This new bit is chilling news> The designated parrot Dr. Frieden's spin should be interesting.
Study: Growing Guinea outbreak caused by new Ebola strain
Filed Under: Ebola; VHF
Lisa Schnirring | Staff Writer | CIDRAP News |
Apr 17, 2014
http://www.cidrap.umn.edu/news-perspective/2014/04/study-growing-guinea-outbreak-caused-new-ebola-strain
The Ebola virus strain responsible for Guinea's outbreak—now at 197 suspected or confirmed cases—is a new strain that has been sickening and killing people at least as far back as December, researchers reported yesterday.
The results of full genetic sequencing suggest that the outbreak in Guinea isn't related to others that have occurred elsewhere in Africa, according to an international team that published its findings online in the New England Journal of Medicine (NEJM).
The report is also the first detailed look at the epidemiologic features among the patients sickened in the early days of the outbreak in the forested region of Guinea, sketching out transmission chains that start with a 2-year-old girl who died in December.
[section on WHO data of April 2014 deleted]
Clinical features, genetic analysis
In the NEJM report, researchers said Guinea's health ministry first learned of clusters of a highly fatal mysterious disease that had been occurring in two cities in the forested region on Mar 10. The finding triggered an epidemiologic investigation by a European team from Doctors without Borders (Medecins Sans Frontieres) and prompted the collection of blood samples and clinical data from 20 patients, which were sent to biosafety level 4 labs for analysis in Lyon, France, and Hamburg, Germany.
Fifteen of the patients tested positive for the virus using conventional filovirus tests, and electron microscopy identified the Ebola virus in the serum of one patient. Researchers isolated the virus from cell culture in samples from five patients.
The team's genetic analysis found a high degree of similarity among 15 partial and 3 full-length sequences. Meanwhile, their full-length sequence analysis revealed that the Ebola clade is separate from other known viruses of its kind.
Clinical investigation found that the most common symptoms among confirmed case-patients were fever, severe diarrhea, and vomiting, but hemorrhage was less common. The case-fatality rate (CFR) of initial cases was 86% and for suspected cases was 71%, consistent with EVD.
Three fruit bat species that are thought to harbor Ebola viruses are found in large parts of West Africa, and the first outbreak in Guinea serves as a warning that the whole West African region is at risk for the disease, the team concluded.
Evidence of single introduction
The group's look back at the transmission chains found that the first suspected case was a 2-year-old girl from Gueckedou prefecture who died in early December. They also found that an infected health worker from the same part of Guinea appears to have spread the virus to Macenta, Nzerekore, and Kissidougou in February. As the outbreak grew, 13 of the confirmed cases could be linked to four clusters.
Researchers concluded that genetic evidence and epidemiologic links between the cases suggests a single introduction of the virus from animals to humans, which could have occurred in early December or before. They wrote that they suspect the virus was transmitted for months before clusters of cases in Gueckedou and Macenta signaled that an outbreak was under way.
Hemorrhage wasn't documented for most of the patients when blood samples were obtained, but could have occurred later, the team noted. They said, however, that the term "Ebola virus disease" was developed to emphasize that hemorrhage isn't seen in all patients. The researchers said the CFR is consistent with previous Ebola outbreaks.
That the Guinea Ebola strain is a separate clade suggests that the pathogen that sparked the outbreak evolved parallel with those seen in the Democratic Republic of Congo and Gabon and was not introduced into Guinea—the first West African nation to experience an Ebola outbreak—from those countries.
Re: my 3276
That comment about this version of EVD having less hemorrhage than previous strains/clades, does this mean what I think it does?
That it delays the ravaging process upon the organs for a bit longer.
That it might allow longer period of mobility without obvious external signs flagging it as EVD as with Patrick Sawyer and others.
And that leads to the question, Have there been autopsy reports published in med journals/NIH/CDC? Seems that would be a high priority task to track effects different from prior strains/clades?