Strategies in Ebola virus disease (EVD) diagnostics at the point of care

Abstract

Ebola virus disease (EVD) is a devastating, highly infectious illness with a high mortality rate. The disease is endemic to regions of Central and West Africa, where there is limited laboratory infrastructure and trained staff. The recent 2014 West African EVD outbreak has been unprecedented in case numbers and fatalities, and has proven that such regional outbreaks can become a potential threat to global public health, as it became the source for the subsequent transmission events in Spain and the USA. The urgent need for rapid and affordable means of detecting Ebola is crucial to control the spread of EVD and prevent devastating fatalities. Current diagnostic techniques include molecular diagnostics and other serological and antigen detection assays; which can be time-consuming, laboratory-based, often require trained personnel and specialized equipment. In this review, we discuss the various Ebola detection techniques currently in use, and highlight the potential future directions pertinent to the development and adoption of novel point-of-care diagnostic tools. Finally, a case is made for the need to develop novel microfluidic technologies and versatile rapid detection platforms for early detection of EVD.

Early detection of Ebola virus proteins in peripheral blood mononuclear cells from infected mice

“…Therefore, the utility of tests that assess antibody responses to pinpoint EBOV as etiologic agent of an infection are limited especially at pre-symptomatic and/or acute stage of EVD. EBOV IgM has a relatively shorter half-life compared to other viral IgM classes based on analysis of samples obtained from EVD survivors further limiting its diagnostic window [2]. PBMC sample collection has been used historically for the detailed characterization of immune responses to infectious agents.…”

“…Once infected, the incubation period of Ebola virus disease (EVD) in humans can vary from 2 to 21 days, and it presents initially with common symptoms such as fever, fatigue, muscle pain, headache, and sore throat. Real-time polymerase chain reaction (RT-PCR) is the gold standard for the detection of EBOV during acute infection in outbreak settings, but the earliest window for viral genomic RNA detection in blood samples is roughly 48-72 h postonset of symptoms [1,2]. For RT-PCR based diagnosis of EVD, RNA is first extracted from whole blood, and extraction requires several steps, including sample collection and inactivation, viral RNA extraction, reverse transcription and cDNA amplification.…”

“…The genome of EBOV is linear, (−) ssRNA and encodes for seven genes which produce 9 proteins: a nucleoprotein (NP), a polymerase cofactor (VP35), a matrix protein (VP40), a transmembrane glycoprotein (GP), 2 truncated secreted versions of GP (sGP, and ssGP), a transcriptional activator (VP30), a viral envelope-associated protein (VP24) and a RNA-dependent RNA polymerase (L) [5]. A number of RT-PCR assays have been developed to target EBOV genes, including the two most abundant constituent parts of the Ebola virion, VP40 and GP [2]. Unfortunately, the low fidelity of the EBOV L protein leads to high genetic drift, meaning that for every new EBOV outbreak, there is the potential for reduced RT-PCR assay sensitivity and specificity due sequence variations between viral strains [6,7].…”

Emerging technologies for home‐based semen analysis

“…Microfluidic devices are being developed for various applications in medicine including disease diagnosis, tissue culture, and cryopreservation (Asghar et al ., , , ; Hafeez et al ., ; Miki & Clapham, ; Seiringer et al ., ; Tasoglu et al ., ,; Islam et al ., ; Shafiee et al ., ; Safavieh et al ., 2016; Adenmosun et al ., ; Coarsey et al ., ; Kanakasabapathy et al ., ). Like paper‐based devices, these microfluidic devices also provide a quick way to evaluate semen with a simple readout.…”

Synthesis and biological evaluation of novel tricyclic matrinic derivatives as potential anti-filovirus agents

“…Members of the filovirus can cause an acute lethal hemorrhagic fever in humans 1 , 2 , 3 , 4 . The 2014–2015 EBOV breakout in West Africa caused more than 28,600 human infections and killed 11,300 people 5 , 6 . Worse still, new flare-ups have occurred several times after the EBOV breakout was over 6 .…”