첫 번째 에볼라 출혈열 발발은 1976년 콩고 민주 공화국과 수단에서 발생했으며, 이후 2014년서 아프리카에서 27,741건, 11,284건의 사망자가 발생했다. 발열은 Filoviridae 계열에 속하며 ssRNA 게놈을 가진 에볼라 바이러스에 의해 발생했다. 바이러스의 알려진 아형은 Bundibugyo ebolavirus, Reston ebolavirus, Sudan ebolavirus, Tai Forest ebolavirus 및 Zaire ebolavirus이다. 역사적으로 에볼라의 주요 발생 지역은 동부 및 중부 아프리카 열대 지방에서 발생했다. 서아프리카에서의 발발로 인해 전세계 사회에서 수많은 사망과 공포가 확산되었다. 효과적인 치료와 백신이 없는 상황에서 전염병을 관리하고 통제하는 가장 중요한 방법은 정확한 진단을 통해서이다. WHO(세계 보건기구)는 체외진단(IVD) 검사에서 에볼라의 선택과 사용에 관한 긴급 지침을 발표했다. RealStar Ebolavirus Screen RT-PCR키트 1.0 (Altona), Liferiver-Ebola Virus (EBOV) 실시간 RT-PCR 키트, Xpert 에볼라 검사 및 ReEBOV 항원 검사를 통해 수많은 회사 및 연구 기관에서 진단을 받고 4가지 WHO 조달 승인 진단을 확인했다. 또한, 신속한 검사 키트 Rapid Diagnosis Test (RDT)와 같은 새로운 진단법이 현재 연구 중이다.
첫 번째 에볼라 출혈열 발발은 1976년 콩고 민주 공화국과 수단에서 발생했으며, 이후 2014년서 아프리카에서 27,741건, 11,284건의 사망자가 발생했다. 발열은 Filoviridae 계열에 속하며 ssRNA 게놈을 가진 에볼라 바이러스에 의해 발생했다. 바이러스의 알려진 아형은 Bundibugyo ebolavirus, Reston ebolavirus, Sudan ebolavirus, Tai Forest ebolavirus 및 Zaire ebolavirus이다. 역사적으로 에볼라의 주요 발생 지역은 동부 및 중부 아프리카 열대 지방에서 발생했다. 서아프리카에서의 발발로 인해 전세계 사회에서 수많은 사망과 공포가 확산되었다. 효과적인 치료와 백신이 없는 상황에서 전염병을 관리하고 통제하는 가장 중요한 방법은 정확한 진단을 통해서이다. WHO(세계 보건기구)는 체외진단(IVD) 검사에서 에볼라의 선택과 사용에 관한 긴급 지침을 발표했다. RealStar Ebolavirus Screen RT-PCR 키트 1.0 (Altona), Liferiver-Ebola Virus (EBOV) 실시간 RT-PCR 키트, Xpert 에볼라 검사 및 ReEBOV 항원 검사를 통해 수많은 회사 및 연구 기관에서 진단을 받고 4가지 WHO 조달 승인 진단을 확인했다. 또한, 신속한 검사 키트 Rapid Diagnosis Test (RDT)와 같은 새로운 진단법이 현재 연구 중이다.
The first Ebola hemorrhagic fever outbreak occurred in the Democratic Republic of Congo and Sudan in 1976 and then emerged in West Africa in 2014 with a total of 27,741 cases and 11,284 deaths. The fever is caused by the Ebola virus, which belongs to the Filoviridae family and contains a ssRNA genom...
The first Ebola hemorrhagic fever outbreak occurred in the Democratic Republic of Congo and Sudan in 1976 and then emerged in West Africa in 2014 with a total of 27,741 cases and 11,284 deaths. The fever is caused by the Ebola virus, which belongs to the Filoviridae family and contains a ssRNA genome. The known subtypes of the virus are Bundibugyo ebolavirus, Reston ebolavirus, Sudan ebolavirus, $Ta\ddot{i}$ Forest ebolavirus, and Zaire ebolavirus. The Ebola outbreak was historically originated majorly from the East and Central African tropical belt. The current outbreaks in West Africa caused numerous deaths and spread fear in global society. In the absence of effective treatment strategies and any vaccine, accurate diagnosis is the most important contributing factor in the management and control of the epidemic disease. WHO (World Health Organization) has announced emergency guidance for the selection and use of Ebola in in vitro diagnostic assays. Numerous companies and research institutions have studied the various diagnosis methods and identified four WHO procurement approved as diagnosis kits: RealStar Ebolavirus Screen RT-PCR kit 1.0 (Altona), Liferiver-Ebola Virus (EBOV) Real time RT-PCR kit, Xpert Ebola Assay, and ReEBOV Antigen Rapid Test Kit. The efficiency of novel diagnostic kits such as Rapid Diagnosis Test (RDT) is currently being evaluated.
The first Ebola hemorrhagic fever outbreak occurred in the Democratic Republic of Congo and Sudan in 1976 and then emerged in West Africa in 2014 with a total of 27,741 cases and 11,284 deaths. The fever is caused by the Ebola virus, which belongs to the Filoviridae family and contains a ssRNA genome. The known subtypes of the virus are Bundibugyo ebolavirus, Reston ebolavirus, Sudan ebolavirus, $Ta\ddot{i}$ Forest ebolavirus, and Zaire ebolavirus. The Ebola outbreak was historically originated majorly from the East and Central African tropical belt. The current outbreaks in West Africa caused numerous deaths and spread fear in global society. In the absence of effective treatment strategies and any vaccine, accurate diagnosis is the most important contributing factor in the management and control of the epidemic disease. WHO (World Health Organization) has announced emergency guidance for the selection and use of Ebola in in vitro diagnostic assays. Numerous companies and research institutions have studied the various diagnosis methods and identified four WHO procurement approved as diagnosis kits: RealStar Ebolavirus Screen RT-PCR kit 1.0 (Altona), Liferiver-Ebola Virus (EBOV) Real time RT-PCR kit, Xpert Ebola Assay, and ReEBOV Antigen Rapid Test Kit. The efficiency of novel diagnostic kits such as Rapid Diagnosis Test (RDT) is currently being evaluated.
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제안 방법
The map denotes the locations of Ebola viruses outbreaks by colored circles for Zaire ebolavirus (red), Sudan ebolavirus (blue), and Both of types (purple). It was modified from the Simplified angular world map.
The ReEBOV Antigen Rapid Test kit manufactured by Corgenix Medical Corporation (USA) is the only antigen test WHO procurement approved in February 19, 2015. The test is intended for presumptive detection of the EVD so that the results should be confirmed by another more complicated IVD such as RT-PCR [20]. The test is immune chromatographic dipstick immune-assay for detecting Ebola virus VP40 antigen.
이론/모형
Xpert Ebola Assay is the only WHO procurement approved automated RT-PCR in May 8, 2015 which performs qualitative detection of ZEBOV discovered in the West Africa 2014. The assay is customized Cepheid GeneXpert Instrument Systems and uses the single-use disposable GeneXpert cartridges which contain real-time reverse transcription PCR reagents and detect the total nucleic acids of Zaire ebolavirus. Also, every steps from purification to detection progresses continuously in the system [19].
The test is intended for presumptive detection of the EVD so that the results should be confirmed by another more complicated IVD such as RT-PCR [20]. The test is immune chromatographic dipstick immune-assay for detecting Ebola virus VP40 antigen. Without laboratory restriction and special equipment, the kit can be used by technicians who passed minimum training [21].
성능/효과
Study showed that the antigen test result of fingerstick testing corresponded to the result of venous blood draw. Also, the antigen test had sensitivity of 100% and specificity of 92% compared with the Altona RT-PCR assay. Through this result, the test could help health-care workers find the infected patients as soon as possible and classify the patients who need more management.
The sensitivity and specificity for the RT-PCR with capillary blood samples were 86.8% (95% confidence interval [CI], 71.9%−95.6%; 33/38 patients) and 100% (95% CI, 84.6%−100%; 22/22 patients).
후속연구
The study is focused on the application of ReEBOV antigen test with fingerstick samples which suggests the possibility of another point-of-care rapid diagnosis. Study showed that the antigen test result of fingerstick testing corresponded to the result of venous blood draw.
참고문헌 (22)
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What you need to know about Ebola. TORONTO SUN 2014 WEDNESDAY, JULY 30, 2014. Available from http://www.torontosun.com/2014/07/30/what-you-need-to-know-about-ebola.
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Team WIS. 1978. Ebola haemorrhagic fever in Sudan, 1976. Bullein of the World Health Organization 56: 247-270.
Bwaka MA, Bonnet M-J, Calain P, Colebunders P, Roo AD, Guimard Y, et al. 1999. Ebola hemorrhagic fever in Kikwit, Democratic Republic of the Congo: clinical observations in 103 patients. J. Infect. Dis. 179: S1-S7.
Lamunu M, Lutwama JJ, Kamugisha J, Opio A, Nambooze J, Ndayimirijed N, et al. 2004. Containing a haemorrhagic fever epidemic: the Ebola experience in Uganda (October 2000-January 2001). Int. J. Infect. Dis. 8: 27-37.
Situation Summary Data Published on 12 November 2014. Ebola data and statistics 2014. Available from http://apps.who.int/gho/data/view.ebola-sitrep.ebola-summary-20141112?langen.
Situation Summary Data Published on 02 January 2015. Ebola data and statistics 2015. Available from http://apps.who.int/gho/data/view.ebola-sitrep.ebola-summary-20150102?langen.
Situation Summary Data Published on 01 April 2015. Ebola data and statistics 2015. Available from http://apps.who.int/gho/data/view.ebola-sitrep.ebola-summary-20150401?langen.
Situation Summary Data Published on 05 August 2015. Ebola data and statistics 2015. Available from http://apps.who.int/gho/data/view.ebola-sitrep.ebola-summary-20150805?langen.
Diagnostics. Essential medicines and health products. 2014. Available from http://who.int/medicines/ebola-treatment/emp_ebola_diagnostics/en/.
WHO. Selection and Use of Ebola in vitro Diagnostic Assays. Emergencies preparedness, response 2015. Available from http://www.who.int/csr/resources/publications/ebola/ivd-assays/en/.
Perkins MD, Kessel M. 2015. What Ebola tells us about outbreak diagnostic readiness. Nat. Biotechnol. 33: 464-469.
RealStar $^{(R)}$ Filovirus Screen RT-PCR Kit 1.0, in WHO Emergency Quality Assessment Mechanism for EVD IVDs.
RealStar $^{(R)}$ Ebolavirus RT-PCR Kit*. Available from http://www.altonadiagnostics.com/realstar-ebolavirus-rt-pcr-kit.html.
Xpert $^{(R)}$ Ebola Assay, in WHO Emergency Use Assessment and Listing for EVD IVDs.
ReEBOV $^{TM}$ Antigen Rapid Test Kit, in WHO Emergency Use Assessment and Listing for Ebola Virus Disease IVDs.
Broadhurst MJ, Kelly JD, Miller A, Semper A, Bailey D, Groppelli E, et al. 2015. ReEBOV Antigen Rapid Test kit for point-of-care and laboratory-based testing for Ebola virus disease: a field validation study. Lancet 386: 867-874.
Strecker T, Palyi B, Ellerbrok H, Jonckheere S, Clerck H, Bore JA, et al. 2015. Field evaluation of capillary blood samples as a collection specimen for the rapid diagnosis of ebola virus infection during an outbreak emergency. Clin. Infect. Dis. 61: 669-675.
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