scholarly journals Ebola or Not? Evaluating the Ill Traveler From Ebola-Affected Countries in West Africa

2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Jessica K. Fairley ◽  
Phyllis E. Kozarsky ◽  
Colleen S. Kraft ◽  
Jeannette Guarner ◽  
James P. Steinberg ◽  
...  
Keyword(s):  
West Africa ◽  
Infection Control ◽  
Ebola Virus ◽  
Virus Disease ◽  
Plasmodium Falciparum Malaria ◽  
The United States ◽  
Case Definition ◽  
Lessons Learned ◽  
Treatment Unit ◽  
Life Threatening

Abstract Background.  The 2014–2015 Ebola epidemic in West Africa had global impact beyond the primarily affected countries of Guinea, Liberia, and Sierra Leone. Other countries, including the United States, encountered numerous patients who arrived from highly affected countries with fever or other signs or symptoms consistent with Ebola virus disease (EVD). Methods.  We describe our experience evaluating 25 travelers who met the US Centers for Disease Control and Prevention case definition for a person under investigation (PUI) for EVD from July 20, 2014 to January 28, 2015. All patients were triaged and evaluated under the guidance of institutional protocols to the emergency department, outpatient tropical medicine clinic, or Emory's Ebola treatment unit. Strict attention to infection control and early involvement of public health authorities guided the safe evaluation of these patients. Results.  None were diagnosed with EVD. Respiratory illnesses were common, and 8 (32%) PUI were confirmed to have influenza. Four patients (16%) were diagnosed with potentially life-threatening infections or conditions, including 3 with Plasmodium falciparum malaria and 1 with diabetic ketoacidosis. Conclusions.  In addition to preparing for potential patients with EVD, Ebola assessment centers should consider other life-threatening conditions requiring urgent treatment, and travelers to affected countries should be strongly advised to seek pretravel counseling. Furthermore, attention to infection control in all aspects of PUI evaluation is paramount and has presented unique challenges. Lessons learned from our evaluation of potential patients with EVD can help inform preparations for future outbreaks of highly pathogenic communicable diseases.

Serosurvey on healthcare personnel caring for patients with Ebola virus disease and Lassa virus in the United States

2020 ◽  
Vol 41 (4) ◽  
pp. 385-390
Author(s):  
Colleen S. Kraft ◽  
Aneesh K. Mehta ◽  
Jay B. Varkey ◽  
G. Marshall Lyon ◽  
Sharon Vanairsdale ◽  
...  
Keyword(s):  
Infection Control ◽  
Ebola Virus ◽  
Virus Disease ◽  
Adenovirus Type ◽  
The United States ◽  
Ebola Virus Disease ◽  
University Hospital ◽  
Healthcare Personnel ◽  
Lassa Virus ◽  
Serum Samples

AbstractObjective:Healthcare personnel (HCP) were recruited to provide serum samples, which were tested for antibodies against Ebola or Lassa virus to evaluate for asymptomatic seroconversion.Setting:From 2014 to 2016, 4 patients with Ebola virus disease (EVD) and 1 patient with Lassa fever (LF) were treated in the Serious Communicable Diseases Unit (SCDU) at Emory University Hospital. Strict infection control and clinical biosafety practices were implemented to prevent nosocomial transmission of EVD or LF to HCP.Participants:All personnel who entered the SCDU who were required to measure their temperatures and complete a symptom questionnaire twice daily were eligible.Results:No employee developed symptomatic EVD or LF. EVD and LF antibody studies were performed on sera samples from 42 HCP. The 6 participants who had received investigational vaccination with a chimpanzee adenovirus type 3 vectored Ebola glycoprotein vaccine had high antibody titers to Ebola glycoprotein, but none had a response to Ebola nucleoprotein or VP40, or a response to LF antigens.Conclusions:Patients infected with filoviruses and arenaviruses can be managed successfully without causing occupation-related symptomatic or asymptomatic infections. Meticulous attention to infection control and clinical biosafety practices by highly motivated, trained staff is critical to the safe care of patients with an infection from a special pathogen.

scholarly journals Lessons learned from implementation of a national hotline for Ebola virus disease emergency preparedness in South Sudan

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Velma K. Lopez ◽  
Sharmila Shetty ◽  
Angelo Thon Kouch ◽  
Matthew Tut Khol ◽  
Richard Lako ◽  
...  
Keyword(s):  
Emergency Preparedness ◽  
Ebola Virus ◽  
Virus Disease ◽  
South Sudan ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Case Definition ◽  
Lessons Learned ◽  
Ebola Virus Disease ◽  
Humanitarian Emergency

Abstract Background The world’s second largest Ebola outbreak occurred in the Democratic Republic of Congo from 2018 to 2020. At the time, risk of cross-border spread into South Sudan was very high. Thus, the South Sudan Ministry of Health scaled up Ebola preparedness activities in August 2018, including implementation of a 24-h, toll-free Ebola virus disease (EVD) hotline. The primary purpose was the hotline was to receive EVD alerts and the secondary goal was to provide evidence-based EVD messages to the public. Methods To assess whether the hotline augmented Ebola preparedness activities in a protracted humanitarian emergency context, we reviewed 22 weeks of call logs from January to June 2019. Counts and percentages were calculated for all available data. Results The hotline received 2114 calls during the analysis period, and an additional 1835 missed calls were documented. Callers used the hotline throughout 24-h of the day and were most often men and individuals living in Jubek state, where the national capital is located. The leading reasons for calling were to learn more about EVD (68%) or to report clinical signs or symptoms (16%). Common EVD-related questions included EVD signs and symptoms, transmission, and prevention. Only one call was documented as an EVD alert, and there was no documentation of reported symptoms or whether the person met the EVD case definition. Conclusions Basic surveillance information was not collected from callers. To trigger effective outbreak investigation from hotline calls, the hotline should capture who is reporting and from where, symptoms and travel history, and whether this information should be further investigated. Electronic data capture will enhance data quality and availability of information for review. Additionally, the magnitude of missed calls presents a major challenge. When calls are answered, there is potential to provide health communication, so risk communication needs should be considered. However, prior to hotline implementation, governments should critically assess whether their hotline would yield actionable data and if other data sources for surveillance or community concerns are available.

Biochemical testing in a laboratory tent and semi-intensive care of Ebola patients on-site in a remote part of Guinea: a paradigm shift based on a bleach-sensitive point-of-care device

2017 ◽  
Vol 55 (12) ◽  
Author(s):  
Leonid M. Irenge ◽  
Jean-Michel Dindart ◽  
Jean-Luc Gala
Keyword(s):  
Paradigm Shift ◽  
Ebola Virus ◽  
Virus Disease ◽  
Care Delivery ◽  
Point Of Care ◽  
Operating Conditions ◽  
Supportive Treatment ◽  
Treatment Unit ◽  
Life Threatening ◽  
Biochemical Testing

Abstract:Background:During the West Africa Ebola virus disease (EVD) outbreak, a Belgian laboratory was deployed for supporting the Ebola treatment unit (ETU) of N’Zerekore, Guinea. Besides diagnosis of EVD and malaria, biochemical parameters were tested and used to guide supportive treatment of EVD.Methods:To preserve analytes stability, lithium-heparin blood samples were analyzed using the i-STATResults:Providing the medical staff with real-time biochemical data modified their therapeutic attitude, shifting from empiric to a semi-intensive laboratory-guided treatment of hydro-electrolytic disturbances, metabolic acidosis and/or impaired kidney function. As illustrated with representative EVD cases (n=8), optimized supportive treatment with intravenous fluid therapy and electrolyte replacement often helped correct these abnormalities. However, the harsh operating conditions, especially the use of bleach decontamination inside the glovebox, caused several technical failures and the final breakdown of the POCT device.Conclusions:POCT availability resulted in a paradigm shift in laboratory practice and care delivery at the N’Zerekore ETU. We conclude that there is urgent need for novel well-designed and validated POCT devices usable by non-expert operators in high ambient temperature and limited space. These devices should withstand regular and thorough decontamination by the personnel working on-site with life-threatening pathogens and be compatible with high biosafety level procedures. Such specific users’ requirements need a European validation and standardization process of proposed solutions led by the EU Standardization Committee (CEN).

Lessons Learned From Hospital Ebola Preparation

2015 ◽  
Vol 36 (6) ◽  
pp. 627-631 ◽  
Author(s):  
Daniel J. Morgan ◽  
Barbara Braun ◽  
Aaron M. Milstone ◽  
Deverick Anderson ◽  
Ebbing Lautenbach ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Ebola Virus ◽  
Virus Disease ◽  
The United States ◽  
Routine Care ◽  
Lessons Learned ◽  
Convenience Sample ◽  
Control And Prevention ◽  
Prevention Activities ◽  
Healthcare Epidemiology

BACKGROUNDHospital Ebola preparation is underway in the United States and other countries; however, the best approach and resources involved are unknown.OBJECTIVETo examine costs and challenges associated with hospital Ebola preparation by means of a survey of Society for Healthcare Epidemiology of America (SHEA) members.DESIGNElectronic survey of infection prevention experts.RESULTSA total of 257 members completed the survey (221 US, 36 international) representing institutions in 41 US states, the District of Columbia, and 18 countries. The 221 US respondents represented 158 (43.1%) of 367 major medical centers that have SHEA members and included 21 (60%) of 35 institutions recently defined by the US Centers for Disease Control and Prevention as Ebola virus disease treatment centers. From October 13 through October 19, 2014, Ebola consumed 80% of hospital epidemiology time and only 30% of routine infection prevention activities were completed. Routine care was delayed in 27% of hospitals evaluating patients for Ebola.LIMITATIONSConvenience sample of SHEA members with a moderate response rate.CONCLUSIONSHospital Ebola preparations required extraordinary resources, which were diverted from routine infection prevention activities. Patients being evaluated for Ebola faced delays and potential limitations in management of other diseases that are more common in travelers returning from West Africa.Infect Control Hosp Epidemiol 2015;00(0): 1–5

scholarly journals Ebola virus disease epidemic in West Africa: lessons learned and issues arising from West African countries

2015 ◽  
Vol 15 (1) ◽  
pp. 54-57 ◽  
Author(s):  
Obinna O Oleribe ◽  
Babatunde L Salako ◽  
M Mourtalla Ka ◽  
Albert Akpalu ◽  
Mairi McConnochie ◽  
...  
Keyword(s):  
West Africa ◽  
Ebola Virus ◽  
Virus Disease ◽  
West African ◽  
Lessons Learned ◽  
Ebola Virus Disease ◽  
African Countries

scholarly journals COVID-19 Pandemic Readiness Status of West Africa

2020 ◽  
Author(s):  
Virgil Kaussi Lokossou ◽  
Basil Benduri Kaburi ◽  
Delia Akosua Bandoh ◽  
Edgard-Marius Ouendo ◽  
Aboubacar Ouédraogo ◽  
...  
Keyword(s):  
West Africa ◽  
Emergency Preparedness ◽  
Ebola Virus ◽  
Virus Disease ◽  
Lessons Learned ◽  
Incident Management ◽  
Pandemic Preparedness ◽  
The West ◽  
Member States ◽  
Regional Coordination

Abstract Background From the onset of COVID-19 pandemic in late December 2019, countries have been stepping up their pandemic preparedness and response activities in accordance with WHO recommendations. Informed by the recent lessons learned from the West Africa Ebola Virus Disease outbreak, and subsequent investments made in public health emergency preparedness and response in the Economic Community of West African States (ECOWAS) region, the West Africa Health Organisation (WAHO) is providing regional leadership in the COVID-19 pandemic preparedness and response. We assessed the COVID-19 pandemic readiness status of West Africa. Methods We conducted survey of all 15 ECOWAS member states between February 27 and March 15, 2020. We purposively selected a minimum of two respondents from each of the 15 ECOWAS member states – interviewing 37 in all using an interviewer-administered questionnaire based on the nine item WHO national capacity review tool for novel corona virus (nCOV). We also reviewed reports of COVID-19 pandemic preparedness meetings and trainings organized by WAHO. We performed a thematic analysis on the data and described the strengths and weaknesses of the ongoing pandemic readiness efforts of West Africa. Results Overall, the strengths of pandemic readiness of the region were: capacity to test 86.7% (13/15) of member states; functional incident management systems (100%); rapid response teams 100%, and at least two of the three tiers of field epidemiology workforce (100%). Within the region also, there existed good cross-border collaborations among member states, active participation of health ministers of member states in regional coordination meetings and decision making. Member states described the numbers of qualified biomedical scientists/technicians, field epidemiologists, risk communicators, and COVID-19 case management teams as inadequate. None of the member states had stockpiles of COVID-19 test kits, laboratory supplies, and personal protective equipment. Conclusion ECOWAS member states are taking appropriate COVID-19 pandemic preparedness measures in all pillars towards a regional response. Rather than a total lack, there are insufficiencies in numbers of skilled workforce, logistics, and supplies. Governments of member states are supportive of the coordination and technical direction of WAHO and WHO.

scholarly journals Rapid establishment of a frontline field laboratory in response to an imported outbreak of Ebola virus disease in western Uganda, June 2019

2021 ◽  
Vol 15 (12) ◽  
pp. e0009967
Author(s):  
Amy J. Schuh ◽  
Jackson Kyondo ◽  
James Graziano ◽  
Stephen Balinandi ◽  
Markus H. Kainulainen ◽  
...  
Keyword(s):  
United States ◽  
General Hospital ◽  
Ebola Virus ◽  
Virus Disease ◽  
Hemorrhagic Fever ◽  
The United States ◽  
Ebola Virus Disease ◽  
World Health ◽  
Treatment Unit ◽  
Field Laboratory

The Democratic Republic of the Congo (DRC) declared an Ebola virus disease (EVD) outbreak in North Kivu in August 2018. By June 2019, the outbreak had spread to 26 health zones in northeastern DRC, causing >2,000 reported cases and >1,000 deaths. On June 10, 2019, three members of a Congolese family with EVD-like symptoms traveled to western Uganda’s Kasese District to seek medical care. Shortly thereafter, the Viral Hemorrhagic Fever Surveillance and Laboratory Program (VHF program) at the Uganda Virus Research Institute (UVRI) confirmed that all three patients had EVD. The Ugandan Ministry of Health declared an outbreak of EVD in Uganda’s Kasese District, notified the World Health Organization, and initiated a rapid response to contain the outbreak. As part of this response, UVRI and the United States Centers for Disease Control and Prevention, with the support of Uganda’s Public Health Emergency Operations Center, the Kasese District Health Team, the Superintendent of Bwera General Hospital, the United States Department of Defense’s Makerere University Walter Reed Project, and the United States Mission to Kampala’s Global Health Security Technical Working Group, jointly established an Ebola Field Laboratory in Kasese District at Bwera General Hospital, proximal to an Ebola Treatment Unit (ETU). The laboratory consisted of a rapid containment kit for viral inactivation of patient specimens and a GeneXpert Instrument for performing Xpert Ebola assays. Laboratory staff tested 76 specimens from alert and suspect cases of EVD; the majority were admitted to the ETU (89.3%) and reported recent travel to the DRC (58.9%). Although no EVD cases were detected by the field laboratory, it played an important role in patient management and epidemiological surveillance by providing diagnostic results in <3 hours. The integration of the field laboratory into Uganda’s National VHF Program also enabled patient specimens to be referred to Entebbe for confirmatory EBOV testing and testing for other hemorrhagic fever viruses that circulate in Uganda.

scholarly journals Marginalisation, Ebola and Health for All: From Outbreak to Lessons Learned

2019 ◽  
Vol 16 (17) ◽  
pp. 3023 ◽  
Author(s):  
Clare Shelley-Egan ◽  
Jim Dratwa
Keyword(s):  
West Africa ◽  
Ebola Virus ◽  
Democratic Republic ◽  
Cultural Practices ◽  
Virus Disease ◽  
Lessons Learned ◽  
The Past ◽  
Multiple Dimensions ◽  
Republic Of The Congo ◽  
Main Components

The Ebola epidemic in West Africa between 2014 and 2015 was the deadliest since the discovery of the virus four decades ago. With the second-largest outbreak of Ebola virus disease currently raging in the Democratic Republic of the Congo, (DRC) it is clear that lessons from the past can be quickly forgotten—or be incomplete in the first instance. In this article, we seek to understand the health challenges facing marginalised people by elaborating on the multiple dimensions of marginalisation in the case of the West Africa Ebola epidemic. We trace and unpack modes of marginalisation, beginning with the “outbreak narrative” and its main components and go on to examine other framings, including the prioritisation of the present over the past, the positioning of ‘Us versus Them’; and the marginalisation—in responses to the outbreak—of traditional medicine, cultural practices and other practices around farming and hunting. Finally, we reflect on the ‘lessons learned’ framing, highlighting what is included and what is left out. In conclusion, we stress the need to acknowledge—and be responsive to—the ethical, normative framings of such marginalisation.

scholarly journals Response to Ebola Virus Disease Outbreak in Nigeria, West Africa: The Zaria experience

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Aisha Abubakar ◽  
Kabir Sabitu ◽  
Mohammed Nasir Sambo ◽  
Abdulrazaq Gobir ◽  
Sani Abrahim ◽  
...  
Keyword(s):  
West Africa ◽  
Infection Control ◽  
Case Management ◽  
Prevention And Control ◽  
Ebola Virus ◽  
Virus Disease ◽  
Ebola Virus Disease ◽  
University Teaching ◽  
Health Organization ◽  
And Control

ObjectiveTo assess the formation and function of a joint committee of the Ahmadu Bello University (ABU) and the Ahmadu Bello University Teaching Hospital (ABUTH) to prevent and control EVD in Zaria and the North West sub region of Nigeria.IntroductionThe Ebola Virus Disease (EVD) outbreak in West Africa was unprecedented in spread and its attendant response. There were over 15 000 confirmed cases and over 9 000 suspected cases. The response to the outbreak was massive within Africa and beyond. The outbreak in Nigeria affected 19 people and led to 7 deaths (CFR 37%).There were more than 891 contacts of these cases under surveillance as at 23rd September 2014. Nigeria was declared EVD free by the World Health Organization in October 2014.Nationwide there was targeted preparedness to prevent and control EVD. In Zaria, this led to the formation of a joint committee of the Ahmadu Bello University (ABU) and the Ahmadu Bello University Teaching Hospital (ABUTH) to prevent and control EVD in Zaria and the sub region as a whole.MethodsA joint multidisciplinary committee was formed by ABU and ABUTH with representatives from the Department of Community Medicine, Internal Medicine, Nursing sciences, Veterinary Public Health, Medical Microbiology, Mass Communication, Directorate of Public Affairs ABU Zaria, General Administration and Management services division ABUTH, the University Health Services and the Centre for Disease Risk Management under the Department of Geography. Four subcommittees were created steered by the main committee. The subcommittees were Surveillance; Case Management; Infection Control and Social and Mass mobilization subcommitteesResultsThe committee conducted seminars and trainings in case management, surveillance and infection control. Mass media campaigns included radio jingles production and airing as well as production of flyers and posters on EVD prevention and control. There was a phone in live radio programme. Screening exercise for raised temperature was conducted using laser thermometers at main entry points. A case of suspected EVD was managed who turned out to be a case of dengue haemorrhagic fever.ConclusionsThe committee was enriched by its multidisciplinary nature and a blueprint for the control and prevention of EVD was developed in line with national and global standards. The committee was hampered with lack of funds to implement fully the blueprint for the prevention and control of EVD in Zaria and its environs. The committee transformed into the ABU/ABUTH Epidemic Preparedness and Response Committee after the outbreak was over to address other emerging epidemics.ReferencesABU/ABUTH Joint Committee For The Prevention And Control Of Ebola Virus Disease (ABUPACE) Blueprint For Prevention And Control Of Ebola Virus Disease In ABU/ABUTH Zaria 2014. Pages 1-44World Health Organization. WHO declares end of Ebola outbreak in Nigeria www.who.int/mediacentre/news/statements/2014/nigeria-ends-ebola/en/ 

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