslinkers engineered to promote aberrant protein-protein interactions, thereby blocking their orderly transport and packaging. Previously, we had generated single-domain antibodies (sdAbs) against Filoviruses that have all targeted highly conserved C-terminal regions of NP known to be repetitively exposed along the length of the RNCs of Marburgvirus (MARV) and Ebolavirus (EBOV). Our crosslinker design consisted of dimeric sdAb expressed intracellularly, which we call Xintrabodies (X- for crosslinking). Electron microscopy of purified NP polymers incubated with purified sdAb constructs showed NP aggregation occurred in a genus-specific manner with dimeric and not monomeric sdAb. A virus-like particle (VLP) assay was used for initial evaluation where we found that dimeric sdAb inhibited NP incorporation into VP40-based VLPs whereas monomeric sdAb did not. Inhibition of NP packaging was genus specific. Confocal microscopy revealed dimeric sdAb was diffuse when expressed alone but focused on pools of NP when the two were coexpressed, while monomeric sdAb showed ambivalent partition. Infection of stable Vero cell lines expressing dimeric sdAb specific for either MARV or EBOV NP resulted in smaller plaques and reduced progeny of cognate virus relative to wild-type Vero cells. Though the impact was marginal at later time-points, the collective data suggest that viral replication can be reduced by crosslinking intracellular NP using relatively small amounts of dimeric sdAb to restrict NP packaging. The stoichiometry and ease of application of the approach would likely benefit from transitioning away from intracellular expression of crosslinking sdAb to exogenous delivery of antibody. By retuning sdAb specificity, the approach of crosslinking highly conserved regions of assembly critical proteins may well be applicable to inhibiting replication processes of a broad spectrum of viruses.
- Phase 2 Placebo-Controlled Trial of Two Vaccines to Prevent Ebola in Liberia.
Phase 2 Placebo-Controlled Trial of Two Vaccines to Prevent Ebola in Liberia. [Journal Article, Research Support, Non-U.S. Gov't]N Engl J Med 2017 10 12; 377(15):1438-1447.NEJMKennedy SB, Bolay F, Kieh M, et al. Background The safety and efficacy of vaccines to prevent Ebola virus disease (EVD) were unknown when the incidence of EVD was peaking in Liberia. Methods We initiated a randomized, placebo-controlled,...Publisher Full TextBackground The safety and efficacy of vaccines to prevent Ebola virus disease (EVD) were unknown when the incidence of EVD was peaking in Liberia. Methods We initiated a randomized, placebo-controlled, phase 3 trial of the chimpanzee adenovirus 3 vaccine (ChAd3-EBO-Z) and the recombinant vesicular stomatitis virus vaccine (rVSV∆G-ZEBOV-GP) in Liberia. A phase 2 subtrial was embedded to evaluate safety and immunogenicity. Because the incidence of EVD declined in Liberia, the phase 2 component was expanded and the phase 3 component was eliminated. Results A total of 1500 adults underwent randomization and were followed for 12 months. The median age of the participants was 30 years; 36.6% of the participants were women. During the week after the administration of vaccine or placebo, adverse events occurred significantly more often with the active vaccines than with placebo; these events included injection-site reactions (in 28.5% of the patients in the ChAd3-EBO-Z group and 30.9% of those in the rVSV∆G-ZEBOV-GP group, as compared with 6.8% of those in the placebo group), headache (in 25.1% and 31.9%, vs. 16.9%), muscle pain (in 22.3% and 26.9%, vs. 13.3%), feverishness (in 23.9% and 30.5%, vs. 9.0%), and fatigue (in 14.0% and 15.4%, vs. 8.8%) (P<0.001 for all comparisons); these differences were not seen at 1 month. Serious adverse events within 12 months after injection were seen in 40 participants (8.0%) in the ChAd3-EBO-Z group, in 47 (9.4%) in the rVSV∆G-ZEBOV-GP group, and in 59 (11.8%) in the placebo group. By 1 month, an antibody response developed in 70.8% of the participants in the ChAd3-EBO-Z group and in 83.7% of those in the rVSV∆G-ZEBOV-GP group, as compared with 2.8% of those in the placebo group (P<0.001 for both comparisons). At 12 months, antibody responses in participants in the ChAd3-EBO-Z group (63.5%) and in those in the rVSV∆G-ZEBOV-GP group (79.5%) remained significantly greater than in those in the placebo group (6.8%, P<0.001 for both comparisons). Conclusions A randomized, placebo-controlled phase 2 trial of two vaccines that was rapidly initiated and completed in Liberia showed the capability of conducting rigorous research during an outbreak. By 1 month after vaccination, the vaccines had elicited immune responses that were largely maintained through 12 months. (Funded by the National Institutes of Allergy and Infectious Diseases and the Liberian Ministry of Health; PREVAIL I ClinicalTrials.gov number, NCT02344407 .).0>
- Relationship between viremia and specific organ damage in Ebola patients: a cohort study.
Relationship between viremia and specific organ damage in Ebola patients: a cohort study. [Journal Article]Clin Infect Dis 2017 Aug 20.CILanini S, Portella G, Vairo F, et al. This study provides evidence to support that Ebola virus may have a direct role in muscular damage and imbalance of the coagulation system. We did not found strong evidence suggestive of a direct role ...Publisher Full TextPathogenesis of Ebola virus disease remains poorly understood. We used concomitant determination of routine laboratory biomarkers and Ebola viremia to explore the potential role of viral replication in specific organ damage.We recruited patients with detectable Ebola viremia admitted to the EMERGENCY ONG ONLUS Ebola Treatment Center in Sierra Leone. Repeated measure of Ebola viremia, ALT, AST, bilirubin, CPK, LDH, aPTT, INR, creatinine and BUN were recorded. Patients were followed-up since admission until death or discharge.One hundred patients (49 survivors and 51 non-survivors) were included in the analysis. Unadjusted analysis to compare survivors and non-survivors provided evidence that all biomarkers were significantly above the normal range and that the extent of these abnormalities was generally higher in non-survivors than in survivors. Multivariable mixed effect models provided strong evidence for a biological gradient (suggestive of a direct role in organ damage) between the viremia levels and either ALT, AST, CPK LDH, aPTT and INR. In contrast no direct linear association was found between viremia and either creatinine, BUN or bilirubin.This study provides evidence to support that Ebola virus may have a direct role in muscular damage and imbalance of the coagulation system. We did not found strong evidence suggestive of a direct role of Ebola virus in kidney damage. The role of the virus in liver damage remains unclear, but our evidence suggests that acute severe liver injury is not a typical feature of Ebola virus disease.