What Do We Know About Controlling Ebola Virus Disease Outbreaks?

2017 ◽  
Vol 8 ◽  
Keyword(s):  
Ebola Virus ◽  
Virus Disease ◽  
Disease Outbreaks ◽  
Ebola Virus Disease

The Epidemiological Presentation Pattern of Ebola Virus Disease Outbreaks: Changes from 1976 to 2019

2020 ◽  
Vol 35 (3) ◽  
pp. 247-253
Author(s):  
Pedro Arcos González ◽  
Ángel Fernández Camporro ◽  
Anneli Eriksson ◽  
Carmen Alonso Llada
Keyword(s):  
At Risk ◽  
Ebola Virus ◽  
Virus Disease ◽  
Disease Outbreaks ◽  
Case Fatality ◽  
Ebola Virus Disease ◽  
World Health ◽  
Study Objective ◽  
Population At Risk ◽  
Case Fatality Ratio

AbstractIntroduction:Ebola Virus Disease (EVD) is the international health emergency paradigm due to its epidemiological presentation pattern, impact on public health, resources necessary for its control, and need for a national and international response.Study Objective:The objective of this work is to study the evolution and progression of the epidemiological presentation profile of Ebola disease outbreaks since its discovery in 1976 to the present, and to explore the possible reasons for this evolution from different perspectives.Methods:Retrospective observational study of 38 outbreaks of Ebola disease occurred from 1976 through 2019, excluding laboratory accidents. United Nations agencies and programs; Ministries of Health; the US Centers for Disease Control and Prevention (CDC); ReliefWeb; emergency nongovernmental organizations; and publications indexed in PubMed, EmBase, and Clinical Key have been used as sources of data. Information on the year of the outbreak, date of beginning and end, duration of the outbreak in days, number of cases, number of deaths, population at risk, geographic extension affected in Km2, and time of notification of the first cases to the World Health Organization (WHO) have been searched and analyzed.Results:Populations at risk have increased (P = .024) and the geographical extent of Ebola outbreaks has grown (P = .004). Reporting time of the first cases of Ebola to WHO has been reduced (P = .017) and case fatality (P = .028) has gone from 88% to 62% in the period studied. There have been differences (P = .04) between the outbreaks produced by the Sudan and Zaire strains of the virus, both in terms of duration and case fatality ratio (Sudan strain 74.5 days on average and 62.7% of case fatality ratio versus Zaire strain with 150 days on average and 55.4% case fatality ratio).Conclusion:There has been a change in the epidemiological profile of the Ebola outbreaks from 1976 through 2019 with an increase in the geographical extent of the outbreaks and the population at risk, as well as a significant decrease in the outbreaks case fatality rate. There have been advances in the detection and management capacity of outbreaks, and the notification time to the WHO has been reduced. However, there are social, economic, cultural, and political obstacles that continue to greatly hinder a more efficient epidemiological approach to Ebola disease, mainly in Central Africa.

scholarly journals COVID-19 Outbreak in Africa: Lessons and Insights from the West African Ebola Virus Disease Epidemics

2020 ◽  
Vol 8 (3) ◽  
pp. 96-99
Author(s):  
Oluwafolajimi Adetoye Adesanya
Keyword(s):  
Ebola Virus ◽  
Democratic Republic Of Congo ◽  
Virus Disease ◽  
Disease Outbreaks ◽  
Ebola Virus Disease ◽  
African Continent ◽  
Outbreak Response ◽  
African Countries ◽  
Response Strategies ◽  
Past Experiences

Over the years, the African continent has had to battle several outbreaks of infectious diseases in different countries. Some of the most deadly were the Ebola virus disease (EVD) outbreaks that occurred in West Africa between 2014 and 2016 affecting Guinea, Liberia, and Sierra Leone and, more recently, from 2018 to 2020 in the Democratic Republic of Congo (DRC). In the era of the COVID-19 pandemic, it is important that as a continent, we draw lessons and insights from our past experiences to guide outbreak response strategies being deployed to curb the latest onslaught. The Ebola outbreaks have shown that disease outbreaks should not be seen only as medical emergencies, but as full blown humanitarian crises, because oftentimes, their socio-economic impacts are more devastating than the more obvious cost to life. In this mini-review, we explore the possible humanitarian costs of the COVID-19 pandemic on the African continent by looking through the lens of our past experiences with the EVD outbreaks, highlighting how the current pandemic could significantly affect the African economy, food security, and vulnerable demographics, like children and the sexual and reproductive health and rights of women and girls. We then proffer recommendations that could be instrumental in preventing a double tragedy involving the devastating health consequences of the virus itself and the deadly fallout from its multi-sectoral knock-on effects in African countries. Keywords: COVID-19, SARS-CoV-2, Ebola Virus Disease, Coronavirus.

scholarly journals Human activities link fruit bat presence to Ebola virus disease outbreaks

Mammal Review ◽  
2019 ◽  
Vol 50 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Jesús Olivero ◽  
John E. Fa ◽  
Miguel Á. Farfán ◽  
Ana L. Márquez ◽  
Raimundo Real ◽  
...  
Keyword(s):  
Human Activities ◽  
Ebola Virus ◽  
Virus Disease ◽  
Disease Outbreaks ◽  
Ebola Virus Disease ◽  
Fruit Bat

scholarly journals Transmission Dynamics and Final Epidemic Size of Ebola Virus Disease Outbreaks with Varying Interventions

PLoS ONE ◽  
2015 ◽  
Vol 10 (7) ◽  
pp. e0131398 ◽  
Author(s):  
Maria Vittoria Barbarossa ◽  
Attila Dénes ◽  
Gábor Kiss ◽  
Yukihiko Nakata ◽  
Gergely Röst ◽  
...  
Keyword(s):  
Ebola Virus ◽  
Virus Disease ◽  
Disease Outbreaks ◽  
Transmission Dynamics ◽  
Ebola Virus Disease ◽  
Epidemic Size ◽  
Final Epidemic Size

Ensuring On-site Ebola Patient Monitoring and Follow-up: Development of a Laboratory Structure Embedded in an Ebola Treatment Center

2019 ◽  
Vol 13 (5-6) ◽  
pp. 1028-1034
Author(s):  
Anita Williams ◽  
Mathieu Amand ◽  
Rafael Van den Bergh ◽  
Hilde De Clerck ◽  
Annick Antierens ◽  
...  
Keyword(s):  
Patient Monitoring ◽  
Ebola Virus ◽  
Virus Disease ◽  
Real Life ◽  
Disease Outbreaks ◽  
Clinical Results ◽  
Ebola Virus Disease ◽  
Treatment Center ◽  
Risk Zones

ABSTRACTThe capacity to rapidly distinguish Ebola virus disease from other infectious diseases and to monitor biochemistry and viremia levels is crucial to the clinical management of suspected Ebola virus disease cases. This article describes the design and practical considerations of a laboratory straddling the high- and low-risk zones of an Ebola treatment center to produce timely diagnostic and clinical results for informed case management of Ebola virus disease in real-life conditions. This innovation may be of relevance for actors requiring flexible laboratory implementation in contexts of high-communicability, high-lethality disease outbreaks.

scholarly journals A meta-analysis of clinical studies conducted during the West Africa Ebola virus disease outbreak confirms the need for randomized control groups

2019 ◽  
Vol 11 (520) ◽  
pp. eaaw1049 ◽  
Author(s):  
Lori E. Dodd ◽  
Dean Follmann ◽  
Michael Proschan ◽  
Jing Wang ◽  
Denis Malvy ◽  
...  
Keyword(s):  
West Africa ◽  
Mortality Risk ◽  
Clinical Studies ◽  
Ebola Virus ◽  
Virus Disease ◽  
Disease Outbreaks ◽  
Ebola Virus Disease ◽  
Control Group ◽  
Control Groups ◽  
Randomized Control

Recent Ebola virus disease outbreaks affirm the dire need for treatments with proven efficacy. Randomized controlled clinical trials remain the gold standard but, during disease outbreaks, may be difficult to conduct due to ethical concerns and challenging field conditions. In the absence of a randomized control group, statistical modeling to create a control group could be a possibility. Such a model-based reference control would only be credible if it had the same mortality risk as that of the experimental group in the absence of treatment. One way to test this counterfactual assumption is to evaluate whether reasonable similarity exists across nonrandomized control groups from different clinical studies, which might suggest that a future control group would be similarly homogeneous. We evaluated similarity across six clinical studies conducted during the 2013–2016 West Africa outbreak of Ebola virus disease. These studies evaluated favipiravir, the biologic ZMapp, the antimalarial drug amodiaquine, or administration of convalescent plasma or convalescent whole blood. We compared the nonrandomized control groups of these six studies comprising 1147 individuals infected with Ebola virus. We found considerable heterogeneity, which did not disappear after statistical modeling to adjust for prognostic variables. Mortality risk varied widely (31 to 66%) across the nonrandomized control arms of these six studies. Models adjusting for baseline covariates (age, sex, and cycle threshold, a proxy for viral load) failed to sufficiently recalibrate these studies and showed that heterogeneity remained. Our findings highlight concerns about making invalid conclusions when comparing nonrandomized control groups to cohorts receiving experimental treatments.

scholarly journals Long-term wildlife mortality surveillance in northern Congo: a model for the detection of Ebola virus disease epizootics

2019 ◽  
Vol 374 (1782) ◽  
pp. 20180339 ◽  
Author(s):  
Eeva Kuisma ◽  
Sarah H. Olson ◽  
Kenneth N. Cameron ◽  
Patricia E. Reed ◽  
William B. Karesh ◽  
...  
Keyword(s):  
Ebola Virus ◽  
Virus Disease ◽  
Behavioural Change ◽  
Disease Outbreaks ◽  
Great Apes ◽  
Congo Basin ◽  
Ebola Virus Disease ◽  
Educational Outreach ◽  
Mortality Surveillance ◽  
Wildlife Mortality

Ebolavirus (EBOV) has caused disease outbreaks taking thousands of lives, costing billions of dollars in control efforts and threatening great ape populations. EBOV ecology is not fully understood but infected wildlife and consumption of animal carcasses have been linked to human outbreaks, especially in the Congo Basin. Partnering with the Congolese Ministry of Health, we conducted wildlife mortality surveillance and educational outreach in the northern Republic of Congo (RoC). Designed for EBOV detection and to alert public health authorities, we established a low-cost wildlife mortality reporting network covering 50 000 km 2 . Simultaneously, we delivered educational outreach promoting behavioural change to over 6600 people in rural northern RoC. We achieved specimen collection by training project staff on a safe sampling protocol and equipping geographically distributed bases with sampling kits. We established in-country diagnostics for EBOV testing, reducing diagnostic turnaround time to 3 days and demonstrated the absence of EBOV in 58 carcasses. Central Africa remains a high-risk EBOV region, but RoC, home to the largest remaining populations of great apes, has not had an epidemic since 2005. This effort continues to function as an untested early warning system in RoC, where people and great apes have died from past Ebola virus disease outbreaks. This article is part of the theme issue ‘Dynamic and integrative approaches to understanding pathogen spillover’.

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