title: Analysis of Diagnostic Findings From the European Mobile Laboratory in Guéckédou, Guinea, March 2014 Through March 2015.
abstract: A unit of the European Mobile Laboratory (EMLab) consortium was deployed to the Ebola virus disease (EVD) treatment unit in Guéckédou, Guinea, from March 2014 through March 2015.
  
  
  
  The unit diagnosed EVD and malaria, using the RealStar Filovirus Screen reverse transcription-polymerase chain reaction (RT-PCR) kit and a malaria rapid diagnostic test, respectively.
  
  
  
  The cleaned EMLab database comprised 4719 samples from 2741 cases of suspected EVD from Guinea. EVD was diagnosed in 1231 of 2178 hospitalized patients (57%) and in 281 of 563 who died in the community (50%). Children aged <15 years had the highest proportion of Ebola virus-malaria parasite coinfections. The case-fatality ratio was high in patients aged <5 years (80%) and those aged >74 years (90%) and low in patients aged 10-19 years (40%). On admission, RT-PCR analysis of blood specimens from patients who died in the hospital yielded a lower median cycle threshold (Ct) than analysis of blood specimens from survivors (18.1 vs 23.2). Individuals who died in the community had a median Ct of 21.5 for throat swabs. Multivariate logistic regression on 1047 data sets revealed that low Ct values, ages of <5 and ≥45 years, and, among children aged 5-14 years, malaria parasite coinfection were independent determinants of a poor EVD outcome.
  
  
  
  Virus load, age, and malaria parasite coinfection play a role in the outcome of EVD.
authors.affiliation: Bernhard Nocht Institute for Tropical Medicine European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems.
authors.forename: Romy
authors.initials: R
authors.lastname: Kerber
authors.affiliation: Bernhard Nocht Institute for Tropical Medicine German Center for Infection Research, Hamburg-Munich-Marburg-Riems.
authors.forename: Ralf
authors.initials: R
authors.lastname: Krumkamp
authors.affiliation: World Health Organization.
authors.forename: Boubacar
authors.initials: B
authors.lastname: Diallo
authors.affiliation: Bernhard Nocht Institute for Tropical Medicine German Center for Infection Research, Hamburg-Munich-Marburg-Riems.
authors.forename: Anna
authors.initials: A
authors.lastname: Jaeger
authors.affiliation: Bernhard Nocht Institute for Tropical Medicine European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems.
authors.forename: Martin
authors.initials: M
authors.lastname: Rudolf
authors.affiliation: European Mobile Laboratory Consortium National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Lanini
authors.affiliation: European Mobile Laboratory Consortium Ministry of Health Guinea.
authors.forename: Joseph Akoi
authors.initials: JA
authors.lastname: Bore
authors.affiliation: European Mobile Laboratory Consortium Ministry of Health Guinea.
authors.forename: Fara Raymond
authors.initials: FR
authors.lastname: Koundouno
authors.affiliation: Bernhard Nocht Institute for Tropical Medicine European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems.
authors.forename: Beate
authors.initials: B
authors.lastname: Becker-Ziaja
authors.affiliation: European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems Bundeswehr Institute of Microbiology, Munich.
authors.forename: Erna
authors.initials: E
authors.lastname: Fleischmann
authors.affiliation: European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems Bundeswehr Institute of Microbiology, Munich.
authors.forename: Kilian
authors.initials: K
authors.lastname: Stoecker
authors.affiliation: European Mobile Laboratory Consortium National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Meschi
authors.affiliation: European Mobile Laboratory Consortium National Reference Center for Viral Hemorrhagic Fevers Laboratoire P4 Inserm-Jean Mérieux.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Mély
authors.affiliation: European Mobile Laboratory Consortium Public Health England, Porton Down.
authors.forename: Edmund N C
authors.initials: EN
authors.lastname: Newman
authors.affiliation: European Mobile Laboratory Consortium National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Carletti
authors.affiliation: European Mobile Laboratory Consortium Spiez Laboratory, Federal Office for Civil Protection.
authors.forename: Jasmine
authors.initials: J
authors.lastname: Portmann
authors.affiliation: European Mobile Laboratory Consortium Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Slovenia.
authors.forename: Misa
authors.initials: M
authors.lastname: Korva
authors.affiliation: European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems Institute of Virology, Philipps University Marburg.
authors.forename: Svenja
authors.initials: S
authors.lastname: Wolff
authors.affiliation: European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems Bundeswehr Institute of Microbiology, Munich.
authors.forename: Peter
authors.initials: P
authors.lastname: Molkenthin
authors.affiliation: European Mobile Laboratory Consortium National Biosafety Laboratory, National Center for Epidemiology, Budapest, Hungary.
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Kis
authors.affiliation: European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems Institute of Virology, Philipps University Marburg.
authors.forename: Anne
authors.initials: A
authors.lastname: Kelterbaum
authors.affiliation: European Mobile Laboratory Consortium National Reference Center for Viral Hemorrhagic Fevers Laboratoire P4 Inserm-Jean Mérieux.
authors.forename: Anne
authors.initials: A
authors.lastname: Bocquin
authors.affiliation: European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems Institute of Virology, Philipps University Marburg.
authors.forename: Thomas
authors.initials: T
authors.lastname: Strecker
authors.affiliation: European Mobile Laboratory Consortium National Reference Center for Viral Hemorrhagic Fevers Unité de Biologie des Infections Virales Emergentes, Institut Pasteur, Lyon, France.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Fizet
authors.affiliation: European Mobile Laboratory Consortium National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
authors.forename: Concetta
authors.initials: C
authors.lastname: Castilletti
authors.affiliation: European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems Institute of Virology, Philipps University Marburg.
authors.forename: Gordian
authors.initials: G
authors.lastname: Schudt
authors.affiliation: European Mobile Laboratory Consortium Public Health England, Porton Down.
authors.forename: Lisa
authors.initials: L
authors.lastname: Ottowell
authors.affiliation: European Mobile Laboratory Consortium Robert Koch Institute, Berlin.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kurth
authors.affiliation: European Mobile Laboratory Consortium Public Health England, Porton Down.
authors.forename: Barry
authors.initials: B
authors.lastname: Atkinson
authors.affiliation: Bernhard Nocht Institute for Tropical Medicine European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems.
authors.forename: Marlis
authors.initials: M
authors.lastname: Badusche
authors.affiliation: European Mobile Laboratory Consortium National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Cannas
authors.affiliation: Bernhard Nocht Institute for Tropical Medicine European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems.
authors.forename: Elisa
authors.initials: E
authors.lastname: Pallasch
authors.affiliation: European Mobile Laboratory Consortium Public Health England, Porton Down.
authors.forename: Andrew
authors.initials: A
authors.lastname: Bosworth
authors.affiliation: European Mobile Laboratory Consortium Robert Koch Institute, Berlin.
authors.forename: Constanze
authors.initials: C
authors.lastname: Yue
authors.affiliation: European Mobile Laboratory Consortium National Biosafety Laboratory, National Center for Epidemiology, Budapest, Hungary.
authors.forename: Bernadett
authors.initials: B
authors.lastname: Pályi
authors.affiliation: European Mobile Laboratory Consortium Robert Koch Institute, Berlin.
authors.forename: Heinz
authors.initials: H
authors.lastname: Ellerbrok
authors.affiliation: European Mobile Laboratory Consortium Robert Koch Institute, Berlin.
authors.forename: Claudia
authors.initials: C
authors.lastname: Kohl
authors.affiliation: Bernhard Nocht Institute for Tropical Medicine European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems.
authors.forename: Lisa
authors.initials: L
authors.lastname: Oestereich
authors.affiliation: European Mobile Laboratory Consortium Public Health England, Porton Down.
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Logue
authors.affiliation: European Mobile Laboratory Consortium Heinrich Pette Institute-Leibniz Institute for Experimental Virology, Hamburg German Center for Infection Research, Hamburg-Munich-Marburg-Riems.
authors.forename: Anja
authors.initials: A
authors.lastname: Lüdtke
authors.affiliation: European Mobile Laboratory Consortium Robert Koch Institute, Berlin.
authors.forename: Martin
authors.initials: M
authors.lastname: Richter
authors.affiliation: European Mobile Laboratory Consortium Public Health England, Porton Down.
authors.forename: Didier
authors.initials: D
authors.lastname: Ngabo
authors.affiliation: European Mobile Laboratory Consortium Evolutionary Ecology Group, Department of Biology, University of Antwerp.
authors.forename: Benny
authors.initials: B
authors.lastname: Borremans
authors.affiliation: European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems Institute of Virology, Philipps University Marburg.
authors.forename: Dirk
authors.initials: D
authors.lastname: Becker
authors.affiliation: European Mobile Laboratory Consortium Evolutionary Ecology Group, Department of Biology, University of Antwerp.
authors.forename: Sophie
authors.initials: S
authors.lastname: Gryseels
authors.affiliation: European Mobile Laboratory Consortium Institute of Tropical Medicine, Antwerp.
authors.forename: Saïd
authors.initials: S
authors.lastname: Abdellati
authors.affiliation: European Mobile Laboratory Consortium Institute of Tropical Medicine, Antwerp.
authors.forename: Tine
authors.initials: T
authors.lastname: Vermoesen
authors.affiliation: European Mobile Laboratory Consortium Public Health England, Porton Down.
authors.forename: Eeva
authors.initials: E
authors.lastname: Kuisma
authors.affiliation: European Mobile Laboratory Consortium Public Health Agency of Sweden, Solna.
authors.forename: Annette
authors.initials: A
authors.lastname: Kraus
authors.affiliation: Bernhard Nocht Institute for Tropical Medicine European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems.
authors.forename: Britta
authors.initials: B
authors.lastname: Liedigk
authors.affiliation: European Mobile Laboratory Consortium Department of Microbiology and Immunology, Rega Institute, KU Leuven.
authors.forename: Piet
authors.initials: P
authors.lastname: Maes
authors.affiliation: European Mobile Laboratory Consortium Public Health England, Porton Down.
authors.forename: Ruth
authors.initials: R
authors.lastname: Thom
authors.affiliation: European Mobile Laboratory Consortium Department of Microbiology and Immunology, Rega Institute, KU Leuven.
authors.forename: Sophie
authors.initials: S
authors.lastname: Duraffour
authors.affiliation: European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald, Insel Riems, Germany.
authors.forename: Sandra
authors.initials: S
authors.lastname: Diederich
authors.affiliation: European Mobile Laboratory Consortium Robert Koch Institute, Berlin.
authors.forename: Julia
authors.initials: J
authors.lastname: Hinzmann
authors.affiliation: European Mobile Laboratory Consortium Public Health England, Porton Down.
authors.forename: Babak
authors.initials: B
authors.lastname: Afrough
authors.affiliation: European Mobile Laboratory Consortium Janssen-Cilag, Stockholm, Sweden.
authors.forename: Johanna
authors.initials: J
authors.lastname: Repits
authors.affiliation: European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald, Insel Riems, Germany.
authors.forename: Marc
authors.initials: M
authors.lastname: Mertens
authors.affiliation: European Mobile Laboratory Consortium Public Health England, Porton Down.
authors.forename: Inês
authors.initials: I
authors.lastname: Vitoriano
authors.affiliation: European Mobile Laboratory Consortium Swiss Tropical and Public Health Institute, Basel.
authors.forename: Amadou
authors.initials: A
authors.lastname: Bah
authors.affiliation: European Mobile Laboratory Consortium Robert Koch Institute, Berlin.
authors.forename: Andreas
authors.initials: A
authors.lastname: Sachse
authors.affiliation: European Mobile Laboratory Consortium Robert Koch Institute, Berlin.
authors.forename: Jan Peter
authors.initials: JP
authors.lastname: Boettcher
authors.affiliation: Bernhard Nocht Institute for Tropical Medicine European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Wurr
authors.affiliation: Bernhard Nocht Institute for Tropical Medicine European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Bockholt
authors.affiliation: European Mobile Laboratory Consortium Robert Koch Institute, Berlin.
authors.forename: Andreas
authors.initials: A
authors.lastname: Nitsche
authors.affiliation: European Mobile Laboratory Consortium Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Slovenia.
authors.forename: Tatjana Avšič
authors.initials: TA
authors.lastname: Županc
authors.affiliation: European Mobile Laboratory Consortium Spiez Laboratory, Federal Office for Civil Protection.
authors.forename: Marc
authors.initials: M
authors.lastname: Strasser
authors.affiliation: European Mobile Laboratory Consortium National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ippolito
authors.affiliation: European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems Institute of Virology, Philipps University Marburg.
authors.forename: Stephan
authors.initials: S
authors.lastname: Becker
authors.affiliation: European Mobile Laboratory Consortium Laboratoire P4 Inserm-Jean Mérieux.
authors.forename: Herve
authors.initials: H
authors.lastname: Raoul
authors.affiliation: European Mobile Laboratory Consortium Public Health England, Porton Down South General Hospital, University of Southampton, United Kingdom.
authors.forename: Miles W
authors.initials: MW
authors.lastname: Carroll
authors.affiliation: Médecins Sans Frontières, Brussels, Belgium.
authors.forename: Hilde
authors.initials: H
authors.lastname: De Clerck
authors.affiliation: Médecins Sans Frontières, Brussels, Belgium.
authors.forename: Michel
authors.initials: M
authors.lastname: Van Herp
authors.affiliation: Médecins Sans Frontières, Brussels, Belgium.
authors.forename: Armand
authors.initials: A
authors.lastname: Sprecher
authors.affiliation: Institut National de Santé Publique.
authors.forename: Lamine
authors.initials: L
authors.lastname: Koivogui
authors.affiliation: Université Gamal Abdel Nasser de Conakry, Laboratoire des Fièvres Hémorragiques en Guinée, Guinea.
authors.forename: N'Faly
authors.initials: N
authors.lastname: Magassouba
authors.affiliation: Ministry of Health Guinea.
authors.forename: Sakoba
authors.initials: S
authors.lastname: Keïta
authors.affiliation: World Health Organization, Geneva, Switzerland.
authors.forename: Patrick
authors.initials: P
authors.lastname: Drury
authors.affiliation: World Health Organization, Geneva, Switzerland.
authors.forename: Cèline
authors.initials: C
authors.lastname: Gurry
authors.affiliation: World Health Organization, Geneva, Switzerland.
authors.forename: Pierre
authors.initials: P
authors.lastname: Formenty
authors.affiliation: Bernhard Nocht Institute for Tropical Medicine German Center for Infection Research, Hamburg-Munich-Marburg-Riems.
authors.forename: Jürgen
authors.initials: J
authors.lastname: May
authors.affiliation: Bernhard Nocht Institute for Tropical Medicine European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems.
authors.forename: Martin
authors.initials: M
authors.lastname: Gabriel
authors.affiliation: European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems Bundeswehr Institute of Microbiology, Munich.
authors.forename: Roman
authors.initials: R
authors.lastname: Wölfel
authors.affiliation: Bernhard Nocht Institute for Tropical Medicine European Mobile Laboratory Consortium German Center for Infection Research, Hamburg-Munich-Marburg-Riems.
authors.forename: Stephan
authors.initials: S
authors.lastname: Günther
authors.affiliation: European Mobile Laboratory Consortium National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Di Caro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D064790:Clinical Laboratory Services; D029043:Ebolavirus / Q000235:genetics / Q000302:isolation & purification*; D058872:Epidemics; D005260:Female; D016563:Filoviridae; D018702:Filoviridae Infections / Q000150:complications / Q000175:diagnosis* / Q000821:virology; D016701:Guinea; D019142:Hemorrhagic Fever, Ebola / Q000150:complications / Q000175:diagnosis* / Q000821:virology; D006801:Humans; D007223:Infant; D008288:Malaria / Q000150:complications* / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D008952:Mobile Health Units; D012367:RNA, Viral / Q000097:blood; D019562:Viral Load; D055815:Young Adult
chemical_list: D012367:RNA, Viral
keywords: Ebola virus disease; Filovirus; Guinea; epidemic; malaria; mobile laboratory