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PLoS Pathog. 2017 Jan 5;13(1):e1006065. doi: 10.1371/journal.ppat.1006065. eCollection 2017 Jan.

Detection of Viral RNA in Tissues following Plasma Clearance from an Ebola Virus Infected Patient.

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National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense, Rome, Italy.
International Public Health Crisis Group (IPHCG).
Institute of Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut, Federal Research Institute for Animal HealthInsel Riems, Germany.
Research Centre on Infectious Diseases, Faculty of Medicine, Université Laval, Québec Canada.
University College London and NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, United Kingdom.


An unprecedented Ebola virus (EBOV) epidemic occurred in 2013-2016 in West Africa. Over this time the epidemic exponentially grew and moved to Europe and North America, with several imported cases and many Health Care Workers (HCW) infected. Better understanding of EBOV infection patterns in different body compartments is mandatory to develop new countermeasures, as well as to fully comprehend the pathways of human-to-human transmission. We have longitudinally explored the persistence of EBOV-specific negative sense genomic RNA (neg-RNA) and the presence of positive sense RNA (pos-RNA), including both replication intermediate (antigenomic-RNA) and messenger RNA (mRNA) molecules, in the upper and lower respiratory tract, as compared to plasma, in a HCW infected with EBOV in Sierra Leone, who was hospitalized in the high isolation facility of the National Institute for Infectious Diseases "Lazzaro Spallanzani" (INMI), Rome, Italy. We observed persistence of pos-RNA and neg-RNAs in longitudinally collected specimens of the lower respiratory tract, even after viral clearance from plasma, suggesting possible local replication. The purpose of the present study is to enhance the knowledge on the biological features of EBOV that can contribute to the human-to-human transmissibility and to develop effective intervention strategies. However, further investigation is needed in order to better understand the clinical meaning of viral replication and shedding in the respiratory tract.

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