Resurgence of Ebola virus in 2021 in Guinea suggests a new paradigm for outbreaks

Alpha Kabinet Keita*, Fara R. Koundouno, Martin Faye, Ariane Düx, Julia Hinzmann, Haby Diallo, Ahidjo Ayouba, Frederic Le Marcis, Barré Soropogui, Kékoura Ifono, Moussa M. Diagne, Mamadou S. Sow, Joseph A. Bore, Sebastien Calvignac-Spencer, Nicole Vidal, Jacob Camara, Mamadou B. Keita, Annick Renevey, Amadou Diallo, Abdoul K. SoumahSaa L. Millimono, Almudena Mari-Saez, Mamadou Diop, Ahmadou Doré, Fodé Y. Soumah, Kaka Kourouma, Nathalie J. Vielle, Cheikh Loucoubar, Ibrahima Camara, Karifa Kourouma, Giuditta Annibaldis, Assaïtou Bah, Anke Thielebein, Meike Pahlmann, Steven T. Pullan, Miles W. Carroll, Joshua Quick, Pierre Formenty, Anais Legand, Karla Pietro, Michael R. Wiley, Noel Tordo, Christophe Peyrefitte, John T. McCrone, Andrew Rambaut, Youssouf Sidibé, Mamadou D. Barry, Madeleine Kourouma, Cé D. Saouromou, Mamadou Condé, Moussa Baldé, Moriba Povogui, Sakoba Keita, Mandiou Diakite, Mamadou S. Bah, Amadou Sidibe, Dembo Diakite, Fodé B. Sako, Fodé A. Traore, Georges A. Ki-Zerbo, Philippe Lemey, Stephan Günther, Liana E. Kafetzopoulou, Amadou A. Sall, Eric Delaporte, Sophie Duraffour, Ousmane Faye, Fabian H. Leendertz, Martine Peeters, Abdoulaye Toure, N’ Faly Magassouba

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Seven years after the declaration of the first epidemic of Ebola virus disease in Guinea, the country faced a new outbreak—between 14 February and 19 June 2021—near the epicentre of the previous epidemic1,2. Here we use next-generation sequencing to generate complete or near-complete genomes of Zaire ebolavirus from samples obtained from 12 different patients. These genomes form a well-supported phylogenetic cluster with genomes from the previous outbreak, which indicates that the new outbreak was not the result of a new spillover event from an animal reservoir. The 2021 lineage shows considerably lower divergence than would be expected during sustained human-to-human transmission, which suggests a persistent infection with reduced replication or a period of latency. The resurgence of Zaire ebolavirus from humans five years after the end of the previous outbreak of Ebola virus disease reinforces the need for long-term medical and social care for patients who survive the disease, to reduce the risk of re-emergence and to prevent further stigmatization.

Original languageEnglish
Pages (from-to)539-543
Number of pages5
JournalNature
Volume597
Issue number7877
DOIs
Publication statusPublished - 23 Sep 2021
Externally publishedYes

Bibliographical note

Funding Information:
Acknowledgements We thank the ANSS and the Ministry of Health of the Republic of Guinea, the healthcare workers (medical doctors, nurses and laboratory technicians) from the treatment centres in Nzérékoré and Nongo, Conakry; the laboratory personnel in Guékédou, INSP (Conakry) and CERFIG (Conakry). CERFIG also acknowledges J. Gogarten and bioinformatics support from RKI. The UK Health Security Agency would like to thank Oxford Nanopore Technologies for the donation of reagents and equipment to support the setting up of the sequencing capacity at PFHG. BNITM thanks the ARTIC Network (https://artic.network/). The work of CERFIG and TransVIHMI was supported in part by grants from the EBO-SURSY Project funded by the European Union, International Mixt Laboratory ‘RESPIRE’ of IRD (Institut de Recherche pour le Developpement), Montpellier Université d’Excellence (EBOHEALTH; I-Site MUSE, ANR-16-IDEX-0006) and Institut National de la Santé et de la Recherche Médicale (INSERM)/REACTing (REsearch and ACTion targeting emerging infectious diseases). The work of the RKI was partly funded by the German Ministry of Health ‘Global Protection Program’ project TRICE. F.L.M. received funding through the program ‘EBOVAC3 Bringing a prophylactic Ebola vaccine to licensure’ funded by Innovative Medicine Initiative (grant agreement number 800176) and run by London School of Hygiene and Tropical Medicine and INSERM. The work of PFHG and BNITM was supported by the German Federal Ministry of Health through support of the WHO Collaborating Centre for Arbovirus and Hemorrhagic Fever Viruses at the BNITM (agreement ZMV I1-2517WHO005), and through the Global Health Protection Programme (GHPP, agreements ZMV I1-2517GHP-704 and ZMVI1-2519GHP704), and by the Coalition for Epidemic Preparedness Innovations (CEPI). The work of BNITM and the UK Health Security Agency was further supported by the Research and Innovation Programme of the European Union under Horizon 2020 grant agreement no. 871029-EVA-GLOBAL. The European Mobile Laboratory (EMLab) coordinated by BNITM is a technical partner of the WHO Global Outbreak Alert and Response Network (GOARN) and the deployment of EMLab experts and sequencing capacities to Guinea was coordinated and supported by the GOARN Operational Support Team at WHO/HQ and the WHO country office in Guinea. The research leading to these results has received funding from the European Research Council under the European Union’s Horizon 2020 research and innovation programme (grant agreement no. 725422-ReservoirDOCS). The ARTIC Network receives funding from the Wellcome Trust through project 206298/Z/17/Z. P.L. acknowledges support by the Research Foundation – Flanders (‘Fonds voor Wetenschappelijk Onderzoek – Vlaanderen’, G066215N, G0D5117N and G0B9317N).

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Nature Limited.

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