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

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Titre

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

Sujet

Research

Description

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.

Créateur

Mbala-Kingebeni P, Aziza A, Di Paola N, Wiley MR, Makiala-Mandanda S, Caviness K, Pratt CB, Ladner JT, Kugelman JR, Prieto K, Chitty JA, Larson PA, Beitzel B, Ayouba A, Vidal N, Karhemere S, Diop M, Diagne MM, Faye M, Faye O, Aruna A, Nsio J, Mulangu F, Mukadi D, Mukadi P, Kombe J, Mulumba A, Villabona-Arenas CJ, Pukuta E, Gonzalez J, Bartlett ML, Sozhamannan S, Gross SM, Schroth GP, Tim R, Zhao JJ, Kuhn JH, Diallo B, Yao M, Fall IS, Ndjoloko B, Mossoko M, Lacroix A, Delaporte E, Sanchez-Lockhart M, Sall AA, Muyembe-Tamfum JJ, Peeters M, Palacios G, Ahuka-Mundeke S.

Date

2019-04-15

Type

Publication

Citer ce document

Mbala-Kingebeni, P., A. Aziza, N. Di Paola, M. R. Wiley, S. Makiala-Mandanda, K. Caviness, C. B. Pratt, J. T. Ladner, J. R. Kugelman, K. Prieto, J. A. Chitty, P. A. Larson, B. Beitzel, A. Ayouba, N. Vidal, S. Karhemere, M. Diop, M. M. Diagne, M. Faye, O. Faye, A. Aruna, J. Nsio, F. Mulangu, D. Mukadi, P. Mukadi, J. Kombe, A. Mulumba, C. J. Villabona-Arenas, E. Pukuta, J. Gonzalez, M. L. Bartlett, S. Sozhamannan, S. M. Gross, G. P. Schroth, R. Tim, J. J. Zhao, J. H. Kuhn, B. Diallo, M. Yao, I. S. Fall, B. Ndjoloko, M. Mossoko, A. Lacroix, E. Delaporte, M. Sanchez-Lockhart, A. A. Sall, J. J. Muyembe-Tamfum, M. Peeters, G. Palacios, and S. Ahuka-Mundeke. 2019. "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 Lancet. Infectious diseases 19 (6):648-57.

Résumé

Abstract

BACKGROUND:

METHODS:

We used targeted-enrichment sequencing to produce two coding-complete Ebola virus genomes 5 days after declaration of the EVD outbreak in North Kivu. Subsequent sequencing efforts yielded an additional 46 genomes. Genomic information was used to assess early transmission, medical countermeasures, and evolution of Ebola virus.

FINDINGS:

The genomic information demonstrated that the EVD outbreak in the North Kivu and Ituri Provinces was distinct from the 2018 EVD outbreak in Équateur Province of the Democratic Republic of the Congo. Primer and probe mismatches to Ebola virus were identified in silico for all deployed diagnostic PCR assays, with the exception of the Cepheid GeneXpert GP assay.

INTERPRETATION:

The first two coding-complete genomes provided actionable information in real-time for the deployment of the rVSVΔG-ZEBOV-GP Ebola virus envelope glycoprotein vaccine, available therapeutics, and sequence-based diagnostic assays. Based on the mutations identified in the Ebola virus surface glycoprotein (GP₁₂) observed in all 48 genomes, deployed monoclonal antibody therapeutics (mAb114 and ZMapp) should be efficacious against the circulating Ebola virus variant. Rapid Ebola virus genomic characterisation should be included in routine EVD outbreak response procedures to ascertain efficacy of medical countermeasures.