title: Interpretation of Negative Molecular Test Results in Patients With Suspected or Confirmed Ebola Virus Disease: Report of Two Cases.
abstract: Quantitative reverse-transcription polymerase chain reaction (qRT-PCR) is the most sensitive quantitative diagnostic assay for detection of Ebola virus in multiple body fluids. Despite the strengths of this assay, we present 2 cases of Ebola virus disease (EVD) and highlight the potential for false-negative results during the early and late stages of EVD. The first case emphasizes the low negative-predictive value of qRT-PCR during incubation and the early febrile stage of EVD, and the second case emphasizes the potential for false-negative results during recovery and late neurologic complications of EVD. Careful interpretation of test results are needed to guide difficult admission and discharge decisions in suspected or confirmed EVD.
authors.affiliation: Médecins Sans Frontières , Operational Center of Brussels , Belgium ; Department of International Health , School of Public Health, Johns Hopkins University , Baltimore , Maryland.
authors.forename: Jeffrey K
authors.initials: JK
authors.lastname: Edwards
authors.affiliation: Médecins Sans Frontières , Operational Center of Brussels , Belgium ; Department of Infectious Diseases and Tropical Medicine , J.W. Goethe-University Hospital , Frankfurt , Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Kleine
authors.affiliation: Laboratory of Virology, National Institute of Allergy and Infectious Diseases , National Institutes of Health , Rocky Mountain Laboratories , Hamilton , Montana.
authors.forename: Vincent
authors.initials: V
authors.lastname: Munster
authors.affiliation: Médecins Sans Frontières , Operational Center of Brussels , Belgium.
authors.forename: Ruggero
authors.initials: R
authors.lastname: Giuliani
authors.affiliation: Clinton Health Initiative , Monrovia , Liberia.
authors.forename: Moses
authors.initials: M
authors.lastname: Massaquoi
authors.affiliation: Médecins Sans Frontières , Operational Center of Brussels , Belgium.
authors.forename: Armand
authors.initials: A
authors.lastname: Sprecher
authors.affiliation: Médecins Sans Frontières , Operational Center of Brussels , Belgium ; Department of Critical Care Medicine, Clinical Center , National Institutes of Health , Bethesda , Maryland.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Chertow
keywords: Ebola; Liberia; PCR; West Africa; hemorrhagic fever