This article is more than 5 years old. Information may no longer be current.
Ebola treatment units disrupt transmission in remote locales
Click Here to Manage Email Alerts
When adequate isolation and treatment of Ebola are possible in remote areas, community-based Ebola treatment units have the potential to hinder virus transmission and improve survival, according to recent data.
Researchers evaluated the number of cases propagated by a single case of Ebola virus in an uninfected area (reproduction number) before and after interventions were introduced for nine Liberian outbreaks in 2014. As part of these interventions, symptomatic individuals were promptly isolated through home self-isolation or relocation to an Ebola treatment unit (ETU), and their contacts were noted and surveilled. In addition, Ebola prevention messages and information regarding safe burials were offered.
Investigation forms were completed for all case-patients through interviews, and the researchers retrospectively created transmission chains by identifying the source-patients for known cases and linking them to the index case. Cases were categorized as occurring before or after public health interventions began. The reproduction number was calculated as a mean of secondary infections from cases that occurred before and after interventions were initiated. Risk factors were identified for secondary cases, with the relationship between patient admission to an ETU and survival also evaluated.
Results showed that the reproduction number decreased 94% after intervention, from 1.7 (95% CI, 1.2-2.6) to 0.1 (95% CI, 0.02-0.6). Patients who were admitted to an ETU had a 90% lower risk for secondary infections (RR = 0.1; 95% CI, 0.04-0.3) compared with those who died. The case fatality rate was 68% (95% CI, 60-74), with admission to an ETU linked to a 50% decreased risk for death when compared with those not admitted to an ETU (HR = 0.5; 95% CI, 0.4-0.8).
“We present strong evidence that when capacity for isolation and treatment of Ebola is sufficient, rapid response strategies in remote areas that engage communities to promptly isolate and remove case-patients for care have the dual benefit of contributing to interruption of transmission and improving survival rates through treatment at ETUs,” the researchers wrote. “Provided basic interventions are implemented and communities are accepting, outbreaks of Ebola in rural areas can be controlled rapidly.” – by Jen Byrne
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts