Ebola Virus Disease: Rapid Diagnosis and Timely Case Reporting are Critical to the Early Response for Outbreak Control

Abstract

Abstract. Ebola virus disease (EVD) is a life-threatening zoonosis caused by infection with the Ebola virus. Since the first reported EVD outbreak in the Democratic Republic of the Congo, several small outbreaks have been reported in central Africa with about 2,400 cases occurring between 1976 and 2013. The 2013-2015 EVD outbreak in west Africa is the first documented outbreak in this region and the largest ever with over 27,000 cases and more than 11,000 deaths. Although EVD transmission rates have recently decreased in west Africa, this crisis continues to threaten global health and security, particularly since infected travelers could spread EVD to other resource-limited areas of the world. Because vaccines and drugs are not yet licensed for EVD, outbreak control is dependent on the use of non-pharmaceutical interventions (e.g., infection control practices, isolation of EVD cases, contact tracing with follow-up and quarantine, sanitary burial, health education). However, delays in diagnosing and reporting EVD cases in less accessible rural areas continue to hamper control efforts. New advances in rapid diagnostics for identifying presumptive EVD cases and in mobile-based technologies for communicating critical health-related information should facilitate deployment of an early response to prevent the amplification of sporadic EVD cases into large-scale outbreaks.

Lessons from the Ebola Outbreak: Action Items for Emerging Infectious Disease Preparedness and Response

“…We Need to Produce Better Diagnostic Tools Laboratory tests that rapidly and reliably diagnose infections, ideally even in the early asymptomatic stages, often play a key role in outbreak containment strategies (Stamm 2015). For maximum effectiveness, medical and veterinary diagnostic tests must be sensitive and specific, they must provide rapid results, they must be affordable, and they must use technology that is user-friendly and accessible in diverse settings (Stothard and Adams 2014).…”

Responding to ever-changing epidemiological dynamics of Ebola virus disease

“…To establish the most effective countermeasures for EVD, we suggest a re-examination of the adaptability of the currently available primary healthcare approaches employed globally for control of HIV/AIDS, 40 Malaria and Neglected Tropical Diseases. 41 42 Those approaches usually involve the establishment and deployment of a community-focused, mobile healthcare mechanism 43 purposefully aimed at strengthening healthcare logistics for contact tracing and adherence to medication. Addressing the unequal impact on men, women and children's health should also be advocated.…”

Building an Intelligent Hospital to Fight Contagion

“…Single bedrooms were shown as a means to avoid influenza transmission in hospitals [7], whereas hand hygiene [8] and catheter control have been proven efficient in the fight of frequent hospital-acquired infection [9,10]. Fast microbiological identification [11], such as diagnosis at the point of care (POC), has also been reported as an efficient means to control contagion [12]; in addition, microbiologic and epidemiological surveys should help to anticipate sanitary crises. The SARS lessons lead to the revival of patient biocontainment, suggesting the creation of high-level isolation units (HLIUs) across the word [13,14] and updating healthcare protocols for secure care of very highly contagious patients [15], which have been proven efficient in the care of Ebola virus disease in Europe and the United States [16].…”