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

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.

Seroprevalence of anti-SARS-CoV-2 antibodies among blood donors from December 2020 to June 2021 in Koutiala district, Mali.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus associated with coronavirus disease (COVID-19). At the time of the study, little data on the level of exposure of the population in Koutiala district in Mali to SARS-CoV-2 was available. Although blood donors are not representative of the general population, a COVID-19 seroprevalence estimate in this population was intended to assess the extent of community transmission, serve as a health alert system, and help guide the public health response. We measured seroprevalence of anti-SARS-CoV-2 antibodies using NG-Biotech SARS-Cov-2 RDT and ECLIA test between January and June 2020. This is a cross-sectional study of volunteer blood donors aged 18 to 60 years, independent of any previous COVID-19 disease. A stratified analysis of seroprevalence by month of sample collection and a comparison of the results of the NG-Biotech SARS-Cov-2 RDT with those of the ECLIA test was performed. The overall prevalence of antibodies to SARS-Cov-2 virus assessed by the NG-Biotech SARS-Cov-2 RDT was 24.6% (95% CI 21.8-27.4) and by the ECLIA test was 70.2 (95% CI 64.9-75.5). Both estimates remained relatively stable over the study period. We observed SARS-CoV-2 exposure much higher than indicated by case-based surveillance. The national surveillance system, as it was, was not able to detect variations in incidence, and as such, we do not recommend it as an alert system. However, the discrepancy between the results of the rapid test and the ECLIA test shows that further research is required to assess the validity of these test before a more solid conclusion can be drawn it their use in surveillance.

[Chronic otitis media complicated by Bezold's abscess and lateral sinus thrombophlebitis]. / Otite moyenne chronique compliquee d'un abces de Bezold et d'une thrombophlebite du sinus lateral : prise en charge d'un cas.

INTRODUCTION: Mastoiditis is a complication of otitis media and is defined as inflammation (usually infectious) of the mastoid air cells. Its incidence is 1.2 cases per 100,000 in children under 15 years of age, with a higher incidence in infants and a slight male predominance. OBSERVATION: This was a 15-year-old girl, a student living in Bamako, with a history of recurrent otitis suppurativa since childhood. The onset of symptoms was seven weeks after her admission, marked by a left purulent otorrhea of medium abundance of progressive onset associated with unquantified fever, anterior rhinorrhea and hypoacusis without vertigo or tinnitus. The general examination on admission revealed a vigilant patient with a fair general condition, the conjunctiva were well stained with a temperature of 39°c and good hemodynamic constants. The ENT clinical examination revealed a cervico-facial and left retro auricular swelling without disappearance of the retro auricular groove with pre-toric and latero-cervical extension, painful to palpation, firm consistency, skin in front of it with an infiltrated aspect (figure 1). Left otoscopy revealed an obstructive inflammatory stenosis of the external auditory canal (EAC). Cervical CT scan revealed a large phlegmonous abscess in the laterocervix and left pharynx measuring 108 x 58.5 mm (Figure 2 a and b). The patient had received intravenous (IV) bi-antibiotic therapy and effective anticoagulation with low molecular weight heparin. The evolution was marked at one week after the cervicotomy by a significant regression of the left laterocervical swelling and of the clinical and biological inflammatory syndrome. CONCLUSION: The diagnostic and therapeutic delay of chronic otitis media and ear washing can have often serious complications. In front of any latero-cervical mass in a context of otitis, it is necessary to think of a Bezold abscess. The management is well codified according to the literature.

INTRODUCTION: Une mastoïdite est une complication des otites moyennes, elle est définie par une inflammation (en général infectieuse) des cellules aériennes mastoïdiennes. Son incidence est de 1,2 cas pour 100 000 chez les enfants de moins de 15 ans, avec une incidence plus élevée chez les nourrissons et une légère prédominance masculine. OBSERVATION: Il s'agissait d'une jeune fille de 15 ans, élève résidant à Bamako, aux antécédents d'otite suppurée à répétition depuis l'enfance. Le début de la symptomatologie remontait à sept semaines de son admission, marqué par une otorrhée purulente gauche de moyenne abondance d'installation progressive associée à une fièvre non quantifiée, rhinorrhée antérieure et une hypoacousie sans vertige ni acouphène. L'examen général à l'entrée retrouvait, une patiente vigilante, avec un état général passable, les conjonctives étaient bien colorées avec une température à 39°c et des bonnes constantes hémodynamiques. L'examen clinique ORL retrouvait une tuméfactioncervico-faciale etrétro auriculaire gauche sans disparition du sillon retro auriculaire avec extension prétorienne et latero-cervicale, douloureuse à la palpation, de consistance ferme, peau en regard d'aspect infiltré (figure 1). L'otoscopie gauche a retrouvé une sténose inflammatoire obstructive du conduit auditif externe (CAE). La TDM cervicale retrouvait un abcès important phlegmoneux latéro-cervical et pharyngé gauche mesurant 108 x 58,5 mm (Figure 2 a et b). La patiente avait bénéficié d'une bi antibiothérapie par voie intraveineuse (IV) et d'une anticoagulation efficace par héparine à bas poids moléculaire.L'évolution a été marquée à une semaine de la cervicotomie par une régression importante de la tuméfaction latéro-cervicale gauche et du syndrome inflammatoire clinique et biologique. CONCLUSION: Le retard diagnostique et thérapeutique des otites moyennes chroniqueset le lavage de l'oreille peutavoir des complications souvent graves. Devant toute masse latéro-cervicale dans un contexte d'otite, il faut penser à un abcès de Bezold. La prise en charge est bien codifiée selon la littérature.

Case Report: COVID-19 and Lassa Fever Coinfection in an Ebola Suspected Patient in Guinea.

In this case report, we describe a clinical presentation and therapeutic history of a unique case diagnosed with Lassa fever and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a 23-year-old man from Yomou prefecture in southeast Guinea identified with suspected Ebola Virus Disease (EVD) in the midst of an ongoing outbreak of that disease in the same region. On May 3, 2021, he was admitted to the Nzérékoré Epidemic disease treatment center where his clinical condition deteriorated significantly. Laboratory testing performed on the same day reveals a negative EVD polymerase chain reaction (PCR). Three days later, the patient was tested positive for SARS-CoV-2 and Lassa fever by reverse transcriptase PCR (RT-PCR) assays. Laboratory examination also indicated severe hematological and biochemical deteriorations in the patient. This case substantiates the need for systematic differential diagnosis during epidemic-prone disease outbreaks to better manage severely unwell patients.