The global Ebola virus disease response
Glenn Laverack in Health Promotion in Disease Outbreaks and Health Emergencies, 2017
The outbreak of the Ebola virus disease (EVD) in West Africa occurred between 2014 and 2016 and was the largest on record with an unprecedented number of reported cases (n = 28,616 at 9 August 2016) and deaths. The Ebola outbreak undermined already fragile national healthcare systems that were unprepared at almost every level to contain the disease. Several key factors have been identified as directly contributing to the rapid spread of the EVD in West Africa, including the health systems, healthcare workers and poor transportation services. Ebola control efforts must actively involve people and many agencies did learn from their earlier mistakes in the outbreak to make a genuine attempt to better engage with communities. Health promotion made an important contribution to the outbreak because it enabled people to take more control over their lives and health. The Community-Led Ebola Action (CLEA) approach encourages the community to take responsibility and local actions to directly address an Ebola outbreak.
The 2014–2016 Epidemic and Earlier Outbreaks
Joseph R. Masci, Elizabeth Bass in Ebola, 2017
The pattern of Ebola virus disease (EVD) before the 2014–2016 epidemic in West Africa was of sporadic outbreaks in rural areas of East and Central Africa involving a few dozen to a few hundred cases. Despite the understanding of the Ebola virus and EVD that was gained through investigation of these outbreaks, the West African epidemic of 2014–2016 again raised questions about the means of transmission and necessary steps for control. A disproportionate share of cases of EVD occurred among health care workers in West Africa. The West African outbreak was first recognized in the early spring of 2014, and it quickly grew to a magnitude never before seen. The initial cases of the outbreak were first recognized in West Africa in March 2014 and occurred in the adjacent countries of Guinea, Liberia, and Sierra Leone almost simultaneously.
Filoviridae
Erskine L. Palmer, Mary Lane Martin in Electron Microscopy in Viral Diagnosis, 2019
The family Filoviridae is comprised of Marburg virus and Ebola virus. Ebola virus was the cause of an outbreak of hemorrhagic fever in the Sudan and Zaire in 1976. Negative staining reveals a helical ribonucleoprotein surrounded by an envelope covered with surface projections. A second Ebola virus isolation was made from a human during an outbreak of hemorrhagic fever in Sudan in 1979. Marburg and Ebola are negative stranded RNA viruses. Bizarre branching forms are commonly seen by negative stain electron microscopy. There have been no documented imported cases of Marburg or Ebola into the US The diseases have thus far been confined to Africa except for the initial importation of Marburg into Germany. The viral internal constituents can be seen as cylinders in an amorphous matrix. These viruses are very long rods and may be several microns in length.
Ebola virus disease candidate vaccines under evaluation in clinical trials
Published in Expert Review of Vaccines, 2016
Karen A. Martins, Peter B. Jahrling, Sina Bavari, Jens H. Kuhn
Filoviruses are the etiological agents of two human illnesses: Ebola virus disease and Marburg virus disease. Until 2013, medical countermeasure development against these afflictions was limited to only a few research institutes worldwide as both infections were considered exotic due to very low case numbers. Together with the high case-fatality rate of both diseases, evaluation of any candidate countermeasure in properly controlled clinical trials seemed impossible. However, in 2013, Ebola virus was identified as the etiological agent of a large disease outbreak in Western Africa including almost 30,000 infections and more than 11,000 deaths, including case exportations to Europe and North America. These large case numbers resulted in medical countermeasure development against Ebola virus disease becoming a global public-health priority. This review summarizes the status quo of candidate vaccines against Ebola virus disease, with a focus on those that are currently under evaluation in clinical trials.
Considerations for Safe EMS Transport of Patients Infected with Ebola Virus
Published in Prehospital Emergency Care, 2015
John J. Lowe, Katelyn C. Jelden, Paul J. Schenarts, Lloyd E. Rupp, Kingdon J. Hawes, Benjamin M. Tysor, Raymond G. Swansiger, Shelly S. Schwedhelm, Philip W. Smith, Shawn G. Gibbs
The Nebraska Biocontainment Unit through the Nebraska Medical Center in Omaha, Nebraska, recently received patients with confirmed Ebola virus from West Africa. The Nebraska Biocontainment Unit and Omaha Fire Department's emergency medical services (EMS) coordinated patient transportation from airport to the high-level isolation unit. Transportation of these highly infectious patients capitalized on over 8 years of meticulous planning and rigorous infection control training to ensure the safety of transport personnel as well as the community during transport. Although these transports occurred with advanced notice and after confirmed Ebola virus disease (EVD) diagnosis, approaches and key lessons acquired through this effort will advance the ability of any EMS provider to safely transport a confirmed or suspected patient with EVD. Three critical areas have been identified from our experience: ambulance preparation, appropriate selection and use of personal protective equipment, and environmental decontamination.
Sexual behaviours in the context of the Ebola virus disease (EVD) in Ghana
Published in Culture, Health & Sexuality, 2018
Evidence suggests that Ebola virus disease can be transmitted through unprotected sexual intercourse, in particular through contact with the semen of an infected person. Yet few studies examine sexual behaviours in the context of Ebola. Using data collected from 460 women and 340 men within 40 selected communities in the Greater Accra Region of Ghana, this study employed hierarchical linear modelling to examine individual and community-level factors that influence willingness to engage in behaviours that protect against the sexual transmission of Ebola. Results indicate that both individual and community-level factors are significant predictors of respondents’ willingness to engage in preventive behaviours. Compared with those with no risks, female respondents with low and medium risk perceptions were significantly more likely to indicate they would use condoms to prevent the sexual transmission of Ebola (AOR = 2.23; p < 0.01). Compared with men who were very concerned, those who were not very concerned (AOR = 0.356; p < 0.01) and not at all concerned (AOR = 0.356; p < 0.05) about Ebola were significantly less likely to protect against the sexual transmission of Ebola. Female respondents in communities with high knowledge about Ebola were significantly more likely to engage in behaviours preventing the sexual transmission of Ebola virus disease (AOR = 1.93; p < 0.05).