Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
Global Health Security Department, Infectious Diseases Institute, Makerere University, Kampala, Uganda.
Nat Rev Dis Primers. 2020 Feb 20;6(1):13. doi: 10.1038/s41572-020-0147-3.
Ebola virus disease (EVD) is a severe and frequently lethal disease caused by Ebola virus (EBOV). EVD outbreaks typically start from a single case of probable zoonotic transmission, followed by human-to-human transmission via direct contact or contact with infected bodily fluids or contaminated fomites. EVD has a high case-fatality rate; it is characterized by fever, gastrointestinal signs and multiple organ dysfunction syndrome. Diagnosis requires a combination of case definition and laboratory tests, typically real-time reverse transcription PCR to detect viral RNA or rapid diagnostic tests based on immunoassays to detect EBOV antigens. Recent advances in medical countermeasure research resulted in the recent approval of an EBOV-targeted vaccine by European and US regulatory agencies. The results of a randomized clinical trial of investigational therapeutics for EVD demonstrated survival benefits from two monoclonal antibody products targeting the EBOV membrane glycoprotein. New observations emerging from the unprecedented 2013-2016 Western African EVD outbreak (the largest in history) and the ongoing EVD outbreak in the Democratic Republic of the Congo have substantially improved the understanding of EVD and viral persistence in survivors of EVD, resulting in new strategies toward prevention of infection and optimization of clinical management, acute illness outcomes and attendance to the clinical care needs of patients.
埃博拉病毒病(EVD)是由埃博拉病毒(EBOV)引起的一种严重且常致命的疾病。EVD 疫情通常始于单一例可能的人畜共患病传播,随后通过直接接触或接触受感染的体液或受污染的媒介物发生人与人之间的传播。EVD 的病死率很高;其特征为发热、胃肠道症状和多器官功能障碍综合征。诊断需要病例定义和实验室检测的组合,通常是实时逆转录 PCR 检测病毒 RNA,或基于免疫测定法检测 EBOV 抗原的快速诊断检测。医学应对措施研究的最新进展导致最近欧洲和美国监管机构批准了一种针对 EBOV 的疫苗。针对 EVD 治疗药物的随机临床试验结果表明,两种针对 EBOV 膜糖蛋白的单克隆抗体产品具有生存获益。从史无前例的 2013-2016 年西非 EVD 疫情(历史上最大规模的疫情)和刚果民主共和国正在发生的 EVD 疫情中出现的新观察结果,极大地提高了对 EVD 和 EVD 幸存者中病毒持续存在的认识,从而为预防感染和优化临床管理、急性疾病结局以及满足患者临床护理需求制定了新策略。