title: Detection of Ebola virus in oral fluid specimens during outbreaks of Ebola virus hemorrhagic fever in the Republic of Congo.
abstract: 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.
authors.affiliation: World Health Organization, Department of Communicable Diseases Surveillance and Response, Geneva, Switzerland. formentyp@who.int
authors.forename: Pierre
authors.initials: P
authors.lastname: Formenty
authors.forename: Eric Maurice
authors.initials: EM
authors.lastname: Leroy
authors.forename: Alain
authors.initials: A
authors.lastname: Epelboin
authors.forename: Francois
authors.initials: F
authors.lastname: Libama
authors.forename: Marco
authors.initials: M
authors.lastname: Lenzi
authors.forename: Hinrich
authors.initials: H
authors.lastname: Sudeck
authors.forename: Philippe
authors.initials: P
authors.lastname: Yaba
authors.forename: Yokouidé
authors.initials: Y
authors.lastname: Allarangar
authors.forename: Paul
authors.initials: P
authors.lastname: Boumandouki
authors.forename: Virginot Blad
authors.initials: VB
authors.lastname: Nkounkou
authors.forename: Christian
authors.initials: C
authors.lastname: Drosten
authors.forename: Allen
authors.initials: A
authors.lastname: Grolla
authors.forename: Heinz
authors.initials: H
authors.lastname: Feldmann
authors.forename: Cathy
authors.initials: C
authors.lastname: Roth
mesh_terms: 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
chemical_list: D000914:Antibodies, Viral; D000956:Antigens, Viral