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Biomedical and Environmental Sciences 2023年第1期36卷 86-93页

作者： SHANG Wei Jing JING Wen Zhan LIU Jue LIU Min School of Public Health Peking UniversityBeijing 100191China

Objective To analyze the global epidemic status of the ebola virus disease(EVD) and assess the importation risk into China.Methods Data from World Health Organization reports were used. We described the global epidemic status of EVD from 1976–2021, and assessed and ranked the importation risk of EVD from the diseaseoutbreaking countries into China using the risk matrix and Borda count methods, respectively.Results From 1976–2021, EVD mainly occurred in western and central Africa, with the highest cumulative number of cases(14,124 cases) in Sierra Leone, and the highest cumulative fatality rate(85%) in the Congo. Outbreaks of EVD have occurred in the Democratic Republic of the Congo and Guinea since 2018. The importation risk into China varies across countries with outbreaks of disease.The Democratic Republic of the Congo had an extremely high risk(23 Borda points), followed by Guinea and Liberia. Countries with a moderate importation risk were Nigeria, Uganda, Congo, Sierra Leone,Mali, and Gabon, while countries with a low importation risk included Sudan, Senegal, and Co te d’Ivoire.Conclusion China is under the risk of EVD importation with the globalization and severe epidemic status of EVD. Key attention need to be paid to the Democratic Republic of the Congo, Guinea, and Liberia. Therefore, it is necessary to prevent and prepare in advance for importation risk in China.

关键词： ebola virus disease Infectious disease Importation risk Risk matrix method

Sustainable strategies for ebola virus disease outbreak preparedness in Africa:a case study on lessons learnt in countries neighbouring the Democratic Republic of the Congo

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Infectious diseases of Poverty 2022年第6期11卷 60-69页

作者： Caroline S.Ryan Marie‑Roseline D.Belizaire Miriam Nanyunja Olushayo Oluseun Olu Yahaya Ali Ahmed Anderson Latt Matthew Tut Kol Bertrand Bamuleke Jayne Tusiime Nadia Nsabimbona Ishata Conteh Shamiso Nyashanu Patrick Otim Ramadan Solomon Fisseha Woldetsadik Jean‑Pierre Mulunda Nkata Jim T.Ntwari Senya D.Nzeyimana Leopold Ouedraogo Georges Batona Vedaste Ndahindwa Elizabeth A.Mgamb Magdalene Armah Joseph Francis Wamala Argata Guracha Guyo Alex Yao Sokemawu Freeman Alexander Chimbaru Innocent Komakech Muhau Kuku Walter M.Firmino Grace E.Saguti Faraja Msemwa Shikanga O‑Tipo Precious C.Kalubula Ngoy Nsenga Ambrose Otau Talisuna WHO Sub-Regional Ofce for Africa NairobiKenya WHO Country Ofce BanguiCentral African Republic WHO Country Ofce JubaSouth Sudan WHO Regional Ofce for Africa BrazzavilleCongo WHO Sub-Regional Ofce for Africa DakarSenegal Africa Centres for disease Control and Prevention Addis AbabaEthiopia WHO Country Ofce BrazzavilleCongo WHO Coun‑try Ofce BujumburaBurundi WHO Country Ofce AsmaraEritrea WHO Country Ofce KigaliRwanda WHO Country Ofce KampalaUganda WHO Country Ofce LuandaAngola WHO Country Ofce Dar Es SalaamTanzania WHO Country Ofce LusakaZambia

Background: From May 2018 to September 2022, the Democratic Republic of Congo (DRC) experienced seven ebola virus disease (EVD) outbreaks within its borders. During the 10th EVD outbreak (2018–2020), the largest experienced in the DRC and the second largest and most prolonged EVD outbreak recorded globally, a WHO risk assessment identified nine countries bordering the DRC as moderate to high risk from cross border importation. These countries implemented varying levels of ebola virus disease preparedness interventions. This case study highlights the gains and shortfalls with the ebola virus disease preparedness interventions within the various contexts of these countries against the background of a renewed and growing commitment for global epidemic preparedness highlighted during recent World Health Assembly events.Main text: Several positive impacts from preparedness support to countries bordering the affected provinces in the DRC were identified, including development of sustained capacities which were leveraged upon to respond to the subsequent coronavirus disease 2019 (COVID-19) pandemic. Shortfalls such as lost opportunities for operationalizing cross-border regional preparedness collaboration and better integration of multidisciplinary perspectives, vertical approaches to response pillars such as surveillance, over dependence on external support and duplication of efforts especially in areas of capacity building were also identified. A recurrent theme that emerged from this case study is the propensity towards implementing short-term interventions during active ebola virus disease outbreaks for preparedness rather than sustainable investment into strengthening systems for improved health security in alignment with IHR obligations, the Sustainable Development Goals and advocating global policy for addressing the larger structural determinants underscoring these outbreaks.Conclusions: Despite several international frameworks established at the global level for emergency preparedness, a shortfall exists betwee

关键词： ebola virus disease Emergency preparedness and response Lessons learned Case study International Health Regulations Democratic Republic of the Congo

ebola virus disease: General Characteristics, Thoughts, and Perspectives

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Biomedical and Environmental Sciences 2014年第8期27卷 651-653页

作者： CHENG Ying LI Yu YU Hong Jie Division of Infectious disease Key Laboratory of Surveillance and Early-warning on Infectious Disease Chinese Center for Disease Control and Prevention

In December 2013, a new round of ebola virus disease （EVD） first occurred in a remote countryside of Guinea and then spread in Guinea, Liberia, Sierra Leone, and Nigeria of West Africa. EVD, caused by ebolavirus and previously known as ebola hemorrhagic fever, is an acute infectious disease with fatality rates up to 90%. As of August 22, 2014, the number of suspected and confirmed cases was 2615, causing 1427 deaths[I]. On August 8, 2014, World Health Organization announced the current outbreak in West Africa as an international public health emergency. The global epidemic tendency remains ambiguous to date. In recent years, China closely collaborates with West Africa in labor, business, overseas education, and also sends aid medical team there. Thus, the risk of importing the disease cannot be ignored. We conduct this literature review of epidemiology, pathogen, prophylaxis, and treatment to provide evidence for controlling the risk and carrying out effective interventions.

关键词： EVD Thoughts and Perspectives ebola virus disease General Characteristics

Indirect costs associated with deaths from the ebola virus disease in West Africa

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Infectious diseases of Poverty 2015年第1期4卷 95-104页

作者： Joses Muthuri Kirigia Felix Masiye Doris Gatwiri Kirigia Patricia Akweongo Health Systems and Services Cluster World Health OrganizationRegional Office for AfricaBrazzavilleCongo Department of Economics University of ZambiaLusakaZambia The KEMRI-Wellcome Trust Research Programme NairobiKenya School of Public Health University of GhanaAccraGhana

Background:By 28 June 2015,there were a total of 11,234 deaths from the ebola virus disease(EVD)in five West African countries(Guinea,Liberia,Mali,Nigeria and Sierra Leone).The objective of this study was to estimate the future productivity losses associated with EVD deaths in these West African countries,in order to encourage increased investments in national health systems.Methods:A cost-of-illness method was employed to calculate future non-health(NH)gross domestic product(GDP)(NHGDP)losses associated with EVD deaths.The future non-health GDP loss(NHGDPLoss)was discounted at 3%.Separate analyses were done for three different age groups(45 years)for the five countries(Guinea,Liberia,Mali,Nigeria,and Sierra Leone)affected by EVD.We also conducted a one-way sensitivity analysis at 5 and 10%discount rates to gauge their impacts on expected NHGDPLoss.Results:The discounted value of future NHGDPLoss due to the 11,234 deaths associated with EVD was estimated to be Int$(international dollars)155,663,244.About 27.86%of the loss would be borne by Guinea,34.84%by Liberia,0.10%by Mali,0.24%by Nigeria and 36.96%by Sierra Leone.About 27.27%of the loss is attributed to those aged under 14 years,66.27%to those aged 15–44 years and 6.46%to those aged over 45 years.The average NHGDPLoss per EVD death was estimated to be Int$17,473 for Guinea,Int$11,283 for Liberia,Int$25,126 for Mali,Int$47,364 for Nigeria and Int$14,633 for Sierra Leone.Conclusion:In spite of alluded limitations,the estimates of human and economic losses reported in this paper,in addition to those projected by the World Bank,show that EVD imposes a significant economic burden on the affected West African countries.That heavy burden,coupled with human rights and global security concerns,underscores the urgent need for increased domestic and external investments to enable Guinea,Liberia and Sierra Leone(and other vulnerable African countries)to develop resilient health systems,including core capacities to detect,assess,notify,verify a

关键词： ebola virus disease Non-health GDP loss Indirect cost Cost-of-illness

An ebola virus disease model with fear and environmental transmission dynamics

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Infectious disease Modelling 2021年第1期6卷 545-559页

作者： M.L.Juga F.Nyabadza F.Chirove Department of Mathematics and Applied Mathematics University of JohannesburgAuckland Park CampusJohannesburg2006South Africa

Recent ebola virus disease(EVD)outbreaks have been limited not only to the interactions between humans but also to the complex interplay of the environment,human and socio-economic factors.Changes in human behaviour as a result of fear can also affect disease transmission dynamics.In this paper,a compartmental model is used to study the dynamics of EVD incorporating fear and environmental transmission.We formulate a fear dependent contact rate function to measure the rate of person to person,as well as pathogen to person transmissions.The epidemic threshold and the model equilibria are determined and,their stabilities are analysed.The model is validated by fitting it to data from the 2019 and 2020 EVD outbreaks in the Democratic Republic of Congo.Our results suggest that the fear of death from EVD may reduce the transmission and aid the control of the disease,but it is not sufficient to eradicate the disease.Policymakers need to also implement other control measures such as case finding,media campaigns,Quarantine and increase in the number of beds in the ebola treatment centers,good laboratory services,safe burials and social mobilisation,to eradicate the disease.

关键词： ebola virus disease Fear Contaminated environment Reproduction number Mathematical modelling Pathogens

What did we learn from preparing for cross-border transmission of ebola virus disease into a complex humanitarian setting-The Republic of South Sudan?

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Infectious diseases of Poverty 2020年第2期9卷 106-107页

作者： Olushayo Oluseun Olu Richard Lako Joseph Francis Wamala Patrick Otim Ramadan Caroline Ryan Ifeanyi Udenweze Kibebu Berta Argata Guracha Guyo Alex Sokemawu Michael Tukuru Henry John Gray Alex Chimbaru World Health Organization ebola virus disease preparedness team JubaRepublic of South Sudan 不详

Background:Following the West Africa ebola virus disease(EVD)outbreak(2013-2016),WHO developed a preparedness checklist for its member states.This checklist is currently being applied for the first time on a large and systematic scale to prepare for the cross border importation of the ongoing EVD outbreak in the Democratic Republic of Congo hence the need to document the lessons learnt from this experience.This is more pertinent considering the complex humanitarian context and weak health system under which some of the countries such as the Republic of South Sudan are implementing their EVD preparedness interventions.Main text:We identified four main lessons from the ongoing EVD preparedness efforts in the Republic South Sudan.First,EVD preparedness is possible in complex humanitarian settings such as the Republic of South Sudan by using a longer-term health system strengthening approach.Second,the Republic of South Sudan is at risk of both domestic and cross border transmission of EVD and several other infectious disease outbreaks hence the need for an integrated and sustainable approach to outbreak preparedness in the country.Third,a phased and well-prioritized approach is required for EVD preparedness in complex humanitarian settings given the costs associated with preparedness and the difficulties in the accurate prediction of outbreaks in such settings.Fourth,EVD preparedness in complex humanitarian settings is a massive undertaking that requires effective and decentralized coordination.Conclusion:Despite a very challenging context,the Republic of South Sudan made significant progress in its EVD preparedness drive demonstrating that it is possible to rapidly scale up preparedness efforts in complex humanitarian contexts if appropriate and context-specific approaches are used.Further research,systematic reviews and evaluation of the ongoing preparedness efforts are required to ensure comprehensive documentation and application of the lessons learnt for future EVD outbreak preparedness and response efforts.

关键词： Lessons learnt ebola virus disease Preparedness Complex humanitarian settings The Republic of South Sudan

Modeling the impact of quarantine during an outbreak of ebola virus disease

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Infectious disease Modelling 2019年第1期4卷 12-27页

作者： Attila Dénes Abba B.Gumel Bolyai Institute University of SzegedAradi vertanúk tere 1.Szeged H-6720Hungary School of Mathematical and Statistical Sciences Arizona State UniversityTempeAZ 85287-1804USA Other affliation:Department of Mathematics and Applied Mathematics University of PretoriaPretoria 0002South Africa

The quarantine of people suspected of being exposed to an infectious agent is one of the most basic public health measure that has historically been used to combat the spread of communicable diseases in human communities.This study presents a new deterministic model for assessing the population-level impact of the quarantine of individuals suspected of being exposed to disease on the spread of the 2014e2015 outbreaks of ebola viral disease.It is assumed that quarantine is imperfect(i.e.,individuals can acquire infection during quarantine).In the absence of quarantine,the model is shown to exhibit global dynamics with respect to the disease-free and its unique endemic equilibrium when a certain epidemiological threshold(denoted byR 0)is either less than or greater than unity.Thus,unlike the full model with imperfect quarantine(which is known to exhibit the phenomenon of backward bifurcation),the version of the model with no quarantine does not undergo a backward bifurcation.Using data relevant to the 2014e2015 ebola transmission dynamics in the three West African countries(Guinea,Liberia and Sierra Leone),uncertainty analysis of the model show that,although the current level and effectiveness of quarantine can lead to significant reduction in disease burden,they fail to bring the associated quarantine reproduction number(R Q0)to a value less than unity(which is needed to make effective disease control or elimination feasible).This reduction of R Q0 is,however,very possible with a modest increase in quarantine rate and effectiveness.It is further shown,via sensitivity analysis,that the parameters related to the effectiveness of quarantine(namely the parameter associated with the reduction in infectiousness of infected quarantined individuals and the contact rate during quarantine)are the main drivers of the disease transmission dynamics.Overall,this study shows that the singular implementation of a quarantine intervention strategy can lead to the effective control or elimination of ebola viral disease in a communit

关键词： ebola virus disease Quarantine Global dynamics

Modeling the role of public health education in ebola virus disease outbreaks in Sudan

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Infectious disease Modelling 2017年第3期2卷 323-340页

作者： Benjamin Levy Christina Edholm Orou Gaoue Roselyn Kaondera-Shava Moatlhodi Kgosimore Suzanne Lenhart Benjamin Lephodisa Edward Lungu Theresia Marijani Farai Nyabadza Department of Mathematics Fitchburg State UniversityUSA Department of Mathematics University of TennesseeUSA Department of Botany University of HawaiiUSA Department of Mathematics University of BotswanaBotswana Department of Mathematics Botswana International University of Science and TechnologyBotswana Department of Mathematics University of Dar es SalaamTanzania Department of Basic Sciences Botswana University of Agriculture and Natural ResourcesBotswana Department of Mathematics University of StellenboschSouth Africa

Public involvement in ebola virus disease(EVD)prevention efforts is key to reducing disease outbreaks.Targeted education through practical health information to particular groups and sub-populations is crucial to controlling the disease.In this paper,we study the dynamics of ebola virus disease in the presence of public health education with the aim of assessing the role of behavior change induced by health education to the dynamics of an outbreak.The power of behavior change is evident in two outbreaks of EVD that took place in Sudan only 3 years apart.The first occurrence was the first documented outbreak of EVD and produced a significant number of infections.The second outbreak produced far fewer cases,presumably because the population in the region learned from the first outbreak.We derive a system of ordinary differential equations to model these two contrasting behaviors.Since the population in Sudan learned from the first outbreak of EVD and changed their behavior prior to the second outbreak,we use data from these two instances of EVD to estimate parameters relevant to two contrasting behaviors.We then simulate a future outbreak of EVD in Sudan using our model that contains two susceptible populations,one being more informed about EVD.Our finding show how a more educated population results in fewer cases of EVD and highlights the importance of ongoing public health education.

关键词： ebola virus disease Public health education Outbreaks Mathematical model Simulations Infectious disease model

ebola virus disease: From epidemiology to prophylaxis

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Journal of Medical Colleges of PLA(China) 2014年第4期29卷 208-216页

作者： Wen-Bin Liu Zi-Xiong Li Yan Du Guang-Wen Cao Department of Epidemiology Second Military Medical University

The outbreak of ebola virus disease(EVD) continues to spread through West Africa. Since the first reported EVD in March 2014, the number of cases has increased rapidly, with the fatality rate of >50%. The most prevalent ebola virus belongs to the species of Zaire ebolavirus, with a mortality rate as high as 90%. Although there were introduced cases in other continents, Africa is the endemic area where fruit bats and apes are suspected to be ebola virus carriers. The virus might be transmitted from the host animals to humans if humans consume relative raw and contaminated meats; however, human-to-human transmission via close contact is the major route of current outbreaks. EVD happens at any seasons and affected people of any race in any age groups. Direct contact with body fluids of EVD patients and living in the contaminated environment greatly increase the risk of being infected. Transmission viaaerosol is less possible but the transmission via droplet is possible in humans. Thus, health care providers are facing danger of getting ebola virus infection. So far, there are limited vaccines, drugs and/or therapies to prevent ebola virus infection or treat EVD. Medical workers should follow the current standard prophylactic procedures. Military forces can orchestrate efficient care to mass EVD casualties. Although it is necessary to speed up the pace of developing effective vaccine and therapeutics for the prevention and treatment of EVD, public health prophylaxis is the most important issue at present to control the spread of this disease cost-effectively.

关键词： ebola virus disease Epidemiology Outbreak Virology Prophylaxis

ebola virus disease: a literature review

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Journal of Coastal Life Medicine 2015年第2期3卷 85-90页

作者： Hirokazu Kimura Hiroyuki Tsukagoshi Akihide Ryo Yoshiroh Oda Toshinobu Kawabata Takashi Majima Kunihisa Kozawa Masayuki Shimojima Infectious disease Surveillance Center National Institute of Infectious Diseases4-7-1 GakuenMusashimurayama-shiTokyo 208-0011Japan Department of Molecular Biodefence Research Yokohama City University Graduate School of Medicine3-9 FukuuraKanazawa-kuYokohama-shiKanagawa 236-0004Japan Gunma Prefectural Institute of Public Health 378 Kamioki-machiMaebashi-shiGunma 371-0052Japan Wakasa Clinic 4-2468-31 WakasaTokorozawa-shiSaitama 359-1151Japan Deparrtment of Virology I National Institute of Infectious Diseases4-7-1GakuenMusashimurayama-shiTokyo 208-0011Japan

ebola virus disease(EVD)is a life-threatening viral disease with a fatality rate ranging from around 30%to 90%.The first EVD outbreak was reported in the 1970s in Zaire(now the Democratic Republic of the Congo).Until 2013,most outbreaks occurred in the Central Africa region,including Zaire,Sudan and Uganda.However,between March and October 2014,over 10000 cases of EVD have been recorded in West Africa,such as in Guinea,Liberia,Sierra Leone,and Nigeria,and a few hospital or secondary infections of EVD have occurred in Spain and the United States of America.EVD is presently one of the world's most feared diseases.In this literature review,we describe the epidemiology,clinical features,diagnosis,and treatment of EVD.

关键词： ebola virus disease Africa Zaire ebola hemorrhagic fever Guinea