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      Serology and Behavioral Perspectives on Ebola Virus Disease Among Bushmeat Vendors in Equateur, Democratic Republic of the Congo, After the 2018 Outbreak

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          Abstract

          After the 2018 Ebola outbreak in Equateur Province, Democratic Republic of the Congo, we conducted behavioral interviews and collected samples from bushmeat vendors and primates in Mbandaka to test for evidence of Ebola virus exposure. Although participants indicated being aware of Ebola, they did not consider themselves at occupational risk for infection. We found antibodies against Zaire ebolavirus in one participant despite no reported history of disease or contact with infected individuals. Our data underline concerns of possible subclinical or undiagnosed Ebola virus infections and the importance and challenges of risk communication to populations who are occupationally exposed to bushmeat.

          Following the 2018 Ebola outbreak in Equateur Province, Democratic Republic of the Congo, bushmeat vendors interviewed in Mbandaka indicated being aware of Ebola, but did not consider themselves at occupational risk. Antibodies against Zaire ebolavirus were detected in one participant.

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          Most cited references9

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          The discovery of Bombali virus adds further support for bats as hosts of ebolaviruses

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            Rapid diagnosis of Ebola hemorrhagic fever by reverse transcription-PCR in an outbreak setting and assessment of patient viral load as a predictor of outcome.

            The largest outbreak on record of Ebola hemorrhagic fever (EHF) occurred in Uganda from August 2000 to January 2001. The outbreak was centered in the Gulu district of northern Uganda, with secondary transmission to other districts. After the initial diagnosis of Sudan ebolavirus by the National Institute for Virology in Johannesburg, South Africa, a temporary diagnostic laboratory was established within the Gulu district at St. Mary's Lacor Hospital. The laboratory used antigen capture and reverse transcription-PCR (RT-PCR) to diagnose Sudan ebolavirus infection in suspect patients. The RT-PCR and antigen-capture diagnostic assays proved very effective for detecting ebolavirus in patient serum, plasma, and whole blood. In samples collected very early in the course of infection, the RT-PCR assay could detect ebolavirus 24 to 48 h prior to detection by antigen capture. More than 1,000 blood samples were collected, with multiple samples obtained from many patients throughout the course of infection. Real-time quantitative RT-PCR was used to determine the viral load in multiple samples from patients with fatal and nonfatal cases, and these data were correlated with the disease outcome. RNA copy levels in patients who died averaged 2 log(10) higher than those in patients who survived. Using clinical material from multiple EHF patients, we sequenced the variable region of the glycoprotein. This Sudan ebolavirus strain was not derived from either the earlier Boniface (1976) or Maleo (1979) strain, but it shares a common ancestor with both. Furthermore, both sequence and epidemiologic data are consistent with the outbreak having originated from a single introduction into the human population.
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              Identification of mosquito bloodmeals using mitochondrial cytochrome oxidase subunit I and cytochrome b gene sequences.

              Primer pairs were designed and protocols developed to selectively amplify segments of vertebrate mitochondrial cytochrome oxidase subunit 1 (COI) and cytochrome b (Cyt b) mtDNA from the bloodmeals of mosquitoes (Diptera: Culicidae). The protocols use two pairs of nested COI primers and one pair of Cyt b primers to amplify short segments of DNA. Resultant sequences are then compared with sequences in GenBank, using the BLAST function, for putative host identification. Vertebrate DNA was amplified from 88% of our sample of 162 wild-caught, blood-fed mosquitoes from Oregon, U.S.A. and GenBank BLAST searches putatively identified 98% of the amplified sequences, including one amphibian, seven mammalian and 14 avian species. Criteria and caveats for putative identification of bloodmeals are discussed.
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                Author and article information

                Journal
                Open Forum Infect Dis
                Open Forum Infect Dis
                ofid
                Open Forum Infectious Diseases
                Oxford University Press (US )
                2328-8957
                August 2020
                17 July 2020
                17 July 2020
                : 7
                : 8
                : ofaa295
                Affiliations
                [1 ] Metabiota Inc , San Francisco, California, USA
                [2 ] Metabiota Inc , Kinshasa, Democratic Republic of the Congo
                [3 ] Metabiota Inc , Nanaimo, Canada
                [4 ] Institut National de Recherche Biomédicale , Kinshasa, Democratic Republic of the Congo
                [5 ] Mbandaka Laboratory, Ministry of Health , Mbandaka, Democratic Republic of the Congo
                [6 ] Mosaic , Yaoundé, Cameroon
                [7 ] One Health Institute, School of Veterinary Medicine, University of California , Davis, California, USA
                Author notes
                Correspondence: Christian E. Lange, DVM, PhD, Metabiota Inc., 38 Victoria Crescent, Nanaimo, BC V9R 5B8, Canada ( clange_virology@ 123456gmx.de ).

                A. L. and C. K. contributed equally to this manuscript.

                Present Affiliation: Labyrinth Global Health, St. Petersburg, FL.

                Article
                ofaa295
                10.1093/ofid/ofaa295
                7443109
                544a6030-b139-47bc-be7a-3e47c4d2a6b0
                © The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence ( http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                : 31 December 2019
                : 06 July 2020
                : 11 July 2020
                : 22 August 2020
                Page count
                Pages: 6
                Funding
                Funded by: United States Agency for International Development, DOI 10.13039/100000200;
                Award ID: AID-OAA-A-14-00102
                Categories
                Brief Reports
                AcademicSubjects/MED00290

                behavior,bushmeat,ebola virus disease,risk perception,serology

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