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. Soumah, Saa 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 and N’. Faly Magassouba
Additional contact information
Alpha Kabinet Keita: Université de Conakry
Fara R. Koundouno: Laboratoire du Projet des Fièvres Hémorragiques de Guinée (PFHG)
Martin Faye: Institut Pasteur de Dakar (IPD)
Ariane Düx: Robert Koch Institute (RKI)
Julia Hinzmann: Bernhard Nocht Institute for Tropical Medicine (BNITM)
Haby Diallo: Université de Conakry
Ahidjo Ayouba: TransVIHMI, Montpellier University/IRD/INSERM
Frederic Le Marcis: Université de Conakry
Barré Soropogui: Laboratoire du Projet des Fièvres Hémorragiques de Guinée (PFHG)
Kékoura Ifono: Laboratoire du Projet des Fièvres Hémorragiques de Guinée (PFHG)
Moussa M. Diagne: Institut Pasteur de Dakar (IPD)
Mamadou S. Sow: Université de Conakry
Joseph A. Bore: Laboratoire du Projet des Fièvres Hémorragiques de Guinée (PFHG)
Sebastien Calvignac-Spencer: Robert Koch Institute (RKI)
Nicole Vidal: TransVIHMI, Montpellier University/IRD/INSERM
Jacob Camara: Laboratoire du Projet des Fièvres Hémorragiques de Guinée (PFHG)
Mamadou B. Keita: Institut National de Santé Publique de Guinée (INSP)
Annick Renevey: Bernhard Nocht Institute for Tropical Medicine (BNITM)
Amadou Diallo: Institut Pasteur de Dakar (IPD)
Abdoul K. Soumah: Université de Conakry
Saa L. Millimono: Laboratoire du Projet des Fièvres Hémorragiques de Guinée (PFHG)
Almudena Mari-Saez: Robert Koch Institute (RKI)
Mamadou Diop: Institut Pasteur de Dakar (IPD)
Ahmadou Doré: Laboratoire du Projet des Fièvres Hémorragiques de Guinée (PFHG)
Fodé Y. Soumah: Hôpital National Donka, Service des Maladies Infectieuses et Tropicales
Kaka Kourouma: Institut National de Santé Publique de Guinée (INSP)
Nathalie J. Vielle: Bernhard Nocht Institute for Tropical Medicine (BNITM)
Cheikh Loucoubar: Institut Pasteur de Dakar (IPD)
Ibrahima Camara: Université de Conakry
Karifa Kourouma: Laboratoire du Projet des Fièvres Hémorragiques de Guinée (PFHG)
Giuditta Annibaldis: Bernhard Nocht Institute for Tropical Medicine (BNITM)
Assaïtou Bah: Laboratoire du Projet des Fièvres Hémorragiques de Guinée (PFHG)
Anke Thielebein: Bernhard Nocht Institute for Tropical Medicine (BNITM)
Meike Pahlmann: Bernhard Nocht Institute for Tropical Medicine (BNITM)
Steven T. Pullan: UK Health Security Agency, National Infection Service, Porton Down
Miles W. Carroll: UK Health Security Agency, National Infection Service, Porton Down
Joshua Quick: University of Birmingham
Pierre Formenty: World Health Organization (WHO)
Anais Legand: World Health Organization (WHO)
Karla Pietro: PraesensBio
Michael R. Wiley: PraesensBio
Noel Tordo: Institut Pasteur de Guinée
Christophe Peyrefitte: Institut Pasteur de Dakar (IPD)
John T. McCrone: University of Edinburgh
Andrew Rambaut: University of Edinburgh
Youssouf Sidibé: Hôpital Régional de Nzérékoré
Mamadou D. Barry: Hôpital Régional de Nzérékoré
Madeleine Kourouma: Hôpital Régional de Nzérékoré
Cé D. Saouromou: Hôpital Régional de Nzérékoré
Mamadou Condé: Hôpital Régional de Nzérékoré
Moussa Baldé: Hôpital National Donka, Service des Maladies Infectieuses et Tropicales
Moriba Povogui: Université de Conakry
Sakoba Keita: Agence Nationale de Sécurité Sanitaire
Mandiou Diakite: Ministère de la Santé
Mamadou S. Bah: Ministère de la Santé
Amadou Sidibe: Ecole Nationale Supérieure de Lyon
Dembo Diakite: Hôpital National Donka, Service des Maladies Infectieuses et Tropicales
Fodé B. Sako: Hôpital National Donka, Service des Maladies Infectieuses et Tropicales
Fodé A. Traore: Hôpital National Donka, Service des Maladies Infectieuses et Tropicales
Georges A. Ki-Zerbo: World Health Organization (WHO)
Philippe Lemey: Immunology and Transplantation, Rega Institute, KU Leuven
Stephan Günther: Bernhard Nocht Institute for Tropical Medicine (BNITM)
Liana E. Kafetzopoulou: Bernhard Nocht Institute for Tropical Medicine (BNITM)
Amadou A. Sall: Institut Pasteur de Dakar (IPD)
Eric Delaporte: TransVIHMI, Montpellier University/IRD/INSERM
Sophie Duraffour: Bernhard Nocht Institute for Tropical Medicine (BNITM)
Ousmane Faye: Institut Pasteur de Dakar (IPD)
Fabian H. Leendertz: Robert Koch Institute (RKI)
Martine Peeters: TransVIHMI, Montpellier University/IRD/INSERM
Abdoulaye Toure: Université de Conakry
N’. Faly Magassouba: Laboratoire du Projet des Fièvres Hémorragiques de Guinée (PFHG)

Nature, 2021, vol. 597, issue 7877, 539-543

Abstract: 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.

Date: 2021
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DOI: 10.1038/s41586-021-03901-9

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