Suchergebnisse

Thirty years after the discovery of HIV-1, the early transmission, dissemination, and establishment of the virus in human populations remain unclear. Using statistical approaches applied to HIV-1 sequence data from central Africa, we show that from the 1920s Kinshasa (in what is now the Democratic Republic of Congo) was the focus of early transmission and the source of pre-1960 pandemic viruses elsewhere. Location and dating estimates were validated using the earliest HIV-1 archival sample, also from Kinshasa. The epidemic histories of HIV-1 group M and nonpandemic group O were similar until ~1960, after which group M underwent an epidemiological transition and outpaced regional population growth. Our results reconstruct the early dynamics of HIV-1 and emphasize the role of social changes and transport networks in the establishment of this virus in human populations.

On August 1, 2018, the Democratic Republic of the Congo declared its tenth Ebola virus disease outbreak. To aid the epidemiologic response, the Institut National de Recherche Biomédicale implemented an end-to-end genomic surveillance system, including sequencing, bioinformatic analysis, and dissemination of genomic epidemiologic results to frontline public health workers. We report 744 new genomes sampled between July 27, 2018 and April 27, 2020 generated by this surveillance effort. Together with previously available sequence data (n = 48 genomes), these data represent almost 24% of all laboratory-confirmed Ebola virus infections in DRC in the analyzed period. We inferred spatiotemporal transmission dynamics from the genomic data as new sequences were generated and disseminated the results to support epidemiologic response efforts. Here, we provide an overview of how this genomic surveillance system functioned, present a full phylodynamic analysis of 792 Ebola genomes from the Nord Kivu outbreak, and discuss how the genomic surveillance data informed response efforts and public health decision-making.

During the 2018-2020 Nord Kivu Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo, an individual who had received the Merck rVSV-ZEBOV vaccine was diagnosed with EVD. His treatment included an Ebola virus-specific monoclonal antibody (mAb114), and he recovered within 14 days but re-presented six months later with severe EVD-like illness and Ebola virus viremia and died. We initiated an epidemiological and genomic investigation that showed the patient had a relapse of acute EVD, which led to a transmission chain that resulted in 91 cases spanning six health zones over four-months.