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Commentary

Nigeria Index Matches Ebola Sub-Clade In Guinea & Sierra Leone
Recombinomics Commentary 17:15
August 11, 2014

The lab in LUTH under Prof Omilabu received samples on July 22nd and the next day provided results of a pan-FILOVIRUS family diagnosis, that is evidence of presence of a virus belonging to the family of Ebola virus (including Marburg, Ebola-Zaire, Ebola-Sudan Bundibugyo virus, Reston virus, and Taï Forest virus).

Samples were also sent to Prof. Happi’s lab at the Redeemer’s University (RUN), late on July 23. The Happi team worked and tested and confirmed that the virus was the specific Ebola-Zaire type virus early on July 25, 2014. All these happened before confirmation came in from Dakar. I understand the RUN lab will commence sequencing studies pretty soon. My congratulations to our colleagues in LUTH and RUN for a great job.

The lab at LUTH (Lagos University Teaching Hospital) has released a 239 BP sequence, LIB/NIG 01072014, from the Nigeria index case, Patrick Sawyer.  The RNA polymerase (L gene) sequence is identical to all 2014 Ebola virus (EBOV) at Genbank (3 from March collections in Guinea and 95 June collections from Sierra Leone), in contrast to all earlier Ebola sequences..

The index case arrived in Lagos on July 20 from Monrovia, Liberia (via planes from Monrovia to Accra, Ghana and Accra to Lagos, with a stop in Lome, Togo) but denied contact with Ebola patients (even though he had close contact with his sister, Princess Nyuennyue, who was Ebola lab confirmed and died in early July).  He was tested for Malaria and HIV, but was not tested for Ebola until July 22 (and the sample was used to PCR confirm a filovirus, as noted above, as well as generate the 239 BP sequence).

The delay in confirmation of Ebola has led to the infection of a large number of contacts, who are largely health care workers (HCW) and media reports indicate additional patients at First Consultant Hospital Obalande (including a pregnant patient), where the index case was treated.

Thus, the recently released sequence represents Ebola circulating in Nigeria and Liberia, which matches sequences from Sierra Leone and Guinea, confirming that the outbreaks in all four countries are linked to a single introduction, which appears to be a 2 year old boy in Guinea and late 2013 (he died December 6, 2013).

The most recent WHO update of August 8 on cases through August 6, cites 13 cases in Nigeria (which included 7 probable cases, which were those lab confirmed in Nigeria).  However, none are listed as confirmed because of delays in transporting a sample to the WHO regional center in Senegal.  As noted above, the index case has been confirmed by at least two labs in Nigeria by PCR, as well as sequence confirmation that the Ebola is the novel Zaire sub-clade described previously.

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