Resurgence of Ebola virus in 2021 in Guinea suggests a new paradigm for outbreaks

Keita AK, Koundouno FR, Faye M, Düx A, Hinzmann J, Diallo H, Ayouba A, Le Marcis F, Soropogui B, Ifono K, Diagne MM, Sow MS, Bore JA, Calvignac-Spencer S, Vidal N, Camara J, Keita MB, Renevey A, Diallo A, Soumah AK, Millimono SL, Mari-Saez A, Diop M, Doré A, Soumah FY, Kourouma K, Vielle NJ, Loucoubar C, Camara I, Kourouma K, Annibaldis G, Bah A, Thielebein A, Pahlmann M, Pullan ST, Carroll MW, Quick J, Formenty P, Legand A, Pietro K, Wiley MR, Tordo N, Peyrefitte C, McCrone JT, Rambaut A, Sidibé Y, Barry MD, Kourouma M, Saouromou CD, Condé M, Baldé M, Povogui M, Keita S, Diakite M, Bah MS, Sidibe A, Diakite D, Sako FB, Traore FA, Ki-Zerbo GA, Lemey P, Günther S, Kafetzopoulou LE, Sall AA, Delaporte E, Duraffour S, Faye O, Leendertz FH, Peeters M, Toure A & Magassouba NF

(2021) Nature 597, 539-543.

Seven years after the declaration of the first epidemic of Ebola virus disease in Guinea, the country faced a new outbreak?between 14 February and 19 June 2021?near the epicentre of the previous epidemic1,2. Here we use next-generation sequencing to generate complete or near-complete genomes of Zaire ebolavirus from samples obtained from 12 different patients. These genomes form a well-supported phylogenetic cluster with genomes from the previous outbreak, which indicates that the new outbreak was not the result of a new spillover event from an animal reservoir. The 2021 lineage shows considerably lower divergence than would be expected during sustained human-to-human transmission, which suggests a persistent infection with reduced replication or a period of latency. The resurgence of Zaire ebolavirus from humans five years after the end of the previous outbreak of Ebola virus disease reinforces the need for long-term medical and social care for patients who survive the disease, to reduce the risk of re-emergence and to prevent further stigmatization. © 2021, The Author(s), under exclusive licence to Springer Nature Limited.

Andrew Rambaut, 2007