Early transmission and case fatality of Ebola virus at the index site of the 2013–16 west African Ebola outbreak: a cross-sectional seroprevalence survey
作者： Joseph W S Timothy , Yper Hall , Joseph Akoi-Boré , Boubacar Diallo , Thomas R W Tipton
DOI: 10.1016/S1473-3099(18)30791-6
关键词: Ebola virus 、 Transmission (medicine) 、 Case fatality rate 、 Demography 、 Seroprevalence 、 Population 、 Outbreak 、 Epidemiology 、 Odds ratio 、 Medicine 、 Infectious Diseases
摘要: Summary Background To date, epidemiological studies at the index site of 2013–16 west African Ebola outbreak in Meliandou, Guinea, have been restricted their scope. We aimed to determine occurrence previously undocumented virus disease (EVD) cases and infections, reconstruct transmission events. Methods This cross-sectional seroprevalence survey adult population Meliandou used a highly specific oral fluid test detailed interviews all households village key informants. Each household was interviewed, with members prompted describe events outbreak, any illness within household, possible contact suspected cases. Information for deceased individuals provided by relatives living same household. Symptoms were based on Makona variant EVD case definitions (focusing fever, vomiting, diarrhoea). For antibody testing, we an glycoprotein IgG capture enzyme immunoassay developed from validated assay. A maximum exposure level assigned every participant using predetermined scale. generalised linear model (logit function) estimate odds ratios association sociodemographic variables infection. adjusted estimates age exposure, as appropriate. Findings Between June 22, July 9, 2017, enrolled 237 participants 27 Meliandou. Two refused participate one absent. All adults participating who present interview swab which 224 suitable analysis. In addition 11 deaths described previously, basis clinical description found two probable eight unrecognised anti-Ebola IgG-positive survivors, including had mild symptoms asymptomatic, resulting fatality 55·6% (95% CI 30·8–78·5) adults. Health-care work (adjusted ratio 6·64, 1·54–28·56; p=0·001) (odds trend across five levels 2·79, 1·59–4·883; p Interpretation infection more widespread this spillover than recognised (21 vs cases). show first serological evidence survivors (eight seropositive) report lower reported (55·6% 100% adults). These data high community coverage achievable non-invasive and, accurately documenting beginnings reveal important insight into dynamics risk factors that underpin Funding US Food Drug Administration, Wellcome Trust, German Research Council.
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