Blood Test May Predict Who Lives or Dies with Ebola

In 2014, Ebola exploded across western Africa. It was the worst outbreak of the virus in recorded history, killing more than 11,000 people before it sputtered out in early 2016. In the Republic of Guinea, the epicenter of the epidemic, around 60 percent of people infected with Ebola died.

While the outbreak taught physicians and scientists much about Ebola, many questions remain. Foremost among them: why do some people survive an infection, while others die? Researchers know that some obvious factors, like supportive hospital care, improve prognosis. They also know that high viral load—the amount of virus present in the body—is frequently associated with death. But these factors alone didn’t account for all those who survived or succumbed to the disease, and they didn’t always predict who would live or die.

Now, a team of researchers led by Boston University, the University of Liverpool, Public Health England, and other international agencies has discovered a biomarker that can help predict the progression of the disease: a handful of genes that are overactivated in patients who succumb to the disease. These genes indicate an overly aggressive primary immune response, which can damage organs—particularly the liver—and paradoxically, may hamper a more targeted immune response. The research, funded by the United Kingdom’s National Institute for Health Research and the US Food and Drug Administration, and published on January 19, 2017, in the journal Genome Biology, suggests a new type of blood test that while still in the preliminary stages of development, might be useful in future outbreaks to steer patients to the best treatment.

“The study suggests that something about the way people respond to infection affects their chance of survival,” says John Connor, a School of Medicine associate professor of microbiology at BU’s National Emerging Infectious Diseases Laboratories and corresponding author on the study. “We can get a sense of who will survive and who won’t, and we can get it earlier,” he adds. “This is the first study of this type ever done on this scale.”