Detection of Ebola virus in oral fluid specimens during outbreaks of Ebola virus hemorrhagic fever in the Republic of Congo.
BACKGROUND
Patients who have refused to provide blood samples has meant that there have been significant delays in confirming outbreaks of Ebola virus hemorrhagic fever (EVHF). During the 2 EVHF outbreaks in the Republic of Congo in 2003, we assessed the use of oral fluid specimens versus serum samples for laboratory confirmation of cases of EVHF.


METHODS
Serum and oral fluid specimens were obtained from 24 patients with suspected Ebola and 10 healthy control subjects. Specimens were analyzed for immunoglobulin G antibodies by enzyme-linked immunosorbent assay (ELISA) and for Ebola virus by antigen detection ELISA and reverse-transcriptase polymerase chain reaction (RT-PCR). Oral fluid specimens were collected with a commercially available collection device.


RESULTS
We failed to detect antibodies against Ebola in the oral fluid specimens obtained from patients whose serum samples were seropositive. All patients with positive serum RT-PCR results also had positive results for their oral fluid specimens.


CONCLUSIONS
This study demonstrates the usefulness of oral fluid samples for the investigation of Ebola outbreaks, but further development in antibodies and antigen detection in oral fluid specimens is needed before these samples are used for filovirus surveillance activities in Africa.
Formenty
Pierre
P
World Health Organization, Department of Communicable Diseases Surveillance and Response, Geneva, Switzerland. formentyp@who.int
Leroy
Eric Maurice
EM
Epelboin
Alain
A
Libama
Francois
F
Lenzi
Marco
M
Sudeck
Hinrich
H
Yaba
Philippe
P
Allarangar
Yokouidé
Y
Boumandouki
Paul
P
Nkounkou
Virginot Blad
VB
Drosten
Christian
C
Grolla
Allen
A
Feldmann
Heinz
H
Roth
Cathy
C
D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood / Q000302:isolation & purification; D000956:Antigens, Viral / Q000097:blood / Q000302:isolation & purification; D003223:Congo / Q000453:epidemiology; D004196:Disease Outbreaks; D029043:Ebolavirus / Q000302:isolation & purification*; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D006801:Humans; D008875:Middle Aged; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012463:Saliva / Q000821:virology*; D012680:Sensitivity and Specificity
D000914:Antibodies, Viral; D000956:Antigens, Viral