NY Timesによれば..
Sierra Leone’s explosion of Ebola cases in early summer appears to stem from one traditional healer’s funeral at which 14 women were infected, according to scientists studying the blood of victims.
The funeral was in Koindu, a diamond-mining town across the border from Guéckédou in Guinea, where the outbreak is thought to have begun in December, and the healer was known for treating victims of a mysterious illness that turned out to be Ebola.

The funeral’s central role, which local doctors had anecdotally suspected, was confirmed by geneticists at the Broad Institute of M.I.T. and Harvard who sequenced the virus found in 78 patients treated at Kenema Government Hospital in northeastern Sierra Leone, near the borders with Liberia and Guinea, two countries that are also at the heart of the outbreak.


葬儀は、12月にアウトブレイクが始まったギニアのGuéckédouから、国境をまたいだ鉱山の町Koindu [Kissi Teng Chiefdom]で行われた。この治療師は、後にエボラだと判明した謎の病気の感染者を治療することで知られていた。

葬儀が感染に重要な役割を果たしたという、地元の医師たちの逸話的な疑いは、MMITのBroad Institute及びHarvardによる、シエラレオネ北部のKenema Government Hospitalで治療を受けた78名の患者から採取されたウィルスのシーケンス分析により、確認された。この病院は、同じくアウトブレイク中のリベリアとギニアの国境近くにある。

[DONALD G. McNEIL Jr: "Outbreak in Sierra Leone Is Tied to Single Funeral Where 14 Women Were Infected" (2014/08/28) on NY Times]

12 patients carrying iSNV 10,218 cluster geographically and temporally (HCW-A = unsequenced health care worker, Driver drove HCW-A from Kissi Teng to Jawie, then continued alone to Mambolo, HCW-B treated HCW-A).

iSNV 10,218 clusterを感染輸送した12名の感染者の地理的・時間的な推移。
HCW-A: シーケンス分析できていない医療関係者
Driver: HCW-AをKissi TengからJawierに運び、その後は一人でMamboloに行った。
HCW-B: HCW-Aの治療を行った医師

[Stephen K. Gire et al: "Genomic surveillance elucidates Ebola virus origin and transmission during the 2014 outbreak", Science DOI: 10.1126/science.1259657]

これはWHOのEbola virus disease (EVD)の感染者の数字の時系列の、シエラレオネの立ち上がりに対応する。
The scientists not only found that all 78 had virus traceable to funeral guests, but also showed that the West African Ebola strain was quite different from a strain that has been circulating thousands of miles away in Central Africa since 1976, and that the two probably diverged as far back as 2004.

“No one knows where it’s been during that time,” said Dr. Pardis C. Sabeti, a Harvard geneticist and study co-author.

It might, she added, have circulated in some combination of bats, apes or other forest animals, “or it could have been circulating in humans for 10 years with little or no notice.”

That information is important, experts said, because the diagnostic tests now in use, as well as drugs and vaccines under consideration, are based on the Central African strain and might not work well on this outbreak. For example, a diagnostic test in use now might not give a clear positive if a victim had a low viral load early in an infection.


Harvardの遺伝学者で、この論文の共著者であるDr. Pardis C. Sabetiは「いつ、どこで起きたかはわからない。コウモリやサルやその他の森林の動物の間での感染が続いていたかもしれない。まったく、あるいはほとんど気づかれずに10年以上にわたり、人間の間で感染が続いていたかもしれない。」と述べた。


[DONALD G. McNEIL Jr: "Outbreak in Sierra Leone Is Tied to Single Funeral Where 14 Women Were Infected" (2014/08/28) on NY Times]
The study also found that the 78 victims had two variants of the West African strain. The healer might have been infected with two variants from two of her patients, said Stephen K. Gire, another co-author from Dr. Sabeti’s lab. Or someone else at the funeral could have been infectious.

78名の感染者の研究から西アフリカ株の2つの変種が見つかった。「伝統的治療師は2人の患者から2つの変種に感染した可能性がある。あるいは葬儀参列者の誰かが感染者だったかもしれない」と、Dr. Sabetiのラボのメンバーで共著者のひとりであるStephen K Gireは述べた。

[DONALD G. McNEIL Jr: "Outbreak in Sierra Leone Is Tied to Single Funeral Where 14 Women Were Infected" (2014/08/28) on NY Times]

posted by Kumicit at 2014/09/01 07:49 | Comment(0) | TrackBack(0) | Disease | このブログの読者になる | 更新情報をチェックする