Brief Report: Ebola Virus Transmission Initiated by Relapse of Systemic Ebola Virus Disease

New England Journal of Medicine
April 1, 2021 Vol. 384 No. 13
http://www.nejm.org/toc/nejm/medical-journal

 

Original Articles
Brief Report: Ebola Virus Transmission Initiated by Relapse of Systemic Ebola Virus Disease
Placide Mbala-Kingebeni, M.D., Ph.D. et al
Summary
During the 2018–2020 Ebola virus disease (EVD) outbreak in North Kivu province in the Democratic Republic of Congo, EVD was diagnosed in a patient who had received the recombinant vesicular stomatitis virus–based vaccine expressing a ZEBOV glycoprotein (rVSV-ZEBOV) (Merck). His treatment included an Ebola virus (EBOV)–specific monoclonal antibody (mAb114), and he recovered within 14 days. However, 6 months later, he presented again with severe EVD-like illness and EBOV viremia, and he died. We initiated epidemiologic and genomic investigations that showed that the patient had had a relapse of acute EVD that led to a transmission chain resulting in 91 cases across six health zones over 4 months. (Funded by the Bill and Melinda Gates Foundation and others.)