Cornell researchers have developed a portable diagnostic test that can simultaneously detect and distinguish Ebola and Lassa, two serious viruses whose early symptoms can be difficult to tell apart.
The research could potentially giving health workers a faster way to identify which virus is present and make lifesaving decisions. The work is part of a broader effort by the researchers to move diagnostic capabilities out of centralized laboratories and into portable devices that can be used by health workers in the field.
The study, “Portable Duplex Diagnostic Platform for Point-of-Care Differentiation of Ebola and Lassa Virus” was published Aug. 31 in Analytical Chemistry. It was led by David Erickson, the S.C. Thomas Sze Director of the Sibley School of Mechanical and Aerospace Engineering in the Cornell Duffield College of Engineering; Dr. Saurabh Mehta, the Janet and Gordon Lankton Professor and Founding Director of the Cornell Joan Klein Jacobs Center for Precision Nutrition and Health in the College of Human Ecology; and Keersten Ricks, chief of the diagnostic systems division at the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID).
These findings can be thought of as fitting a lab directly into healthcare providers’ hands, on the ground and in remote locations, the researchers said.
“Similar to a COVID antigen test, a test strip looks for proteins produced by Ebola and Lassa viruses from a single pin prick blood sample,” Erickson said. “The strip is paired with a Portable Rapid Onsite Versatile Image-based Detection System, or ‘PROVIDS,’ and uses a camera to photograph the strip and, in under five seconds, automatically analyzes the lines with software to produce an objective, quantitative result.”
Ebola and Lassa can initially cause similar symptoms, including fever, headache, vomiting and general weakness, but demand completely different medical responses.
Conventional laboratory tests can provide a definitive diagnosis, but access to laboratory infrastructure can be limited in areas where outbreaks occur. In co-endemic regions, where multiple different diseases or infectious agents regularly exist and circulate, those limitations mean patients are often triaged incorrectly while waiting for results.
“The test has to survive and perform where the outbreak actually is, which means hot climates, unreliable electricity, negligeable refrigeration, minimal lab infrastructure and staff with basic training,” Mehta said. “This means that tests should have shelf stability without ‘cold chain,’ results in minutes and not days, simplicity of operation, low cost per test and objective readout that doesn’t depend on operator judgment.”
Ultimately, the researchers envision diagnostic tools that can move with the patient rather than requiring the patient to reach a laboratory – an approach that could be particularly valuable during outbreaks, when rapid decisions about testing, treatment and infection control can be critical.
“What we’re really trying to do is bring several important pieces together in one simple platform,” Erickson said. “The ability to detect viral hemorrhagic fevers from a single sample, the ability to quantitatively read the result rather than relying on somebody interpreting a test, and a platform that is robust enough to work in the field, outside of a traditional laboratory setting.”
Ricks and the USAMRIID team developed the original Ebola and Lassa tests, including organizing top-performing antibodies for potential therapeutics, and provided critical expertise in viral hemorrhagic fevers and played a vital role in the validation of the diagnostics, including testing against viral samples and evaluating the performance and specificity of the platform. Their expertise and access to specialized laboratory capabilities were critical to assessing the technology against high-consequence pathogens, the researchers said.
Erickson and Mehta are co-directors of Point of Care Technologies for Nutrition, Infection, and Cancer for Global Health (PORTENT) at Cornell, which translates breakthrough point-of-care diagnostics into rapid, affordable tests that reduce the burden of chronic disease, curb infectious threats and strengthen prevention efforts.
This most recent research is part of a broader Cornell effort to bring testing closer to where patients first seek care. Other developments include FeverPhone and NutriPhone, which explore the use of mobile technology for point-of-care diagnosis.
The research was funded by the Military Infectious Diseases Research Program, with additional support from the National Institutes of Health’s PORTENT program.
Stephen D’Angelo is the communications manager for biological systems at Cornell Research and Innovation.
