Retrospective Analysis of the 2014–2015 Ebola Epidemic in Liberia

Abstract

Abstract. The 2014-2015 Ebola epidemic has been the most protracted and devastating in the history of the disease. To prevent future outbreaks on this scale, it is imperative to understand the reasons that led to eventual disease control. Here, we evaluated the shifts of Ebola dynamics at national and local scales during the epidemic in Liberia. We used a transmission model calibrated to epidemiological data between June 9 and December 31, 2014, to estimate the extent of community and hospital transmission. We found that despite varied local epidemic patterns, community transmission was reduced by 40-80% in all the counties analyzed. Our model suggests that the tapering of the epidemic was achieved through reductions in community transmission, rather than accumulation of immune individuals through asymptomatic infection and unreported cases. Although the times at which this transmission reduction occurred in the majority of the Liberian counties started before any large expansion in hospital capacity and the distribution of home protection kits, it remains difficult to associate the presence of interventions with reductions in Ebola incidence.

Impact of prophylactic vaccination strategies on Ebola virus transmission: A modeling analysis

“…Multiple mathematical modeling analyses related to Ebola hemorrhagic fever have been undertaken to forecast peak incidence and size of outbreaks [15]. They have evaluated shifts in disease transmission dynamics during epidemics [16], identified factors contributing to the recurrence and persistence of outbreaks [17], assessed the population-level impact of quarantine on disease transmission dynamics [18], estimated size and duration of outbreaks with and without vaccine use [19], assessed the role of sexual transmission in spread of infection during outbreaks [20], captured real-time disease dynamics in the midst of outbreaks [21], projected the short-and long-term course of outbreaks [22], evaluated the effectiveness of control were employed by Janssen Vaccines & Prevention B.V., Leiden, The Netherlands and RP, AK, VM and HB were employed by SmartAnalyst Inc, New York, NY, USA or its subsidiaries. While Janssen Vaccines & Prevention and Janssen Vaccines & Prevention B.V. provided support in the form of salaries to authors CS, VOM, KL and BC, they did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.…”

Patient Satisfaction With Maternity Waiting Homes in Liberia: A Case Study During the Ebola Outbreak

“…Ebola devastated an already fragile health system in Liberia. Health care needs quickly escalated beyond the capacity of understaffed and undersupplied facilities . In a country with already too few providers, many health care workers fled for fear of contracting the disease from patients .…”

Distribution of household disinfection kits during the 2014-2015 Ebola virus outbreak in Monrovia, Liberia: The MSF experience

“…The potential impact of distributing hygiene kits at community level in Liberia has been already acknowledged [12,16]. Merler et al (2015) related decreasing trends of EVD occurrence with the increased isolation capacity, safe burials and household protection kits [17].…”

“…Merler et al (2015) related decreasing trends of EVD occurrence with the increased isolation capacity, safe burials and household protection kits [17]. Atkins et al (2016) alleged that the distribution in Monrovia started in "late October 2014" [16]. Nevertheless, this was the only mass distribution of hygiene kit occurring at the time and it started in week 36, 2014 (i.e.…”