Open AccessA Novel Immunohistochemical Assay for the Detection of Ebola Virus in Skin: Implications for Diagnosis, Spread, and Surveillance of Ebola Hemorrhagic Fever
Author(s) -
Sherif R. Zaki,
WunJu Shieh,
Patricia W. Greer,
Cynthia S. Goldsmith,
Tara Ferebee,
Jacques Katshitshi,
F. Kweteminga Tshioko,
Mpia Ado Bwaka,
Robert Swanepoel,
Philippe Calain,
Ali S. Khan,
Ethleen S. Lloyd,
Pierre E. Rollin,
Thomas G. Ksiazek,
C. J. Peters
Publication year - 1999
Publication title -
the journal of infectious diseases (online. university of chicago press)/the journal of infectious diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.69
H-Index - 252
eISSN - 1537-6613
pISSN - 0022-1899
DOI - 10.1086/514319
Subject(s) - immunohistochemistry , ebola virus , serology , ebola hemorrhagic fever , outbreak , virology , medicine , pathology , viral hemorrhagic fever , antibody , immunology
Laboratory diagnosis of Ebola hemorrhagic fever (EHF) is currently performed by virus isolation and serology and can be done only in a few high-containment laboratories worldwide. In 1995, during the EHF outbreak in the Democratic Republic of Congo, the possibility of using immunohistochemistry (IHC) testing of formalin-fixed postmortem skin specimens was investigated as an alternative diagnostic method for EHF. Fourteen of 19 cases of suspected EHF met the surveillance definition for EHF and were positive by IHC. IHC, serologic, and virus isolation results were concordant for all EHF and non-EHF cases. IHC and electron microscopic examination showed that endothelial cells, mononuclear phagocytes, and hepatocytes are main targets of infection, and IHC showed an association of cellular damage with viral infection. The finding of abundant viral antigens and particles in the skin of EHF patients suggests an epidemiologic role for contact transmission. IHC testing of formalin-fixed skin specimens is a safe, sensitive, and specific method for laboratory diagnosis of EHF and should be useful for EHF surveillance and prevention.