Ebola virus disease contact tracing activities, lessons learned and best practices during the Duport Road outbreak in Monrovia, Liberia, November 2015

Contact tracing in an Ebola virus disease (EVD) outbreak is the process of identifying individuals who may have been exposed to infected persons with the virus, followed by monitoring for 21 days (the maximum incubation period) from the date of the most recent exposure. The goal is to achieve early detection and isolation of any new cases in order to prevent further transmission. We performed a retrospective data analysis of 261 probable and confirmed EVD cases in the national EVD database and 2525 contacts in the Contact Line Lists in Kenema district, Sierra Leone between 27 April and 4 September 2014 to assess the performance of contact tracing during the initial stage of the outbreak. The completion rate of the 21-day monitoring period was 89% among the 2525 contacts. However, only 44% of the EVD cases had contacts registered in the Contact Line List and 6% of probable or confirmed cases had previously been identified as contacts. Touching the body fluids of the case and having direct physical contact with the body of the case conferred a 9- and 20-fold increased risk of EVD status, respectively. Our findings indicate that incompleteness of contact tracing led to considerable unmonitored transmission in the early months of the epidemic. To improve the performance of early outbreak contact tracing in resource poor settings, our results suggest the need for prioritized contact tracing after careful risk assessment and better alignment of Contact Line Listing with case ascertainment and investigation. This article is part of the themed issue ‘The 2013–2016 West African Ebola epidemic: data, decision-making and disease control’.

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Ebola Virus Disease - clinical manifestations, management and future therapies

Journal of The Royal Naval Medical Service ◽

10.1136/jrnms-105-113 ◽

2019 ◽

Vol 105 (2) ◽

pp. 113-120

Author(s):

D O’Brien ◽

M K O’Shea ◽

T E Fletcher

Keyword(s):

Ebola Virus ◽

Virus Disease ◽

Clinical Manifestations ◽

Armed Forces ◽

Lessons Learned ◽

The Body ◽

Ebola Virus Disease ◽

International Response ◽

The Uk ◽

Specific Symptoms

AbstractThe largest epidemic of Ebola Virus Disease in recorded human history occurred in West Africa in 2014 and resulted in significant morbidity and mortality. The causative pathogen, Ebola virus, is readily transmitted through contact with the body fluids of infected individuals and from the bodies of those who have died from the disease. In its early stages, the illness is characterised by non-specific symptoms that mimic many other endemic infectious diseases in countries with limited healthcare resources. These factors contributed to the rapid spread of the outbreak, which required an international response in which the UK Armed Forces played an important role. This review describes the clinical presentation, lessons learned from managing the West African outbreak, and potential future treatments.

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Participatory Monitoring and Evaluation of Ebola Response Activities in Lofa County, Liberia: Some Lessons Learned

International Quarterly of Community Health Education ◽

10.1177/0272684x19846742 ◽

2019 ◽

Vol 40 (1) ◽

pp. 57-66

Author(s):

Ithar Hassaballa ◽

Stephen Fawcett ◽

Charles Sepers ◽

Florence DiGennaro Reed ◽

Jerry Schultz ◽

...

Keyword(s):

Evaluation System ◽

Quantitative Methods ◽

Ebola Virus ◽

Virus Disease ◽

Monitoring And Evaluation ◽

Lessons Learned ◽

Ebola Virus Disease ◽

World Health ◽

Response Effort ◽

Participatory Monitoring

To address the Ebola outbreak in West Africa, the World Health Organization and the United Nations Children’s Fund led a multilevel and multisectoral intervention known as the Ebola response effort. Although surveillance systems were able to detect reduction in Ebola incidence, there was little understanding of the implemented activities within affected areas. To address this gap, this empirical case study examined (a) implementation of Ebola response activities and associated bending the curve of incidence of Ebola virus disease and (b) candidate factors associated with fuller implementation of the Ebola response effort. A mix of qualitative and quantitative methods were used to address these questions. A participatory monitoring and evaluation system was used to capture, code, characterize, and communicate nearly a hundred Ebola response activities implemented in Lofa County, a highly affected area in Liberia. The Ebola response effort was enabled by community engagement and collaboration across different sectors. Results showed fuller implementation corresponded with a marked reduction in Ebola virus disease. This report concludes with a discussion of how monitoring and evaluation can strengthen implementation of activities needed to address disease outbreaks.

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Obstetrical Surgery in the Context of Ebola Virus Disease (Ebola) in Guinea: Lessons Learned from 2 Cases

Open Journal of Obstetrics and Gynecology ◽

10.4236/ojog.2019.910126 ◽

2019 ◽

Vol 09 (10) ◽

pp. 1305-1314

Author(s):

Bah Elhadj Mamoudou ◽

Diallo Ibrahima Sory ◽

DialloThierno Saidou ◽

Leno W. Daniel ◽

Soumah Aboubacar Fode Momo ◽

...

Keyword(s):

Ebola Virus ◽

Virus Disease ◽

Lessons Learned ◽

Ebola Virus Disease

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

Conflict and Health ◽

10.1186/s13031-021-00360-x ◽

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.

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Epidemiological and Surveillance Response to Ebola Virus Disease Outbreak in Lofa County, Liberia (March-September, 2014); Lessons Learned

PLoS Currents ◽

10.1371/10.1371/currents.outbreaks.9681514e450dc8d19d47e1724d2553a5 ◽

2015 ◽

Cited By ~ 1

Author(s):

Koffi Isidore Kouadio ◽

Peter Clement ◽

Josephus Bolongei ◽

Alpha Tamba ◽

Alex Ntale Gasasira ◽

...

Keyword(s):

Ebola Virus ◽

Virus Disease ◽

Disease Outbreak ◽

Lessons Learned ◽

Ebola Virus Disease

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Notes from the Field: Development of a Contact Tracing System for Ebola Virus Disease — Kambia District, Sierra Leone, January–February 2015

MMWR Morbidity and Mortality Weekly Report ◽

10.15585/mmwr.mm6515a4 ◽

2016 ◽

Vol 65 (15) ◽

pp. 402 ◽

Cited By ~ 4

Author(s):

Rebecca Levine ◽

Margherita Ghiselli ◽

Agnes Conteh ◽

Bobson Turay ◽

Andrew Kemoh ◽

...

Keyword(s):

Sierra Leone ◽

Ebola Virus ◽

Virus Disease ◽

Ebola Virus Disease ◽

Contact Tracing ◽

Field Development

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Mathematical modeling of contact tracing as a control strategy of Ebola virus disease

International Journal of Biomathematics ◽

10.1142/s1793524518500936 ◽

2018 ◽

Vol 11 (07) ◽

pp. 1850093 ◽

Cited By ~ 6

Author(s):

T. Berge ◽

A. J. Ouemba Tassé ◽

H. M. Tenkam ◽

J. Lubuma

Keyword(s):

Ebola Virus ◽

Virus Disease ◽

Control Measures ◽

Ebola Virus Disease ◽

Contact Tracing ◽

Asymptotically Stable ◽

Globally Asymptotically Stable ◽

Imperfect Contact ◽

Adequate Treatment ◽

Disease Free

More than 20 outbreaks of Ebola virus disease have occurred in Africa since 1976, and yet no adequate treatment is available. Hence, prevention, control measures and supportive treatment remain the only means to avoid the disease. Among these measures, contact tracing occupies a prominent place. In this paper, we propose a simple mathematical model that incorporates imperfect contact tracing, quarantine and hospitalization (or isolation). The control reproduction number [Formula: see text] of each sub-model and for the full model are computed. Theoretically, we prove that when [Formula: see text] is less than one, the corresponding model has a unique globally asymptotically stable disease-free equilibrium. Conversely, when [Formula: see text] is greater than one, the disease-free equilibrium becomes unstable and a unique globally asymptotically stable endemic equilibrium arises. Furthermore, we numerically support the analytical results and assess the efficiency of different control strategies. Our main observation is that, to eradicate EVD, the combination of high contact tracing (up to 90%) and effective isolation is better than all other control measures, namely: (1) perfect contact tracing, (2) effective isolation or full hospitalization, (3) combination of medium contact tracing and medium isolation.

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