Enhancing Ebola Virus Disease Surveillance And Prevention In Counties Without Confirmed Cases In Rural Liberia: Experiences From Sinoe County During The Flare-Up In Monrovia, April To June, 2016

Weah, Vera Darling; Doedeh, John S.; Wiah, Samson Q.; Nyema, Emmanuel; Lombeh, Siafa; Naiene, Jeremias

doi:10.1101/139154

Cited by 2 publications

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References 8 publications

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“…While accurate case reporting will minimize the chance of incorrect declarations that Ebola outbreaks are over in future, we note that surveillance during the outbreak alone is not always sufficient. In the 2013-2016 Ebola epidemic in West Africa, additional cases occurred after regions were declared disease-free owing to factors including persistently infected sources [40] and importation of the virus from other geographical regions [41]. There were suspicions of a flare-up arising from a female survivor, who became infectious after her immune system was weakened by pregnancy [42], although this remains unproven [43].…”

Section: Discussionmentioning

confidence: 99%

Rigorous surveillance is necessary for high confidence in end-of-outbreak declarations for Ebola and other infectious diseases

Thompson

Morgan

Jalava

2019

Phil. Trans. R. Soc. B

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One contribution of 16 to a theme issue 'Modelling infectious disease outbreaks in humans, animals and plants: epidemic forecasting and control'. Subject Areas: computational biology, ecology, health and disease and epidemiology, systems biologyThe World Health Organization considers an Ebola outbreak to have ended once 42 days have passed since the last possible exposure to a confirmed case. Benefits of a quick end-of-outbreak declaration, such as reductions in trade/travel restrictions, must be balanced against the chance of flare-ups from undetected residual cases. We show how epidemiological modelling can be used to estimate the surveillance level required for decision-makers to be confident that an outbreak is over. Results from a simple model characterizing an Ebola outbreak suggest that a surveillance sensitivity (i.e. case reporting percentage) of 79% is necessary for 95% confidence that an outbreak is over after 42 days without symptomatic cases. With weaker surveillance, unrecognized transmission may still occur: if the surveillance sensitivity is only 40%, then 62 days must be waited for 95% certainty. By quantifying the certainty in end-of-outbreak declarations, public health decision-makers can plan and communicate more effectively.This article is part of the theme issue 'Modelling infectious disease outbreaks in humans, animals and plants: epidemic forecasting and control'. This issue is linked with the earlier theme issue 'Modelling infectious disease outbreaks in humans, animals and plants: approaches and important themes'.

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Section: Discussionmentioning

confidence: 99%

Rigorous surveillance is necessary for high confidence in end-of-outbreak declarations for Ebola and other infectious diseases

Thompson

Morgan

Jalava

2019

Phil. Trans. R. Soc. B

View full text Add to dashboard Cite

show abstract

“…While accurate case reporting will minimise the chance of incorrect declarations that Ebola outbreaks are over in future, we note that surveillance during the outbreak alone is not always sufficient. In the 2013-16 Ebola epidemic in West Africa, additional cases occurred after regions were declared disease-free due to factors including persistently infected sources ( 37 ) and importation of the virus from other geographical regions ( 38 ). There were suspicions of a flare-up arising from a female survivor, who became infectious after her immune system was weakened due to pregnancy ( 39 ), although this remains unproven ( 40 ).…”

Section: Discussionmentioning

confidence: 99%

Rigorous surveillance is necessary for high confidence in end-of-outbreak declarations for Ebola and other infectious diseases

Thompson

Morgan

Jalava

2018

Preprint

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9The World Health Organization considers an Ebola outbreak to have ended once 42 days have 10 passed since the last possible exposure to a confirmed case. Benefits of a quick end-of-outbreak 11 declaration, such as reductions in trade/travel restrictions, must be balanced against the chance of 12 flare-ups from undetected residual cases. We show how epidemiological modelling can be used 13 to estimate the surveillance level required for decision-makers to be confident that an outbreak is 14 over. Results from a simple model characterising an Ebola outbreak suggest that a surveillance 15 sensitivity (i.e. case reporting percentage) of 79% is necessary for 95% confidence that an 16 outbreak is over after 42 days without symptomatic cases. With weaker surveillance, 17 unrecognised transmission may still occur: if the surveillance sensitivity is only 40%, then 62 18 days must be waited for 95% certainty. By quantifying the certainty in end-of-outbreak 19 declarations, public health decision-makers can plan and communicate more effectively. 20 21 Keywords 22 Ebola virus disease; End-of-outbreak declarations; World Health Organization; Outbreak 23 forecasting; Surveillance 24 2 25 Main Text 26

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Enhancing Ebola Virus Disease Surveillance And Prevention In Counties Without Confirmed Cases In Rural Liberia: Experiences From Sinoe County During The Flare-Up In Monrovia, April To June, 2016

Abstract: Introduction

Cited by 2 publications

References 8 publications

Rigorous surveillance is necessary for high confidence in end-of-outbreak declarations for Ebola and other infectious diseases

Rigorous surveillance is necessary for high confidence in end-of-outbreak declarations for Ebola and other infectious diseases

Rigorous surveillance is necessary for high confidence in end-of-outbreak declarations for Ebola and other infectious diseases

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