Distinguishing epidemiological features of the 2013-2016 West Africa Ebola virus disease outbreak.
Distinguishing epidemiological features of the 2013-2016 West Africa Ebola virus disease outbreak.
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DOI：
10.1080/21665044.2015.1129889
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发表时间：
2016-01-01
期刊：
影响因子：
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通讯作者：
Rechkemmer, Andreas
中科院分区：
文献类型：
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作者：
Shultz, James M;Espinel, Zelde;Rechkemmer, Andreas
本灾难复杂性案例研究探讨了 2013 年 7 月 24 日在西班牙加利西亚圣地亚哥德孔波斯特拉郊区发生的西班牙最严重的火车出轨事故。火车脱轨通常是可以幸存的。然而，在这种情况下，人为错误是一个主要因素，因为火车司机驾驶阿尔维亚火车以两倍于公布速度的速度进入左弯。所有 13 节车厢都脱轨，许多车厢冲进弯道上的混凝土护栏，导致极高的伤亡。 224 名列车乘客中，80 人（36%）死亡，其余 144 人（4%）全部受伤。官方调查报告确定，这次事故是完全可以预防的。 2013-2016年西非埃博拉病毒病疫情以其范围、规模和复杂性而引人注目。本简报介绍了本次疫情爆发的一系列独特的流行病学特征。与 40 年来的一次同时爆发和此前的 23 次埃博拉病毒病疫情相比，这是唯一一次涉及多个国家并符合大流行资格的埃博拉病毒病疫情。从多个衡量标准来看，2013-2016 年的疫情爆发被准确地描述为最高级：就病例数和死亡人数而言，规模最大、死亡人数最多；持续时间最长；地理分布最为广泛，与疫情相关的病例发生在 10 个国家。相比之下，与其他 24 次疫情相比，2013-2016 年疫情的病死率要低得多。持续监测和公共卫生监测特别感兴趣的人群包括 17,000 多名“幸存者”，即成功康复的埃博拉患者。国际公共卫生部门采取了密集的应对措施，应对了这次疫情爆发带来的严峻挑战。通过应用多种疾病遏制和干预策略，2014 年中期埃博拉病例近乎指数级的增长速度被成功减缓、逆转并最终停止。
This disaster complexity case study examines Spain's deadliest train derailment that occurred on July 24, 2013 on the outskirts of Santiago de Compostela, Galicia, Spain. Train derailments are typically survivable. However, in this case, human error was a primary factor as the train driver powered the Alvia train into a left curve at more than twice the posted speed. All 13 cars came off the rails with many of the carriages careening into a concrete barrier lining the curve, leading to exceptional mortality and injury. Among the 224 train occupants, 80 (36%) were killed and all of the remaining 144 (4%) were injured. The official investigative report determined that this crash was completely preventable.The 2013-2016 West Africa Ebola virus disease epidemic was notable for its scope, scale, and complexity. This briefing presents a series of distinguishing epidemiological features that set this outbreak apart. Compared to one concurrent and 23 previous outbreaks of the disease over 40years, this was the only occurrence of Ebola virus disease involving multiple nations and qualifying as a pandemic. Across multiple measures of magnitude, the 2013-2016 outbreak was accurately described using superlatives: largest and deadliest in terms of numbers of cases and fatalities; longest in duration; and most widely dispersed geographically, with outbreak-associated cases occurring in 10 nations. In contrast, the case-fatality rate was much lower for the 2013-2016 outbreak compared to the other 24 outbreaks. A population of particular interest for ongoing monitoring and public health surveillance is comprised of more than 17,000 "survivors," Ebola patients who successfully recovered from their illness. The daunting challenges posed by this outbreak were met by an intensive international public health response. The near-exponential rate of increase of incident Ebola cases during mid-2014 was successfully slowed, reversed, and finally halted through the application of multiple disease containment and intervention strategies.