Global & Disaster Medicine

Asymptomatic Ebola: A Rare Event

Glynn JR, Bower H, Johnson S, et al. Asymptomatic infection and unrecognized Ebola virus disease in Ebola-affected households in Sierra Leone: a cross-sectional study using a new non-invasive assay for antibodies to Ebola virus. Lancet Infect Dis 2017;17:645-653.

“…..By using control subjects, Glynn and colleagues incorporated appropriate rigor into their low overall estimate of 2.6% asymptomatic infection. If asymptomatic infection is a rare event, as this study suggests, then outbreak control should be focused on identifying symptomatic individuals and initiating the appropriate infection control measures to halt an outbreak.

Additionally, the novel assay used in the study, which requires just oral swabbing, is an important new tool that can be employed in similar studies and to understand where Ebola has occurred in the past. As a new outbreak of Ebola has been identified in the DRC, it will be important to use this near real-time approach to target efforts on tasks that have the highest yield. As USAMRIID’s Kuhn and Bavari write in an accompanying editorial, “The biggest threat to human populations therefore remains another introduction of Ebola virus from its natural host–and not transmission from an apparently healthy person infected with Ebola virus…….”


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