Surveillance and outbreak report Open Access
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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.


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  1. Helleringer S, Noymer A. Magnitude of Ebola relative to other causes of death in Liberia, Sierra Leone, and Guinea. Lancet Glob Health. 2015;3(5):e255-6.  https://doi.org/10.1016/S2214-109X(15)70103-8  PMID: 25889466 
  2. Baize S, Pannetier D, Oestereich L, Rieger T, Koivogui L, Magassouba N, et al. Emergence of Zaire Ebola virus disease in Guinea. N Engl J Med. 2014;371(15):1418-25.  https://doi.org/10.1056/NEJMoa1404505  PMID: 24738640 
  3. Zinszer K, Morrison K, Anema A, Majumder MS, Brownstein JS. The velocity of Ebola spread in parts of west Africa. Lancet Infect Dis. 2015;15(9):1005-7.  https://doi.org/10.1016/S1473-3099(15)00234-0  PMID: 26333328 
  4. Carroll MW, Matthews DA, Hiscox JA, Elmore MJ, Pollakis G, Rambaut A, et al. Temporal and spatial analysis of the 2014-2015 Ebola virus outbreak in West Africa. Nature. 2015;524(7563):97-101.  https://doi.org/10.1038/nature14594  PMID: 26083749 
  5. World Health Organization. Situation report - Ebola virus disease 10 June 2016 Geneva, Switzerland2016 [Accessed 12 Nov 2016]. Available from: http://apps.who.int/iris/bitstream/10665/208883/1/ebolasitrep_10Jun2016_eng.pdf?ua=1
  6. European Centre for Disease Prevention and Control (ECDC). Outbreak of Ebola virus disease in West Africa. 10th update – 14 April 2015. Stockholm, Sweden: ECDC; 2015.
  7. European Centre for Disease Prevention and Control (ECDC). Outbreak of Ebola virus disease in West Africa. 11th update – 11 May 2015. Stockholm, Sweden: ECDC; 2015.
  8. World Health Organization (WHO). Situation report - Ebola virus disease 8 July 2015. Geneva: WHO; 2015.
  9. European Centre for Disease Prevention and Control (ECDC). Outbreak of Ebola virus disease in West Africa. 13th update – 13 October 2015. Stockholm, Sweden: ECDC; 2015.
  10. World Health Organization (WHO). Situation report - Ebola virus disease 6 May 2015. Geneva: WHO; 2015.
  11. Quick J, Loman NJ, Duraffour S, Simpson JT, Severi E, Cowley L, et al. Real-time, portable genome sequencing for Ebola surveillance. Nature. 2016;530(7589):228-32.  https://doi.org/10.1038/nature16996  PMID: 26840485 
  12. Institut National de la Statistique. Répartition population et densité par Région et Préfecture Conakry, Guinea. [Accessed 07 Sep 2016]. Available from: http://www.stat-guinee.org/index.php/statistiques/donnees-structurelles/demographie/31-population-densite-region-prefecture
  13. World Health Organization (WHO). Situation Epidémiologique Hebdomadaire Epidémie d’Ebola en Guinée, Semaine 19, 2015. Conakry, Guinée: 2015. WHO; [Accessed 13 May 2015]. French. Available from: https://guinea-ebov.github.io/code/files/sitreps/hebdo/SitRep_hebdo_Guinee_Semaine19_2015.pdf
  14. World Health Organization (WHO). Situation Epidémiologique Hebdomadaire Epidémie d’Ebola en Guinée, Semaine 20, 2015. Conakry, Guinée: 2015. [Accessed 20 May 2015]. French. Available from: https://guinea-ebov.github.io/code/files/sitreps/hebdo/SitRep_hebdo_Guinee_Semaine20_2015.pdf
  15. World Health Organization (WHO). Ebola virus disease. Geneva: WHO; 2018. Available from: http://www.who.int/mediacentre/factsheets/fs103/en/
  16. World Health Organization (WHO). Field Situation: how to conduct safe and dignified burial of a patient who has died from suspected or confirmed Ebola virus disases. Geneva: WHO; 2014. Available from: http://www.who.int/mediacentre/news/notes/2014/ebola-burial-protocol/en
  17. Holmes EC, Dudas G, Rambaut A, Andersen KG. The evolution of Ebola virus: Insights from the 2013-2016 epidemic. Nature. 2016;538(7624):193-200.  https://doi.org/10.1038/nature19790  PMID: 27734858 
  18. Shears P, O’Dempsey TJ. Ebola virus disease in Africa: epidemiology and nosocomial transmission. J Hosp Infect. 2015;90(1):1-9.  https://doi.org/10.1016/j.jhin.2015.01.002  PMID: 25655197 
  19. Faye O, Boëlle PY, Heleze E, Faye O, Loucoubar C, Magassouba N, et al. Chains of transmission and control of Ebola virus disease in Conakry, Guinea, in 2014: an observational study. Lancet Infect Dis. 2015;15(3):320-6.  https://doi.org/10.1016/S1473-3099(14)71075-8  PMID: 25619149 
  20. WHO Ebola Response Team. Ebola virus disease in West Africa--the first 9 months of the epidemic and forward projections. N Engl J Med. 2014;371(16):1481-95.  https://doi.org/10.1056/NEJMoa1411100  PMID: 25244186 
  21. World Health Organization (WHO). 2015 WHO Strategic Response Plan - West Africa Ebola Outbreak. Geneva: WHO; 2016.
  22. Ebola ça Suffit Ring Vaccination Trial Consortium. The ring vaccination trial: a novel cluster randomised controlled trial design to evaluate vaccine efficacy and effectiveness during outbreaks, with special reference to Ebola. BMJ. 2015;351:h3740. PMID: 26215666 
  23. Henao-Restrepo AM, Longini IM, Egger M, Dean NE, Edmunds WJ, Camacho A, et al. Efficacy and effectiveness of an rVSV-vectored vaccine expressing Ebola surface glycoprotein: interim results from the Guinea ring vaccination cluster-randomised trial. Lancet. 2015;386(9996):857-66.  https://doi.org/10.1016/S0140-6736(15)61117-5  PMID: 26248676 

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