Ebola virus disease in West Africa--the first 9 months of the epidemic and forward projections.
Ebola virus disease in West Africa--the first 9 months of the epidemic and forward projections.
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DOI：
10.1056/nejmoa1411100
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发表时间：
2014-10-16
期刊：
影响因子：
--
通讯作者：
Yoti Z
中科院分区：
文献类型：
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作者：
WHO Ebola Response Team;Aylward B;Barboza P;Bawo L;Bertherat E;Bilivogui P;Blake I;Brennan R;Briand S;Chakauya JM;Chitala K;Conteh RM;Cori A;Croisier A;Dangou JM;Diallo B;Donnelly CA;Dye C;Eckmanns T;Ferguson NM;Formenty P;Fuhrer C;Fukuda K;Garske T;Gasasira A;Gbanyan S;Graaff P;Heleze E;Jambai A;Jombart T;Kasolo F;Kadiobo AM;Keita S;Kertesz D;Koné M;Lane C;Markoff J;Massaquoi M;Mills H;Mulba JM;Musa E;Myhre J;Nasidi A;Nilles E;Nouvellet P;Nshimirimana D;Nuttall I;Nyenswah T;Olu O;Pendergast S;Perea W;Polonsky J;Riley S;Ronveaux O;Sakoba K;Santhana Gopala Krishnan R;Senga M;Shuaib F;Van Kerkhove MD;Vaz R;Wijekoon Kannangarage N;Yoti Z
2014年3月23日，世界卫生组织（WHO）获悉几内亚爆发埃博拉病毒病（EVD）。8月8日，世卫组织宣布疫情为“国际关注的突发公共卫生事件”。截至2014年9月14日，西非5个国家--几内亚、利比里亚、尼日利亚、塞内加尔和塞拉利昂--共报告了4507例可能和确诊病例，包括2296例埃博拉病毒病（扎伊尔种）死亡。我们分析了截至9月14日在几内亚、利比里亚、尼日利亚和塞拉利昂收集的3343例确诊和667例可能的埃博拉病例的详细数据子集。大多数患者的年龄为15至44岁（49.9%为男性），我们估计，在已知感染临床结局的人群中，病死率为70.8%（95%置信区间[CI]，69至73）。感染过程，包括体征和症状、潜伏期（11.4天）和连续间隔（15.3天），与以往埃博拉病毒病暴发中报告的情况相似。根据指数增长的初始阶段，几内亚的估计基本繁殖数（R 0）为1.71（95%CI，1.44至2.01），利比里亚为1.83（95%CI，1.72至1.94），塞拉利昂为2.02（95%CI，1.79至2.26）。估计的当前再生产数（R）为1.81（95% CI，1.60 - 2.03）几内亚，1.51（95% CI，1.41至1.60），利比里亚和1.38塞拉利昂（95% CI，1.27至1.51）;相应的倍增时间为15.7天（95% CI，12.9 - 20.3），利比里亚为23.6天（95% CI，20.2 - 28.2），塞拉利昂为30.2天（95% CI，23.6 - 42.3）。假设本次疫情控制措施不变，到2014年11月2日，预计几内亚累计报告确诊和可能病例5740例，利比里亚累计报告确诊和可能病例9890例，塞拉利昂累计报告确诊和可能病例5000例，合计超过2万例。这些数据表明，如果控制措施没有大幅改善，预计未来几个月，埃博拉病毒病的病例和死亡人数将继续从每周数百人增加到数千人。
On March 23, 2014, the World Health Organization (WHO) was notified of an out-break of Ebola virus disease (EVD) in Guinea. On August 8, the WHO declared the epidemic to be a “public health emergency of international concern.” By September 14, 2014, a total of 4507 probable and confirmed cases, including 2296 deaths from EVD (Zaire species) had been reported from five countries in West Africa — Guinea, Liberia, Nigeria, Senegal, and Sierra Leone. We analyzed a detailed subset of data on 3343 confirmed and 667 probable Ebola cases collected in Guinea, Liberia, Nigeria, and Sierra Leone as of September 14. The majority of patients are 15 to 44 years of age (49.9% male), and we estimate that the case fatality rate is 70.8% (95% confidence interval [CI], 69 to 73) among persons with known clinical outcome of infection. The course of infection, including signs and symptoms, incubation period (11.4 days), and serial interval (15.3 days), is similar to that reported in previous outbreaks of EVD. On the basis of the initial periods of exponential growth, the estimated basic reproduction numbers (R0) are 1.71 (95% CI, 1.44 to 2.01) for Guinea, 1.83 (95% CI, 1.72 to 1.94) for Liberia, and 2.02 (95% CI, 1.79 to 2.26) for Sierra Leone. The estimated current reproduction numbers (R) are 1.81 (95% CI, 1.60 to 2.03) for Guinea, 1.51 (95% CI, 1.41 to 1.60) for Liberia, and 1.38 (95% CI, 1.27 to 1.51) for Sierra Leone; the corresponding doubling times are 15.7 days (95% CI, 12.9 to 20.3) for Guinea, 23.6 days (95% CI, 20.2 to 28.2) for Liberia, and 30.2 days (95% CI, 23.6 to 42.3) for Sierra Leone. Assuming no change in the control measures for this epidemic, by November 2, 2014, the cumulative reported numbers of confirmed and probable cases are predicted to be 5740 in Guinea, 9890 in Liberia, and 5000 in Sierra Leone, exceeding 20,000 in total. These data indicate that without drastic improvements in control measures, the numbers of cases of and deaths from EVD are expected to continue increasing from hundreds to thousands per week in the coming months.