Containing a haemorrhagic fever epidemic: the Ebola experience in Uganda (October 2000–January 2001)

Abstract

This was recognized as the largest reported outbreak of EHF in the world. Control interventions were very successful in containing the epidemic. The community structures used to contain the epidemic have continued to perform well after containment of the outbreak, and have proved useful in the identification of other outbreaks. This was also the first outbreak response co-ordinated by the WHO under the Global Outbreak Alert and Response Network, a voluntary organization recently created to co-ordinate technical and financial resources to developing countries during outbreaks.

Lassa Fever Epidemic in Nigeria - Outbreak Investigation, Risk Factors and Empirical Analysis from 2012 To 2016

“…Implementation relied substantially on surveillance for cases and contacts, case management and infection control, and availability of a Lassa virus diagnostic facility in the country, as well as effective public information and communication. Some of these approaches [13] have been adopted previously to contain [14] other outbreaks Ali et al [15] of viral hemorrhagic Yilmaz et al [16].…”

Diagnostic schemes for reducing epidemic size of african viral hemorrhagic fever outbreaks

“…As reference scenario we use a simple "astute observer" [14] model. At a certain probability p 1 a given general-population case will lead an observer, that is an astute health worker, to conclude that an Ebola epidemic is in process, and at a potentially different probability p 2 a given health worker case will lead to the same conclusion.…”

“…While hospital-amplified VHF outbreaks have been linked to unacceptable needle-sharing and absence of basic infection control precautions in some institutions [7,12,13], the vast majority of documented VHF outbreaks involving hospitals have seen nosocomial transmission due to inadequate isolation facilities and because gloves and expensive protective clothing were not always used by attending personnel [13][14][15][16]. As most in-patients in often overcrowded, under-resourced and understaffed hospitals in equatorial Africa have a fever of infectious origin, highest-level barrier precautions cannot feasibly be implemented, nor do most common infections require them.…”

“…As most in-patients in often overcrowded, under-resourced and understaffed hospitals in equatorial Africa have a fever of infectious origin, highest-level barrier precautions cannot feasibly be implemented, nor do most common infections require them. Notwithstanding, appropriate barrier practices can be, and have been, rapidly instituted in African hospitals during hemorrhagic fever outbreaks [16][17][18][19], and have led to rapid abatement of all documented Ebola and Marburg outbreaks [20,21].…”

“…However VHFs often do not present symptoms different from those seen in malaria, typhoid fever and other infections at early stages and the clinical case definitions for Ebola and Marburg hemorrhagic fevers are unreliable [8,18,23,24]. The Uganda outbreak eventually came to light because physicians did detect an anomaly, but that was a spike in the number of deaths, by which time the epidemic was well underway [14,25]. Recognizing unusual cases early, without epidemiological context, in an outbreak is difficult for even the most skilled diagnostician when such cases Table 1: Outbreak size, fatalities, time to detection and numbers of health workers infected in documented filovirus outbreaks without clear evidence of needle-reuse.…”