Ebola virus transmission initiated by systemic ebola virus disease relapse

Placide Mbala-Kingebeni, Catherine Pratt, Mbusa Mutafali Ruffin, Matthias G Pauthner, Faustin Bile, Andrew Rambaut, Antoine Nkuba Ndaye, Allison Black, Eddy Kinganda Lusamaki, Martin Faye, Amuri Aziza, Moussa M Diagne, Daniel Mukadi, Bailey White, James Hadfield, Karthik Gangavarapu, Nella Bisento, Donatien Kazadi, Bibiche Nsunda, Marceline AkongaOlivier Tshiani, John Misasi, Aurelie Ploquin, Victor Epaso, Emilia Sana Paka, Yannick Tutu Tshia N’kasar, Fabrice Mambu, Francois Edidi, Meris Matondo, Junior Bula Bula, Boubacar Diallo, Mory Keita, Marie Roseline Darnycka Belizaire, Ibrahima Soce Fall, Abdoulaye Yam, Mulangu Sabue, Anne W. Rimion, Elias L Salfati, Ali Torkamani, Marc A. Suchard, Ian Crozier, Lisa E. Hensley, Andrew Rambaut, Ousmane Faye, Amadou A. Sall, Nancy J. Sullivan, Trevor Bedford, Kristian G. Andersen, Michael R. Wiley, Steve Ahuka-Mundeke, Jean-Jacques Muyembe-Tamfum

Research output: Contribution to journalArticlepeer-review


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 aZEBOV 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.)
Original languageEnglish
Pages (from-to)1240-1247
Number of pages8
JournalNew England Journal of Medicine
Early online date1 Apr 2021
Publication statusE-pub ahead of print - 1 Apr 2021

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