cord-001611-9xgmanai	2015	As a part of preparing for their role in studying highly infectious diseases, SCSU staff has been trained, drilled, and observed using personal protective equipment (PPE) and has regularly rehearsed patient scenarios requiring the most intensive isolation procedures known. Setting our level of isolation for patients with EVD in the SCSU was a major challenge because guidelines were still emerging based on the known mode of transmission, and there was limited experience in Western health care facilities with the potential for transmission during invasive procedures and close quarters contact. We have had extensive experience at the Clinical Center with complex or rare infections requiring special isolation procedures and with the significant effort required to contain a resistant or difficult-to-treat infectious agent within a health care setting. When it became known we were caring for a patient with EVD, our leadership team became the subject of numerous calls for information about how we were handling the various aspects of the admission, notably staffing and procedures for isolation and use for PPE.
cord-001827-vqoxd64i	2015	
cord-002500-9p2n8tjx	2017	
cord-002885-dhdyxnr3	2018	The objective of this study was to understand frontline physicians'' and nurses'' perspectives about personal protective equipment (PPE) use during the 2014-2016 EVD outbreak in West Africa and to incorporate these findings into the development process of a WHO rapid advice guideline. The specific objectives were to understand and describe frontline physician and nurses'' perspectives about PPE use, while providing direct care for EVD patients in the unprecedented conditions of the 2014-2016 EVD outbreak in West Africa and to incorporate these findings into the rapid advice guideline development process. The findings of the survey were presented at the guideline development meeting and incorporated into evidence-to-decision tables (Supplementary File 2) to inform the formulation of recommendations for PPE components in the context of an EVD outbreak. We developed the study protocol, obtained WHO ethics approval, contacted the participants, delivered the survey, analysed the data, and presented the findings as part of the evidence-to-decision tables at the expert panel meeting where the recommendations were formulated in a period of 8 weeks.
cord-003127-1t0mklwi	2018	Ten countries were directly impacted, three of which experienced significant outbreaks (Guinea, Liberia, and Sierra Leone), while seven countries reported one or more EVD cases without widespread human-to-human transmission (Italy, Mali, Nigeria, Senegal, Spain, the UK, and the US) [9, 10] . Specifically, we 1) conduct a quantitative analysis of country-specific factors in Guinea, Liberia, and Sierra Leone and 2) conduct a qualitative analysis of patterns of disease incidence and transmission among all countries with ≥1 case of EVD to draw lessons learned from the 2014 West African Ebola outbreak for managing emerging transnational health security threats. Although four new confirmed cases were diagnosed in Guinea during March 17-28, the WHO Director-General declared on March 29, 2016 the end of the Public Health Emergency of International Concern regarding the EVD outbreak in West Africa [9] .
cord-003507-22ylifqo	2019	As of May 27, 2018, 6 suspected, 13 probable and 35 confirmed cases of Ebola virus disease (EVD) had been reported in Équateur Province, Democratic Republic of Congo. We modeled Ebola virus transmission using a stochastic branching process model that included reproduction numbers from past Ebola outbreaks and a particle filtering method to generate a probabilistic projection of the outbreak size and duration conditioned on its reported trajectory to date; modeled using high (62%), low (44%), and zero (0%) estimates of vaccination coverage (after deployment). With the stochastic model, using high, low, and zero estimates of vaccination coverage, the median outbreak sizes for probable and confirmed cases were 82 cases (95% prediction interval [PI]: 55, 156), 104 cases (95% PI: 58, 271), and 213 cases (95% PI: 64, 1450), respectively. We modeled Ebola virus transmission using a stochastic branching process model, parameterized by transmission rates estimated from the dynamics of prior EVD outbreaks, and conditioned on agreement with reported case counts from the 2018 EVD outbreak to date.
cord-003917-bswndfvk	2019	Filoviruses have become a worldwide public health concern, especially during the 2013–2016 Western Africa Ebola virus disease (EVD) outbreak—the largest outbreak, both by number of cases and geographical extension, recorded so far in medical history. During the 2013–2016 Western Africa outbreak, Ebola virus (EBOV) was detected in the lung of infected patients suggesting a role in lung pathogenesis. However, new evidences collected during the recent 2013-2016 Ebola outbreak hypothesized shedding of the virus in the lung and identified viral replication markers in sputum samples collected from EBOV infected patients [14] . However, new evidences collected during the recent 2013-2016 Ebola outbreak hypothesized shedding of the virus in the lung and identified viral replication markers in sputum samples collected from EBOV infected patients [14] . Interestingly, evidence collected in animal studies, in the epidemiological analysis of transmission chains, and in the most recent Ebola outbreaks suggests that EBOV may be able to cause primary pulmonary infection.
cord-004069-nuep8nim	2019	A pharmacokinetic (PK) study in rhesus macaques (2 groups of 2 males and 2 females) was performed to monitor plasma concentrations of AQ (Fig. 1a ) and the active metabolite DEAQ (Fig. 1b) . samples from infected animals collected on days 0, 3, 5, and 7 postexposure and on day of necropsy (days 6, 7 or 8) were analyzed for determination of plasma levels of AQ and its metabolite DEAQ. Animals that were treated on days 0, 1 and 2 (Group 2, Fig. 7a ), had plasma DEAQ levels ranging from 0 to 205 ng/ml on days 3, 5, 7 and 8 postexposure. www.nature.com/scientificreports www.nature.com/scientificreports/ The goal of the study was to treat animals with AQ using a similar dosing strategy as for human patients, with a target blood concentration range of the parent compound AQ of 29.2 ± 10.9 ng/mL 12 .
cord-004269-g6ki6vyy	2020	BACKGROUND: As demonstrated during the global Ebola crisis of 2014–2016, healthcare institutions in high resource settings need support concerning preparedness during threats of infectious disease outbreaks. Second, these triggers informed the design of a phased preparedness system which was tested in a focus group discussion ( RESULTS: Four preparedness phases were identified: preparedness phase green is a situation without the presence of the infectious disease threat that requires centralized care, anywhere in the world. Use of this system by both curative healthcare institutions and the (municipal) public health service, could help to effectively communicate and align preparedness activities during future threats of severe infectious diseases. In the second phase of the focus group, preparedness activities identified in step 1 were presented to representatives of each type of healthcare institution separately. While specific preparedness activities differ between types of healthcare institutions and threat phases, in this study, a uniform enhanced preparedness system has been developed.
cord-004639-qwxkn0j0	2020	
cord-006182-kck5e1ry	2019	The primary objective of COGiTATE (CppOpt GuIded Therapy Assessment of Target Effectiveness) is to demonstrate feasibility of individualising CPP at CPPopt in TBI patients, expressed as the percentage of monitoring time for which CPP is within 5 mmHg of regularly updated CPPopt targets during the first 5 days of Intensive Care Unit (ICU) admission. Neurocritical care has become increasingly subspecialized.Yet, due to limited availability of dedicated Neurocritical Care units (NCCUs), often patients may need to be admitted to ICUs other than NCCUs. This survey based study was conducted to explore self-reported knowledge in recognizing and managing some common neurological emergencies such as stroke, status epilepticus, raised intracranial pressure etc among critical care nurses at a Comprehensive Stroke Center. Coagulation factor Xa (recombinant), inactivated-Xa inhibitor associated life--factor prothrombin complex concentrate (PCC) was utilized offRetrospective, single center, cohort study including adult intracranial hemorrhage patients who received discharge between efficacy (defined by International Society on Thrombosis and Haemostasis criteria), thrombotic events, ICU and hospital length of stay, and mortality.
cord-006870-f5w6fw6q	2017	Subjective perceptions of recovery were assessed via responses to the forced-choice dichotomized question, "Do you feel that you have made a complete recovery from the arrest?"Objective outcome measures of recovery included: Repeatable Battery for Neuropsychological Status (RBANS), Modified Lawton Physical Self-Maintenance Scale (L-ADL), Barthel Index (BI), Cerebral Performance Category Scale (CPC), Center for Epidemiological Studies-Depression scale (CES-D), and Post traumatic stress disorder-checklist (PTSD-C). Utilizing data from the Citicoline Brain Injury Treatment (COBRIT) trial, a prospective multicenter study, we identified 224 patients who met the inclusion criteria; 1) placement of an ICP monitoring device, 2) Glasgow coma score (GCS) less than 9, 3) EVD placement prior to arrival or within 6 hours of arrival at the study institution. The objective of this study was to examine the incidence rates of pre-specified medical and neurological ICU complications, and their impact on post-traumatic in-hospital mortality and 12month functional outcomes.
cord-011129-btaxvmsr	2020	
cord-012040-24112w2j	2020	
cord-016177-fz48wydz	2020	Emergency medical services are a key element in health systems for the evaluation and treatment of patients exposed to highly infectious diseases or bioterrorism agents. • Developing a case definition for person under investigation • Standardized questions for dispatchers to identify possible infection • Preparation for and evaluation upon arrival on scene by EMS personnel • Precautions while transporting patients and contacting appropriate receiving hospital • Monitoring of potentially exposed EMS personnel • Maintenance of transportation vehicles and equipment • Decontamination processes Similar peer-reviewed frameworks have been proposed for a pandemic of influenza and other respiratory illnesses [4] . Appropriate implementation of these principles can potentially help prevent further spread of disease or agent exposure, initiate appropriate care of ill patients, protect essential EMS responders, and promote efficient use of healthcare resources.
cord-016946-p883xjq5	2017	Ebola, and further emerging infectious diseases (EIDs), are associated with a host of negative consequences in terms of life expectancy and development in affected societies, states and economies, and also pose a threat to peace and security directly and beyond the region of West Africa. September 18, 2014: Building on the precedent set in the global response to the HIV and AIDS pandemic, the United Nation''s Security Council (UNSC) passed Resolution 2177 (2014), in which it called upon immediate measures to respond to the spreading outbreak. The myriad systems'' failures arising from the world''s averted attention to the post-Ebola reality of West Africa also fails to address the concomitant shortages and medical challenges which undermine effective local and national response to an epidemic /pandemic threat. In addition, from this vantage point-that of the "end" of the Ebola pandemic in West Africa-it appears that the only epidemics /pandemics to which an international or global response will be mounted are those with resonance in the developed world-including in Germany.
cord-017569-fv88n70v	2017	
cord-017903-92hnaiyc	2018	These two facilities cared for seven Ebola virus disease (EVD) patients during the 2014-2016 outbreak, while another two were cared for at the National Institutes of Health''s Special Clinical Studies Unit, which had also developed HLCC capability. First, patients harboring diseases caused by pathogens that require handling under BSL-4 conditions in the laboratory would seem to be obvious candidates for clinical management under HLCC conditions. Lujo virus, an Old World arenavirus closely related to Lassa, was first described in 2008 as the cause of a single outbreak of viral hemorrhagic fever involving five patients in Lusaka, Zambia, and Johannesburg, South Africa (the name, Lujo, derives from the two cities) [20] . It would seem prudent to manage patients potentially harboring such diseases under HLCC conditions when feasible and to handle their causative viruses in a BSL-4 laboratory.
cord-018364-b06084r1	2019	Transmission of Ebola disease is still being studied, but it is known that person-toperson contact is the most common form of spread. One study found the risk of developing EVD for healthcare workers to be 100 times that of the general community during an outbreak of Ebola in Sierra Leone [67] . After the outbreak of SARS in 2003 many countries starting using boarder screening to try to identify possibly ill people in hopes of limiting spread of infectious disease, others jumped on board after the 2009 H1N1 influenza pandemic. An article by the CDC, published around the same time as the article recommending travel restriction for high-risk individuals, concludes that border screens are expensive and not effective in preventing the spread of disease [100] . Infection Prevention and Control Recommendations for Hospitalized Patients Under Investigation (PUIs) for Ebola Virus Disease (EVD) in U
cord-018780-zeok60hn	2018	A patient presenting to healthcare facilities with specific clinical and epidemiological risk factors for infection with one of these pathogens may be termed a person under investigation (PUI) for the disease, and healthcare staff should utilize carefully developed protocols and procedures to guide their subsequent isolation and clinical evaluation practices until the disease has been ruled in or out. After the patient has been safely isolated, senior clinic staff must be notified and must contact appropriate subject matter experts for direction on next steps including (1) whether (based on information already available) the patient meets PUI criteria or if additional information is required; (2) if the latter, direction on the safe use of PPE and distancing from the patient; (3) advice on what types of care can safely be provided in that setting for patients confirmed as PUIs; and (4) instructions on transferring the patient to another more appropriate location for further clinical evaluation and management if deemed necessary.
cord-020610-hsw7dk4d	2019	
cord-030370-89n13hml	2019	
cord-255040-xzs7d497	2016	Our aim was to measure students'' anticipated negative emotional responses and avoidance activities (dependent variables) to a possible outbreak of EVD (5) . We constructed scales for the dependent and independent variables to assess EVD-related perceptions: 1) misconceptions/knowledge about transmission modes, 2) scenarios of an EVD outbreak in Guangzhou (chances, severity, control), 3) efficacy of preventive measures and self-protection, and 4) public stigma toward EVD survivors. In multivariate analyses that adjusted for significant background variables, we found positive associations between both dependent variables and the following independent variables: perceived fatality of EVD, perceived nonavailability of treatment, misconceptions regarding modes of transmission, perceived severity of a Guangzhou outbreak, perceived efficacy of restricting Africans'' travel, perceived efficacy of avoiding African-inhabited areas, and public stigma toward EVD survivors.
cord-257504-tqzvdssb	2015	title: Preparation of an intensive care unit in France for the reception of a confirmed case of Ebola virus infection() The current Ebola Virus Disease (EVD) outbreak in West Africa is a major challenge for the worldwide medical community. The current Ebola Virus Disease (EVD) outbreak in West Africa is a major challenge for the worldwide medical community. The preparation of a modern Intensive Care Unit (ICU) to treat an EVD patient in good conditions requires time and specific equipment. The preparation of a modern Intensive Care Unit (ICU) to treat an EVD patient in good conditions requires time and specific equipment. Thus, the preparation of intensive care units in affluent countries is necessary in order to be able to receive a confirmed case of EVD with two main goals: (i) to treat the patient and (ii) to protect the healthcare providers.
cord-258504-pnd46ipd	2019	
cord-259754-7skgb6eu	2014	We also discuss the critical need to collect detailed epidemiological data in real-time during the course of an ongoing epidemic, carry out further studies to estimate the effectiveness of interventions during past outbreaks and the ongoing epidemic, and develop large-scale modeling studies to study the spread and control of viral hemorrhagic fevers in the context of the highly heterogeneous economic reality of African countries. In particular, the epidemic is unfolding in a region characterized by limited public health infrastructure including: (1) a lack of essential supplies to implement infection control measures in health care settings; (2) scarcity of health care workers and staff to manage a growing case burden and carry out essential contact tracing activities to find new cases quickly so that these can be effectively isolated [12] ; and (3) the absence of epidemiological surveillance for the timely identification of case clusters [13, 14] .
cord-260037-ys62jrgw	2015	The policy also requires that (2) resuscitation not be attempted for patients with advanced EVD, as resuscitation would be medically futile; (3) providers caring for or having contact with patients with confirmed or suspected EVD be properly protected and trained; (4) the treating team identify and treat in advance likely causes of cardiac and respiratory arrest to minimize the need for emergency response; (5) patients with EVD and their proxies be involved in care discussions; and (6) care team and provider discretion guide the care of patients with EVD. (3) providers caring for or having contact with patients with confi rmed or suspected EVD be properly protected and trained; (4) the treating team identify and treat in advance likely causes of cardiac and respiratory arrest to minimize the need for emergency response;
cord-260779-riw5xs3j	2016	
cord-265017-byyx2y47	2016	In the United States, bioterrorism became a household word in October 2001, when Bacillus anthracis (the causative agent of anthrax) spores were introduced into the US Postal Service system by several letters dropped into a mailbox in Trenton, New Jersey (see Fig. 1 .1). At the same time as the French were signing the 1925 Geneva Protocol, they were developing a biological warfare program to complement the one they had established for chemical weapons during World War I (Rosebury and Kabat, 1947) . What many people do not know about the group is that it developed and attempted to use biological agents (anthrax, Q fever, Ebola virus, and botulinum toxin) on at least 10 other occasions. To illustrate these points we will briefly discuss four items of international interest that have been emphasized in the media: accidental shipment of live anthrax-positive controls samples, the 2014/2015 Ebola outbreak in West Africa, cases of Middle East respiratory syndrome coronavirus (MERS-CoV) in South Korea and Saudi Arabia, and a massive outbreak of highly pathogenic avian influenza (HPAI).
cord-266415-8w5elfro	2014	
cord-269476-lrk4ty99	2015	
cord-269770-7hau5yge	2014	title: Respiratory protection for healthcare workers treating Ebola virus disease (EVD): Are facemasks sufficient to meet occupational health and safety obligations? Some diseases exclusively transmit through the airborne route in natural setting (e.g. tuberculosis), while other diseases mainly transmit through the droplet or contact modes but short range respiratory aerosols are generated during high risk procedures which increases the risk of infection transmission (Roy and Milton, 2004) . For example, the primary mode of influenza transmission is thought to be droplet (reflected in guidelines which largely recommend surgical masks), but there is increasing evidence that it is also spread by shortrange respiratory aerosols (Bischoff et al., 2013; Tellier, 2009) . Current evidence suggests that human to human transmission occurs predominantly though direct contact with blood and body secretions, (World Health Organization (WHO), 2014a) and this is the basis of the WHO and the CDC recommendations for facemasks to protect HCWs from EVD.
cord-272991-opvs2ejd	2020	
cord-280164-dukccrjb	2020	
cord-283181-7f0ljuk6	2014	
cord-283812-ocfjj79v	2016	
cord-286548-7or373vf	2020	
cord-288734-xinkqs6u	2017	Discovered in 1976 during the first documented outbreak of Ebola virus disease (EVD) in the town of Yambuku in northern Zaire (today Democratic Republic of the Congo), EBOV has since caused sporadic human disease outbreaks of varying magnitude in Equatorial African countries (Sanchez et al. Antigen-presenting cells are a putative initial target of EBOV infection and previous research in animal models of disease has indicated that dendritic cells (DCs) and macrophages are early and preferred targets of EBOV and support virus replication (Geisbert et al. Clinical presentation, biochemical, and haematological parameters and their association with outcome in patients with Ebola virus disease: an observational cohort study Sequence-based human leukocyte antigen-B typing of patients infected with Ebola virus in Uganda in 2000: identification of alleles associated with fatal and nonfatal disease outcomes
cord-290637-3tgtstd4	2016	
cord-293221-gf9wy4a9	2020	It is on this basis that this study was conducted to (assess) the knowledge, perceptions, beliefs and preventive practices against EVD in a predominantly agrarian rural community in Southwest Nigeria. METHODS: This was a cross-sectional study conducted in Igbogila town, Yewa North Local Government Area of Ogun State, Southwest Nigeria in the latter part of 2014 during the EVD outbreak. However, a closer look at past EVD outbreaks revealed that they often originated from rural agrarian communities where there are many misconceptions about the disease, refusal of early isolation and quarantine, and unsafe burial rites practices which aggravate epidemics [8, 9] . No case of EVD was recorded in the study area during the outbreak, nevertheless the limited data provides relevant information useful to researchers and other public health stakeholders in infectious disease prevention and control. Study on public knowledge, attitudes and practices relating to Ebola virus disease prevention and medical care in Sierra Leone
cord-298796-ajzfnd7g	2017	To identify barriers to maintaining and applying capabilities of US high-level isolation units (HLIUs) used during the Ebola virus disease outbreak, during 2016 we surveyed HLIUs. HLIUs identified sustainability challenges and reported the highly infectious diseases they would treat. After the initial designation, 1 ETC in each US Department of Health and Human Services region was selected as a Regional Ebola and Other Special Pathogens Treatment Center (RESPTC) capable of managing HIDs for extended periods (3) . In 2009, a consensus group of infectious disease experts in Europe defined high-level isolation units (HLIUs) as facilities providing optimal infection containment and procedures specifically designed for HID care and released specifications for such units (1) . The EVD outbreak revealed vulnerabilities within the US healthcare and public health infrastructure to address HIDs. We aimed to identify barriers to maintenance of recently developed isolation and care capabilities, how those capabilities might be applied to outbreaks other than EVD, and further infrastructure and resources HLIUs would add if additional funding were available.
cord-300080-l0fyxtva	2015	With the presentation of patients with Ebola to US acute care facilities, ethical questions have been raised in both the press and medical literature as to how US emergency departments, emergency physicians, emergency nurses and other stakeholders in the healthcare system should approach the current epidemic and its potential for spread in the domestic environment. With the presentation of patients with Ebola to US acute care facilities, ethical questions have been raised in both the press and medical literature as to how US emergency departments, emergency physicians, emergency nurses and other stakeholders in the healthcare system should approach the current epidemic and its potential for spread in the domestic environment. WHAT 41 It is anticipated that patients with a confirmed EVD diagnosis will be transferred to these hospitals which will have enough PPE and other treatment requirements (isolation rooms, dedicated equipment and designated physicians, nurses and other necessary health care professionals and staff with proper training under CDC guidelines) to manage patients for at least 7 days, after which governmental agencies would assist in acquiring more supplies and expertise if needed.
cord-300133-yc2wxgid	2015	
cord-306972-alyyju5x	2020	
cord-309141-vwudbuzz	2020	As with the Ebola outbreak, global under-5 mortality and morbidity should be considered a public health emergency of international concern. T he 2019-2020 Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) was a tragic and significant threat to thousands of people in the DRC and West Africa in general. 11, 12 Globally, measles surged in 2019 and killed about 140,000 worldwide, 13 which is about 9.2 times the total number of deaths caused by EVD in its 43-year history as a human pathogen. However, in my view, the "unfinished agenda for child survival," 14 also qualifies as a public health emergency that should be of international concern. 15 Clearly, global child mortality fits the World Health Organization''s definition of a "Grade 3" emergency and should be categorized as such. The "unfinished agenda for child survival," also qualifies as a public health emergency that should be of international concern.
cord-314460-dbrp4vxc	2019	
cord-327641-hqnem2zs	2016	BACKGROUND: Clinical and laboratory data were collected and analysed from patients with Ebola virus disease (EVD) in Jui Government Hospital in Freetown, Sierra Leone, where patients with EVD were received and/or treated from October 1, 2014 to March 21, 2015 during the West Africa EVD outbreak. In the 2014 outbreak, the first lab-confirmed EVD patient was reported in May, 2014 in Guinea and since then the Zaire Ebola Virus (ZEBOV) has rapidly spread across Sierra Leone and to other West Africa countries. A retrospective, observational study was conducted using data collected from all patients with confirmed EVD who were admitted to the Holding and Treatment Center of Jui Government Hospital from October 1, 2014 to March 21, 2015. In our study, the multivariate analyses showed that EBOV viral load, abdominal pain, confusion, conjunctivitis, and vomiting were independently associated with the death outcome of EVD patients.
cord-329726-4494x6ii	2020	
cord-330647-w1bpeqzg	2015	The largest outbreak of Ebola virus disease (EVD) in history has renewed interest in filoviruses and has provided an unprecedented impetus to the development of new therapeutics and vaccines for this highly lethal infection. Nucleic acid amplification is the diagnostic test of choice because of its high sensitivity (especially in the early phase of illness); its ability to differentiate between different agents of viral hemorrhagic fever; and its relatively lower biohazard, if the viruses are appropriately inactivated; and because antigen and antibody assays are often unavailable in laboratories in nonendemic countries. 119e123 Animal studies also demonstrate the efficacy of favipiravir in the treatment of Junín virus, arenavirus, and EBOV hemorrhagic fevers, and the drug was used to treat human EVD in the 2014 West African epidemic.
cord-340194-ibli36rq	2014	
cord-356242-tydil7d7	2019	
cord-356327-kxyo4rfv	2015