Retrospective Analysis of the 2014-2015 Ebola Epidemic in Liberia
Retrospective Analysis of the 2014-2015 Ebola Epidemic in Liberia
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DOI：
10.4269/ajtmh.15-0328
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发表时间：
2016-04-01
影响因子：
3.3
通讯作者：
Galvani, Alison P.
中科院分区：
文献类型：
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作者：
Atkins, Katherine E.;Pandey, Abhishek;Galvani, Alison P.
2014-2015年的埃博拉疫情是该病历史上持续时间最长、破坏性最强的一次。为了防止未来发生如此规模的疫情，必须了解导致疾病最终得到控制的原因。在这里，我们评估了利比里亚疫情期间埃博拉疫情在国家和地方层面的变化。我们使用根据2014年6月9日至12月31日期间流行病学数据校准的传播模型来估计社区和医院传播的程度。我们发现，尽管当地的流行模式各不相同，但在所有分析的县中，社区传播均减少了 40-80%。我们的模型表明，疫情的逐渐减少是通过减少社区传播来实现的，而不是通过无症状感染和未报告病例来积累免疫个体。尽管利比里亚大多数县的传播减少发生在医院容量大幅扩张和家庭防护套件分发之前，但仍然很难将干预措施的存在与埃博拉发病率的减少联系起来。
The 2014-2015 Ebola epidemic has been the most protracted and devastating in the history of the disease. To prevent future outbreaks on this scale, it is imperative to understand the reasons that led to eventual disease control. Here, we evaluated the shifts of Ebola dynamics at national and local scales during the epidemic in Liberia. We used a transmission model calibrated to epidemiological data between June 9 and December 31, 2014, to estimate the extent of community and hospital transmission. We found that despite varied local epidemic patterns, community transmission was reduced by 40-80% in all the counties analyzed. Our model suggests that the tapering of the epidemic was achieved through reductions in community transmission, rather than accumulation of immune individuals through asymptomatic infection and unreported cases. Although the times at which this transmission reduction occurred in the majority of the Liberian counties started before any large expansion in hospital capacity and the distribution of home protection kits, it remains difficult to associate the presence of interventions with reductions in Ebola incidence.