Ebola virus (EBOV) infection results in Ebola virus disease (EVD), an often severe disease with a nonspecific presentation. Since its recognition, periodic outbreaks of EVD continue to occur in sub-Saharan Africa. The 2013-2016 West African EVD outbreak was the largest recorded, resulting in a substantial cohort of EVD survivors with persistent health complaints and variable immune responses. In this study, we characterize humoral immune responses in EVD survivors and their contacts in Eastern Sierra Leone. We found high levels of EBOV IgG in EVD survivors and lower yet substantial antibody levels in household contacts, suggesting subclinical transmission. Neutralizing antibody function was prevalent but variable in EVD survivors, raising questions about the durability of immune responses from natural infection with EBOV. Additionally, we found that certain discrete symptoms-ophthalmologic and auditory-are associated with EBOV IgG seropositivity, while an array of symptoms are associated with the presence of neutralizing antibody.
Competing Interests: Potential conflicts of interest. The Viral Hemorrhagic Fever Consortium (VHFC) is a partnership of academic and industry scientists developing diagnostics, therapeutics, and vaccines for Lassa fever and other severe diseases. Tulane University and various industry partners have filed US and foreign patent applications on behalf of the VHFC for several of these technologies. If commercial products are developed, VHFC members may receive royalties or profits. R. F. G. is currently an affiliate and cofounder of Zalgen Labs, LLC. Zalgen Labs is the company that manufactures the primary commercialized ELISA used in this study, which presents a potential conflict of interest. No Zalgen employees were involved with the data analysis or interpretation of the results in this study. This does not alter our adherence to journal policies on sharing data and materials. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
(© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)