Spillover of ebolaviruses into people in eastern Democratic Republic of Congo prior to the 2018 Ebola virus disease outbreak

Tracey Goldstein; Manjunatha N Belaganahalli; Eddy K Syaluha; Jean-Paul K Lukusa; Denise J Greig; Simon J Anthony; Alexandre Tremeau-Bravard; Riddhi Thakkar; Adrian Caciula; Nischay Mishra; W Ian Lipkin; Jasjeet K Dhanota; Brett R Smith; Victoria M Ontiveros; Nistara Randhawa; Michael Cranfield; Christine K Johnson; Kirsten V Gilardi; Jonna A K Mazet

doi:10.1186/s42522-020-00028-1

Spillover of ebolaviruses into people in eastern Democratic Republic of Congo prior to the 2018 Ebola virus disease outbreak

One Health Outlook. 2020;2(1):21. doi: 10.1186/s42522-020-00028-1. Epub 2020 Nov 4.

Authors

Tracey Goldstein¹, Manjunatha N Belaganahalli¹, Eddy K Syaluha², Jean-Paul K Lukusa², Denise J Greig¹, Simon J Anthony^{3

4}, Alexandre Tremeau-Bravard¹, Riddhi Thakkar³, Adrian Caciula³, Nischay Mishra³, W Ian Lipkin³, Jasjeet K Dhanota¹, Brett R Smith¹, Victoria M Ontiveros¹, Nistara Randhawa¹, Michael Cranfield^{1

2}, Christine K Johnson¹, Kirsten V Gilardi^{1

2}, Jonna A K Mazet¹

Affiliations

¹ One Health Institute & Karen C Drayer Wildlife Health Center, School of Veterinary Medicine, University of California Davis, California, USA.
² Mountain Gorilla Veterinary Project Inc, Goma, Democratic Republic of the Congo.
³ Center for Infection and Immunity, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032 USA.
⁴ Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY USA.

Abstract

Background: The second largest Ebola virus disease (EVD) outbreak began in the Democratic Republic of Congo in July 2018 in North Kivu Province. Data suggest the outbreak is not epidemiologically linked to the 2018 outbreak in Equateur Province, and that independent introduction of Ebola virus (EBOV) into humans occurred. We tested for antibodies to ebolaviruses in febrile patients seeking care in North Kivu Province prior to the EVD outbreak.

Methods: Patients were enrolled between May 2017 and April 2018, before the declared start of the outbreak in eastern DRC. Questionnaires were administered to collect demographic and behavioural information to identify risk factors for exposure. Biological samples were evaluated for ebolavirus nucleic acid, and for antibodies to ebolaviruses. Prevalence of exposure was calculated, and demographic factors evaluated for associations with ebolavirus serostatus.

Results: Samples were collected and tested from 272 people seeking care in the Rutshuru Health Zone in North Kivu Province. All patients were negative for filoviruses by PCR. Intial screening by indirect ELISA found that 30 people were reactive to EBOV-rGP. Results were supported by detection of ebolavirus reactive linear peptides using the Serochip platform. Differential screening of all reactive serum samples against the rGP of all six ebolaviruses and Marburg virus (MARV) showed that 29 people exhibited the strongest reactivity to EBOV and one to Bombali virus (BOMV), and western blotting confirmed results. Titers ranged from 1:100 to 1:12,800. Although both sexes and all ages tested positive for antibodies, women were significantly more likely to be positive and the majority of positives were in February 2018.

Conclusions: We provide the first documented evidence of exposure to Ebola virus in people in eastern DRC. We detected antibodies to EBOV in 10% of febrile patients seeking healthcare prior to the declaration of the 2018-2020 outbreak, suggesting early cases may have been missed or exposure ocurred without associated illness. We also report the first known detection of antibodies to BOMV, previously detected in bats in West and East Africa, and show that human exposure to BOMV has occurred. Our data suggest human exposure to ebolaviruses may be more frequent and geographically widespread.

Keywords: Bombali virus; Eastern DRC; Ebola virus; Ebola virus disease; Ebolavirus serology; Zoonosis.