Fidest – Agenzia giornalistica/press agency

Quotidiano di informazione – Anno 29 n° 20

New important insights in potential role of respiratory compartment in human-to-human Ebola virus transmission

Posted by fidest press agency su lunedì, 9 gennaio 2017

For the first time, evidence of Ebola virus (EBOV) replication in the lungs of a patient recovering from infection has been found by an international group of scientists. The study was led by the National Institute for Infectious Diseases “Lazzaro Spallanzani” (INMI) in Rome (Italy) in collaboration with colleagues from University College in London (UK), Friedrich-Loeffler-Institut Riems (Germany) and Université Laval, Quebec (Canada). ebola-virusThe devastating 2013-2016 Ebola outbreak in West Africa, resulted in 28,610 cases and 11,308 deaths. The rapid spread of the Ebola represented many unprecedented public health challenges. Of major concern was the high risk of person to person spread and defining the actual mode of transmission. Whilst studies on Ebola patients evacuated to Europe and USA for treatment have suggested that Ebola might cause lung damage, evidence of lung infection by the Ebola virus is lacking.The study by Biava et al. to be published on January 5, 2017 in PLOS Pathogens investigated the presence of Ebola virus genetic material in the lungs and blood during treatment and recovery of a healthcare worker who was evacuated from West Africa and treated in Rome, Italy. The patient showed persistence of EBOV replication markers within the respiratory tract. The researchers monitored the levels of EBOV viral RNAs (negative and positive sense RNAs) known to be associated with Ebola replication, and compared these with viral RNAs levels in the patient’s blood. They found that viral RNA and viral replication markers remained in the lungs (lower respiratory tract) for up to five days after it was no longer detectable in the blood. The results suggest that EBOV may replicate in the lungs, although it is possible that the lungs simply provided a protective environment that allowed RNA to linger longer than it did in the blood. However, the scientists note the presence of RNA for both total RNA and replication markers in the lungs, supporting the possibility of active replication.Senior author of the study, Giuseppe Ippolito, from INMI in Rome said: “These results suggest an important role of the respiratory tract in the pathogenesis of Ebola virus disease and may have new implications for infection prevention and control measures, especially for healthcare workers and family providing direct and non-direct care to Ebola patients in healthcare facilities. It also raises concerns regarding potential risk of human-to-human transmission and the need to redesign prevention control measures.”
Co-author, Professor Alimuddin Zumla of University College London stated that “the findings of the study are significant and it may explain the rapid spread of the outbreak, and the cluster of Ebola cases which were reported in the West African outbreak where no source of the chain of transmission was identified”. He added that “further studies are required to better understand the actual role of EBOV in lung pathology, and the specific role of aerosol transmission of EBOV from infected patients. These missed research opportunities during the Ebola epidemic highlight the critical need for funders and governments to build capacity and empower local scientists and healthcare workers to enable them to conduct priority basic science, pathogenesis and clinical trials research during outbreaks.” (Giuseppe Ippolito MD Scientific Director National Institute for Infectious Diseases Lazzaro Spallanzani)

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