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Ebola Patient Virus Cycle Threshold and Risk of Household Transmission of Ebola Virus.
The Journal of Infectious Diseases ( IF 6.4 ) Pub Date : 2019-12-19 , DOI: 10.1093/infdis/jiz511
Mary R Reichler 1 , Dana Bruden 2 , Harold Thomas 3 , Bobbie Rae Erickson 4 , Barbara Knust 4 , Nadia Duffy 5 , John Klena 4 , Thomas Hennessy 2 ,
Affiliation  

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.

中文翻译:

埃博拉患者病毒周期阈值和埃博拉病毒在家庭中传播的风险。

背景 确定埃博拉病毒 (EBOV) 家庭传播的风险因素对于指导埃博拉疫情期间的预防措施非常重要。方法 我们招募了 2014 年 12 月至 2015 年 4 月在塞拉利昂弗里敦的所有确诊 EBOV 病患者及其家庭接触者,他们是家庭中的首例患者。对指示患者和接触者进行了访谈,并对接触者进行了 21 天的随访,以确定继发病例。流行病学数据与 EBOV 实时逆转录聚合酶链反应循环阈值 (Ct) 数据相关联,这些数据来自从登记的指示病例患者获得的初始诊断样本。结果 150 名登记的索引患者中有 106 名 (71%) 可获得 Ct 数据。在 Ct 结果中,85 个(80%)来自活体患者的血液标本,21 个(20%)来自死者的口腔拭子标本。血液和拭子样本的中值 Ct 值分别为 21.0 和 24.0 (P = .007)。在多变量分析中,在调整流行病学因素后,最低五分之一的血液样本的 Ct 值是家庭传播风险增加 (P = .009) 和家庭接触者继发性发病率升高 (P = .03) 的独立预测因子。因素。结论 我们的研究结果表明,有可能将来自急性 EBOV 诊断标本的 Ct 值用于指示患者作为高风险家庭和高风险接触群体的早期预测指标,以帮助优先考虑 EBOV 疾病调查和控制工作。分别(P = .007)。在多变量分析中,在调整流行病学因素后,最低五分之一的血液样本的 Ct 值是家庭传播风险增加 (P = .009) 和家庭接触者继发性发病率升高 (P = .03) 的独立预测因子。因素。结论 我们的研究结果表明,有可能将来自急性 EBOV 诊断标本的 Ct 值用于指示患者作为高风险家庭和高风险接触群体的早期预测指标,以帮助优先考虑 EBOV 疾病调查和控制工作。分别(P = .007)。在多变量分析中,在调整流行病学因素后,最低五分之一的血液样本的 Ct 值是家庭传播风险增加 (P = .009) 和家庭接触者继发性发病率升高 (P = .03) 的独立预测因子。因素。结论 我们的研究结果表明,有可能将来自急性 EBOV 诊断标本的 Ct 值用于指示患者作为高风险家庭和高风险接触群体的早期预测指标,以帮助优先考虑 EBOV 疾病调查和控制工作。调整流行病学因素后。结论 我们的研究结果表明,有可能将来自急性 EBOV 诊断标本的 Ct 值用于指示患者作为高风险家庭和高风险接触群体的早期预测指标,以帮助优先考虑 EBOV 疾病调查和控制工作。调整流行病学因素后。结论 我们的研究结果表明,有可能将来自急性 EBOV 诊断标本的 Ct 值用于指示患者作为高风险家庭和高风险接触群体的早期预测指标,以帮助优先考虑 EBOV 疾病调查和控制工作。
更新日期:2019-12-20
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