Shifting the paradigm - Applying universal standards of care to Ebola virus disease

As the Democratic Republic of Congo’s (DRC’s) 10th outbreak of Ebola virus disease (EVD) rages in this resource-limited, wartorn region, advances in the delivery of supportive care and the introduction of investigational therapies provide a glimmer of hope amid the mounting infections. In the absence of effective therapies or vaccines, EVD outbreak response has centered around the most basic of public health principles — identification and isolation of patients with suspected and confirmed EVD and tracking of all the contacts of the confirmed patients, who are then rapidly isolated if they show signs of disease. This strategy of “identify, isolate, and track” allows public health responders to curtail and eventually eliminate virus transmission in the community and has been the foundation of EVD outbreakcontrol efforts since the disease was first described in 1976

Ebola virus disease: an update on post-exposure prophylaxis

The massive outbreak of Ebola virus disease in west Africa between 2013 and 2016 resulted in intense efforts to evaluate the efficacy of several specific countermeasures developed through years of preclinical work, including the first clinical trials for therapeutics and vaccines. In this Review, we discuss how the experience and data generated from that outbreak have helped to advance the understanding of the use of these countermeasures for post-exposure prophylaxis against Ebola virus infection. In future outbreaks, post-exposure prophylaxis could play an important part in reducing community transmission of Ebola virus by providing more immediate protection than does immunisation as well as providing additional protection for health-care workers who are inadvertently exposed over the course of their work. We propose provisional guidance for use of post-exposure prophylaxis in Ebola virus disease and identify the priorities for future preparedness and further research

New filovirus disease classification and nomenclature

Filoviruses, the members of the family Filoviridae, are currently classified into one proposed and five established genera (Supplementary Table 1). Of the twelve described filoviruses, six have been identified as aetiological agents of naturally occurring human disease outbreaks

Feasibility and effectiveness of a brief, intensive phylogenetics workshop in a middle-income country

There is an increasing role for bioinformatic and phylogenetic analysis in tropical medicine research. However, scientists working in low- and middle-income regions may lack access to training opportunities in these methods. To help address this gap, a 5-day intensive bioinformatics workshop was offered in Lima, Peru. The syllabus is presented here for others who want to develop similar programs. To assess knowledge gained, a 20-point knowledge questionnaire was administered to participants (21 participants) before and after the workshop, covering topics on sequence quality control, alignment/formatting, database retrieval, models of evolution, sequence statistics, tree building, and results interpretation. Evolution/tree-building methods represented the lowest scoring domain at baseline and after the workshop. There was a considerable median gain in total knowledge scores (increase of 30%, p < 0.001) with gains as high as 55%. A 5-day workshop model was effective in improving the pathogen-applied bioinformatics knowledge of scientists working in a middle-income country setting