Portal de Periódicos da CAPES

Ebola Patient Virus Cycle Threshold and Risk of Household Transmission of Ebola Virus

2019; Oxford University Press; Volume: 221; Issue: 5 Linguagem: Inglês

10.1093/infdis/jiz511

1537-6613

M. R. Reichler, Dana Bruden, Harold Thomas, Bobbie R. Erickson, Barbara Knust, Nadezhda Duffy, John D. Klena, Thomas Hennessy, James Bangura, Charles Keimbe, Amara Jambai, Oliver Morgan, Ismail Farmar, Francis Davies, Sima Mohamed Dumbuya, Hannah Kamara, Yayah Mohamed Kallon, Joseph Kpukumu, Sheku Abu, Fatmata Bangura, Rahim Saidu Bangura, Tomeh Bangura, Hassan Benya, Sandi Blango, Imurana Conteh, Peter Conteh, Bintu Jabbie, Sheku Jabbie, Luseni Kamara, Francis Lansana, Maada Rogers, Brima Sahr Sewa, Matthew Yamba, Patricia A. Bessler, Faith Washburn, Elizabeth Ervin, Shelley Campbell, Wendy Chung, E. H. Nichols, Sara Hersey,

COVID-19 epidemiological studies

Abstract Background Identifying risk factors for household transmission of Ebola virus (EBOV) is important to guide preventive measures during Ebola outbreaks. Methods We enrolled all confirmed persons with EBOV disease who were the first case patient in a household from December 2014 to April 2015 in Freetown, Sierra Leone, and their household contacts. Index patients and contacts were interviewed, and contacts were followed up for 21 days to identify secondary cases. Epidemiologic data were linked to EBOV real-time reverse-transcription polymerase chain reaction cycle threshold (Ct) data from initial diagnostic specimens obtained from enrolled index case patients. Results Ct data were available for 106 (71%) of 150 enrolled index patients. Of the Ct results, 85 (80%) were from blood specimens from live patients and 21 (20%) from oral swab specimens from deceased patients. The median Ct values for blood and swab specimens were 21.0 and 24.0, respectively (P = .007). In multivariable analysis, a Ct value from blood specimens in the lowest quintile was an independent predictor of both increased risk of household transmission (P = .009) and higher secondary attack rate among household contacts (P = .03), after adjustment for epidemiologic factors. Conclusions Our findings suggest the potential to use Ct values from acute EBOV diagnostic specimens for index patients as an early predictor of high-risk households and high-risk groups of contacts to help prioritize EBOV disease investigation and control efforts.