Understanding the epidemiology and natural history of unrecognized Ebola virus infection

了解未被识别的埃博拉病毒感染的流行病学和自然史

• 批准号: 9806757
• 负责人: John Daniel Kelly
• 金额: $ 19.91万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9806757
• 关键词: Address; African; Animals; Antibodies; Antibody Response; Area; Biometry; Blindness; Caring; Clinical; Comprehensive Health Care; Counseling; Data Analyses; Data Collection; Detection; Development; Diagnosis; Disease; Disease Outbreaks; Ebola Hemorrhagic Fever; Ebola virus; Emerging Communicable Diseases; Enrollment; Epidemiology; Exposure to; Filovirus; Follow-Up Studies; Frankfurt-Marburg Syndrome Virus; Future; Glycoproteins; Health care facility; Healthcare; Immunoglobulin G; Individual; Infection; Inflammatory Response; International; Lead; Liberia; Link; Longitudinal Studies; Longitudinal cohort; Low Prevalence; Mental Depression; Mental Health; Mentored Patient-Oriented Research Career Development Award; Mentors; Monkeypox; National Institute of Allergy and Infectious Disease; Natural History; Observational Study; Outcome; Patients; Policies; Population; Population Sizes; Prevalence; Public Health; Publishing; Quality of life; Recording of previous events; Reporting; Research; Resolution; Resources; Risk; Serologic tests; Serological; Services; Survivors; Symptoms; Uveitis; Viral; Viral Hemorrhagic Fevers; Virus; Virus Diseases; Work; World Health Organization; anxiety symptoms; base; career development; clinical care; cohort; data management; depressive symptoms; design; disability; improved; programs; psychosocial; recruit; seropositive; skills; tool

PROJECT SUMMARY/ABSTRACT A large number of Ebola virus infections may have been unrecognized during the 2013-2016 West African outbreak, both undiagnosed Ebola virus disease (EVD) as well as mildly symptomatic and asymptomatic infection. The epidemiology and natural history of infection in this unrecognized population, which is defined by positive Ebola serology and a history of exposure, are poorly understood. For instance, it is unknown if individuals with unrecognized infection have similar clinical and psychosocial sequelae as recognized cases, such as uveitis, depression, and work-related disability. Understanding the extent to which post-infectious sequelae occur and the predictors of unrecognized infection will bolster efforts to screen and link unrecognized, infected individuals - both symptomatic and asymptomatic - to survivor services and to better identify this population in future outbreaks. I will study a well characterized cohort of individuals with serological evidence of past, unrecognized, Ebola virus infection. I will utilize an existing cohort of close contacts of EVD survivors developed by the National Institute of Allergy and Infectious Diseases' Partnership for Research on Ebola Virus in Liberia (PREVAIL). The PREVAIL program began a natural history study of EVD survivors and their close contacts in June 2015. Over 1,100 EVD survivors have been enrolled with the aim of characterizing their post-EVD clinical sequelae, viral persistence, and durability of antibody response. Over 2,300 close contacts have also been enrolled as the comparison population. A total of 230 (10%) close contacts of EVD survivors were found to be seropositive by the quantitative FANG Ebola EIA and had not been reported as having had EVD. At study baseline, 57% of this population reported having had symptoms in the three-week period after exposure to Ebola virus, and 43% did not. This will be the first systematic, longitudinal study of unrecognized survivors of Ebola virus infection. This K23 proposal aims to: (1) identify the clinical sequelae of unrecognized, symptomatic Ebola virus infection, (2) identify the predictors and clinical sequelae of unrecognized, asymptomatic Ebola virus infection, and (3) identify psychosocial sequelae among unrecognized, symptomatic EVD survivors. My career development aims involve: (1) design of observational studies, (2) advanced biostatistics, and (3) field epidemiology in low-resource settings. This plan will be carried out with coursework, directed study, and the guidance of an international team of mentors. In addition to future study of longer-term sequelae of EVD, I will apply these skills and expertise to an R01 application in which I study the epidemiology and natural history of other viral hemorrhagic fever and emerging infectious diseases such as Marburg virus and monkeypox.

项目摘要/摘要 在2013 - 2016年西部，可能无法识别出大量的埃博拉病毒感染 非洲爆发，均未诊断未诊断的埃博拉病毒疾病（EVD）以及轻度症状和 无症状感染。在这个未认可的人群中，感染的流行病学和自然史， 这是由阳性埃博拉血清学和暴露史所定义的，对此知之甚少。例如，它是 未知感染的人是否具有类似的临床和社会心理后遗症 公认的病例，例如葡萄膜炎，抑郁和与工作有关的残疾。了解多大程度的程度 感染后的后遗症发生，未识别感染的预测因素将促进筛查和 将未识别的，感染的人（无论是有症状和无症状）与幸存者服务联系起来 在未来的爆发中更好地识别这一人群。 我将研究一个具有良好特征的人群，具有过去的血清学证据，无法识别， 埃博拉病毒感染。我将利用由EVD幸存者建立的现有的一系列密切联系 美国国家过敏和传染病研究所在利比里亚的埃博拉病毒研究伙伴关系 （盛行）。盛行的计划开始了对EVD幸存者的自然历史研究，并在 2015年6月。已招募了1,100多个EVD幸存者，目的是表征其EVD后临床 后遗症，病毒持久性和抗体反应的耐用性。超过2300个密切联系也已经 作为比较人群入学。共有230（10％）的EVD幸存者的密切接触是 通过定量的Fang Ebola EIA的血清阳性，尚未报道已有EVD。在研究中 基线，该人群中有57％的人报告在暴露后三周有症状 埃博拉病毒和43％的病毒没有。这将是对未识别的幸存者的首次系统的纵向研究 埃博拉病毒感染。 该K23提案的目的是：（1）确定未识别的，有症状的埃博拉病毒的临床后遗症 感染，（2）确定未识别的无症状埃博拉病毒感染的预测因子和临床后遗症， （3）在未识别的，有症状的EVD幸存者中确定心理社会后遗症。我的职业 开发目的涉及：（1）观察性研究的设计，（2）高级生物统计学和（3）字段 低资源环境中的流行病学。该计划将通过课程工作，定向学习以及 国际导师团队的指导。除了将来对EVD的长期后遗症的研究之外，我还将 将这些技能和专业知识应用于R01应用程序，在其中我研究了流行病学和自然历史 其他病毒出血热和新兴的传染病，例如马堡病毒和蒙基托克斯。