This article is more than 5 years old. Information may no longer be current.
Major gaps identified in contact tracing in Guinea Ebola outbreak
Click Here to Manage Email Alerts
During the recent Ebola virus disease outbreak in Guinea, control measures such as contact tracing and case identification fell well short of 100%, according to researchers.
“Incomplete contact tracing and delayed time to isolation of suspected case-patients may result in transmission of Ebola virus disease to others in the community, perpetuating the epidemic,” Meredith G. Dixon, MD, of the CDC, and colleagues wrote in their study.
From March 2014 to July, there were 3,748 Ebola virus disease (EVD) cases and 2,499 EVD-related deaths in Guinea, which were part of the largest reported EVD epidemic.
In a retrospective review, the researchers assessed contact tracing efforts in two prefectures of Guinea — Kindia and Faranah — from September to December 2014. They examined national and local data about case-patients, defined as anyone infected with EVD, and their contacts.
According to Dixon and colleagues, a contact is at-risk for EVD infection if the individual:
- cohabitated with a confirmed or probable EVD patient;
- had physical contact with a case-patient while the person was ill;
- touched an EVD patient’s body fluid, clothes or linens; or
- was an infant breast-fed by the case-patient.
The findings revealed gaps in contact tracing efforts in Kindia and Faranah. Less than one-third of case patients in both prefectures were registered as contacts before case identification, according to the researchers. The resulting delay in isolation, should any contacts become symptomatic, can lead to further disease spread, they said. Patients suspected of having EVD who are not isolated can spread disease.
In addition, about two-thirds of case-patients had no registered contacts; consequently, their contacts were not properly investigated, the researchers said.
“Every EVD case-patient not previously observed as a contact represents an unidentified chain of transmission,” Dixon and colleagues wrote. “Every contact not identified or followed up on represents a possible transmission opportunity.”
Time to isolation was delayed in both prefectures. In Kindia, the median time to isolation for suspected EVD cases was 5 days; in Faranah, it was 3 days, according to the researchers.
“Whereas no single control measure in this epidemic in Guinea will achieve the goal of ‘Getting to Zero,’ our findings show that the control measures of case identification and contact tracing individually were not reaching target levels of 100% and thus need improvement to assist in termination of this outbreak in Guinea,” the researchers wrote. – by Colleen Owens
Disclosure: The researchers report receiving funding from the CDC, WHO and the Guinea Ministry of Health.
Click Here to Manage Email Alerts