Ebola Virus Disease Outbreaks: Lessons Learned From Past and Facing Future Challenges
Author:
Dembek Zygmunt1ORCID, Hadeed Steven1ORCID, Tigabu Bersabeh2, Schwartz-Watjen Kierstyn3, Glass Michael4, Dressner Michelle5, Frankel Dianne5, Blaney David56ORCID, Eccles III Thomas G5, Chekol Tesema1, Owens Akeisha7, Wu Aiguo7ORCID
Affiliation:
1. Support to DTRA Technical Reachback, Battelle Memorial Institute , Columbus, OH 43201, USA 2. Support to DTRA Technical Reachback, Global Systems Engineering (GSE) , Alexandria, VA 22312, USA 3. Support to DTRA Technical Reachback, Applied Research Associates (ARA) , Albuquerque, NM 87110, USA 4. SME Support to DTRA Technical Reachback, Manta Solutions , Charlottesville, VA 22901, USA 5. Office of the Command Surgeon, U.S. Africa Command , APO, AE 09751, USA 6. Office of Readiness and Response, U.S. Centers for Disease Control and Prevention , Atlanta, GA 30329, USA 7. Technical Reachback, Defense Threat Reduction Agency (DTRA) , Fort Belvoir, VA 22060, USA
Abstract
ABSTRACT
Introduction
The purpose of this review is to examine African Ebola outbreaks from their first discovery to the present, to determine how the medical and public health response has changed and identify the causes for those changes. We sought to describe what is now known about the epidemiology and spread of Ebola virus disease (EVD) from the significant outbreaks that have occurred and outbreak control methods applied under often challenging circumstances. Given the substantial role that the U.S. Government and the U.S. DoD have played in the 2014 to 2016 West African Ebola outbreak, the role of the DoD and the U.S. Africa Command in controlling EVD is described.
Materials and Methods
A descriptive method design was used to collect and analyze all available Ebola outbreak literature using the PubMed database. An initial literature search was conducted by searching for, obtaining, and reading original source articles on all major global Ebola outbreaks. To conduct a focused search, we used initial search terms “Ebola outbreak,” “Ebola virus disease,” “Ebola response,” “Ebola countermeasures,” and also included each country’s name where Ebola cases are known to have occurred. From the 4,673 unique articles obtained from this search and subsequent article title review, 307 articles were identified for potential inclusion. Following abstract and article review, 45 original source articles were used to compile the history of significant Ebola outbreaks. From this compilation, articles focused on each respective subsection of this review to delineate and describe the history of EVD and response, identifying fundamental changes, were obtained and incorporated.
Results
We present known Ebola virus and disease attributes, including a general description, seasonality and location, transmission capacity, clinical symptoms, surveillance, virology, historical EVD outbreaks and response, international support for Ebola outbreak response, U.S. DoD support, medical countermeasures supporting outbreak response, remaining gaps to include policy limitations, regional instability, climate change, migration, and urbanization, public health education and infrastructure, and virus persistence and public awareness.
Conclusions
The health and societal impacts of EVD on Africa has been far-reaching, with about 35,000 cases and over 15,000 deaths, with small numbers of cases spreading globally. However, the history of combatting EVD reveals that there is considerable hope for African nations to quickly and successfully respond to Ebola outbreaks, through use of endemic resources including Africa CDC and African Partner Outbreak Response Alliance and the U.S. Africa Command with greater DoD reachback. Although there remains much to be learned about the Ebola virus and EVD including whether the potential for novel strains to become deadly emerging infections, invaluable vaccines, antivirals, and public health measures are now part of the resources that can be used to combat this disease.
Funder
Defense Threat Reduction Agency
Publisher
Oxford University Press (OUP)
Cited by
2 articles.
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