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Euro Surveill. 2018 Mar;23(12). doi: 10.2807/1560-7917.ES.2018.23.12.17-00140.

Field investigation with real-time virus genetic characterisation support of a cluster of Ebola virus disease cases in Dubréka, Guinea, April to June 2015.

Author information

1
The Public Health Agency of Sweden, Solna, Sweden.
2
European Centre for Disease Prevention and Control (ECDC), Solna, Sweden.
3
Centers for Disease Control and Prevention, Atlanta, Georgia, United States.
4
The European Mobile Laboratory Consortium, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany.
5
Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany.
6
Institute of Microbiology and Infection, University of Birmingham, Birmingham, United Kingdom.
7
Gastrointestinal Bacterial Reference Unit, Colindale, Public Health England, London, United Kingdom.
8
Direction Prefectural de la Santé, Dubréka, Guinea.
9
Postgraduate Training for Applied Epidemiology, Robert Koch Institute, Berlin, Germany.
10
World Health Organization, Conakry, Guinea.
11
Ministère de la Santé, Conakry, Guinea.
12
University of Southampton, South General Hospital, Southampton, United Kingdom.
13
National Infection Service, Public Health England, Porton Down, Wiltshire, United Kingdom.
14
World Health Organization, Geneva, Switzerland.

Abstract

On 11 May 2015, the Dubréka prefecture, Guinea, reported nine laboratory-confirmed cases of Ebola virus disease (EVD). None could be epidemiologically linked to cases previously reported in the prefecture. We describe the epidemiological and molecular investigations of this event. We used the Dubréka EVD registers and the Ebola treatment centre's (ETC) records to characterise chains of transmission. Real-time field Ebola virus sequencing was employed to support epidemiological results. An epidemiological cluster of 32 cases was found, of which 27 were laboratory confirmed, 24 were isolated and 20 died. Real-time viral sequencing on 12 cases demonstrated SL3 lineage viruses with sequences differing by one to three nt inside a single phylogenetic cluster. For isolated cases, the average time between symptom onset and ETC referral was 2.8 days (interquartile range (IQR): 1-4). The average time between sample collection and molecular results' availability was 3 days (IQR: 2-5). In an area with scarce resources, the genetic characterisation supported the outbreak investigations in real time, linking cases where epidemiological investigation was limited and reassuring that the responsible strain was already circulating in Guinea. We recommend coupling thorough epidemiological and genomic investigations to control EVD clusters.

KEYWORDS:

Ebola virus; Guinea; laboratory surveillance; outbreaks; viral haemorrhagic fever

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