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J Infect Dis. 2016 Oct 15;214(suppl 3):S250-S257. Epub 2016 Sep 16.

Analysis of Diagnostic Findings From the European Mobile Laboratory in Guéckédou, Guinea, March 2014 Through March 2015.

Author information

1
Bernhard Nocht Institute for Tropical Medicine European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems.
2
Bernhard Nocht Institute for Tropical Medicine German Center for Infection Research, Hamburg-Munich-Marburg-Riems.
3
World Health Organization.
4
European Mobile Laboratory Consortium National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
5
European Mobile Laboratory Consortium Ministry of Health Guinea.
6
European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems Bundeswehr Institute of Microbiology, Munich.
7
European Mobile Laboratory Consortium National Reference Center for Viral Hemorrhagic Fevers Laboratoire P4 Inserm-Jean Mérieux.
8
European Mobile Laboratory Consortium Public Health England, Porton Down.
9
European Mobile Laboratory Consortium Spiez Laboratory, Federal Office for Civil Protection.
10
European Mobile Laboratory Consortium Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Slovenia.
11
European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems Institute of Virology, Philipps University Marburg.
12
European Mobile Laboratory Consortium National Biosafety Laboratory, National Center for Epidemiology, Budapest, Hungary.
13
European Mobile Laboratory Consortium National Reference Center for Viral Hemorrhagic Fevers Unité de Biologie des Infections Virales Emergentes, Institut Pasteur, Lyon, France.
14
European Mobile Laboratory Consortium Robert Koch Institute, Berlin.
15
European Mobile Laboratory Consortium Heinrich Pette Institute-Leibniz Institute for Experimental Virology, Hamburg German Center for Infection Research, Hamburg-Munich-Marburg-Riems.
16
European Mobile Laboratory Consortium Evolutionary Ecology Group, Department of Biology, University of Antwerp.
17
European Mobile Laboratory Consortium Institute of Tropical Medicine, Antwerp.
18
European Mobile Laboratory Consortium Public Health Agency of Sweden, Solna.
19
European Mobile Laboratory Consortium Department of Microbiology and Immunology, Rega Institute, KU Leuven.
20
European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald, Insel Riems, Germany.
21
European Mobile Laboratory Consortium Janssen-Cilag, Stockholm, Sweden.
22
European Mobile Laboratory Consortium Swiss Tropical and Public Health Institute, Basel.
23
European Mobile Laboratory Consortium Laboratoire P4 Inserm-Jean Mérieux.
24
European Mobile Laboratory Consortium Public Health England, Porton Down South General Hospital, University of Southampton, United Kingdom.
25
Médecins Sans Frontières, Brussels, Belgium.
26
Institut National de Santé Publique.
27
Université Gamal Abdel Nasser de Conakry, Laboratoire des Fièvres Hémorragiques en Guinée, Guinea.
28
Ministry of Health Guinea.
29
World Health Organization, Geneva, Switzerland.

Abstract

BACKGROUND:

A unit of the European Mobile Laboratory (EMLab) consortium was deployed to the Ebola virus disease (EVD) treatment unit in Guéckédou, Guinea, from March 2014 through March 2015.

METHODS:

The unit diagnosed EVD and malaria, using the RealStar Filovirus Screen reverse transcription-polymerase chain reaction (RT-PCR) kit and a malaria rapid diagnostic test, respectively.

RESULTS:

The cleaned EMLab database comprised 4719 samples from 2741 cases of suspected EVD from Guinea. EVD was diagnosed in 1231 of 2178 hospitalized patients (57%) and in 281 of 563 who died in the community (50%). Children aged <15 years had the highest proportion of Ebola virus-malaria parasite coinfections. The case-fatality ratio was high in patients aged <5 years (80%) and those aged >74 years (90%) and low in patients aged 10-19 years (40%). On admission, RT-PCR analysis of blood specimens from patients who died in the hospital yielded a lower median cycle threshold (Ct) than analysis of blood specimens from survivors (18.1 vs 23.2). Individuals who died in the community had a median Ct of 21.5 for throat swabs. Multivariate logistic regression on 1047 data sets revealed that low Ct values, ages of <5 and ≥45 years, and, among children aged 5-14 years, malaria parasite coinfection were independent determinants of a poor EVD outcome.

CONCLUSIONS:

Virus load, age, and malaria parasite coinfection play a role in the outcome of EVD.

KEYWORDS:

Ebola virus disease; Filovirus; Guinea; epidemic; malaria; mobile laboratory

PMID:
27638946
PMCID:
PMC5050480
DOI:
10.1093/infdis/jiw269
[Indexed for MEDLINE]
Free PMC Article

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