Parallels Between SARS and Ebola Super Spreaders
Recombinomics Commentary
December 9, 2007
Jonah was the primary doctor for Muhindo Jeremiah, an older gentleman who had been active in visiting the sick in Kikyo then fell ill in Bundibugyo. A week and a half ago Muhindo died.
The above description of Jeremiah Muhindo, sounds remarkably similar to the physician, Liu Jianlun, who had been treating patients in China for a “mysterious disease” in February, 2003. The physician travel to Hong Kong to attend a wedding. After checking into room 911 at the Metropole Hotel, he fell ill and checked out, after vomiting in the hall. He subsequently died of SARS and did several guests and visitors on the 9th floor of the hotel. However, they first traveled to Singapore, Hanoi, Toronto, and Hong Kong before they developed symptoms. They were “super spreaders” and infected many contacts, including family members and health care workers.
The sequences of SARS CoV from the contacts indicated the index case was infected with multiple variants of the virus, possibly because he had seen many patients in China and was co-infected. The isolates from contacts were similar, but minor differences paired up with both earlier and later cases, indicating the super-spreaders, also had co-infections. These variants were generated through recombination.
The same scenario may be developing in Uganda involving a novel Ebola virus. The Bundibugyo strain is distinct from earlier Ebola isolates, and recent reports have described recombination in Ebola. In the recent demonstration Zaire isolates from patients and apes were compare to demonstrate the recombination, which was between closely related sequences.
Jeremiah Muhindo has been linked to fatal infections in contacts and health care workers at the Bundibugyo hospital, where Muhindo was the first Ebola linked fatality. His primary care doctor, Jonah Kule, had last contact on November 23, when he adjusted his patient’s oxygen mask. Five days later Dr Kule developed symptoms, and died on December 4. Within 24 hours, four other health care workers linked to the Bundigbugyo hospital, as well as a contact died. Muhindo’s mother, brother, wife, daughter, and two friends had been hospitalized. On December 7, his brother also died. Thus, at least six contacts have died and five others have been hospitalized (one of the health care workers has been discharged).
The spike in health care worker deaths, at the same tike as the deaths of contacts, suggests these cases may be linked and these cases may also be super-spreaders because they have been co-infected with multiple variants of the Bundibugyo Ebola species.
More information on the status of contacts, as well as sequences from this cluster would be useful.
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