Immediate Shared Diagnostics Approach Recommended for Ebola Outbreak

A NIH scientist has emphasized the need for an immediate, "real-time" global data sharing and regional diagnostic approach to improve the world's response to the recent Ebolavirus outbreak underway among the peoples of West Africa.

The origin, locations, and natural habitat of Ebolavirus remain unknown. On the basis of available evidence and the nature of similar viruses, researchers suggest that the virus is zoonotic and normally maintained in a host native to Africa. An absence of effective intervention strategies makes diagnosis a key element in response. But without access to modern molecular techniques, early diagnosis of Ebola hemorrhagic fevers can be particularly difficult because early symptoms are often similar to other infectious diseases, such as malaria and typhoid fever.

In an invited perspective article in the New England Journal of Medicine (NEJM), published May 7, 2014, Ebola expert Heinz Feldmann, MD, PhD, from the National Institute of Allergy and Infectious Diseases (NIAID; Bethesda, MD, USA) of the National Institutes of Health (NIH), emphasizes the need for scientists everywhere to make their relevant data available in real-time to colleagues involved in the public health response to a given outbreak. He cites past responses to influenza and SARS (severe acute respiratory syndrome) outbreaks as successful examples of global information sharing. Rapid diagnoses are key to controlling outbreaks of such deadly pathogens for which no therapies are available. The immediate availability of viral gene sequencing data, for example, can reduce waiting times for test results and help to determine whether established test methods will work or fail.

Dr. Feldmann, chief of NIAID’s Laboratory of Virology, conducts research on Ebola and other hemorrhagic fever viruses. Among other suggestions, he recommends that medical and public health staff in and near locations known to be endemic for Ebola be trained to assess infection risks and diagnose disease. Enhancing the capabilities of local laboratory workers would make test results available more rapidly by eliminating the need to ship samples to distant reference laboratories.

Dr. Feldmann and his NIAID colleague David Safronetz, PhD, explored this regional diagnostic approach while working with Malian health researchers and officials in April, after Mali reported 12 suspected Ebola cases. The NIAID group worked at the International Center for Excellence in Research, a partnership between NIAID and Mali’s University of Bamako, where they observed isolation procedures and showed local physicians how to handle Ebola specimens and test for disease. In this case, all the suspected cases in Mali tested negative.

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National Institute of Allergy and Infectious Diseases (NIAID)