# pos

id: cord-286548-7or373vf
pos: NNP
token:
  https://stoppneumonia.org/open-letter-to-leaders-of-the-global-coronavirus-response-on-access-to-medical-oxygen/

lemma:
  https://stoppneumonia.org/open-letter-to-leaders-of-the-global-coronavirus-response-on-access-to-medical-oxygen/


id: cord-283181-7f0ljuk6
pos: NNP
token:
  cdc.gov/vhf/ebola/hcp/interim-guidance-specimen-collectionsubmission-patients-suspected-infection-ebola.html

lemma:
  cdc.gov/vhf/ebola/hcp/interim-guidance-specimen-collectionsubmission-patients-suspected-infection-ebola.html


# ent

id: cord-003507-22ylifqo
type: GGP
entity:
  Wannier S Rae Hoff Nicole A Mukadi Patrick Sinai Cyrus Ackley Sarah Chen Xianyun Gao Daozhou Selo Bernice Mossoko Mathais Okitolonda Wemakoy Emile Richardson Eugene T Rutherford George W Lietman Thomas M Muyembe Tamfum Jean Jacques Rimoin Anne W Porco Travis C title Projections of Ebola


id: cord-003917-bswndfvk
type: ORG
entity:
  CDC Centers for Disease Control and Prevention Guidance for Donning and Doffing Personal Protective Equipment PPE During Management of Patients with Ebola Virus Disease Interim Infection Prevention


id: cord-004269-g6ki6vyy
type: ORG
entity:
  Israel European Centre for Disease Prevention and Control Public Health Emergency Preparedness for Cases of Viral Haemorrhagic Fever Ebola


id: cord-012040-24112w2j
type: FAC
entity:
  Epidemic Republique Democratique du Congo Evaluation des Presentations des Services de souns de Sante EPSS


id: cord-004639-qwxkn0j0
type: CELL_LINE
entity:
  Refugees UNICEF United Nations Children s Fund URCS Uganda Red Cross Society USAID United States Agency for International Development US CDC United States Centers


id: cord-004639-qwxkn0j0
type: ORG
entity:
  IOM International Organisation for Migration Makerere University School of Public Health MoH Ministry of Health MTI


id: cord-016946-p883xjq5
type: WORK_OF_ART
entity:
  Introducing Ebola EVD An Unnecessary Surprise date 2017 05 09 journal Coordinating Global Health Policy Responses DOI


id: cord-017569-fv88n70v
type: ORG
entity:
  United States Department of Labor Occupational Safety and Health Administration Guidance on Personal Protective Equipment


id: cord-020610-hsw7dk4d
type: WORK_OF_ART
entity:
  Bushmeat Hunting Deforestation and Prediction of Zoonoses Emergence Uncovering Zoonoses Awareness in an Emerging Disease Hotspot Social Science


id: cord-020610-hsw7dk4d
type: WORK_OF_ART
entity:
  Unintended Consequences of the Bushmeat Ban Impact of the Ebola Virus Disease Outbreak on Market Chains and Trade of Agricultural Products


id: cord-258504-pnd46ipd
type: EVENT
entity:
  Guidelines for Isolation Precautions Preventing Transmission of Infectious Agents in Healthcare Settings


id: cord-260779-riw5xs3j
type: WORK_OF_ART
entity:
  The Use of Ebola Convalescent Plasma to Treat Ebola Virus Disease in Resource Constrained Settings A Perspective From the Field date 2016 01 01


id: cord-259754-7skgb6eu
type: CELL_TYPE
entity:
  natural habitat 63 64 65 66 Ebola outbreaks among humans have been associated with direct exposure to fruit bats and mortality among other wild animals


id: cord-259754-7skgb6eu
type: EVENT
entity:
  Infectious Diseases of Humans Mathematical Epidemiology of Infectious Diseases Model Building Different


id: cord-283812-ocfjj79v
type: DISEASE
entity:
  Nipah virus hantaviruses West Nile virus Ebola virus severe acute respiratory syndrome coronavirus SARS CoV Middle East respiratory syndrome coronavirus MERS CoV


id: cord-006182-kck5e1ry
type: DNA
entity:
  CAT and MAT groups p 0 341 0 593 and 0 503 respectively In overweight patients body mass index prevented dramatic reductions in PaO2 and SaO2 p 0 05


id: cord-006182-kck5e1ry
type: GGP
entity:
  2 9 1 3 6 6 p 0 0077 and midline shift 5mm 2 3 1 1 4 9 p 0 0219 Rotterdam score was significantly higher in patients with unfavorable outcome 3 7 vs 4 5 p 0


id: cord-006182-kck5e1ry
type: WORK_OF_ART
entity:
  Trends and Predictors of In hospital Mortality for Status Epilepticus National Inpatient Sample Study Head or


id: cord-283181-7f0ljuk6
type: DNA
entity:
  528 including 364 laboratoryconfirmed 99 probable and 65 suspected cases with 337 deaths case fatality rate¼64 Guinea


id: cord-265017-byyx2y47
type: ORG
entity:
  the American Indian Pandemic Influenza Emergency Planning and Community Preparedness Postal Testing Increasing


id: cord-269476-lrk4ty99
type: FAC
entity:
  Guinea Preliminary Report Ebola Underscoring the Global Disparities in Health Care Resources WHO Ebola Response Team Ebola Virus Disease


id: cord-269770-7hau5yge
type: LAW
entity:
  National Guidelines for Recognition and Management of Viral Haemorrhagic Fevers Draft Guidelines Available at Guidelines for Certification of a Physical Containment Level 4 Facility Version 2 Transmission of Ebola virus Zaire


id: cord-269770-7hau5yge
type: ORG
entity:
  the Attention of Healthcare Professionals and Health Authorities Regarding the Identification of and


id: cord-269770-7hau5yge
type: ORG
entity:
  Unprecedented Number of World Health Organization WHO Ebola Virus Disease Update West Africa Infection Prevention


id: cord-288734-xinkqs6u
type: LAW
entity:
  CTLA 4 and PD 1 Pathways Similarities Differences and Implications of Their Inhibition Van den Enden E Van den Enden E 1999 Ebola


id: cord-330647-w1bpeqzg
type: ORG
entity:
  Democratic Republic of the Congo International Scientific and Technical Committee for Marburg Hemorrhagic Fever Control


id: cord-330647-w1bpeqzg
type: DISEASE
entity:
  influenza A H1N1 virus via global airline transportation United Nations World Tourism Organization UNWTO Tourism Highlights Assessing the impact of travel restrictions


id: cord-006870-f5w6fw6q
type: DISEASE
entity:
  pneumonia venous thromboembolism pulmonary embolism sepsis septic shock pulmonary edema gastrointestinal bleeding


# url

id: cord-286548-7or373vf
domain: stoppneumonia.org
url:
  http://stoppneumonia.org/open-letter-to-leaders-of-the-global-coronavirus-response-on-access-to-medical-oxygen/


# bib

id: cord-001611-9xgmanai
author: Matlock, Ann Marie
date: 2015-01-01
txt: ./txt/cord-001611-9xgmanai.txt
cache: ./cache/cord-001611-9xgmanai.txt
extension: .txt
mime: text/plain
url: http://europepmc.org/articles/pmc4402233?pdf=render
doi: 10.1016/j.outlook.2014.11.015
abstract: nan
summary:
  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.

title:
  Providing nursing care to Ebola patients on the national stage: The National Institutes of Health experience


id: cord-001827-vqoxd64i
title: Ebola virus disease in the Democratic Republic of the Congo, 1976-2014
author: Rosello, Alicia
date: 2015-11-03
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4629279/
doi: 10.7554/elife.09015
abstract:
  The Democratic Republic of the Congo has experienced the most outbreaks of Ebola virus disease since the virus' discovery in 1976. This article provides for the first time a description and a line list for all outbreaks in this country, comprising 996 cases. Compared to patients over 15 years old, the odds of dying were significantly lower in patients aged 5 to 15 and higher in children under five (with 100% mortality in those under 2 years old). The odds of dying increased by 11% per day that a patient was not hospitalised. Outbreaks with an initially high reproduction number, R (>3), were rapidly brought under control, whilst outbreaks with a lower initial R caused longer and generally larger outbreaks. These findings can inform the choice of target age groups for interventions and highlight the importance of both reducing the delay between symptom onset and hospitalisation and rapid national and international response. DOI: http://dx.doi.org/10.7554/eLife.09015.001


id: cord-002500-9p2n8tjx
author: Lambe, Teresa
date: 2017-05-26
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5394635/
doi: 10.1098/rstb.2016.0295
title:
  A review of Phase I trials of Ebola virus vaccines: what can we learn from the race to develop novel vaccines?

abstract:
  Sporadic outbreaks of Ebola virus infection have been documented since the mid-Seventies and viral exposure can lead to lethal haemorrhagic fever with case fatalities as high as 90%. There is now a comprehensive body of data from both ongoing and completed clinical trials assessing various vaccine strategies, which were rapidly advanced through clinical trials in response to the 2013–2016 Ebola virus disease (EVD) public health emergency. Careful consideration of immunogenicity post vaccination is essential but has been somewhat stifled because of the wide array of immunological assays and outputs that have been used in the numerous clinical trials. We discuss here the different aspects of the immune assays currently used in the Phase I clinical trials for Ebola virus vaccines, and draw comparisons across the immune outputs where possible; various trials have examined both cellular and humoral immunity in European and African cohorts. Assessment of the safety data, the immunological outputs and the ease of field deployment for the various vaccine modalities will help both the scientific community and policy-makers prioritize and potentially license vaccine candidates. If this can be achieved, the next outbreak of Ebola virus, or other emerging pathogen, can be more readily contained and will not have such widespread and devastating consequences. This article is part of the themed issue ‘The 2013–2016 West African Ebola epidemic: data, decision-making and disease control’.


id: cord-002885-dhdyxnr3
author: Den Boon, Saskia
date: 2018-03-09
txt: ./txt/cord-002885-dhdyxnr3.txt
cache: ./cache/cord-002885-dhdyxnr3.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5820616/
doi: 10.12688/f1000research.12922.2
summary:
  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.

title:
  Incorporating health workers’ perspectives into a WHO guideline on personal protective equipment developed during an Ebola virus disease outbreak

abstract:
  Background: Ebola virus disease (EVD) health facility transmission can result in infection and death of health workers. The World Health Organization (WHO) supports countries in preparing for and responding to public health emergencies, which often require developing new guidance in short timelines with scarce evidence. 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. Methods : We surveyed frontline physicians and nurses deployed to West Africa between March and September of 2014. Results: We developed the protocol, obtained ethics approval, 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 within eight weeks. Forty-four physicians and nurses responded to the survey. They generally felt at low or extremely low risk of virus transmission with all types of PPE used. Eye protection reduced the ability to provide care, mainly due to impaired visibility because of fogging. Heat and dehydration were a major issue for 76% of the participants using goggles and for 64% using a hood. Both gowns and coveralls were associated with significant heat stress and dehydration. Most participants (59%) were very confident that they were using PPE correctly. Conclusion : Our study demonstrated that it was possible to incorporate primary data on end-users’ preferences into a rapid advice guideline for a public health emergency in difficult field conditions. Health workers perceived a balance between transmission protection and ability to care for patients effectively while wearing PPE. These findings were used by the guideline development expert panel to formulate WHO recommendations on PPE for frontline providers caring for EVD patients in outbreak conditions.


id: cord-003127-1t0mklwi
author: Wendelboe, Aaron M.
date: 2018-07-27
txt: ./txt/cord-003127-1t0mklwi.txt
cache: ./cache/cord-003127-1t0mklwi.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6064117/
doi: 10.1186/s12992-018-0396-z
summary:
  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] .

title:
  Managing emerging transnational public health security threats: lessons learned from the 2014 West African Ebola outbreak

abstract:
  BACKGROUND: Pandemics pose significant security/stability risks to nations with fragile infrastructures. We evaluated characteristics of the 2014 West African Ebola outbreak to elucidate lessons learned for managing transnational public health security threats. METHODS: We used publically available data to compare demographic and outbreak-specific data for Guinea, Sierra Leone, and Liberia, including key indicator data by the World Health Organization. Pearson correlation statistics were calculated to compare country-level infrastructure characteristics with outbreak size and duration. RESULTS: Hospital bed density was inversely correlated with longer EVD outbreak duration (r = − 0.99). Country-specific funding amount allocations were more likely associated with number of incident cases than the population at-risk or infrastructure needs. Key indicators demonstrating challenges for Guinea included: number of unsafe burials, percent of EVD-positive samples, and days between symptom onset and case hospitalization. Sierra Leone’s primary key indicator was the number of districts with ≥1 security incident. Liberia controlled their outbreak before much of the key-indicator data were collected. CONCLUSION: Many of the country-level factors, particularly the WHO key indicators were associated with controlling the epidemic. The infrastructure of countries affected by communicable diseases should be assessed by international political and public health leaders.


id: cord-003507-22ylifqo
author: Kelly, J. Daniel
date: 2019-03-07
txt: ./txt/cord-003507-22ylifqo.txt
cache: ./cache/cord-003507-22ylifqo.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6405095/
doi: 10.1371/journal.pone.0213190
summary:
  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.

title:
  Projections of Ebola outbreak size and duration with and without vaccine use in Équateur, Democratic Republic of Congo, as of May 27, 2018

abstract:
  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 used reported case counts and time series from prior outbreaks to estimate the total outbreak size and duration with and without vaccine use. 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). Additionally, we used the time series for 18 prior Ebola outbreaks from 1976 to 2016 to parameterize the Thiel-Sen regression model predicting the outbreak size from the number of observed cases from April 4 to May 27. We used these techniques on probable and confirmed case counts with and without inclusion of suspected cases. Probabilistic projections were scored against the actual outbreak size of 54 EVD cases, using a log-likelihood score. 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. With the Thiel-Sen regression model, the median outbreak size was estimated to be 65.0 probable and confirmed cases (95% PI: 48.8, 119.7). Among our three mathematical models, the stochastic model with suspected cases and high vaccine coverage predicted total outbreak sizes closest to the true outcome. Relatively simple mathematical models updated in real time may inform outbreak response teams with projections of total outbreak size and duration.


id: cord-003917-bswndfvk
title: Pulmonary Involvement during the Ebola Virus Disease
author: Lalle, Eleonora
date: 2019-08-24
txt: ./txt/cord-003917-bswndfvk.txt
cache: ./cache/cord-003917-bswndfvk.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6784166/
doi: 10.3390/v11090780
summary:
  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.

abstract:
  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. EVD is associated with pathologies in several organs, including the liver, kidney, and lung. 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, little is known about lung pathogenesis and the controversial issue of aerosol transmission in EVD. This review highlights the pulmonary involvement in EVD, with a special focus on the new data emerging from the 2013–2016 Ebola outbreak.


id: cord-004069-nuep8nim
title: In Vivo Activity of Amodiaquine against Ebola Virus Infection
author: DeWald, Lisa Evans
date: 2019-12-27
txt: ./txt/cord-004069-nuep8nim.txt
cache: ./cache/cord-004069-nuep8nim.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6934550/
doi: 10.1038/s41598-019-56481-0
summary:
  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 .

abstract:
  During the Ebola virus disease (EVD) epidemic in Western Africa (2013‒2016), antimalarial treatment was administered to EVD patients due to the high coexisting malaria burden in accordance with World Health Organization guidelines. In an Ebola treatment center in Liberia, EVD patients receiving the combination antimalarial artesunate-amodiaquine had a lower risk of death compared to those treated with artemether-lumefantrine. As artemether and artesunate are derivatives of artemisinin, the beneficial anti-Ebola virus (EBOV) effect observed could possibly be attributed to the change from lumefantrine to amodiaquine. Amodiaquine is a widely used antimalarial in the countries that experience outbreaks of EVD and, therefore, holds promise as an approved drug that could be repurposed for treating EBOV infections. We investigated the potential anti-EBOV effect of amodiaquine in a well-characterized nonhuman primate model of EVD. Using a similar 3-day antimalarial dosing strategy as for human patients, plasma concentrations of amodiaquine in healthy animals were similar to those found in humans. However, the treatment regimen did not result in a survival benefit or decrease of disease signs in EBOV-infected animals. While amodiaquine on its own failed to demonstrate efficacy, we cannot exclude potential therapeutic value of amodiaquine when used in combination with artesunate or another antiviral.


id: cord-004269-g6ki6vyy
title: Qualitative Research: Institutional Preparedness During Threats of Infectious Disease Outbreaks
author: de Rooij, Doret
date: 2020-01-23
txt: ./txt/cord-004269-g6ki6vyy.txt
cache: ./cache/cord-004269-g6ki6vyy.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6998699/
doi: 10.1155/2020/5861894
summary:
  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.

abstract:
  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. This study aimed to exploratively develop a standardized preparedness system to use during unfolding threats of severe infectious diseases. METHODS: A qualitative three-step study among infectious disease prevention and control experts was performed. First, interviews (n = 5) were conducted to identify which factors trigger preparedness activities during an unfolding threat. Second, these triggers informed the design of a phased preparedness system which was tested in a focus group discussion (n = 5) were conducted to identify which factors trigger preparedness activities during an unfolding threat. Second, these triggers informed the design of a phased preparedness system which was tested in a focus group discussion (n = 5) were conducted to identify which factors trigger preparedness activities during an unfolding threat. 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. Phase yellow is an outbreak in the world with some likelihood of imported cases. Phase orange is a realistic chance of an unexpected case within the country, or unrest developing among population or staff; phase red is cases admitted to hospitals in the country, potentially causing a shortage of resources. Specific preparedness activities included infection prevention, diagnostics, patient care, staff, and communication. Consensus was reached on the need for the development of a preparedness system and national coordination during threats. CONCLUSIONS: In this study, we developed a standardized system to support institutional preparedness during an increasing threat. 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.


id: cord-004639-qwxkn0j0
title: Uganda’s experience in Ebola virus disease outbreak preparedness, 2018–2019
author: Aceng, Jane Ruth
date: 2020-03-19
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081536/
doi: 10.1186/s12992-020-00548-5
abstract:
  BACKGROUND: Since the declaration of the 10th Ebola Virus Disease (EVD) outbreak in DRC on 1st Aug 2018, several neighboring countries have been developing and implementing preparedness efforts to prevent EVD cross-border transmission to enable timely detection, investigation, and response in the event of a confirmed EVD outbreak in the country. We describe Uganda’s experience in EVD preparedness. RESULTS: On 4 August 2018, the Uganda Ministry of Health (MoH) activated the Public Health Emergency Operations Centre (PHEOC) and the National Task Force (NTF) for public health emergencies to plan, guide, and coordinate EVD preparedness in the country. The NTF selected an Incident Management Team (IMT), constituting a National Rapid Response Team (NRRT) that supported activation of the District Task Forces (DTFs) and District Rapid Response Teams (DRRTs) that jointly assessed levels of preparedness in 30 designated high-risk districts representing category 1 (20 districts) and category 2 (10 districts). The MoH, with technical guidance from the World Health Organisation (WHO), led EVD preparedness activities and worked together with other ministries and partner organisations to enhance community-based surveillance systems, develop and disseminate risk communication messages, engage communities, reinforce EVD screening and infection prevention measures at Points of Entry (PoEs) and in high-risk health facilities, construct and equip EVD isolation and treatment units, and establish coordination and procurement mechanisms. CONCLUSION: As of 31 May 2019, there was no confirmed case of EVD as Uganda has continued to make significant and verifiable progress in EVD preparedness. There is a need to sustain these efforts, not only in EVD preparedness but also across the entire spectrum of a multi-hazard framework. These efforts strengthen country capacity and compel the country to avail resources for preparedness and management of incidents at the source while effectively cutting costs of using a “fire-fighting” approach during public health emergencies.


id: cord-006182-kck5e1ry
title: 17th Annual Meeting, Neurocritical Care Society, October 15–18, 2019, Vancouver, Canada
author: nan
date: 2019-10-01
txt: ./txt/cord-006182-kck5e1ry.txt
cache: ./cache/cord-006182-kck5e1ry.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7100118/
doi: 10.1007/s12028-019-00857-7
abstract: nan
summary:
  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.


id: cord-006870-f5w6fw6q
title: Abstracts Presented at the Neurocritical Care Society (NCS) 15th Annual Meeting
author: nan
date: 2017-09-19
txt: ./txt/cord-006870-f5w6fw6q.txt
cache: ./cache/cord-006870-f5w6fw6q.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103238/
doi: 10.1007/s12028-017-0465-9
abstract: nan
summary:
  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.


id: cord-011129-btaxvmsr
title: Viral genomics in Ebola virus research
author: Di Paola, Nicholas
date: 2020-05-04
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223634/
doi: 10.1038/s41579-020-0354-7
abstract:
  Filoviruses such as Ebola virus continue to pose a substantial health risk to humans. Advances in the sequencing and functional characterization of both pathogen and host genomes have provided a wealth of knowledge to clinicians, epidemiologists and public health responders during outbreaks of high-consequence viral disease. Here, we describe how genomics has been historically used to investigate Ebola virus disease outbreaks and how new technologies allow for rapid, large-scale data generation at the point of care. We highlight how genomics extends beyond consensus-level sequencing of the virus to include intra-host viral transcriptomics and the characterization of host responses in acute and persistently infected patients. Similar genomics techniques can also be applied to the characterization of non-human primate animal models and to known natural reservoirs of filoviruses, and metagenomic sequencing can be the key to the discovery of novel filoviruses. Finally, we outline the importance of reverse genetics systems that can swiftly characterize filoviruses as soon as their genome sequences are available.


id: cord-012040-24112w2j
author: Hung, Yuen W
date: 2020-07-27
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7389747/
doi: 10.1136/bmjgh-2019-002119
title:
  Impact of a free care policy on the utilisation of health services during an Ebola outbreak in the Democratic Republic of Congo: an interrupted time-series analysis

abstract:
  BACKGROUND: During past outbreaks of Ebola virus disease (EVD) and other infectious diseases, health service utilisation declined among the general public, delaying health seeking behaviour and affecting population health. From May to July 2018, the Democratic Republic of Congo experienced an outbreak of EVD in Equateur province. The Ministry of Public Health introduced a free care policy (FCP) in both affected and neighbouring health zones. We evaluated the impact of this policy on health service utilisation. METHODS: Using monthly data from the national Health Management Information System from January 2017 to January 2019, we examined rates of the use of nine health services at primary health facilities: total visits; first and fourth antenatal care visits; institutional deliveries; postnatal care visits; diphtheria, pertussis and tetanus (DTP) vaccinations and visits for uncomplicated malaria, pneumonia and diarrhoea. We used controlled interrupted time series analysis with a mixed effects model to estimate changes in the rates of services use during the policy (June–September 2018) and afterwards. FINDINGS: Overall, use of most services increased compared to control health zones, including EVD affected areas. Total visits and visits for pneumonia and diarrhoea initially increased more than two-fold relative to the control areas (p<0.001), while institutional deliveries and first antenatal care increased between 20% and 50% (p<0.01). Visits for DTP, fourth antenatal care visits and postnatal care visits were not significantly affected. During the FCP period, visit rates followed a downward trend. Most increases did not persist after the policy ended. INTERPRETATION: The FCP was effective at rapidly increasing the use of some health services both EVD affected and not affected health zones, but this effect was not sustained post FCP. Such policies may mitigate the adverse impact of infectious disease outbreaks on population health.


id: cord-016177-fz48wydz
title: Emergency Triage of Highly Infectious Diseases and Bioterrorism
author: Bezek, Sarah
date: 2020-01-03
txt: ./txt/cord-016177-fz48wydz.txt
cache: ./cache/cord-016177-fz48wydz.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7120388/
doi: 10.1007/978-3-030-33803-9_3
summary:
  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.

abstract:
  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. Triage and early identification at any point of care can have a significant impact on the prevention and management of these diseases. This chapter reviews triage practices, including early isolation and decontamination, of highly infectious diseases and bioterrorism agents at different health system levels.


id: cord-016946-p883xjq5
title: Introducing Ebola (EVD): An Unnecessary Surprise
author: Bindenagel Šehović, Annamarie
date: 2017-05-09
txt: ./txt/cord-016946-p883xjq5.txt
cache: ./cache/cord-016946-p883xjq5.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7121383/
doi: 10.1007/978-3-319-52006-3_4
summary:
  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.

abstract:
  Chapter 4 tackles the Ebola (Ebola Virus Disease, EVD) pandemic of 2014/2015. It notes that coming in the wake of the ongoing HIV pandemic, the rights of those infected with Ebola to be identified and treated were largely uncontested. The questions of who would be treated, by whom, with what, remained however extremely contentious. The international response to the pandemic also saw, for the first time, not only non-state actors involved in mediating and mitigating a health crisis, but also military intervention. This chapter lays out both the uses and the dilemmas of military response. It explores the impact of these interventions in this Ebola pandemic, with a view towards possible future military deployments against health threats, and offers an initial analysis of the consequences thereof on the relationship between individual and state rights and responsibilities.


id: cord-017569-fv88n70v
title: Viral Hemorrhagic Fever Preparedness
author: Hewlett, Angela
date: 2017-09-10
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7122159/
doi: 10.1007/978-3-319-60980-5_21
abstract:
  The 2014–2016 outbreak of Ebola virus disease (EVD) in West Africa marked the 25th such occurrence but was noteworthy in its massive scope, causing more human morbidity and mortality than the previous 24 recorded outbreaks combined. As of April 2016, there were 28,652 cases resulting in at least 11,325 deaths, nearly all in the three nations of Guinea, Liberia, and Sierra Leone (Centers for Disease Control and Prevention. http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/index.html. Accessed 2 June 2016). Moreover, the 2014–2016 outbreak was the first in which patients, albeit few in number, were afforded sophisticated intensive care in the United States and in Europe. This “high-level containment care” (HLCC) was provided in specially designed purpose-built biocontainment units (BCUs). In this chapter, we explore the history and evolution of biocontainment, discuss its unique engineering and infection control modalities, and offer recommendations for the clinical and operational management of Ebola and other viral hemorrhagic fevers (VHFs).


id: cord-017903-92hnaiyc
author: Cieslak, Theodore J.
date: 2018-07-07
txt: ./txt/cord-017903-92hnaiyc.txt
cache: ./cache/cord-017903-92hnaiyc.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7122591/
doi: 10.1007/978-3-319-77032-1_1
summary:
  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.

title:
  Communicable Diseases and Emerging Pathogens: The Past, Present, and Future of High-Level Containment Care

abstract:
  High-level containment care involves the management of patients with highly hazardous communicable diseases in specialized biocontainment units possessing a unique collection of engineering, administrative, and personnel controls. These controls are more stringent than those found in conventional airborne infection isolation rooms and provide additional safeguards against nosocomial disease transmission. Borne amidst a convergence of events in 1969, the employment of HLCC units was validated during the 2014–2016 Ebola virus disease outbreak, and the United States (as well as many other nations) is in the process of expanding its HLCC capacity. Beyond Ebola, however, the specific diseases that might warrant care in a HLCC unit remain unclear. We review here the fascinating history of HLCC and of biocontainment units and make recommendations regarding those highly hazardous communicable diseases that might optimally be managed in these units.


id: cord-018364-b06084r1
title: The Emerging Threat of Ebola
author: LaBrunda, Michelle
date: 2019-06-07
txt: ./txt/cord-018364-b06084r1.txt
cache: ./cache/cord-018364-b06084r1.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7123219/
doi: 10.1007/978-3-030-23491-1_6
summary:
  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

abstract:
  Ebola is one of the deadliest infectious disease of the modern era. Over 50% of those infected die. Prior to 1976, the disease was unknown. No one knows exactly where it came from, but it is postulated that a mutation in an animal virus allowed it to jump species and infect humans. In 1976 simultaneous outbreaks of Ebola occurred in what is now South Sudan and the Democratic Republic of the Congo (DRC). For 20 years, only sporadic cases were seen, but in 1995 a new outbreak occurred killing hundreds in the DRC. Since that time the frequency of these outbreaks has been increasing. It is uncertain why this is occurring, but many associate it with increasing human encroachment into forested areas bringing people and animals into more intimate contact and increased mobility of previously remote population. This chapter will navigate Ebola in the context of global health and security. There are multiple objectives of this chapter. First is to provide a basic understanding of Ebola disease processes and outbreak patterns. Second, is to explore the interplay between social determinants of health and Ebola. The role of technology in spreading Ebola outbreaks will be explained as will Ebola’s potential as a bioweapon. Readers will gain understanding of the link between environmental degradation and Ebola outbreaks. This chapter will be divided into five main sections. These are (1) a case study; (2) Ebola Disease process; (3) Social determinants of health and Ebola; (4) Ebola in the modern era, and (5) the link between Ebola and environmental degradation.


id: cord-018780-zeok60hn
title: Evaluation of the Person Under Investigation
author: Biddinger, Paul D.
date: 2018-07-07
txt: ./txt/cord-018780-zeok60hn.txt
cache: ./cache/cord-018780-zeok60hn.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7123748/
doi: 10.1007/978-3-319-77032-1_12
summary:
  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.

abstract:
  A person under investigation (PUI) is defined as a patient who presents with both clinical and epidemiological risk factors for a specific infectious disease. In the case of infectious diseases that present risks of transmission to healthcare workers (HCWs) and patients, the use of the identify-isolate-inform framework is essential to protect staff and patients and the delivery of safe and effective care. This includes early identification of PUIs, institution of appropriate transmission-based precautions including use of specific personal protective equipment (PPE) and isolation, and prompt notification of relevant personnel, including relevant experts and authorities. Depending on the specific infection suspected, once appropriate infection control measures have been implemented, clinical evaluation of PUIs can vary in complexity. In the case of Ebola virus disease (EVD), the need for specialized PPE and training, well-developed procedures, and dedicated space can be extremely resource-intensive and costly for facilities. In addition, depending upon the need to reduce risks to other patients and HCWs, regular laboratory and imaging equipment may not be available (or available at the standard frequency or turnaround time) to support medical care. Lastly, diagnostic tests needed to confirm the diagnosis may not be available at the healthcare facility and may instead be accessible through public health authorities. This testing may take several days to confirm the diagnosis or rule out the presence of the suspected infection. Thus, the potential period of evaluation for a PUI can extend well beyond a typical clinic or emergency department (ED) visit. Thoughtful and coordinated planning efforts are required across the community and across the hospital to be able to adequately care for the PUI.


id: cord-020610-hsw7dk4d
author: Thys, Séverine
date: 2019-10-12
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141173/
doi: 10.1007/978-3-030-26795-7_7
title:
  Contesting the (Super)Natural Origins of Ebola in Macenta, Guinea: Biomedical and Popular Approaches

abstract:
  In December 2013, a two-year-old child died from viral haemorrhagic fever in Méliandou village in the South-East of Guinea, and constituted the likely index case of a major epidemic. When the virus was formally identified as Ebola, epidemiologists started to investigate the chains of transmission, while local people were trying to make sense out of these deaths. The epidemic control measures taken by national and international health agencies were soon faced by strong reluctance and a sometimes aggressive attitude of the affected communities. Based on ethnographic work in Macenta (Forest region) in the autumn of 2014 for the Global Outbreak and Alert Response Network (GOARN) of the World Health Organization, this chapter shows that while epidemiologists involved in the outbreak response attributed the first Ebola deaths in the Forest region to the transmission of a virus from an unknown animal reservoir, local citizens believed these deaths were caused by the breach of a taboo. Epidemiological and popular explanations, mainly evolving in parallel, but sometimes overlapping, were driven by different explanatory models: a biomedical model embodying nature in the guise of an animal disease reservoir, which in turn poses as threat to humanity, and a traditional-religious model wherein nature and culture are not dichotomized. The chapter will argue that epidemic responses must be flexible and need to systematically document popular discourse(s), rumours, codes, practices, knowledge and opinions related to the outbreak event. This precious information must be used not only to shape and adapt control interventions and health promotion messages, but also to trace the complex biosocial dynamics of such zoonotic disease beyond the usual narrow focus on wild animals as the sources of infection.


id: cord-030370-89n13hml
title: Ebola Virus Disease in the Obstetric Population
author: Brown, Colin S.
date: 2019-04-11
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7418530/
doi: 10.1007/978-3-319-94854-6_4
abstract:
  The clinical management of Ebola created a significant challenge during the outbreak in West Africa, due to the paucity of previous research conducted into the optimum treatment regimen. That left many centres, to some extent, having to ‘work out’ best practice as they went along, and attempting to conduct real time prospective research. Médecins Sans Frontières (MSF) [1] were the only organization to have provided relatively in depth practical guidance prior to the outbreak and this manual was the basis of further planning between the WHO, national Ministry of Health and Sanitation in Sierra Leone, and other relevant stakeholders. Additionally, guidance changed over the epidemic as experience grew. This chapter will describe four key areas in the management of Ebola in West Africa. Firstly, it outlines the most recent WHO guidance; secondly, it looks back at how Ebola was managed in differing low and high resource settings; thirdly it outlines possible and optimal options for managing complications, paying particular attention to some of the controversies faced; fourthly it describes recent and ongoing studies into potential novel therapies that may shape future practice.


id: cord-255040-xzs7d497
title: Anticipated Negative Responses by Students to Possible Ebola Virus Outbreak, Guangzhou, China
author: Lau, Joseph T.F.
date: 2016-01-17
txt: ./txt/cord-255040-xzs7d497.txt
cache: ./cache/cord-255040-xzs7d497.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.3201/eid2201.150898
doi: 10.3201/eid2201.150898
abstract: nan
summary:
  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.


id: cord-257504-tqzvdssb
author: Dubost, Clément
date: 2015-11-24
txt: ./txt/cord-257504-tqzvdssb.txt
cache: ./cache/cord-257504-tqzvdssb.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.accpm.2015.10.002
doi: 10.1016/j.accpm.2015.10.002
summary:
  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.

title:
  Preparation of an intensive care unit in France for the reception of a confirmed case of Ebola virus infection()

abstract:
  The current Ebola Virus Disease (EVD) outbreak in West Africa is a major challenge for the worldwide medical community. On April 29th 2015, the World Health Organization (WHO) declared 26,277 infected cases; among them, 10,884 have deceased. The epidemic is still ongoing, particularly in Sierra Leone. It is now clear that northern countries will be implicated in the care of EVD patients, both in the field and back at home. Because of the severity of EVD, a fair amount of patients may require intensive care. It is highly probable that intensive care would be able to significantly reduce the mortality linked with EVD. The preparation of a modern Intensive Care Unit (ICU) to treat an EVD patient in good conditions requires time and specific equipment. The cornerstone of this preparation includes two main goals: treating the patient and protecting healthcare providers. Staff training is time consuming and must be performed far in advance of patient arrival. To be efficient, preparation should be planned at a national level with help from public authorities, as was the case in France during the summer of 2014. Due to the severity of the disease, the high risk of transmission and scarce knowledge on EVD treatment, our propositions are necessarily original and innovative. Our review includes four topics: a brief report on the actual outbreak, where to receive and hospitalize the patients, the specific organization of the ICU and finally ethical aspects.


id: cord-258504-pnd46ipd
title: Experience of Chicagoland acute care hospitals in preparing for Ebola virus disease, 2014–2015
author: Bleasdale, Susan C.
date: 2019-07-08
url: https://doi.org/10.1080/15459624.2019.1628966
doi: 10.1080/15459624.2019.1628966
abstract:
  During the 2014–2015 Ebola Virus Disease (EVD) outbreak, hospitals in the United States selected personal protective equipment (PPE) and trained healthcare personnel (HCP) in anticipation of receiving EVD patients. To improve future preparations for high-consequence infectious diseases, it was important to understand factors that affected PPE selection and training in the context of the EVD outbreak. Semistructured interviews were conducted with HCP involved with decision-making during EVD preparations at acute care hospitals in the Chicago, IL area to gather information about the PPE selection and training process. HCP who received training were surveyed about elements of training and their perceived impact and overall experience by email invitation. A total of 28 HCP from 15 hospitals were interviewed, and 55 HCP completed the survey. Factors affecting PPE selection included: changing guidance, vendor supply, performance evaluations, and perceived risk and comfort for HCP. Cost did not affect selection. PPE acquisition challenges were mitigated by: sharing within hospital networks, reusing PPE during training, and improvising with existing PPE stock. Selected PPE ensembles were similar across sites. Training included hands-on activities with trained observers, instructional videos, and simulations/drills, which were felt to increase HCP confidence. Many felt refresher training would be helpful. Hands-on training was perceived to be effective, but there is a need to establish the appropriate frequency of refresher training frequency to maintain competence. Lacking confidence in the CDC guidance, interviewed trainers described turning to other sources of information and developing independent PPE evaluation and selection. Response to emerging and/or high consequence infectious diseases would be enhanced by transparent, risk-based guidance for PPE selection and training that addresses protection level, ease of use, ensembles, and availability.


id: cord-259754-7skgb6eu
title: Transmission dynamics and control of Ebola virus disease (EVD): a review
author: Chowell, Gerardo
date: 2014-10-10
txt: ./txt/cord-259754-7skgb6eu.txt
cache: ./cache/cord-259754-7skgb6eu.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/25300956/
doi: 10.1186/s12916-014-0196-0
summary:
  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] .

abstract:
  The complex and unprecedented Ebola epidemic ongoing in West Africa has highlighted the need to review the epidemiological characteristics of Ebola Virus Disease (EVD) as well as our current understanding of the transmission dynamics and the effect of control interventions against Ebola transmission. Here we review key epidemiological data from past Ebola outbreaks and carry out a comparative review of mathematical models of the spread and control of Ebola in the context of past outbreaks and the ongoing epidemic in West Africa. We show that mathematical modeling offers useful insights into the risk of a major epidemic of EVD and the assessment of the impact of basic public health measures on disease spread. 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.


id: cord-260037-ys62jrgw
title: Ebola Virus Disease Ethics and Emergency Medical Response Policy
author: Jecker, Nancy S.
date: 2015-09-30
txt: ./txt/cord-260037-ys62jrgw.txt
cache: ./cache/cord-260037-ys62jrgw.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/25855946/
doi: 10.1378/chest.15-0135
summary:
  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;

abstract:
  Caring for patients affected with Ebola virus disease (EVD) while simultaneously preventing EVD transmission represents a central ethical challenge of the EVD epidemic. To address this challenge, we propose a model policy for resuscitation and emergent procedure policy of patients with EVD and set forth ethical principles that lend support to this policy. The policy and principles we propose bear relevance beyond the EVD epidemic, offering guidance for the care of patients with other highly contagious, virulent, and lethal diseases. The policy establishes (1) a limited code status for patients with confirmed or suspected EVD. Limited code status means that a code blue will not be called for patients with confirmed or suspected EVD at any stage of the disease; however, properly protected providers (those already in full protective equipment) may initiate resuscitative efforts if, in their clinical assessment, these efforts are likely to benefit the patient. 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. We discuss ethical issues involving medical futility and the duty to avoid harm and propose a utilitarian-based principle of triage to address resource scarcity in the emergency setting.


id: cord-260779-riw5xs3j
author: van Griensven, Johan
date: 2016-01-01
url: https://www.ncbi.nlm.nih.gov/pubmed/26261205/
doi: 10.1093/cid/civ680
title:
  The Use of Ebola Convalescent Plasma to Treat Ebola Virus Disease in Resource-Constrained Settings: A Perspective From the Field

abstract:
  The clinical evaluation of convalescent plasma (CP) for the treatment of Ebola virus disease (EVD) in the current outbreak, predominantly affecting Guinea, Sierra Leone, and Liberia, was prioritized by the World Health Organization in September 2014. In each of these countries, nonrandomized comparative clinical trials were initiated. The Ebola-Tx trial in Conakry, Guinea, enrolled 102 patients by 7 July 2015; no severe adverse reactions were noted. The Ebola-CP trial in Sierra Leone and the EVD001 trial in Liberia have included few patients. Although no efficacy data are available yet, current field experience supports the safety, acceptability, and feasibility of CP as EVD treatment. Longer-term follow-up as well as data from nontrial settings and evidence on the scalability of the intervention are required. CP sourced from within the outbreak is the most readily available source of anti-EVD antibodies. Until the advent of effective antivirals or monoclonal antibodies, CP merits further evaluation.


id: cord-265017-byyx2y47
title: Seeds of Destruction
author: Ryan, Jeffrey R.
date: 2016-03-25
txt: ./txt/cord-265017-byyx2y47.txt
cache: ./cache/cord-265017-byyx2y47.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/B9780128020296000013
doi: 10.1016/b978-0-12-802029-6.00001-3
summary:
  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).

abstract:
  This chapter provides the reader with an understanding and appreciation for the scope and importance of biological threats and the opportunity to see where they may be and have become the desire of terrorist groups and the makings of weapons of mass destruction. The history of biological warfare is covered in depth. These major events are important in helping us understand the issues related to using biological substances against an adversary. The difference between biosecurity and biodefense are explained and then related to homeland security and homeland defense, respectively. This chapter also details how expensive these programs are, with nearly $80 billion having been spent on civilian biodefense since fiscal year 2001 in the United States alone. As discussed herein, there is a significant difference in the reality and the potential of bioterrorism. Bioterrorism on a large scale is a low-probability event. Bioterrorism on a small scale is a fairly routine occurrence with little potential. Biological threats remain very much in the news. Recent examples, such as laboratory incidents, the Ebola outbreak of 2014, and other emerging threats, are covered in this chapter.


id: cord-266415-8w5elfro
author: Tambo, Ernest
date: 2014-08-05
url: https://www.ncbi.nlm.nih.gov/pubmed/25120913/
doi: 10.1186/2049-9957-3-29
title:
  Need of surveillance response systems to combat Ebola outbreaks and other emerging infectious diseases in African countries

abstract:
  There is growing concern in Sub-Saharan Africa about the spread of the Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, and the public health burden that it ensues. Since 1976, there have been 885,343 suspected and laboratory confirmed cases of EVD and the disease has claimed 2,512 cases and 932 fatality in West Africa. There are certain requirements that must be met when responding to EVD outbreaks and this process could incur certain challenges. For the purposes of this paper, five have been identified: (i) the deficiency in the development and implementation of surveillance response systems against Ebola and others infectious disease outbreaks in Africa; (ii) the lack of education and knowledge resulting in an EVD outbreak triggering panic, anxiety, psychosocial trauma, isolation and dignity impounding, stigmatisation, community ostracism and resistance to associated socio-ecological and public health consequences; (iii) limited financial resources, human technical capacity and weak community and national health system operational plans for prevention and control responses, practices and management; (iv) inadequate leadership and coordination; and (v) the lack of development of new strategies, tools and approaches, such as improved diagnostics and novel therapies including vaccines which can assist in preventing, controlling and containing Ebola outbreaks as well as the spread of the disease. Hence, there is an urgent need to develop and implement an active early warning alert and surveillance response system for outbreak response and control of emerging infectious diseases. Understanding the unending risks of transmission dynamics and resurgence is essential in implementing rapid effective response interventions tailored to specific local settings and contexts. Therefore, the following actions are recommended: (i) national and regional inter-sectorial and trans-disciplinary surveillance response systems that include early warnings, as well as critical human resources development, must be quickly adopted by allied ministries and organisations in African countries in epidemic and pandemic responses; (ii) harnessing all stakeholders commitment and advocacy in sustained funding, collaboration, communication and networking including community participation to enhance a coordinated responses, as well as tracking and prompt case management to combat challenges; (iii) more research and development in new drug discovery and vaccines; and (iv) understanding the involvement of global health to promote the establishment of public health surveillance response systems with functions of early warning, as well as monitoring and evaluation in upholding research-action programmes and innovative interventions.


id: cord-269476-lrk4ty99
author: Mohammed, Abdulaziz
date: 2015-08-27
url: https://doi.org/10.1186/s12889-015-2167-6
doi: 10.1186/s12889-015-2167-6
title:
  An evaluation of psychological distress and social support of survivors and contacts of Ebola virus disease infection and their relatives in Lagos, Nigeria: a cross sectional study − 2014

abstract:
  BACKGROUND: By September 2014, an outbreak of Ebola Viral Disease (EVD) in West African countries of Guinea, Liberia, Sierra Leone, Senegal and Nigeria, had recorded over 4500 and 2200 probable or confirmed cases and deaths respectively. EVD, an emerging infectious disease, can create fear and panic among patients, contacts and relatives, which could be a risk factor for psychological distress. Psychological distress among this subgroup could have public health implication for control of EVD, because of potential effects on patient management and contact tracing. We determined the Prevalence, pattern and factors associated with psychological distress among survivors and contacts of EVD and their relatives. METHODS: In a descriptive cross sectional study, we used General Health Questionnaire to assess psychological distress and Oslo Social Support Scale to assess social support among 117 participants who survived EVD, listed as EVD contacts or their relatives at Ebola Emergency Operation Center in Lagos, Nigeria. Factors associated with psychological distress were determined using chi square/odds ratio and adjusted odds ratio. RESULTS: The mean age and standard deviation of participants was 34 +/ - 9.6 years. Of 117 participants, 78 (66.7 %) were females, 77 (65.8 %) had a tertiary education and 45 (38.5 %) were health workers. Most frequently occurring psychological distress were inability to concentrate (37.6 %) and loss of sleep over worry (33.3 %). Losing a relation to EVD outbreak (OR = 6.0, 95 % CI, 1.2–32.9) was significantly associated with feeling unhappy or depressed while being a health worker was protective (OR = 0.4, 95 % CI, 0.2–0.9). Adjusted Odds Ratio (AOR) showed losing a relation (AOR = 5.7, 95 % CI, 1.2–28.0) was a predictor of “feeling unhappy or depressed”, loss of a relation (AOR = 10.1, 95 % CI, 1.7–60.7) was a predictor of inability to concentrate. CONCLUSIONS: Survivors and contacts of EVD and their relations develop psychological distress. Development of psychological distress could be predicted by loss of family member. It is recommended that psychiatrists and other mental health specialists be part of case management teams. The clinical teams managing EVD patients should be trained on recognition of common psychological distress among patients. A mental health specialist should review contacts being monitored for EVD for psychological distress or disorders.


id: cord-269770-7hau5yge
author: MacIntyre, C. Raina
date: 2014-09-08
txt: ./txt/cord-269770-7hau5yge.txt
cache: ./cache/cord-269770-7hau5yge.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/25218265/
doi: 10.1016/j.ijnurstu.2014.09.002
abstract: nan
summary:
  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.

title:
  Respiratory protection for healthcare workers treating Ebola virus disease (EVD): Are facemasks sufficient to meet occupational health and safety obligations?


id: cord-272991-opvs2ejd
author: Masiira, Ben
date: 2020-10-13
url: https://www.ncbi.nlm.nih.gov/pubmed/33051282/
doi: 10.1136/bmjgh-2020-002874
title:
  Building a new platform to support public health emergency response in Africa: the AFENET Corps of Disease Detectives, 2018–2019

abstract:
  Public health emergency (PHE) response in sub-Saharan Africa is constrained by inadequate skilled public health workforce and underfunding. Since 2005, the African Field Epidemiology Network (AFENET) has been supporting field epidemiology capacity development and innovative strategies are required to use this workforce. In 2018, AFENET launched a continental rapid response team: the AFENET Corps of Disease Detectives (ACoDD). ACoDD comprises field epidemiology graduates and residents and was established to support PHE response. Since 2018, AFENET has deployed the ACoDD to support response to several PHEs. The main challenges faced during ACoDD deployments were financing of operations, ACoDD safety and security, resistance to interventions and distrust of the responders by some communities. Our experience during these deployments showed that it was feasible to mobilise and deploy ACoDD within 48 hours. However, the sustainability of deployments will depend on establishing strong linkages with the employers of ACoDD members. PHEs are effectively controlled when there is a fast deployment and strong linkages between the stakeholders. There are ongoing efforts to strengthen PHE preparedness and response in sub-Saharan Africa. ACoDD members are a competent workforce that can effectively augment PHE response. ACoDD teams mentored front-line health workers and community health workers who are critical in PHE response. Public health emergence response in sub-Saharan Africa is constrained by inadequacies in a skilled workforce and underfunding. ACoDD can be utilised to overcome the challenges of accessing a skilled public health workforce. To improve health security in sub-Saharan Africa, more financing of PHE response is needed.


id: cord-280164-dukccrjb
author: Nachega, Jean B.
date: 2020-06-19
url: https://www.ncbi.nlm.nih.gov/pubmed/32563272/
doi: 10.4269/ajtmh.20-0642
title:
  Responding to the Challenge of the Dual COVID-19 and Ebola Epidemics in the Democratic Republic of Congo—Priorities for Achieving Control

abstract:
  As of June 11, 2020, the Democratic Republic of the Congo (DRC) has reported 4,258 COVID-19 cases with 90 deaths. With other African countries, the DRC faces the challenge of striking a balance between easing public health lockdown measures to curtail the spread of SARS-CoV-2 and minimizing both economic hardships for large sectors of the population and negative impacts on health services for other infectious and noninfectious diseases. The DRC recently controlled its tenth Ebola virus disease (EVD) outbreak, but COVID-19 and a new EVD outbreak beginning on June 1, 2020 in the northwest Équateur Province have added an additional burden to health services. Although the epidemiology and transmission of EVD and COVID-19 differ, leveraging the public health infrastructures and experiences from coordinating the EVD response to guide the public health response to COVID-19 is critical. Building on the DRC’s 40 years of experience with 10 previous EVD outbreaks, we highlight the DRC’s multi-sectoral public health approach to COVID-19, which includes community-based screening, testing, contact-tracing, risk communication, community engagement, and case management. We also highlight remaining challenges and discuss the way forward for achieving control of both COVID-19 and EVD in the DRC.


id: cord-283812-ocfjj79v
author: Blumberg, Lucille
date: 2016-06-15
url: https://doi.org/10.1016/j.ijid.2016.06.011
doi: 10.1016/j.ijid.2016.06.011
title:
  Hosting of mass gathering sporting events during the 2013–2016 Ebola virus outbreak in West Africa: experience from three African countries

abstract:
  • Mass gatherings at sporting events attract millions of international and national host-country travellers, who may put themselves at risk of acquiring local endemic infectious diseases. • The 2013–2016 Ebola virus disease (EVD) outbreak in West Africa that resulted in over 28 637 cases and 11 315 deaths required that countries holding these events put in place public health programmes for enhanced surveillance and specific response plans for any suspected cases of EVD. • Three major sports events were held in Africa during the EVD outbreak, attended by athletes from numerous African countries including Liberia, Sierra Leone, and Guinea, the three countries most affected by EVD: the African Youth Games (Botswana), Africa Cup of Nations (Equatorial Guinea), and All-Africa Games (Republic of Congo). • A large range of infectious diseases other than EVD were considered with respect to the differential diagnosis of acute febrile illnesses and for the provision of laboratory diagnostics and treatment options. • The experience from these three mass gathering events during the Ebola epidemic illustrates that these events can be held safely provided that countries put measures in place for enhanced surveillance and response systems for communicable diseases.


id: cord-286548-7or373vf
title: Leveraging investments in Ebola preparedness for COVID-19 in Sub-Saharan Africa
author: Ayebare, Rodgers
date: 2020-03-18
url: https://doi.org/10.12688/aasopenres.13052.1
doi: 10.12688/aasopenres.13052.1
abstract:
  The emergence of SARS-CoV-2 in China and transmission to more than 80 territories worldwide, including nine countries in Africa, presents a delicate situation for low-resource settings. Countries in Eastern and Central Africa have been on high alert since mid-2018 in anticipation of regional spread of the Ebola virus from the Democratic Republic of Congo. Significant investment has been made to support enhanced surveillance at point of entry and hospitals, infection control practices, clinical case management, and clinical research. With a new threat on the horizon, African countries have an opportunity to leverage the existing capacities for Ebola preparedness to brace for the imminent threat.


id: cord-288734-xinkqs6u
title: Ebola Virus Disease in Humans: Pathophysiology and Immunity
author: Muñoz-Fontela, César
date: 2017-03-30
txt: ./txt/cord-288734-xinkqs6u.txt
cache: ./cache/cord-288734-xinkqs6u.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/82_2017_11
doi: 10.1007/82_2017_11
summary:
  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

abstract:
  Viruses of the Ebolavirus genus cause sporadic epidemics of severe and systemic febrile disease that are fueled by human-to-human transmission. Despite the notoriety of ebolaviruses, particularly Ebola virus (EBOV), as prominent viral hemorrhagic fever agents, and the international concern regarding Ebola virus disease (EVD) outbreaks, very little is known about the pathophysiology of EVD in humans and, in particular, about the human immune correlates of survival and immune memory. This lack of basic knowledge about physiological characteristics of EVD is probably attributable to the dearth of clinical and laboratory data gathered from past outbreaks. The unprecedented magnitude of the EVD epidemic that occurred in West Africa from 2013 to 2016 has allowed, for the first time, evaluation of clinical, epidemiological, and immunological parameters in a significant number of patients using state-of-the-art laboratory equipment. This review will summarize the data from the literature regarding human pathophysiologic and immunologic responses to filoviral infection.


id: cord-290637-3tgtstd4
author: Ferranti, Erin P.
date: 2016-12-31
url: https://api.elsevier.com/content/article/pii/S0029655416300495
doi: 10.1016/j.outlook.2016.04.002
title:
  Implementation of an educational program for nursing students amidst the Ebola virus disease epidemic

abstract:
  Abstract Background The global Ebola virus disease (EVD) epidemic of 2014/2015 prompted faculty at Emory University to develop an educational program for nursing students to increase EVD knowledge and confidence and decrease concerns about exposure risk. Purpose The purpose of this article is to describe the development, implementation, and evaluation of the EVD Just-in-Time Teaching (JiTT) educational program. Methods Informational sessions, online course links, and a targeted, self-directed slide presentation were developed and implemented for the EVD educational program. Three student surveys administered at different time points were used to evaluate the program and change in students' EVD knowledge, confidence in knowledge, and risk concern. Discussion Implementation of a JiTT educational program effectively achieved our goals to increase EVD knowledge, decrease fear, and enhance student confidence in the ability to discuss EVD risk. These achievements were sustained over time. Conclusion JiTT methodology is an effective strategy for schools of nursing to respond quickly and comprehensively during an unanticipated infectious disease outbreak.


id: cord-293221-gf9wy4a9
author: Idowu, Abiodun Benjamin
date: 2020-08-31
txt: ./txt/cord-293221-gf9wy4a9.txt
cache: ./cache/cord-293221-gf9wy4a9.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32867755/
doi: 10.1186/s12889-020-09441-7
summary:
  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

title:
  Ebola virus disease in the eyes of a rural, agrarian community in Western Nigeria: a mixed method study

abstract:
  BACKGROUND: Ebola virus disease (EVD) is a severe hemorrhagic disease caused by Ebola virus. Several outbreaks have been reported in Africa and often originated from remote agrarian communities where there are enormous misconceptions of the disease, refusal of early isolation and quarantine, and unsafe burial rites practices which aggravates the epidemics. 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. Mixed methods were used for data collection. Quantitative data collection was done using a pre-tested interviewer administered questionnaire. Four hundred and seven respondents selected by multi-stage sampling technique were interviewed. Descriptive and inferential statistics were done, and the level of significance was set at 0.05. Qualitative data collection involved four focus group discussions a year after the epidemic was declared over in the country. The discussions were recorded, transcribed and analyzed along major themes. RESULTS: All respondents were aware of EVD with radio and television being the major sources of information. Knowledge of the disease was however very poor with many misconceptions and it was significantly influenced by educational level of respondent. EVD survivors will be welcomed back into the community by few residents (36.8%) and a much fewer proportion (27.2%) will freely entertain a survivor in their house. Most would prefer local herbalists over orthodox medical practitioners to care for their loved one in case they contract EVD. Although respondents knew that burying a victim is dangerous, they opposed cremation. CONCLUSION: There was poor knowledge of EVD with a lot of misconceptions. Community members were not pro-active about prevention with dire consequences in the event of an outbreak. Continuous public education should be done via mass media, traditional institutions and other community-based channels as part of emergency preparedness.


id: cord-298796-ajzfnd7g
title: Sustainability of High-Level Isolation Capabilities among US Ebola Treatment Centers
author: Herstein, Jocelyn J.
date: 2017-06-17
txt: ./txt/cord-298796-ajzfnd7g.txt
cache: ./cache/cord-298796-ajzfnd7g.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/28518036/
doi: 10.3201/eid2306.170062
summary:
  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.

abstract:
  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. HLIUs expended substantial resources in development but must strategize models of sustainability to maintain readiness.


id: cord-300080-l0fyxtva
author: Venkat, Arvind
date: 2015-03-10
txt: ./txt/cord-300080-l0fyxtva.txt
cache: ./cache/cord-300080-l0fyxtva.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/25770003/
doi: 10.1016/j.jen.2015.01.012
summary:
  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.

title:
  Ethical Issues in the Response to Ebola Virus Disease in US Emergency Departments: A Position Paper of the American College of Emergency Physicians, the Emergency Nurses Association and the Society for Academic Emergency Medicine

abstract:
  The 2014 outbreak of Ebola Virus Disease (EVD) in West Africa has presented a significant public health crisis to the international health community and challenged US emergency departments to prepare for patients with a disease of exceeding rarity in developed nations. 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. To address these concerns, the American College of Emergency Physicians, the Emergency Nurses Association and the Society for Academic Emergency Medicine developed this joint position paper to provide guidance to US emergency physicians, emergency nurses and other stakeholders in the healthcare system on how to approach the ethical dilemmas posed by the outbreak of EVD. This paper will address areas of immediate and potential ethical concern to US emergency departments in how they approach preparation for and management of potential patients with EVD.


id: cord-300133-yc2wxgid
title: Ebola Virus Infection: Overview and Update on Prevention and Treatment
author: Martínez, Miguel J.
date: 2015-09-12
url: https://doi.org/10.1007/s40121-015-0079-5
doi: 10.1007/s40121-015-0079-5
abstract:
  In 2014 and 2015, the largest Ebola virus disease (EVD) outbreak in history affected large populations across West Africa. The goal of this report is to provide an update on the epidemic and review current progress in the development, evaluation and deployment of prevention and treatment strategies for EVD. Relevant information was identified through a comprehensive literature search using Medline, PubMed and CINAHL Complete and using the search terms Ebola, Ebola virus disease, Ebola hemorrhagic fever, West Africa outbreak, Ebola transmission, Ebola symptoms and signs, Ebola diagnosis, Ebola treatment, vaccines for Ebola and clinical trials on Ebola. Through 22 July 2015, a total of 27,741 EVD cases and 11,284 deaths were reported from all affected countries. Several therapeutic agents and novel vaccines for EVD have been developed and are now undergoing evaluation. Concurrent with active case investigation, contact tracing, surveillance and supportive care to patients and communities, there has been rapid progress in the development of new therapies and vaccines against EVD. Continued focus on strengthening clinical and public health infrastructure will have direct benefits in controlling the spread of EVD and will provide a strong foundation for deployment of new drugs and vaccines to affected countries when they become available. The unprecedented West Africa Ebola outbreak, response measures, and ensuing drug and vaccine development suggest that new tools for Ebola control may be available in the near future. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s40121-015-0079-5) contains supplementary material, which is available to authorized users.


id: cord-306972-alyyju5x
author: James, Peter Bai
date: 2020-02-05
url: https://www.ncbi.nlm.nih.gov/pubmed/32020858/
doi: 10.1186/s12889-020-8279-7
title:
  An assessment of Ebola-related stigma and its association with informal healthcare utilisation among Ebola survivors in Sierra Leone: a cross-sectional study

abstract:
  BACKGROUND: We examined the magnitude and correlates of Ebola virus disease (EVD)-related stigma among EVD survivors in Sierra Leone since their return to their communities. In addition, we determined whether EVD-related stigma is a predictor of informal health care use among EVD survivors. METHODS: We conducted a cross-sectional study among 358 EVD survivors in five districts across all four geographic regions (Western Area, Northern Province, Eastern Province and Southern Province) of Sierra Leone. Ebola-related stigma was measured by adapting the validated HIV related stigma for people living with HIV/AIDS instrument. We also measured traditional and complementary medicine (T&CM) use (as a measure of informal healthcare use). Data were analysed using descriptive statistics and regression analysis. RESULTS: EVD survivors report higher levels of internalised stigma (0.92 ± 0.77) compared to total enacted stigma (0.71 ± 0.61). Social isolation (0.96 ± 0.88) was the highest reported enacted stigma subscale. Ebola survivors who identified as Christians [AOR = 2.51, 95%CI: 1.15–5.49, p = 0.021], who perceived their health to be fair/poor [AOR = 2.58, 95%CI: 1.39–4.77. p = 0.003] and who reside in the northern region of Sierra Leone [AOR = 2.80, 95%CI: 1.29–6.07, p = 0.009] were more likely to experience internalised stigma. Verbal abuse [AOR = 1.95, 95%CI: 1.09–3.49, p = 0.025] and healthcare neglect [AOR = 2.35, 95%CI: 1.37–4.02, p = 0.002] were independent predictors of T&CM use among EVD survivors. CONCLUSION: Our findings suggest EVD-related stigma (internalised and enacted) is prevalent among EVD survivors since their return to their communities. Religiosity, perceived health status and region were identified as independent predictors of internalised stigma. Verbal abuse and healthcare neglect predict informal healthcare use. EVD survivor-centred and community-driven anti-stigma programs are needed to promote EVD survivors’ recovery and community re-integration.


id: cord-309141-vwudbuzz
title: Ebola: A Hyperinflated Emergency
author: Barbiero, Victor K.
date: 2020-06-30
txt: ./txt/cord-309141-vwudbuzz.txt
cache: ./cache/cord-309141-vwudbuzz.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.9745/ghsp-d-19-00422
doi: 10.9745/ghsp-d-19-00422
summary:
  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.

abstract:
  As with the Ebola outbreak, global under-5 mortality and morbidity should be considered a public health emergency of international concern.


id: cord-314460-dbrp4vxc
title: Review of Literature for Air Medical Evacuation High-Level Containment Transport
author: Gibbs, Shawn G.
date: 2019-10-31
url: https://www.ncbi.nlm.nih.gov/pubmed/31578975/
doi: 10.1016/j.amj.2019.06.006
abstract:
  Abstract Introduction Aeromedical evacuation (AE) is a challenging process, further complicated when a patient has a highly hazardous communicable disease (HHCD). We conducted a review of the literature to evaluate the processes and procedures utilized for safe AE high-level containment transport (AE-HLCT) of patients with HHCDs. Methods A literature search was performed in PubMed/MEDLINE (from 1966 through January 2019). Authors screened abstracts for inclusion criteria and full articles were reviewed if the abstract was deemed to contain information related to the aim. Results Our search criteria yielded 14 publications and were separated based upon publication dates, with the natural break point being the beginning of the 2013-2016 Ebola virus disease epidemic. Best practices and recommendations from identified articles are subdivided into pre-flight preparations, inflight operations, and post-flight procedures. Conclusions Limited peer-reviewed literature exists on AE-HLCT, including important aspects related to healthcare worker fatigue, alertness, shift scheduling, and clinical care performance. This hinders the sharing of best practices to inform evacuations and equip teams for future outbreaks. Despite the successful use of different aircraft and technologies, the unique nature of the mission opens the opportunity for greater coordination and development of consensus standards for AE-HLCT operations.


id: cord-327641-hqnem2zs
title: Clinical presentations and outcomes of patients with Ebola virus disease in Freetown, Sierra Leone
author: Ji, Ying-Jie
date: 2016-11-03
txt: ./txt/cord-327641-hqnem2zs.txt
cache: ./cache/cord-327641-hqnem2zs.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/27806732/
doi: 10.1186/s40249-016-0195-9
summary:
  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.

abstract:
  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. METHODS: The study admitted 285 patients with confirmed EVD and followed them up till the endpoint (recovery or death). EVD was confirmed by quantitative RT-PCR assays detecting blood Ebola virus (EBOV). RESULTS: Among the 285 lab-confirmed EVD cases in Jui Government Hospital, 146 recovered and 139 died, with an overall survival rate of 51.23 %. Patients under the age of 6 years had a lower survival rate (37.50 %). Most non-survivors (79.86 %) died within 7 days after admission and the mean hospitalization time for non-survivors was 5.56 ± 6.11 days. More than half survivors (63.69 %) turned blood EBOV negative within 3 weeks after admission and the mean hospitalization time for survivors was 20.38 ± 7.58 days. High blood viral load (≥10(6) copies/ml) was found to be predictive of the non-survival outcome as indicated by the Receiver Operating Characteristic (ROC) curve analysis. The probability of patients’ survival was less than 15 % when blood viral load was greater than 10(6) copies/ml. Multivariate analyses showed that blood viral load (P = 0.005), confusion (P = 0.010), abdominal pain (P = 0.003), conjunctivitis (P = 0.035), and vomiting (P = 0.004) were factors independently associated with the outcomes of EVD patients. CONCLUSIONS: Most death occurred within 1 week after admission, and patients at the age of 6 or younger had a lower survival rate. Most surviving patients turned blood EBOV negative within 1–4 weeks after admission. Factors such as high blood viral load, confusion, abdominal pain, vomiting and conjunctivitis were associated with poor prognosis for EVD patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40249-016-0195-9) contains supplementary material, which is available to authorized users.


id: cord-330647-w1bpeqzg
title: Ebola virus disease in nonendemic countries
author: Wong, Samson Sai-Yin
date: 2015-05-31
txt: ./txt/cord-330647-w1bpeqzg.txt
cache: ./cache/cord-330647-w1bpeqzg.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0929664615000637
doi: 10.1016/j.jfma.2015.01.012
summary:
  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.

abstract:
  The 2014 West African outbreak of Ebola virus disease was unprecedented in its scale and has resulted in transmissions outside endemic countries. Clinicians in nonendemic countries will most likely face the disease in returning travelers, either among healthcare workers, expatriates, or visiting friends and relatives. Clinical suspicion for the disease must be heightened for travelers or contacts presenting with compatible clinical syndromes, and strict infection control measures must be promptly implemented to minimize the risk of secondary transmission within healthcare settings or in the community. We present a concise review on human filoviral disease with an emphasis on issues that are pertinent to clinicians practicing in nonendemic countries.


id: cord-340194-ibli36rq
title: Ebola virus disease: a highly fatal infectious disease reemerging in West Africa
author: To, Kelvin K.W.
date: 2014-11-29
url: https://www.ncbi.nlm.nih.gov/pubmed/25456100/
doi: 10.1016/j.micinf.2014.11.007
abstract:
  Ebolavirus can cause a highly fatal and panic-generating human disease which may jump from bats to other mammals and human. High viral loads in body fluids allow efficient transmission by contact. Lack of effective antivirals, vaccines and public health infrastructures in parts of Africa make it difficult to health workers to contain the outbreak.


id: cord-356242-tydil7d7
author: Wannier, S. Rae
date: 2019-07-26
url: https://doi.org/10.1016/j.epidem.2019.100353
doi: 10.1016/j.epidem.2019.100353
title:
  Estimating the impact of violent events on transmission in Ebola virus disease outbreak, Democratic Republic of the Congo, 2018–2019

abstract:
  INTRODUCTION: As of April 2019, the current Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) is occurring in a longstanding conflict zone and has become the second largest EVD outbreak in history. It is suspected that after violent events occur, EVD transmission will increase; however, empirical studies to understand the impact of violence on transmission are lacking. Here, we use spatial and temporal trends of EVD case counts to compare transmission rates between health zones that have versus have not experienced recent violent events during the outbreak. METHODS: We collected daily EVD case counts from DRC Ministry of Health. A time-varying indicator of recent violence in each health zone was derived from events documented in the WHO situation reports. We used the Wallinga-Teunis technique to estimate the reproduction number R for each case by day per zone in the 2018–2019 outbreak. We fit an exponentially decaying curve to estimates of R overall and by health zone, for comparison to past outbreaks. RESULTS: As of 16 April 2019, the mean overall R for the entire outbreak was 1.11. We found evidence of an increase in the estimated transmission rates in health zones with recently reported violent events versus those without (p = 0.008). The average R was estimated as between 0.61 and 0.86 in regions not affected by recent violent events, and between 1.01 and 1.07 in zones affected by violent events within the last 21 days, leading to an increase in R between 0.17 and 0.53. Within zones with recent violent events, the mean estimated quenching rate was lower than for all past outbreaks except the 2013–2016 West African outbreak. CONCLUSION: The difference in the estimated transmission rates between zones affected by recent violent events suggests that violent events are contributing to increased transmission and the ongoing nature of this outbreak.


id: cord-356327-kxyo4rfv
title: Ebola Virus Disease: Experience and Decision Making for the First Patients outside of Africa
author: Stephens, David S.
date: 2015-07-28
url: https://doi.org/10.1371/journal.pmed.1001857
doi: 10.1371/journal.pmed.1001857
abstract:
  David Stephens and colleagues describe their experience of treating patients with Ebola virus disease at Emory University in the United States.


