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vaccine nanoparticles displaying recombinant ebola virus glycoprotein for induction of potent antibody and polyfunctional t cell responses.the recent outbreaks of ebolavirus (ebov) in west africa underscore the urgent need to develop an effective ebov vaccine. here, we report the development of synthetic nanoparticles as a safe and highly immunogenic platform for vaccination against ebov. we show that a large recombinant ebov antigen (rgp) can be incorporated in a configurational manner into lipid-based nanoparticles, termed interbilayer-crosslinked multilamellar vesicles (icmvs). the epitopes and quaternary structure of rgp were p ...201930471480
stillbirths and neonatal deaths surveillance during the 2014-2015 ebola virus disease outbreak in sierra leone.to determine the rate of stillbirth and neonatal death reporting and testing for ebola virus during the 2014-2015 ebola virus disease (evd) outbreak in sierra leone.201930467853
multi-professional simulation and risk perception of health care workers caring for ebola-infected patients.treatment of infections that require high-level isolation can cause anxiety and fear among health care workers. adequate and complete multi-professional simulation-based training could reduce those feelings and improve patient care.201930460729
perspectives towards antiviral drug discovery against ebola virus.ebola virus disease (evd), caused by ebola viruses, resulted in more than 11 500 deaths according to a recent 2018 who report. with mortality rates up to 90%, it is nowadays one of the most deadly infectious diseases. however, no food and drug administration-approved ebola drugs or vaccines are available yet with the mainstay of therapy being supportive care. the high fatality rate and absence of effective treatment or vaccination make ebola virus a category-a biothreat pathogen. fortunately, a ...201930431654
aeromedical transfer of patients with viral hemorrhagic fever.for >40 years, the british royal air force has maintained an aeromedical evacuation facility, the deployable air isolator team (dait), to transport patients with possible or confirmed highly infectious diseases to the united kingdom. since 2012, the dait, a joint department of health and ministry of defence asset, has successfully transferred 1 case-patient with crimean-congo hemorrhagic fever, 5 case-patients with ebola virus disease, and 5 case-patients with high-risk ebola virus exposure. cur ...201930431424
mining of ebola virus entry inhibitors identifies approved drugs as two-pore channel pore blockers.two-pore channels (tpcs) are ca2+-permeable ion channels localised to the endo-lysosomal system where they regulate trafficking of various cargoes including viruses. as a result, tpcs are emerging as important drug targets. however, their pharmacology is ill-defined. there are no approved drugs to target them. and their mechanism of ligand activation is largely unknown. here, we identify a number of fda-approved drugs as tpc pore blockers. using a model of the pore of human tpc2 based on recent ...201930408544
adherence to universal travel screening in the emergency department during epidemic ebola virus disease.during the 2014 west african ebola virus disease (evd) outbreak, the u.s. centers for disease control and prevention recommended that all emergency department (ed) patients undergo travel screening for risk factors of importing evd.201930342859
confronting the threat of bioterrorism: realities, challenges, and defensive strategies.global terrorism is a rapidly growing threat to world security, and increases the risk of bioterrorism. in this review, we discuss the potential threat of bioterrorism, agents that could be exploited, and recent developments in technologies and policy for detecting and controlling epidemics that have been initiated intentionally. the local and international response to infectious disease epidemics, such as the severe acute respiratory syndrome and west african ebola virus epidemic, revealed seri ...201930340981
naturally occurring single mutations in ebola virus observably impact infectivity.sequencing of ebola virus (ebov) genomes during the 2014-2016 epidemic identified several naturally occurring, dominant mutations potentially impacting virulence or tropism. in this study, we characterized ebov variants carrying one of the following substitutions: a82v in the glycoprotein (gp), r111c in the nucleoprotein (np), or d759g in the rna-dependent rna polymerase (l). compared with the wild-type (wt) ebov c07 isolate, np and l mutants conferred a replication advantage in monkey vero e6, ...201930333174
contemporary anti-ebola drug discovery approaches and platforms.the ebola virus has a grave potential to destabilize civil society as we know it. the past few deadly ebola outbreaks were unprecedented in size: the 2014-15 ebola west africa outbreak saw the virus spread from the epicenter through to guinea, sierra leone, nigeria, congo, and liberia. the 2014-15 ebola west africa outbreak was associated with almost 30,000 suspected or confirmed cases and over 11,000 documented deaths. the more recent 2018 outbreak in the democratic republic of congo has so far ...201930516045
surveillance in the field: over-identification of ebola suspect cases and its contributing factors in west african at-risk contexts.during an ebola outbreak, the who recommends that health professionals consider people as suspect cases (scs) when they show key signs such as the sudden onset of high fever or specific symptoms after having had contact with a suspect or confirmed ebola case. scs should then get care, be isolated and be reported to health authorities until the ebola virus disease is confirmed through a lab test. this exploratory study aims to understand this identification process in the field based on a qualita ...201930319027
environmental temperature and case fatality of patients with ebola virus disease in sierra leone and liberia, 2014-2015: a retrospective cohort study.fluid loss during ebola virus disease (evd) infections from gastrointestinal dysfunction leads to volume depletion. it is possible that high environmental temperatures may exacerbate volume depletion or interfere with the provision of medical care by providers in full personal protective equipment. we investigated the effect of environmental temperature on case fatality.201930307686
a novel personal protective equipment coverall was rated higher than standard ebola virus personal protective equipment in terms of comfort, mobility and perception of safety when tested by health care workers in liberia and in a united states biocontainment unit.during the 2014-2016 ebola virus epidemic, more than 500 health care workers (hcws) died in spite of the use of personal protective equipment (ppe). the johns hopkins university center for bioengineering innovation and design (cbid) and jhpiego, an international nongovernmental organization affiliate of johns hopkins, collaborated to create new ppe to improve the ease of the doffing process.201930301656
revitalization of integrated disease surveillance and response in sierra leone post ebola virus disease outbreak.the ministry of health and sanitation (mohs) in sierra leone partially rolled out the implementation of integrated disease surveillance and response (idsr) in 2003. after the ebola virus disease outbreak in 2014-2015, there was need to strengthen idsr to ensure prompt detection and response to epidemic-prone diseases. we describe the processes, successes and challenges of revitalizing public health surveillance in a country recovering from a protracted ebola virus disease outbreak.201930940125
in silico designed ebola virus t-cell multi-epitope dna vaccine constructions are immunogenic in mice.background: the lack of effective vaccines against ebola virus initiates a search for new approaches to overcoming this problem. the aim of the study was to design artificial polyepitope t-cell immunogens⁻⁻candidate dna vaccines against ebola virus and to evaluate their capacity to induce a specific immune response in a laboratory animal model. method: design of two artificial polyepitope t-cell immunogens, one of which (ev.ctl) includes cytotoxic and the other (ev.th)⁻⁻t-helper epitopes of ebol ...201930934980
institutional trust and misinformation in the response to the 2018-19 ebola outbreak in north kivu, dr congo: a population-based survey.the current outbreak of ebola in eastern dr congo, beginning in 2018, emerged in a complex and violent political and security environment. community-level prevention and outbreak control measures appear to be dependent on public trust in relevant authorities and information, but little scholarship has explored these issues. we aimed to investigate the role of trust and misinformation on individual preventive behaviours during an outbreak of ebola virus disease (evd).201930928435
sexual transmission and the probability of an end of the ebola virus disease epidemic.the criteria of zero ebola cases defined by the world health organization did not explicitly account for the sexual transmission and led to multiple recrudescent events in west africa from 2015 to 2016, partly indeed caused by sexual transmission from survivors. we devised a statistical model to compute the probability of the end of an ebola virus disease epidemic, accounting for sexual transmission and under-ascertainment of cases. analyzing the empirical data in guinea, liberia and sierra leon ...201930928349
bayesian inference of transmission chains using timing of symptoms, pathogen genomes and contact data.there exists significant interest in developing statistical and computational tools for inferring 'who infected whom' in an infectious disease outbreak from densely sampled case data, with most recent studies focusing on the analysis of whole genome sequence data. however, genomic data can be poorly informative of transmission events if mutations accumulate too slowly to resolve individual transmission pairs or if there exist multiple pathogens lineages within-host, and there has been little foc ...201930925168
a medical records and data capture and management system for lassa fever in sierra leone: approach, implementation, and challenges.situated in southeastern sierra leone, kenema government hospital (kgh) maintains one of the world's only lassa fever isolation wards and was a strategic ebola virus disease (evd) treatment facility during the 2014 evd outbreak. since 2006, the viral hemorrhagic fever consortium (vhfc) has carried out research activities at kgh, capturing clinical and laboratory data for suspected cases of lassa fever. here we describe the approach, progress, and challenges in designing and maintaining a data ca ...201930921383
control of ebola virus disease outbreaks: comparison of health care worker-targeted and community vaccination strategies.health care workers (hcw) are at risk of infection during ebola virus disease outbreaks and therefore may be targeted for vaccination before or during outbreaks. the effect of these strategies depends on the role of hcw in transmission which is understudied.201930981563
policy and science for global health security: shaping the course of international health.the global burden of infectious diseases and the increased attention to natural, accidental, and deliberate biological threats has resulted in significant investment in infectious disease research. translating the results of these studies to inform prevention, detection, and response efforts often can be challenging, especially if prior relationships and communications have not been established with decision-makers. whatever scientific information is shared with decision-makers before, during, a ...201930974815
inhibitors of signal peptide peptidase and subtilisin/kexin-isozyme 1 inhibit ebola virus glycoprotein-driven cell entry by interfering with activity and cellular localization of endosomal cathepsins.emerging viruses such as severe fever and thrombocytopenia syndrome virus (sftsv) and ebola virus (ebov) are responsible for significant morbidity and mortality. host cell proteases that process the glycoproteins of these viruses are potential targets for antiviral intervention. the aspartyl protease signal peptide peptidase (spp) has recently been shown to be required for processing of the glycoprotein precursor, gn/gc, of bunyamwera virus and for viral infectivity. here, we investigated whethe ...201930973897
shifting the paradigm - applying universal standards of care to ebola virus disease. 201930970184
ebolavirus polymerase uses an unconventional genome replication mechanism.most nonsegmented negative strand (nns) rna virus genomes have complementary 3' and 5' terminal nucleotides because the promoters at the 3' ends of the genomes and antigenomes are almost identical to each other. however, according to published sequences, both ends of ebolavirus genomes show a high degree of variability, and the 3' and 5' terminal nucleotides are not complementary. if correct, this would distinguish the ebolaviruses from other nns rna viruses. therefore, we investigated the termi ...201930962389
dr congo ebola virus treatment centres attacked. 201930957744
comprehensive clinical and laboratory follow-up of a female patient with ebola virus disease: sierra leone ebola virus persistence study.the clinical, virologic, and immunologic findings in a female ebola virus disease patient are described. during the long-term follow-up, ebola virus rna was detectable in vaginal fluid before 36 days after symptom onset, with nearly an identical genome sequence as in acute phase blood. ebola-specific t cells retained activation at 56 days after disease onset.201930949523
understanding long-term effects of ebola virus disease. 201931036880
effectiveness of dettol antiseptic liquid for inactivation of ebola virus in suspension.the efficacy of dettol antiseptic liquid (dal) for inactivating ebola virus (makona c07 variant) (ebov/mak) within an organic load in suspension was evaluated per astm e1052-11. three dal lots were evaluated at dilutions of 1:10, 1:20, and 1:40, with contact times of 0.5, 1, 5, and 10 min. approximately 7 log10 tissue culture infectious dose50 (tcid50) of ebov/mak was exposed to dal at ambient temperature. each dilution tested reduced the infectious ebov/mak titer by ~5 log10 within one min. det ...201931036865
ebola virus disease in women and children. 201931033589
expanding research capacity in sub-saharan africa through informatics, bioinformatics, and data science training programs in mali.bioinformatics and data science research have boundless potential across africa due to its high levels of genetic diversity and disproportionate burden of infectious diseases, including malaria, tuberculosis, hiv and aids, ebola virus disease, and lassa fever. this work lays out an incremental approach for reaching underserved countries in bioinformatics and data science research through a progression of capacity building, training, and research efforts. two global health informatics training pr ...201931031807
ebola virus disease: clinical challenges, recognition, and management.the 2014 to 2016 ebola outbreak response resulted in many lessons learned about biocontainment patient care, leading to enhanced domestic capabilities for highly infectious and hazardous communicable diseases. however, additional opportunities for improvement remain. the article identifies and describes key considerations and challenges for laboratory analysis, clinical management, transportation, and personnel management during the care of patients infected with ebola or other special pathogens ...201931027659
inflammatory and humoral immune response during ebola virus infection in survivor and fatal cases occurred in sierra leone during the 2014⁻2016 outbreak in west africa.ebola virus (ebov) infection is characterized by an excessive inflammatory response, a loss of lymphocytes and a general paralysis of the immune system, however pathophysiological mechanisms are not fully understood. in a cohort of 23 fatal and 21 survivors of ebola virus disease (evd) cases admitted to the emergency ebola-treatment-center in goderich (freetown, sierra leone) during the 2014 to 2016 ebov epidemic in western africa, we analyzed the pathway-focused gene expression profile of secre ...201931018522
identification of ruvbl1 and ruvbl2 as novel cellular interactors of the ebola virus nucleoprotein.ebola virus (ebov) is a filovirus that has become a global public health threat in recent years. ebov is the causative agent of a severe, often fatal hemorrhagic fever. a productive viral infection relies on the successful recruitment of host factors for various stages of the viral life cycle. to date, several investigations have discovered specific host-pathogen interactions for various ebov proteins. however, relatively little is known about the ebov nucleoprotein (np) with regard to host inte ...201931018511
caring for patients with ebola virus disease: are u.s. biocontainment centers ready for the next outbreak?the 2014 west african ebola virus disease (evd) outbreak is the largest and deadliest evd epidemic to date, resulting in fivefold more cases than all other outbreaks combined. this outbreak was particularly devastating to healthcare workers in west africa and resulted in several evd patients being medically evacuated for treatment in the u.s. and europe. governmental agencies provide recommendations for triaging and testing patients with evd, however best laboratory practices are still unknown a ...201931010606
identifying gaps in frontline healthcare facility high-consequence infectious disease preparedness.hospital infection disease preparedness gaps were brought to the forefront during the 2013-2016 ebola virus disease (evd) outbreak. the ability of us hospitals to rapidly identify, isolate, and manage patients with potentially high-consequence pathogens is a critical component to health security. since the evd cases in dallas, texas, the continuity of hospital preparedness has been questionable. while certain hospitals were designated as evd treatment facilities, the readiness of most american h ...201931009258
emerging infectious diseases and antimicrobial resistance (eidar).the infectious disease clinical research program's (idcrp) emerging infectious diseases and antimicrobial resistance (eidar) research area is a department of defense (dod) clinical research capability that is responsive and adaptive to emerging infectious disease (eid) threats to us military readiness. among active-duty and other military health system (mhs) beneficiaries, eidar research is largely focused on evaluating the incidence, risk factors, and acute- and long-term health effects of mili ...201931004432
current status of small molecule drug development for ebola virus and other filoviruses.the filovirus family includes some of the deadliest viruses known, including ebola virus and marburg virus. these viruses cause periodic outbreaks of severe disease that can be spread from person to person, making the filoviruses important public health threats. there remains a need for approved drugs that target all or most members of this virus family. small molecule inhibitors that target conserved functions hold promise as pan-filovirus therapeutics. to date, compounds that effectively targe ...201931003196
the world after ebola: an overview of ebola complications, vaccine development, lessons learned, financial losses, and disease preparedness.the 2014-2016 ebola outbreak in west africa was the largest of its kind with 11,000 deaths and approximately 28,637 affected cases. the aim of the study was to analyze the global situation after the ebola outbreak including ebola complications, vaccine development, lessons learned, financial losses, and disease preparedness. we searched in pubmed, google, and google scholar by using keywords ebola virus, ebola vaccine development and ebola virus transmission, the world after ebola, financial los ...201931002597
serologic prevalence of ebola virus in equatorial africa.we conducted a serologic survey of 2,430 serum samples collected during 1997-2012 for various studies to determine the prevalence of the hemorrhagic fever virus ebola virus (ebov) in equatorial africa. we screened serum samples for neutralizing antibodies by using a pseudotype microneutralization assay and a newly developed luciferase immunoprecipitation system assay. specimens seroreactive for ebov were confirmed by using an elisa. our results suggest a serologic prevalence of 2%-3.5% in the re ...201931002071
retrospective versus real-time ebola virus sequencing. 201931000466
2018 ebola virus disease outbreak in équateur province, democratic republic of the congo: a retrospective genomic characterisation.the 2018 ebola virus disease (evd) outbreak in équateur province, democratic republic of the congo, began on may 8, and was declared over on july 24; it resulted in 54 documented cases and 33 deaths. we did a retrospective genomic characterisation of the outbreak and assessed potential therapeutic agents and vaccine (medical countermeasures).201931000465
medical countermeasures during the 2018 ebola virus disease outbreak in the north kivu and ituri provinces of the democratic republic of the congo: a rapid genomic assessment.the real-time generation of information about pathogen genomes has become a vital goal for transmission analysis and characterisation in rapid outbreak responses. in response to the recently established genomic capacity in the democratic republic of the congo, we explored the real-time generation of genomic information at the start of the 2018 ebola virus disease (evd) outbreak in north kivu province.201931000464
calu-3 cells are largely resistant to entry driven by filovirus glycoproteins and the entry defect can be rescued by directed expression of dc-sign or cathepsin l.priming of the viral glycoprotein (gp) by the cellular proteases cathepsin b and l (catb, catl) is believed to be essential for cell entry of filoviruses. however, pseudotyping systems that predominantly produce non-filamentous particles have frequently been used to prove this concept. here, we report that gp-mediated entry of retroviral-, rhabdoviral and filoviral particles depends on catb/catl activity and that this effect is cell line-independent. moreover, we show that the human cell line ca ...201930999160
development, qualification, and validation of the filovirus animal nonclinical group anti-ebola virus glycoprotein immunoglobulin g enzyme-linked immunosorbent assay for human serum samples.the need for an efficacious vaccine against highly pathogenic filoviruses was reinforced by the recent and devastating 2014-2016 outbreak of ebola virus (ebov) disease in guinea, sierra leone, and liberia that resulted in more than 10,000 casualties. such a vaccine would need to be vetted through a u.s. food and drug administration (fda) traditional, accelerated, or animal rule or similar european medicines agency (ema) regulatory pathway. under the fda animal rule, vaccine-induced immune respon ...201930998735
cross-reactive neutralizing human survivor monoclonal antibody bdbv223 targets the ebolavirus stalk.three ebolavirus genus viruses cause lethal disease and lack targeted therapeutics: ebola virus, sudan virus and bundibugyo virus. monoclonal antibody (mab) cocktails against the surface glycoprotein (gp) present a potential therapeutic strategy. here we report two crystal structures of the antibody bdbv223, alone and complexed with its gp2 stalk epitope, an interesting site for therapeutic/vaccine design due to its high sequence conservation among ebolaviruses. bdbv223, identified in a human su ...201930996276
mechanism of inhibition of ebola virus rna-dependent rna polymerase by remdesivir.remdesivir (gs-5734) is a 1'-cyano-substituted adenosine nucleotide analogue prodrug that shows broad-spectrum antiviral activity against several rna viruses. this compound is currently under clinical development for the treatment of ebola virus disease (evd). while antiviral effects have been demonstrated in cell culture and in non-human primates, the mechanism of action of ebola virus (ebov) inhibition for remdesivir remains to be fully elucidated. the ebov rna-dependent rna polymerase (rdrp) ...201930987343
evaluation of ebola virus disease surveillance system in tonkolili district, sierra leone.the ebola virus disease (evd) epidemic devastated west africa, with sierra leone recording over 50% of the 28,610 cases across the three most affected countries. enhanced surveillance system was developed for improved identification of cases and response in sierra leone. here, we evaluated the surveillance system to determine its strengths and challenges in meeting the set objectives.201930984324
in silico screening of sugar alcohol compounds to inhibit viral matrix protein vp40 of ebola virus.ebola virus is a virulent pathogen that causes highly lethal hemorrhagic fever in human and non-human species. the rapid growth of this virus infection has made the scenario increasingly complicated to control the disease. receptor viral matrix protein (vp40) is highly responsible for the replication and budding of progeny virus. the binding of rna to vp40 could be the crucial factor for the successful lifecycle of the ebola virus. in this study, we aimed to identify the potential drug that coul ...201930982214
extracellular vesicles and ebola virus: a new mechanism of immune evasion.ebola virus (ebov) disease can result in a range of symptoms anywhere from virtually asymptomatic to severe hemorrhagic fever during acute infection. additionally, spans of asymptomatic persistence in recovering survivors is possible, during which transmission of the virus may occur. in acute infection, substantial cytokine storm and bystander lymphocyte apoptosis take place, resulting in uncontrolled, systemic inflammation in affected individuals. recently, studies have demonstrated the presenc ...201931052499
characterisation of infectious ebola virus from the ongoing outbreak to guide response activities in the democratic republic of the congo: a phylogenetic and in vitro analysis.the ongoing ebola virus outbreak in the ituri and north kivu provinces of the democratic republic of the congo, which began in july, 2018, is the second largest ever recorded. despite civil unrest, outbreak control measures and the administration of experimental therapies and a vaccine have been initiated. the aim of this study was to test the efficacy of candidate therapies and diagnostic tests with the outbreak strain ituri ebola virus. lacking a virus isolate from this outbreak, a recombinant ...201931300330
progress in elucidating potential markers and mechanisms of rapid protection conferred by the vsv-vectored ebola virus vaccine.research progress over the past 20 years has yielded several experimental ebola virus (ebov) vaccine candidates, which were shown to be effective in nonhuman primates when given 28 days before a lethal challenge. of these, the vesicular stomatitis virus (vsv)-vectored vaccine against ebov (vsv-ebov) is unique at being able to induce rapid protection, with 100% survival achieved as soon as 7 days after ebov challenge. in a recent mbio article, menicucci et al. carried out a transcriptome analysis ...201931311887
repurposing quinacrine against ebola virus infection in vivo.quinacrine hydrochloride is a small-molecule, orally bioavailable drug that has been used clinically as an antimalarial and for many other applications. a machine learning model trained on ebola virus (ebov) screening data identified quinacrine as a potent (nanomolar) in vitro inhibitor. in the current study, quinacrine 25 mg/kg was shown to protect 70% of mice (statistically significant) from a lethal challenge with mouse-adapted ebov with once-daily intraperitoneal dosing for 8 days.201931307979
dendritic cells/macrophages-targeting feature of ebola glycoprotein and its potential as immunological facilitator for antiviral vaccine approach.in the prevention of epidemic and pandemic viral infection, the use of the antiviral vaccine has been the most successful biotechnological and biomedical approach. in recent times, vaccine development studies have focused on recruiting and targeting immunogens to dendritic cells (dcs) and macrophages to induce innate and adaptive immune responses. interestingly, ebola virus (ebov) glycoprotein (gp) has a strong binding affinity with dcs and macrophages. shreds of evidence have also shown that th ...201931569539
ebola virus: pathogenesis and countermeasure development.since its discovery in 1976, ebola virus (ebov) has caused numerous outbreaks of fatal hemorrhagic disease in africa. the biggest outbreak on record is the 2013-2016 epidemic in west africa with almost 30,000 cases and over 11,000 fatalities, devastatingly affecting guinea, liberia, and sierra leone. the epidemic highlighted the need for licensed drugs or vaccines to quickly combat the disease. while at the beginning of the epidemic no licensed countermeasures were available, several experimenta ...201931567063
ensuring on-site ebola patient monitoring and follow-up: development of a laboratory structure embedded in an ebola treatment center.the capacity to rapidly distinguish ebola virus disease from other infectious diseases and to monitor biochemistry and viremia levels is crucial to the clinical management of suspected ebola virus disease cases. this article describes the design and practical considerations of a laboratory straddling the high- and low-risk zones of an ebola treatment center to produce timely diagnostic and clinical results for informed case management of ebola virus disease in real-life conditions. this innovati ...201931232266
operational research: did health systems in sierra leone recover after the 2014-15 ebola outbreak?findings from participants who attended the second post-ebola sort-it course are reported in five short papers on the "legacy of ebola on health systems in sierra-leone". after a decline of health service provision and utilisation during the ebola outbreak, present findings show recovery over time in the post-ebola period. however, important challenges remain, including an important health workforce gap.201931231516
one month follow up of a neonate born to a mother who survived ebola virus disease during pregnancy: a case report in the democratic republic of congo.the authors report a 1 month follow up of a neonate described as "miracle baby" because she was born ebola virus disease-free and survived after her mother was infected with ebola virus during the third trimester of pregnancy.201931215482
trends of and factors associated with cesarean section related surgical site infections in guinea.since the adoption of free obstetric care policy in guinea in 2011, no study has examined the surgical site infections in maternity facilities. the objective of this study was to assess the trends of and factors associated with surgical site infection following cesarean section in guinean maternity facilities from 2013 to 2015. this was a retrospective cohort study using routine medical data from ten facilities. overall, the incidence of surgical site infections following cesarean section showed ...201931214304
world health organization resists declaring ebola emergency - for third time. 201931213685
[bushmeat, human impacts and human health in tropical rainforests: the ebola virus case].at a time when more than 5 million tonnes of bushmeat are harvested annually from tropical forests, and which account for a significant, but unrecorded, share of the gross domestic product of many forest countries, decision makers are encouraged, within conservation and food security policies, to understand the role that wildlife can play in the conservation of ecosystem services. in this article, we present an analysis of the problem, describing the role played by bushmeat in human diets, and t ...201931210471
active monitoring versus direct active monitoring for ebola virus disease in the united states: experiences and perceptions of former persons under monitoring in the district of columbia and indiana.during the 2014-2016 west africa ebola outbreak, the centers for disease control and prevention recommended daily monitoring and surveillance of persons arriving in the united states (us) from impacted areas through either active monitoring (phone calls, online platforms, and so on) or direct active monitoring (in-person or electronic visualization). intensiveness of policies implemented by state/local jurisdictions varied markedly. to study the experiences and perceptions of active monitoring v ...201931207426
centers for disease control and prevention's temporary epidemiology field assignee program: supporting state and local preparedness in the wake of ebola.the centers for disease control and prevention launched the temporary epidemiology field assignee (tefa) program to help state and local jurisdictions respond to the risk of ebola virus importation during the 2014-2016 ebola outbreak in west africa. we describe steps taken to launch the 2-year program, its outcomes and lessons learned.201931205697
sequencing of mrna from whole blood using nanopore sequencing.sequencing in remote locations and resource-poor settings presents unique challenges. nanopore sequencing can be successfully used under such conditions, and was deployed to west africa during the recent ebola virus epidemic, highlighting this possibility. in addition to its practical advantages (low cost, ease of equipment transport and use), this technology also provides fundamental advantages over second-generation sequencing approaches, particularly the very long read length, ability to dire ...201931205309
logistical challenges in the dr congo ebola virus response. 201931204652
t-705 induces lethal mutagenesis in ebola and marburg populations in macaques.nucleoside analogues (na) disrupt rna viral rna-dependent rna polymerase (rdrp) function and fidelity for multiple viral families. the mechanism of action (moa) of t-705 has been attributed alternatively or concurrently to chain termination and lethal mutagenesis depending on the viral species during in vitro studies. in this study, we evaluated the effect of t-705 on the viral population in non-human primates (nhps) after challenge with ebola virus (ebov) or marburg virus (marv) to identify the ...201931195019
estimating undetected ebola spillovers.the preparedness of health systems to detect, treat, and prevent onward transmission of ebola virus disease (evd) is central to mitigating future outbreaks. early detection of outbreaks is critical to timely response, but estimating detection rates is difficult because unreported spillover events and outbreaks do not generate data. using three independent datasets available on the distributions of secondary infections during evd outbreaks across west africa, in a single district (western area) o ...201931194734
roles of yigl sequence of ebola virus vp40 on genome replication and particle production.ebola virus (ebov) vp40 is a major driving force of nascent virion production and a negative regulator of genome replication/transcription. here, we showed that the yigl sequence at the c-terminus of ebov vp40 is important for virus-like particle (vlp) production and the regulation of genome replication/transcription. accordingly, a mutation in the yigl sequence caused defects in vlp production and genome replication/transcription. the residues i293 and l295 in the yigl sequence were particularl ...201931184566
inhibition of marburg virus rna synthesis by a synthetic anti-vp35 antibody.marburg virus causes sporadic outbreaks of severe hemorrhagic fever with high case fatality rates. approved, effective, and safe therapeutic or prophylactic countermeasures are lacking. to address this, we used phage display to engineer a synthetic antibody, sfab h3, which binds the marburg virus vp35 protein (mvp35). mvp35 is a critical cofactor of the viral replication complex and a viral immune antagonist. sfab h3 displayed high specificity for mvp35 and not for the closely related ebola viru ...201931120240
characterization of novel splice variants of zinc finger antiviral protein (zap).given the unprecedented scale of the recent ebola and zika viral epidemics, it is crucial to understand the biology of host factors with broad antiviral action in order to develop novel therapeutic approaches. here, we look into one such factor: zinc finger antiviral protein (zap) inhibits a variety of rna and dna viruses. alternative splicing results in two isoforms that differ at their c termini: zapl (long) encodes a poly(adp-ribose) polymerase (parp)-like domain that is missing in zaps (shor ...201931118263
creating a national specimen referral system in guinea: lessons from initial development and implementation.in the wake of the 2014-2016, west africa ebola virus disease (evd) outbreak, the government of guinea recognized an opportunity to strengthen its national laboratory system, incorporating capacity and investments developed during the response. the ministry of health (moh) identified creation of a holistic, safe, secure, and timely national specimen referral system as a priority for improved detection and confirmation of priority diseases, in line with national integrated disease surveillance an ...201931111025
longitudinal analysis of the human b cell response to ebola virus infection.ebola virus (ebov) remains a public health threat. we performed a longitudinal study of b cell responses to ebov in four survivors of the 2014 west african outbreak. infection induced lasting ebov-specific immunoglobulin g (igg) antibodies, but their subclass composition changed over time, with igg1 persisting, igg3 rapidly declining, and igg4 appearing late. striking changes occurred in the immunoglobulin repertoire, with massive recruitment of naive b cells that subsequently underwent hypermut ...201931104840
the natural product eugenol is an inhibitor of the ebola virus in vitro.since the 2014 ebola virus (ebov) outbreak in west africa there has been considerable effort towards developing drugs to treat ebola virus disease and yet to date there is no fda approved treatment. this is important as at the time of writing this manuscript there is an ongoing outbreak in the democratic republic of the congo which has killed over 1000.201931101988
incorporation of ebola glycoprotein into hiv particles facilitates dendritic cell and macrophage targeting and enhances hiv-specific immune responses.the development of an effective vaccine against hiv infection remains a global priority. dendritic cell (dc)-based hiv immunotherapeutic vaccine is a promising approach which aims at optimizing the hiv-specific immune response using primed dcs to promote and enhance both the cellular and humoral arms of immunity. since the ebola virus envelope glycoprotein (ebogp) has strong dc-targeting ability, we investigated whether ebogp is able to direct hiv particles towards dcs efficiently and promote po ...201931100082
complete genome sequence of a new ebola virus strain isolated during the 2017 likati outbreak in the democratic republic of the congo.genomic sequencing for early identification of ebola virus remains a big challenge in low-income countries. here, we report the complete genome sequence of an ebola virus strain obtained during the 2017 likati outbreak in the democratic republic of the congo (drc) by using the oxford nanopore technologies (ont) minion sequencer.201931097506
association of ebola virus infection with hearing loss in regions where ebola virus infection is endemic: a systematic review.many survivors of ebola virus infection describe new-onset hearing loss after infection. the prevalence, severity, and pathophysiologic features of hearing loss in this population have not been well characterized.201931095264
identification of ebola virus inhibitors targeting gp2 using principles of molecular mimicry.a key step in the ebola virus (ebov) replication cycle involves conformational changes in viral glycoprotein 2 (gp2) which facilitate host-viral membrane fusion and subsequent release of the viral genome. ebola gp2 plays a critical role in virus entry and has similarities in mechanism and structure to the hiv gp41 protein for which inhibitors have been successfully developed. in this work, a putative binding pocket for the c-terminal heptad repeat in the n-terminal heptad repeat trimer was targe ...201931092576
utilizing the focused conversation method in qualitative public health research: a team-based approach.qualitative research studies are becoming increasingly necessary to understand the complex challenges in the healthcare setting. successfully integrating interdisciplinary teams of investigators can be challenging, as investigators inherently view data through their disciplinary lens. thus, new methods, such as focused conservation, are needed to facilitate qualitative data analysis by interdisciplinary teams. the purpose of this manuscript is to provide a clear description of how we implemented ...201931088551
in silico selection of amplification targets for rapid polymorphism screening in ebola virus outbreaks.to achieve maximum transmission chain tracking in the current ebola outbreak, whole genome sequencing (wgs) has been proposed to provide optimal information. however, wgs remains a costly and time-intensive procedure that is poorly suited for the large numbers of samples being generated, especially under severe time and work-environment constraints as in the present drc outbreak. to better prepare for future outbreaks, where an apparent single outbreak may actually represent overlapping outbreak ...201931080442
analyzing and forecasting the ebola incidence in north kivu, the democratic republic of the congo from 2018-19 in real time.during an ebola virus disease (evd) outbreak, the analysis and forecasting of the incidence in real time is challenged by reporting of cases, especially the reporting delay. it should be remembered that the latest count of cases is likely underestimated in real time, and moreover, the effective reproduction number, i.e. the average number of secondary cases generated by a single primary case at a given point in time, is also underestimated without proper adjustment. the present study aimed to ad ...201931080016
backbone resonance assignments and secondary structure of ebola nucleoprotein 600-739 construct.ebola viral infections have resulted in several deadly epidemics in recent years in west and central africa. because only one of the seven proteins encoded by the viral genome possesses enzymatic activity, disruption of protein-protein interactions is a promising route for antiviral drug development. we carried out a screening campaign to identify small, drug-like compounds that bind to the c-terminal region of the multifunctional ebola nucleoprotein (enp) with the objective of discovering ones ...201931076990
intranasal immunization with recombinant vaccinia virus tiantan harboring zaire ebola virus gp elicited systemic and mucosal neutralizing antibody in mice.accumulating literature revealed that human mucosa was likely one of the important routes for ebov attachment and further infection. therefore inducing effective mucosal immune responses play key role in preventing the virus infection. vaccinia virus tiantan strain (vv) was a remarkably attenuated poxvirus, which has been broadly exploited as a multifunctional vector during the development of genetically recombinant vaccine and cancer therapeutic agent. in this study, we generated a recombinant ...201931076161
conserved b and t cell epitopes prediction of ebola virus glycoprotein for vaccine development: an immuno-informatics approach.ebola virus (ebov), a non-segmented single-stranded rna virus, is often-most transmitted through body fluids like sweat, tears, saliva, and nasal secretions. till date, there is no licensed vaccine of ebov is available in the market; however, the world is increasingly vulnerable to this emerging threat. hence, it is the need of time to develop a vaccine for ebov to hinder its dissemination. the current study has been designed for identification and characterization of the potential b and t-cell ...201931075428
reproductive health sequelae among women who survived ebola virus disease in liberia.to estimate the incidence of failed pregnancy and menstrual irregularities among liberian women who had survived ebola virus disease (evd) and to identify host-specific and disease-specific factors associated with these outcomes.201931074837
evaluation of the sick returned traveler.infections are common during travel, and frontline physicians frequently must evaluate sick returned travelers. sick travelers can be clinically challenging due to the wide range of endemic diseases in different geographic regions. to guide the diagnostic and treatment plan, consideration of endemic and emerging infections in the region of travel, as well as careful review of the travelers' exposures and preventative measures are necessary. routine laboratory tests and cultures cannot confirm ma ...201931072653
ebola virus vp35 has novel ntpase and helicase-like activities.ebola virus (ebov) is a non-segmented, negative-sense rna virus (nnsv) in the family filoviridae, and is recognized as one of the most lethal pathogens in the planet. for rna viruses, cellular or virus-encoded rna helicases play pivotal roles in viral life cycles by remodelling viral rna structures and/or unwinding viral dsrna produced during replication. however, no helicase or helicase-like activity has ever been found to associate with any nnsv-encoded proteins, and it is unknown whether the ...201931066445
author correction: infection with the makona variant results in a delayed and distinct host immune response compared to previous ebola virus variants.a correction to this article has been published and is linked from the html and pdf versions of this paper. the error has not been fixed in the paper.201931065012
glucopyranosyl lipid adjuvant enhances immune response to ebola virus-like particle vaccine in mice.the identification of adjuvants that promote lasting antigen-specific immunity and augment vaccine efficacy are integral to the development of new protein-based vaccines. the ebola virus-like particle (vlp) vaccine expressing ebola virus glycoprotein (gp) and matrix protein (vp40) was used in this study to evaluate the ability of tlr4 agonist glucopyranosyl lipid adjuvant (gla) formulated in a stable emulsion (se) to enhance immunogenicity and promote durable protection against mouse-adapted ebo ...201931174937
the impact of various promotional activities on ebola prevention behaviors and psychosocial factors predicting ebola prevention behaviors in the gambia evaluation of ebola prevention promotions.the outbreak of the ebola virus disease (evd) from 2014 to 2016 is over. however, several outbreaks of contagious diseases have already arisen and will recur. this paper aims to evaluate the effectiveness of evd prevention promotions in the gambia and to assess the psychosocial factors that steer three behaviors: handwashing with soap, calling the ebola hotline, and not touching a person who might be suffering from evd. in 2015, data were gathered from 498 primary care providers. the questionnai ...201931174301
developing a personal protective equipment selection matrix for preventing occupational exposure to ebola virus.in response to the 2014 ebola outbreak in west africa and resulting cases in the united states, the occupational safety and health administration developed a personal protective equipment selection matrix to help employers protect workers from exposure to ebola virus in the event of additional us cases. now, the world's second largest ebola outbreak on record continues to expand in the democratic republic of congo, where more than 70 ebola-infected healthcare workers serve as reminders of the im ...201931173502
ultrasensitive ebola virus antigen sensing via 3d nanoantenna arrays.sensitive detection of pathogens is crucial for early disease diagnosis and quarantine, which is of tremendous need in controlling severe and fatal illness epidemics such as of ebola virus (ebov) disease. serology assays can detect ebov-specific antigens and antibodies cost-effectively without sophisticated equipment; however, they are less sensitive than reverse transcriptase polymerase chain reaction (rt-pcr) tests. herein, a 3d plasmonic nanoantenna assay sensor is developed as an on-chip imm ...201931168856
effect of gamma irradiation on the antibody response measured in human serum from subjects vaccinated with recombinant vesicular stomatitis virus-zaire ebola virus envelope glycoprotein vaccine.rvsvδg-zebov-gp vaccine is a live recombinant (r) vesicular stomatitis virus (vsv), where the vsv g protein is replaced with the zaire ebola virus (zebov) glycoprotein (gp). for vaccine immunogenicity testing, clinical trial sera collected during an active zebov outbreak underwent gamma irradiation (gi) before testing in biosafety level 2 laboratories to inactivate possible wild-type zebov. before irradiating pivotal trial samples, two independent studies evaluated the impact of gi (50 kgy) on b ...201931162004
geographic charisma and the potential energy of ebola.the ebola virus is unparalleled in its charismatic ability to ignite fear, anxiety and disgust at a scale grossly disproportionate to the number of lives it claims. as an archetypal 'emerging infectious disease' (eid), this designation and the politics that have encircled it have provided ebola with a conceptual space in which epidemiology and geography to splice together in the genesis and maintenance of its charismatic valence. even before the west african outbreak of 2013-2016, ebola was an ' ...201931155737
ebola virus replication stands out.a recent study by deflubé et al. (proc. natl. acad. sci. u. s. a. 2019;116:8535-8543) reported that ebola virus genomes have variable 3' terminal nucleotides. this finding is a departure from other nonsegmented, negative-strand rna viruses (nnsvs) that have been studied to date and has broad implications for filoviral replication and innate immune evasion.201931155428
responding to the ebola virus disease outbreak in dr congo: when will we learn from sierra leone? 201931153643
intra-host ebola viral adaption during human infection.the onsite next generation sequencing (ngs) of ebola virus (ebov) genomes during the 2013-2016 ebola epidemic in western africa provides an opportunity to trace the origin, transmission, and evolution of this virus. herein, we have diagnosed a cohort of ebov patients in sierra leone in 2015, during the late phase of the outbreak. the surviving ebov patients had a recovery process characterized by decreasing viremia, fever, and biochemical parameters. ebov genomes sequenced through the longitudin ...201932835207
a qualitative study assessing the feasibility of implementing a group cognitive-behavioural therapy-based intervention in sierra leone.mental health support in sierra leone is sparse, and qualitative research into the feasibility of implementing psychological interventions is equally underdeveloped. following the 2014 ebola virus disease outbreak, south london and maudsley nhs trust were commissioned to develop a psychological intervention that uk clinicians could train national staff with minimal psychological experience to deliver to their peers. following the completion of the stepped care, group-based cognitive-behavioural ...201931144684
can tracking people through phone-call data improve lives? 201931142864
the mental health professional at the feet of the ebola virus: individual treatment and global mental challenges.summarymental health professionals form an important component of the response teams currently working in the democratic republic of the congo to treat what is historically the second-largest ebola outbreak. they provide psychological treatment to patients under extraordinary conditions, helping them cope with anxiety and the daily death of other patients.declaration of interestnone.201931142389
evaluating temperature sensitivity of vesicular stomatitis virus-based vaccines.use of the vesicular stomatitis virus (vsv)-based ebola virus vaccine during outbreaks and the potential use of a similar vsv-based lassa virus vaccine has raised questions about the vaccines' stability should the cold chain fail. we demonstrated that current cold chain conditions might tolerate significant variances without affecting efficacy.201931141474
synthesis and structure-activity relationships of 3,5-disubstituted-pyrrolo[2,3- b]pyridines as inhibitors of adaptor-associated kinase 1 with antiviral activity.there are currently no approved drugs for the treatment of emerging viral infections, such as dengue and ebola. adaptor-associated kinase 1 (aak1) is a cellular serine-threonine protein kinase that functions as a key regulator of the clathrin-associated host adaptor proteins and regulates the intracellular trafficking of multiple unrelated rna viruses. moreover, aak1 is overexpressed specifically in dengue virus-infected but not bystander cells. because aak1 is a promising antiviral drug target, ...201931136173
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