埃博拉病毒病

检查

对于所有疑似埃博拉病毒感染者，应在其隔离期间安排该检测。[110]World Health Organization. Laboratory diagnosis of Ebola virus disease: interim guidance. September 2014 [internet publication]. https://apps.who.int/iris/bitstream/handle/10665/134009/WHO_EVD_GUIDANCE_LAB_14.1_eng.pdf

与 ELISA 检测相比，可提前 24-48 小时出具结果。

现有几种不同的市售 PCR 试剂盒可用，其敏感性、特异性和检测限制各异。[111]Cherpillod P, Schibler M, Vieille G, et al. Ebola virus disease diagnosis by real-time RT-PCR: a comparative study of 11 different procedures. J Clin Virol. 2016 Apr;77:9-14. https://www.journalofclinicalvirology.com/article/S1386-6532(16)00040-8/fulltext http://www.ncbi.nlm.nih.gov/pubmed/26874083?tool=bestpractice.com

在西方国家，仅地区或国家实验室（配有 4 级设备）可以进行此项试验。[7]Feldmann H, Geisbert TW. Ebola haemorrhagic fever. Lancet. 2011 Mar 5;377(9768):849-62. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3406178 http://www.ncbi.nlm.nih.gov/pubmed/21084112?tool=bestpractice.com 在流行区和一些国家，会在地方一级建立 4 级实验室，从而使得在样本送达后的 4 个小时内出结果。

在症状出现后第 3 天至最晚 6-17 天，对患者的血液样本进行 RT-PCR 检测，可检测到病毒 RNA。聚合酶链反应结果呈阳性意味着患者可能感染，尤其当其存在活动性腹泻、呕吐或出血时。

如果聚合酶链反应结果呈阴性，则应在 48 小时内重新进行试验，原因在于病程早期的病毒载量低，可能检测不到。如果强烈怀疑感染，如果检测结果呈阴性，为了排除诊断，应重复进行检测，为了证实感染痊愈，也应获得重复的阴性检查结果。[110]World Health Organization. Laboratory diagnosis of Ebola virus disease: interim guidance. September 2014 [internet publication]. https://apps.who.int/iris/bitstream/handle/10665/134009/WHO_EVD_GUIDANCE_LAB_14.1_eng.pdf

较高的病毒载量与不良结局和病死率升高有关。[20]Bah EI, Lamah MC, Fletcher T, et al. Clinical presentation of patients with Ebola virus disease in Conakry, Guinea. N Engl J Med. 2015 Jan 1;372(1):40-7. https://www.nejm.org/doi/full/10.1056/NEJMoa1411249#t=article http://www.ncbi.nlm.nih.gov/pubmed/25372658?tool=bestpractice.com [21]Chertow DS, Kleine C, Edwards JK, et al. Ebola virus disease in West Africa - clinical manifestations and management. N Engl J Med. 2014 Nov 27;371(22):2054-7. https://www.nejm.org/doi/full/10.1056/NEJMp1413084 http://www.ncbi.nlm.nih.gov/pubmed/25372854?tool=bestpractice.com [22]Schieffelin JS, Shaffer JG, Goba A, et al; KGH Lassa Fever Program; Viral Hemorrhagic Fever Consortium; WHO Clinical Response Team. Clinical illness and outcomes in patients with Ebola in Sierra Leone. N Engl J Med. 2014 Nov 27;371(22):2092-100. https://www.nejm.org/doi/full/10.1056/NEJMoa1411680#t=article http://www.ncbi.nlm.nih.gov/pubmed/25353969?tool=bestpractice.com [70]Sanchez A, Lukwiya M, Bausch D, et al. Analysis of human peripheral blood samples from fatal and nonfatal cases of Ebola (Sudan) hemorrhagic fever: cellular responses, virus load, and nitric oxide levels. J Virol. 2004 Oct;78(19):10370-7. https://jvi.asm.org/content/78/19/10370.full http://www.ncbi.nlm.nih.gov/pubmed/15367603?tool=bestpractice.com [94]Hunt L, Gupta-Wright A, Simms V, et al. Clinical presentation, biochemical, and haematological parameters and their association with outcome in patients with Ebola virus disease: an observational cohort study. Lancet Infect Dis. 2015 Nov;15(11):1292-9. http://www.ncbi.nlm.nih.gov/pubmed/26271406?tool=bestpractice.com [110]World Health Organization. Laboratory diagnosis of Ebola virus disease: interim guidance. September 2014 [internet publication]. https://apps.who.int/iris/bitstream/handle/10665/134009/WHO_EVD_GUIDANCE_LAB_14.1_eng.pdf [112]Towner JS, Rollin PE, Bausch DG, et al. Rapid diagnosis of Ebola hemorrhagic fever by reverse transcription-PCR in an outbreak setting and assessment of patient viral load as a predictor of outcome. J Virol. 2004 Apr;78(8):4330-41. https://jvi.asm.org/content/78/8/4330.full http://www.ncbi.nlm.nih.gov/pubmed/15047846?tool=bestpractice.com

检查

厚型及薄型吉姆萨染色血液涂片和快速诊断试验皆可用来进行疟疾筛查。

在相关的流行病学背景下，检测结果为阴性，则更可能为埃博拉病毒病；然而在 2014 年疫情暴发期间，发现西非多达 5% 的患者合并感染疟疾，因此对所有患者都应考虑双重感染的可能性。[94]Hunt L, Gupta-Wright A, Simms V, et al. Clinical presentation, biochemical, and haematological parameters and their association with outcome in patients with Ebola virus disease: an observational cohort study. Lancet Infect Dis. 2015 Nov;15(11):1292-9. http://www.ncbi.nlm.nih.gov/pubmed/26271406?tool=bestpractice.com

检查

在其他检查手段有限的地区，是一项需进行的重要试验（如果可用）。

可能提示急性肾损伤。[114]McElroy AK, Erickson BR, Flietstra TD, et al. Biomarker correlates of survival in pediatric patients with ebola virus disease. Emerg Infect Dis. 2014 Oct;20(10):1683-90. https://wwwnc.cdc.gov/eid/article/20/10/14-0430_article http://www.ncbi.nlm.nih.gov/pubmed/25279581?tool=bestpractice.com

特别适用于腹泻和呕吐患者。

在 2014 年暴发期间，约 33% 的病例出现因呕吐和腹泻或急性肾损伤导致的低钾血症或高钾血症。[94]Hunt L, Gupta-Wright A, Simms V, et al. Clinical presentation, biochemical, and haematological parameters and their association with outcome in patients with Ebola virus disease: an observational cohort study. Lancet Infect Dis. 2015 Nov;15(11):1292-9. http://www.ncbi.nlm.nih.gov/pubmed/26271406?tool=bestpractice.com

低钙血症已被证实与致死性感染具有相关性。[16]Kortepeter MG, Bausch DG, Bray M. Basic clinical and laboratory features of filoviral hemorrhagic fever. J Infect Dis. 2011 Nov;204 Suppl 3:S810-6. https://jid.oxfordjournals.org/content/204/suppl_3/S810.long http://www.ncbi.nlm.nih.gov/pubmed/21987756?tool=bestpractice.com

有助于指导纠正电解质紊乱和补液。

检查

在其他检查手段有限的地区，是一项需进行的重要试验（如果可用）。

可能提示急性肾损伤，这在 2014 年疫情暴发中较常见，​​且可导致死亡。[22]Schieffelin JS, Shaffer JG, Goba A, et al; KGH Lassa Fever Program; Viral Hemorrhagic Fever Consortium; WHO Clinical Response Team. Clinical illness and outcomes in patients with Ebola in Sierra Leone. N Engl J Med. 2014 Nov 27;371(22):2092-100. https://www.nejm.org/doi/full/10.1056/NEJMoa1411680#t=article http://www.ncbi.nlm.nih.gov/pubmed/25353969?tool=bestpractice.com [94]Hunt L, Gupta-Wright A, Simms V, et al. Clinical presentation, biochemical, and haematological parameters and their association with outcome in patients with Ebola virus disease: an observational cohort study. Lancet Infect Dis. 2015 Nov;15(11):1292-9. http://www.ncbi.nlm.nih.gov/pubmed/26271406?tool=bestpractice.com [114]McElroy AK, Erickson BR, Flietstra TD, et al. Biomarker correlates of survival in pediatric patients with ebola virus disease. Emerg Infect Dis. 2014 Oct;20(10):1683-90. https://wwwnc.cdc.gov/eid/article/20/10/14-0430_article http://www.ncbi.nlm.nih.gov/pubmed/25279581?tool=bestpractice.com

特别适用于腹泻和呕吐患者。

检查

在其他检查手段有限的地区，是一项需进行的重要试验（如果可用）。

血乳酸水平升高是组织低灌注的标志，同时也是休克的一种指标。在具有脓毒症体征的危重患者中，这有助于确定全身性低灌注的程度，并指导液体复苏。[115]Fowler RA, Fletcher T, Fischer WA 2nd, et al. Caring for critically ill patients with Ebola virus disease. Perspectives from West Africa. Am J Respir Crit Care Med. 2014 Oct 1;190(7):733-7. https://www.atsjournals.org/doi/full/10.1164/rccm.201408-1514CP#.VEe1OvldWnA http://www.ncbi.nlm.nih.gov/pubmed/25166884?tool=bestpractice.com

一名在德国接受治疗患者的乳酸水平升高是第 15 天时发生革兰阴性脓毒症的一种指标。[45]Kreuels B, Wichmann D, Emmerich P, et al. A case of severe Ebola virus infection complicated by gram-negative septicemia. N Engl J Med. 2014 Dec 18;371(25):2394-401. https://www.nejm.org/doi/full/10.1056/NEJMoa1411677#t=article http://www.ncbi.nlm.nih.gov/pubmed/25337633?tool=bestpractice.com

检查

在具有脓毒症体征的急性发病患者中，动脉或静脉血液 pH 值和碳酸氢根离子水平检测有助于识别全身性低灌注程度和指导液体复苏。[115]Fowler RA, Fletcher T, Fischer WA 2nd, et al. Caring for critically ill patients with Ebola virus disease. Perspectives from West Africa. Am J Respir Crit Care Med. 2014 Oct 1;190(7):733-7. https://www.atsjournals.org/doi/full/10.1164/rccm.201408-1514CP#.VEe1OvldWnA http://www.ncbi.nlm.nih.gov/pubmed/25166884?tool=bestpractice.com

检查

血小板计数下降和淋巴细胞显著减少可见于感染初期；然而，这不具有诊断意义。在最终康复的患者中，这经常出现在感染较晚期中性粒细胞白细胞增多后，伴有血小板减少正常化。白细胞增多可能会持续存在，并显示出未成熟形态。[16]Kortepeter MG, Bausch DG, Bray M. Basic clinical and laboratory features of filoviral hemorrhagic fever. J Infect Dis. 2011 Nov;204 Suppl 3:S810-6. https://jid.oxfordjournals.org/content/204/suppl_3/S810.long http://www.ncbi.nlm.nih.gov/pubmed/21987756?tool=bestpractice.com

重度疾病患者的血小板计数可能会逐渐下降，这是弥散性血管内凝血 (DIC) 的一种表现。

据报告， 2014 年疫情暴发中 24% 的患者有血红蛋白水平降低，在既往暴发中还伴有出血。[16]Kortepeter MG, Bausch DG, Bray M. Basic clinical and laboratory features of filoviral hemorrhagic fever. J Infect Dis. 2011 Nov;204 Suppl 3:S810-6. https://jid.oxfordjournals.org/content/204/suppl_3/S810.long http://www.ncbi.nlm.nih.gov/pubmed/21987756?tool=bestpractice.com [94]Hunt L, Gupta-Wright A, Simms V, et al. Clinical presentation, biochemical, and haematological parameters and their association with outcome in patients with Ebola virus disease: an observational cohort study. Lancet Infect Dis. 2015 Nov;15(11):1292-9. http://www.ncbi.nlm.nih.gov/pubmed/26271406?tool=bestpractice.com

检查

凝血酶原时间或活化部分凝血活酶时间延长与出血表现（例如弥散性血管内凝血）有相关性。

已发现致死性感染患者在感染后 6-8 天的 D-二聚体水平为存活患者的 4 倍。[116]Rollin PE, Bausch DG, Sanchez A. Blood chemistry measurements and D-Dimer levels associated with fatal and nonfatal outcomes in humans infected with Sudan Ebola virus. J Infect Dis. 2007 Nov 15;196 Suppl 2:S364-71. https://jid.oxfordjournals.org/content/196/Supplement_2/S364.long http://www.ncbi.nlm.nih.gov/pubmed/17940972?tool=bestpractice.com

检查

在重度疾病时血尿或蛋白尿或许可见。[16]Kortepeter MG, Bausch DG, Bray M. Basic clinical and laboratory features of filoviral hemorrhagic fever. J Infect Dis. 2011 Nov;204 Suppl 3:S810-6. https://jid.oxfordjournals.org/content/204/suppl_3/S810.long http://www.ncbi.nlm.nih.gov/pubmed/21987756?tool=bestpractice.com

对液体复苏无反应的少尿是预后不良的体征。

检查

丙氨酸氨基转移酶 (ALT) 和天冬氨酸氨基转移酶 (AST) 水平通常都会升高；然而，大多数研究显示，AST 的升高与 ALT 不成比例，这更加提示系统性组织损伤，而非肝细胞性损伤。[94]Hunt L, Gupta-Wright A, Simms V, et al. Clinical presentation, biochemical, and haematological parameters and their association with outcome in patients with Ebola virus disease: an observational cohort study. Lancet Infect Dis. 2015 Nov;15(11):1292-9. http://www.ncbi.nlm.nih.gov/pubmed/26271406?tool=bestpractice.com

在致死性病例中，AST:ALT 比值在感染后 6-8 天达到 15:1 峰值，而非致死性病例峰值则为 5:1。[5]Formenty P, Hatz C, Le Guenno B, et al. Human infection due to Ebola virus, subtype Côte d'Ivoire: clinical and biologic presentation. J Infect Dis. 1999 Feb;179 Suppl 1:S48-53. https://jid.oxfordjournals.org/content/179/Supplement_1/S48.long http://www.ncbi.nlm.nih.gov/pubmed/9988164?tool=bestpractice.com [16]Kortepeter MG, Bausch DG, Bray M. Basic clinical and laboratory features of filoviral hemorrhagic fever. J Infect Dis. 2011 Nov;204 Suppl 3:S810-6. https://jid.oxfordjournals.org/content/204/suppl_3/S810.long http://www.ncbi.nlm.nih.gov/pubmed/21987756?tool=bestpractice.com [116]Rollin PE, Bausch DG, Sanchez A. Blood chemistry measurements and D-Dimer levels associated with fatal and nonfatal outcomes in humans infected with Sudan Ebola virus. J Infect Dis. 2007 Nov 15;196 Suppl 2:S364-71. https://jid.oxfordjournals.org/content/196/Supplement_2/S364.long http://www.ncbi.nlm.nih.gov/pubmed/17940972?tool=bestpractice.com

胆红素、谷氨酰转移酶和碱性磷酸酶往往稍有升高。丙氨酸氨基转移酶水平大幅升高和重度黄疽提示为其他诊断（例如病毒性肝炎）。

检查

血清淀粉酶水平升高在若干研究中曾有报告，提示患有胰腺炎（重度感染的一种指标）。[16]Kortepeter MG, Bausch DG, Bray M. Basic clinical and laboratory features of filoviral hemorrhagic fever. J Infect Dis. 2011 Nov;204 Suppl 3:S810-6. https://jid.oxfordjournals.org/content/204/suppl_3/S810.long http://www.ncbi.nlm.nih.gov/pubmed/21987756?tool=bestpractice.com

检查

成年患者可有低血糖，但通常并未报道。[22]Schieffelin JS, Shaffer JG, Goba A, et al; KGH Lassa Fever Program; Viral Hemorrhagic Fever Consortium; WHO Clinical Response Team. Clinical illness and outcomes in patients with Ebola in Sierra Leone. N Engl J Med. 2014 Nov 27;371(22):2092-100. https://www.nejm.org/doi/full/10.1056/NEJMoa1411680#t=article http://www.ncbi.nlm.nih.gov/pubmed/25353969?tool=bestpractice.com 但在儿童中并不常见，且可能病情严重。可能为意识模糊的一个可逆转病因。[102]Fitzgerald F, Naveed A, Wing K, et al. Ebola virus disease in children, Sierra Leone, 2014-2015. Emerg Infect Dis. 2016 Oct;22(10):1769-77. https://wwwnc.cdc.gov/eid/article/22/10/16-0579_article http://www.ncbi.nlm.nih.gov/pubmed/27649367?tool=bestpractice.com [103]Shah T, Greig J, van der Plas LM, et al. Inpatient signs and symptoms and factors associated with death in children aged 5 years and younger admitted to two Ebola management centres in Sierra Leone, 2014: a retrospective cohort study. Lancet Glob Health. 2016 Jul;4(7):e495-501. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30097-3/fulltext http://www.ncbi.nlm.nih.gov/pubmed/27340004?tool=bestpractice.com

检查

血培养阴性是有帮助的，因为能据此排除其他非病毒性感染病因（例如脓毒症、肠热症 [伤寒]）。

革兰阴性菌菌血症（推测由肠道菌群移位引起）被确定为两位患者病程中的一种并发症。[45]Kreuels B, Wichmann D, Emmerich P, et al. A case of severe Ebola virus infection complicated by gram-negative septicemia. N Engl J Med. 2014 Dec 18;371(25):2394-401. https://www.nejm.org/doi/full/10.1056/NEJMoa1411677#t=article http://www.ncbi.nlm.nih.gov/pubmed/25337633?tool=bestpractice.com [117]Dickson SJ, Clay KA, Adam M, et al. Enhanced case management can be delivered for patients with EVD in Africa: experience from a UK military Ebola treatment centre in Sierra Leone. J Infect. 2018 Apr;76(4):383-92. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903873 http://www.ncbi.nlm.nih.gov/pubmed/29248587?tool=bestpractice.com 然而，在塞拉利昂开展的一项研究中，对入住埃博拉治疗中心的患者在入院时进行血培养，发现 22 份培养物中只有一份呈阳性，并且推测为污染。[118]Lamb L, Robson J, Ardley C, et al. Bacterial co-infection is rare in patients with Ebola virus disease in a military Ebola virus disease treatment unit in Sierra Leone. J Infect. 2015 Sep;71(3):406-7. http://www.ncbi.nlm.nih.gov/pubmed/25818532?tool=bestpractice.com

因此，应当在基线期和/或出现胃肠症状或其他临床症状恶化时采集血液进行培养。

检查

一种具有高特异性的有用诊断试验；然而，它并不是普遍可用的。与逆转录聚合酶链反应阳性联合可用于证实诊断。

感染后 3-6 天进行的试验结果最有可能是阳性的，感染后 7-16 天进行的试验结果存在很大差异。[49]Rowe AK, Bertolli J, Khan AS, et al. Clinical, virologic, and immunologic follow-up of convalescent Ebola hemorrhagic fever patients and their household contacts, Kikwit, Democratic Republic of the Congo. Commission de Lutte contre les Epidémies à Kikwit. J Infect Dis. 1999 Feb;179 Suppl 1:S28-35. http://www.ncbi.nlm.nih.gov/pubmed/9988162?tool=bestpractice.com

检查

在感染较晚期有用。

感染后早至 2 天，即可从血清中检测到 IgM 抗体，但在感染后长达 9 天，该检测结果的差异性很大。它们会在症状发作后的 30-168 天内转变为阴性。IgG 反应会在感染后的 6-18 天出现，并可持续数年。[49]Rowe AK, Bertolli J, Khan AS, et al. Clinical, virologic, and immunologic follow-up of convalescent Ebola hemorrhagic fever patients and their household contacts, Kikwit, Democratic Republic of the Congo. Commission de Lutte contre les Epidémies à Kikwit. J Infect Dis. 1999 Feb;179 Suppl 1:S28-35. http://www.ncbi.nlm.nih.gov/pubmed/9988162?tool=bestpractice.com

IgM 抗体阳性或 IgG 抗体滴度升高是近期感染的有力证据。

检查

对出现呼吸道症状的患者有用。

肺部浸润并不是感染的典型症状，表明为其他（或共病）诊断。

可能难以在隔离病房内安排实施，应谨慎地进行，以避免污染。[119]Auffermann WF, Kraft CS, Vanairsdale S, et al. Radiographic imaging for patients with contagious infectious diseases: how to acquire chest radiographs of patients infected with the Ebola virus. AJR Am J Roentgenol. 2015 Jan;204(1):44-8. http://www.ncbi.nlm.nih.gov/pubmed/25402496?tool=bestpractice.com

检查

没有条件进行快速 PCR 检测仍是进行有效地、有针对性地隔离感染者的主要障碍。目前，就近可在设备齐全的 3 级或 4 级生物安全实验室进行检测的平均耗时为 4 小时，而偏远地区可能需要数日才获得结果。这意味着，在证实检测结果为阴性前，除埃博拉病毒病外的发热疾病患者也会被强制隔离，并且往往会在不经意间暴露于该病毒。

因此，在治疗中心，快速床旁检测能对感染控制发挥巨大作用。

世界卫生组织正在评估若干现场条件下使用的不同技术。这些技术包括多种基于逆转录聚合酶链反应 (RT-PCR) 的试验，这些试验更易于使用，且出报告的时间更短（＜1 小时）。WHO 已将 ReEBOV™ 抗原快速检测试剂盒列入可能使用的检测试剂盒清单；然而，目前建议仅在特殊情况下使用。 WHO: interim guidance on the use of rapid Ebola antigen detection tests Opens in new window 其他试剂盒也获得了 WHO 紧急使用授权。

替代选择是基于酶联免疫吸附测定的抗原检测试验，这些试验可能仅需要一滴血液，因而检测速度更快，操作更简单。这些试验的主要劣势是敏感性较低，特别是在疾病初期。[120]Butler D. Ebola experts seek to expand testing. Nature. 2014 Dec 11;516(7530):154-5. https://www.nature.com/news/ebola-experts-seek-to-expand-testing-1.16518 http://www.ncbi.nlm.nih.gov/pubmed/25503213?tool=bestpractice.com

使用纳米孔技术可能可以在病毒水平极低的情况下快速检测和测序，并且有可能借助袖珍型检测试剂盒开展。[122]Hoenen T, Groseth A, Rosenke K, et al. Nanopore sequencing as a rapidly deployable ebola outbreak tool. Emerg Infect Dis. 2016 Feb;22(2):331-4. https://wwwnc.cdc.gov/eid/article/22/2/15-1796_article http://www.ncbi.nlm.nih.gov/pubmed/26812583?tool=bestpractice.com [123]Tsang MK, Ye W, Wang G, et al. Ultrasensitive detection of ebola virus oligonucleotide based on upconversion nanoprobe/nanoporous membrane system. ACS Nano. 2016 Jan 26;10(1):598-605. http://www.ncbi.nlm.nih.gov/pubmed/26720408?tool=bestpractice.com [124]Quick J, Loman NJ, Duraffour S, et al. Real-time, portable genome sequencing for Ebola surveillance. Nature. 2016 Feb 11;530(7589):228-32 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4817224 http://www.ncbi.nlm.nih.gov/pubmed/26840485?tool=bestpractice.com

GeneXpert® 诊断工具 (Xpert® Ebola) 已在该领域中试用；该工具是一种自动化的检测盒系统，操作起来只需极少的实验室技能。将灭活样本置于一次性的检测盒中，然后将检测盒放入封闭的机器即可。样本制备、核酸扩增与检测以及结果生成都是自动化的过程，最大化地降低了员工培训需求、感染风险和交叉污染。[125]Semper AE, Broadhurst MJ, Richards J, et al. Performance of the GeneXpert Ebola assay for diagnosis of Ebola virus disease in Sierra Leone: a field evaluation study. PLoS Med. 2016 Mar 29;13(3):e1001980. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001980 http://www.ncbi.nlm.nih.gov/pubmed/27023868?tool=bestpractice.com

美国食品药品监督管理局已批准了一种用于检测扎伊尔型埃博拉病毒的快速一次性使用检测方法。这是第二个获得紧急使用授权的快速抗原指尖检测法，但也是首个使用便携式电池读数器的检测法，可在实验室外提供检测结果。[128]Food and Drug Administration. FDA authorizes emergency use of first Ebola fingerstick test with portable reader. November 2018 [internet publication]. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm625502.htm 一次性使用 OraQuick® 埃博拉病毒快速抗原检测试剂盒也已获得批准，用于检测某些存活者血液中，以及某些近期疑似死于埃博拉病毒病患者的样本（尸体口腔拭子）中的病毒抗原。这是在美国上市的首款针对埃博拉病毒病的快速诊断检测试剂，可提供快速推定性诊断，但随后须进行确认性诊断。[129]Food and Drug Administration. FDA allows marketing of first rapid diagnostic test for detecting Ebola virus antigens. October 2019 [internet publication]. https://www.fda.gov/news-events/press-announcements/fda-allows-marketing-first-rapid-diagnostic-test-detecting-ebola-virus-antigens

据报告，快速检测的汇总灵敏度和特异度分别为 86% 和95%。[130]Muzembo BA, Kitahara K, Ohno A, et al. Rapid diagnostic tests versus RT-PCR for Ebola virus infections: a systematic review and meta-analysis. Bull World Health Organ. 2022 Jul 1;100(7):447-58. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9243686/pdf/BLT.21.287496.pdf http://www.ncbi.nlm.nih.gov/pubmed/35813519?tool=bestpractice.com

这是一个正在发展的领域，多种试剂盒已经获得批准，将在相应国家投入使用。