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. 2019 Jun;19(6):648-657.
doi: 10.1016/S1473-3099(19)30118-5. Epub 2019 Apr 15.

Medical countermeasures during the 2018 Ebola virus disease outbreak in the North Kivu and Ituri Provinces of the Democratic Republic of the Congo: a rapid genomic assessment

Placide Mbala-Kingebeni  1 , Amuri Aziza  2 , Nicholas Di Paola  3 , Michael R Wiley  4 , Sheila Makiala-Mandanda  5 , Katie Caviness  3 , Catherine B Pratt  4 , Jason T Ladner  6 , Jeffrey R Kugelman  7 , Karla Prieto  4 , Joseph A Chitty  3 , Peter A Larson  3 , Brett Beitzel  3 , Ahidjo Ayouba  8 , Nicole Vidal  8 , Stomy Karhemere  2 , Mamadou Diop  9 , Moussa M Diagne  9 , Martin Faye  9 , Ousmane Faye  9 , Aaron Aruna  10 , Justus Nsio  10 , Felix Mulangu  10 , Daniel Mukadi  11 , Patrick Mukadi  2 , John Kombe  10 , Anastasie Mulumba  12 , Christian-Julian Villabona-Arenas  13 , Elisabeth Pukuta  2 , Jeanette Gonzalez  3 , Maggie L Bartlett  14 , Shanmuga Sozhamannan  15 , Stephen M Gross  16 , Gary P Schroth  16 , Roger Tim  16 , Junhua J Zhao  16 , Jens H Kuhn  17 , Boubacar Diallo  18 , Michel Yao  18 , Ibrahima S Fall  18 , Bathe Ndjoloko  10 , Mathias Mossoko  10 , Audrey Lacroix  8 , Eric Delaporte  8 , Mariano Sanchez-Lockhart  14 , Amadou A Sall  9 , Jean-Jacques Muyembe-Tamfum  5 , Martine Peeters  8 , Gustavo Palacios  19 , Steve Ahuka-Mundeke  5
Affiliations

Medical countermeasures during the 2018 Ebola virus disease outbreak in the North Kivu and Ituri Provinces of the Democratic Republic of the Congo: a rapid genomic assessment

Placide Mbala-Kingebeni et al. Lancet Infect Dis. 2019 Jun.

Abstract

Background: The real-time generation of information about pathogen genomes has become a vital goal for transmission analysis and characterisation in rapid outbreak responses. In response to the recently established genomic capacity in the Democratic Republic of the Congo, we explored the real-time generation of genomic information at the start of the 2018 Ebola virus disease (EVD) outbreak in North Kivu Province.

Methods: We used targeted-enrichment sequencing to produce two coding-complete Ebola virus genomes 5 days after declaration of the EVD outbreak in North Kivu. Subsequent sequencing efforts yielded an additional 46 genomes. Genomic information was used to assess early transmission, medical countermeasures, and evolution of Ebola virus.

Findings: The genomic information demonstrated that the EVD outbreak in the North Kivu and Ituri Provinces was distinct from the 2018 EVD outbreak in Équateur Province of the Democratic Republic of the Congo. Primer and probe mismatches to Ebola virus were identified in silico for all deployed diagnostic PCR assays, with the exception of the Cepheid GeneXpert GP assay.

Interpretation: The first two coding-complete genomes provided actionable information in real-time for the deployment of the rVSVΔG-ZEBOV-GP Ebola virus envelope glycoprotein vaccine, available therapeutics, and sequence-based diagnostic assays. Based on the mutations identified in the Ebola virus surface glycoprotein (GP12) observed in all 48 genomes, deployed monoclonal antibody therapeutics (mAb114 and ZMapp) should be efficacious against the circulating Ebola virus variant. Rapid Ebola virus genomic characterisation should be included in routine EVD outbreak response procedures to ascertain efficacy of medical countermeasures.

Funding: Defense Biological Product Assurance Office.

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