• Pierre Formenty, Eric Maurice Leroy, Alain Epelboin, Francois Libama, Marco Lenzi, Hinrich Sudeck, Philippe Yaba, Yokouidé Allarangar, Paul Boumandouki, Virginot Blad Nkounkou, Christian Drosten, Allen Grolla, Heinz Feldmann, and Cathy Roth.
• World Health Organization, Department of Communicable Diseases Surveillance and Response, Geneva, Switzerland. formentyp@who.int
• Clin. Infect. Dis. 2006 Jun 1; 42 (11): 1521-6.

BackgroundPatients who have refused to provide blood samples has meant that there have been significant delays in confirming outbreaks of Ebola virus hemorrhagic fever (EVHF). During the 2 EVHF outbreaks in the Republic of Congo in 2003, we assessed the use of oral fluid specimens versus serum samples for laboratory confirmation of cases of EVHF.MethodsSerum and oral fluid specimens were obtained from 24 patients with suspected Ebola and 10 healthy control subjects. Specimens were analyzed for immunoglobulin G antibodies by enzyme-linked immunosorbent assay (ELISA) and for Ebola virus by antigen detection ELISA and reverse-transcriptase polymerase chain reaction (RT-PCR). Oral fluid specimens were collected with a commercially available collection device.ResultsWe failed to detect antibodies against Ebola in the oral fluid specimens obtained from patients whose serum samples were seropositive. All patients with positive serum RT-PCR results also had positive results for their oral fluid specimens.ConclusionsThis study demonstrates the usefulness of oral fluid samples for the investigation of Ebola outbreaks, but further development in antibodies and antigen detection in oral fluid specimens is needed before these samples are used for filovirus surveillance activities in Africa.

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