Laboratory diagnosis of Ebola virus disease plays a critical role in outbreak response efforts; however, establishing safe and expeditious testing strategies for this high-biosafety-level pathogen in resource-poor environments remains extremely challenging. Since the discovery of Ebola virus in 1976 via traditional viral culture techniques and electron microscopy, diagnostic methodologies have trended toward faster, more accurate molecular assays. Importantly, technological advances have been paired with increasing efforts to support decentralized diagnostic testing capacity that can be deployed at or near the point of patient care. The unprecedented scope of the 2014-2015 West Africa Ebola epidemic spurred tremendous innovation in this arena, and a variety of new diagnostic platforms that have the potential both to immediately improve ongoing surveillance efforts in West Africa and to transform future outbreak responses have reached the field. In this review, we describe the evolution of Ebola virus disease diagnostic testing and efforts to deploy field diagnostic laboratories in prior outbreaks. We then explore the diagnostic challenges pervading the 2014-2015 epidemic and provide a comprehensive examination of novel diagnostic tests that are likely to address some of these challenges moving forward.

中文翻译：

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埃博拉病毒病的诊断：过去、现在和未来。

埃博拉病毒病的实验室诊断在疫情应对工作中发挥着关键作用；然而，在资源匮乏的环境中针对这种高生物安全水平的病原体建立安全、快速的检测策略仍然极具挑战性。自 1976 年通过传统病毒培养技术和电子显微镜发现埃博拉病毒以来，诊断方法已趋向于更快、更准确的分子检测。重要的是，技术进步与支持分散诊断测试能力的努力相结合，这些诊断测试能力可以部署在患者护理点或附近。2014-2015年西非埃博拉疫情规模空前，刺激了这一领域的巨大创新，各种新的诊断平台已经到达现场，这些平台有可能立即改善西非正在进行的监测工作，并改变未来的疫情应对措施。在这篇综述中，我们描述了埃博拉病毒病诊断测试的演变以及在之前的疫情爆发中部署现场诊断实验室的努力。然后，我们探讨了 2014-2015 年流行病中普遍存在的诊断挑战，并对可能解决未来挑战的新型诊断测试进行了全面检查。