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Presence and Persistence of Ebola or Marburg Virus in Patients and Survivors: A Rapid Systematic Review
Open accessAbstract
BACKGROUND: The 2013-15 Ebola outbreak was unprecedented due to sustained transmission within urban environments and thousands of survivors. In 2014 the World Health Organization stated that there was insufficient evidence to give definitive guidance about which body fluids are infectious and when they pose a risk to humans. We report a rapid systematic review of published evidence on the presence of filoviruses in body fluids of infected people and survivors. METHODS: Scientific articles were screened for information about filovirus in human body fluids. The aim was to find primary data that suggested high likelihood of actively infectious filovirus in human body fluids (viral RNA). Eligible infections were from Marburg virus (MARV or RAVV) and Zaire, Sudan, Taï Forest and Bundibugyo species of Ebola. Cause of infection had to be laboratory confirmed (in practice either tissue culture or RT-PCR tests), or evidenced by compatible clinical history with subsequent positivity for filovirus antibodies or inflammatory factors. Data were extracted and summarized narratively. RESULTS: 6831 unique articles were found, and after screening, 33 studies were eligible. For most body fluid types there were insufficient patients to draw strong conclusions, and prevalence of positivity was highly variable. Body fluids taken >16 days after onset were usually negative. In the six studies that used both assay methods RT-PCR tests for filovirus RNA gave positive results about 4 times more often than tissue culture. CONCLUSIONS: Filovirus was reported in most types of body fluid, but not in every sample from every otherwise confirmed patient. Apart from semen, most non-blood, RT-PCR positive samples are likely to be culture negative and so possibly of low infectious risk. Nevertheless, it is not apparent how relatively infectious many body fluids are during or after illness, even when culture-positive, not least because most test results come from more severe cases. Contact with blood and blood-stained body fluids remains the major risk for disease transmission because of the known high viral loads in blood.
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The host of MV is the fruit bat (Rousettus aegyptiacus), with transmission to humans occurring via direct contact with an infected animal host.
“The host of MV is the fruit bat (Rousettus aegyptiacus), with transmission to humans occurring via direct contact with an infected animal host (13,14).”
From Marburg virus disease outbreaks, mathematical models, and disease parameters: a systematic review (2024) · cites this paper as [14]
The Introduction says that Ebola probably has a bat reservoir and that wildlife contact generates some index cases. It does not identify Rousettus aegyptiacus as a Marburg virus host or establish animal-to-human transmission specifically for Marburg virus. (LLM, conf=0.78)
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Cited by
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Marburg virus disease outbreaks, mathematical models, and disease parameters: a systematic review
Cuomo-Dannenburg, G., McCain, K., McCabe, R., Unwin, H. J. T., Doohan, P., Nash, R. K., Hicks, J. T., Charniga, K., Geismar, C., Lambert, B., et al. (2024) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(23)00515-7 · Cited by 65
“The host of MV is the fruit bat (Rousettus aegyptiacus), with human transmission occurring via direct contact with an infected animal host or an infected human [10, 11].”
Metadata
- Authors
- Brainard, J., Pond, K., Hooper, L., Edmunds, K., & Hunter, P.
- Affiliations
- University of East Anglia (GB)
- University of Surrey (GB)
- Corresponding author
- Hunter, Paul
- Venue
- PLOS Neglected Tropical Diseases
- Publisher
- Public Library of Science (PLoS)
- Published
- 2016-02-29
- Volume
- 10
- Issue
- 2
- Pages
- e0004475
- ISSN
- 1935-2727 (ISSN-L)
- 1935-2735
- PMC
- PMC4771830
- OpenAlex
- W2289309620
- Cited by
- 65
- References
- 0
- Citations by year
- 2026: 8 · 2025: 7 · 2024: 8 · 2023: 5 · 2022: 2 · 2021: 5 · 2020: 2 · 2019: 5 · 2018: 6 · 2017: 9 · 2016: 8
- FWCI
- 1.43
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS neglected tropical diseases (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UEA Digital Repository (University of East Anglia) (acceptedVersion)
- Surrey Research Insight Open Access (The University of Surrey) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Funders
- National Institute for Health Research Health Protection Research Unit
- National Institute for Health and Care Research
- Public Health England
- Topics
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Outbreaks Research
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Vectors
- Health Sciences › Medicine › Epidemiology › Virology and Viral Diseases
- Keywords
- Ebola virus, Marburg virus, filoviruses, viral persistence, biological fluids, Ebola survivors, viral RNA, RT-PCR, tissue culture, infectious disease risk, semen, blood-borne transmission
- MeSH terms
- Animals, Body Fluids, Humans, Marburg Virus Disease, Survivors, Hemorrhagic Fever, Ebola, Marburgvirus, Ebolavirus
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