Abstract

Although multiple antigenically distinct ebolavirus species can cause human disease, previous serosurveys focused on only Zaire ebolavirus (EBOV). Thus, the extent of reactivity or exposure to other ebolaviruses, and which sociodemographic factors are linked to this seroreactivity, are unclear. We conducted a serosurvey of 539 healthcare workers (HCW) in Mbandaka, Democratic Republic of the Congo, using ELISA-based analysis of serum IgG against EBOV, Sudan ebolavirus (SUDV) and Bundibugyo ebolavirus (BDBV) glycoproteins (GP). We compared seroreactivity to risk factors for viral exposure using univariate and multivariable logistic regression. Seroreactivity against different GPs ranged from 2.2–4.6%. Samples from six individuals reacted to all three species of ebolavirus and 27 samples showed a species-specific IgG response. We find that community health volunteers are more likely to be seroreactive against each antigen than nurses, and in general, that HCWs with indirect patient contact have higher anti-EBOV GP IgG levels than those with direct contact. Seroreactivity against ebolavirus GP may be associated with positions that offer less occupational training and access to PPE. Those individuals with broadly reactive responses may have had multiple ebolavirus exposures or developed cross-reactive antibodies. In contrast, those individuals with species-specific BDBV or SUDV GP seroreactivity may have been exposed to an ebolavirus not previously known to circulate in the region.

Highlights

  • There are six known, antigenically-distinct Ebolavirus species: Ebola (Zaire; EBOV), Bundibugyo (BDBV), Sudan (SUDV), Taï Forest (TAFV), Reston (RESTV), and Bombali viruses (BOMV), with the first four known to cause severe disease in humans [1]

  • Zaire ebolavirus is known to circulate in the Mbandaka region of the Democratic Republic of the Congo, causing outbreaks in 2018 and 2020

  • We examined the seroprevalence of 539 local Congolese healthcare workers in the Mbandaka region with no known ebolavirus exposure

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Summary

Introduction

There are six known, antigenically-distinct Ebolavirus species: Ebola (Zaire; EBOV), Bundibugyo (BDBV), Sudan (SUDV), Taï Forest (TAFV), Reston (RESTV), and Bombali viruses (BOMV), with the first four known to cause severe disease in humans [1]. As the etiological agent of Ebola Virus Disease (EVD), ebolaviruses have caused over twodozen outbreaks throughout Africa since 1976, with case-fatality rates ranging from 25 to 90% [3]. EVD presents a special challenge in diagnosis as its prodrome mirrors that of bacterial infections and commonly circulating diseases such as malaria. Undetected cases and evidence of possible asymptomatic and paucisymptomatic infections can further complicate diagnosis [7,8]. EBOV has been documented to re-emerge from survivors, spread to their sexual partners and introduce new chains of transmission several years after the original survivors’ initial clinical course [9]. Asymptomatic infection and re-emergence make understanding population seroprevalence a high priority

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