An Ebola outbreak of unprecedented scope emerged in West Africa in December 2013 and presently continues unabated in the countries of Guinea, Sierra Leone, and Liberia. Ebola is not new to Africa, ...and outbreaks have been confirmed as far back as 1976. The current West African Ebola outbreak is the largest ever recorded and differs dramatically from prior outbreaks in its duration, number of people affected, and geographic extent. The emergence of this deadly disease in West Africa invites many questions, foremost among these: why now, and why in West Africa? Here, we review the sociological, ecological, and environmental drivers that might have influenced the emergence of Ebola in this region of Africa and its spread throughout the region. Containment of the West African Ebola outbreak is the most pressing, immediate need. A comprehensive assessment of the drivers of Ebola emergence and sustained human-to-human transmission is also needed in order to prepare other countries for importation or emergence of this disease. Such assessment includes identification of country-level protocols and interagency policies for outbreak detection and rapid response, increased understanding of cultural and traditional risk factors within and between nations, delivery of culturally embedded public health education, and regional coordination and collaboration, particularly with governments and health ministries throughout Africa. Public health education is also urgently needed in countries outside of Africa in order to ensure that risk is properly understood and public concerns do not escalate unnecessarily. To prevent future outbreaks, coordinated, multiscale, early warning systems should be developed that make full use of these integrated assessments, partner with local communities in high-risk areas, and provide clearly defined response recommendations specific to the needs of each community.
Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging pathogen, first recognized in 2012, with a high case fatality risk, no vaccine, and no treatment beyond supportive care. We ...estimated the relative risks of death and severe disease among MERS-CoV patients in the Middle East between 2012 and 2015 for several risk factors, using Poisson regression with robust variance and a bootstrap-based expectation maximization algorithm to handle extensive missing data. Increased age and underlying comorbidity were risk factors for both death and severe disease, while cases arising in Saudi Arabia were more likely to be severe. Cases occurring later in the emergence of MERS-CoV and among health-care workers were less serious. This study represents an attempt to estimate risk factors for an emerging infectious disease using open data and to address some of the uncertainty surrounding MERS-CoV epidemiology.
Infectious disease modeling has played a prominent role in recent outbreaks, yet integrating these analyses into public health decision-making has been challenging. We recommend establishing ...‘outbreak science’ as an inter-disciplinary field to improve applied epidemic modeling.
About the Authors: Caitlin Rivers * E-mail: crivers6@jhu.edu Affiliation: Johns Hopkins Center for Health Security, Maryland, United States of America ORCID logo http://orcid.org/0000-0001-8265-0629 ...Simon Pollett Affiliations Viral Diseases Branch, Walter Reed Army Institute of Research, Marlyand, United States of America, Uniformed Services University of the Health Sciences, Maryland, United States of America, Marie Bashir Institute, University of Sydney, New South Wales, Australia Cecile Viboud Affiliation: National Institutes of Health, Maryland, United States of America Citation: Rivers C, Pollett S, Viboud C (2020) The opportunities and challenges of an Ebola modeling research coordination group. In response to the protracted Ebola virus outbreak in the Democratic Republic of Congo, the international public health community called for increased attention, coordination, and resources to support the response. ...it allowed resources such as open access data and parameter estimates to be shared, thereby improving model quality, comparability, and efficiency of the modeling process. ...we have demonstrated how this model coordination framework could readily be adopted by other groups for future epidemics and indeed has been so in the current COVID-19 outbreak 17.
In the Democratic Republic of the Congo, experienced public-health officials routinely bring new Ebola outbreaks under control. The virus has already infected tens of thousands of people and has ...footholds in communities around the world. ...this year, monkeypox circulated only in limited outbreaks in endemic regions of West and Central Africa. ...public-health officials should not shy away from direct messaging to help members of the public protect themselves - which includes making it clear that the population currently at highest risk is men who have sex with men - and providing guidance on preventing infection and recognizing symptoms.
Forecasting is beginning to be integrated into decision-making processes for infectious disease outbreak response. We discuss how technologies could accelerate the adoption of forecasting among ...public health practitioners, improve epidemic management, save lives, and reduce the economic impact of outbreaks.
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