Resurgence of Ebola virus in 2021 in Guinea suggests a new paradigm for outbreaks

Nature. 2021 Sep;597(7877):539-543. doi: 10.1038/s41586-021-03901-9. Epub 2021 Sep 15.


Seven years after the declaration of the first epidemic of Ebola virus disease in Guinea, the country faced a new outbreak-between 14 February and 19 June 2021-near the epicentre of the previous epidemic1,2. Here we use next-generation sequencing to generate complete or near-complete genomes of Zaire ebolavirus from samples obtained from 12 different patients. These genomes form a well-supported phylogenetic cluster with genomes from the previous outbreak, which indicates that the new outbreak was not the result of a new spillover event from an animal reservoir. The 2021 lineage shows considerably lower divergence than would be expected during sustained human-to-human transmission, which suggests a persistent infection with reduced replication or a period of latency. The resurgence of Zaire ebolavirus from humans five years after the end of the previous outbreak of Ebola virus disease reinforces the need for long-term medical and social care for patients who survive the disease, to reduce the risk of re-emergence and to prevent further stigmatization.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Democratic Republic of the Congo / epidemiology
  • Disease Outbreaks* / statistics & numerical data
  • Ebolavirus / classification
  • Ebolavirus / genetics*
  • Ebolavirus / isolation & purification*
  • Female
  • Guinea / epidemiology
  • Hemorrhagic Fever, Ebola / epidemiology*
  • Hemorrhagic Fever, Ebola / transmission
  • Hemorrhagic Fever, Ebola / virology*
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Male
  • Models, Biological*
  • Persistent Infection / virology
  • Phylogeny
  • Survivors
  • Time Factors
  • Viral Zoonoses / transmission
  • Viral Zoonoses / virology