Risk factors for transmission of Ebola or Marburg virus disease: a systematic review and meta-analysis.
Risk factors for transmission of Ebola or Marburg virus disease: a systematic review and meta-analysis.
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DOI：
10.1093/ije/dyv307
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发表时间：
2016-02
影响因子：
7.7
通讯作者：
Hunter PR
中科院分区：
文献类型：
--
作者：
Brainard J;Hooper L;Pond K;Edmunds K;Hunter PR
背景资料：2013年开始在西非爆发的埃博拉病毒病是前所未有的，因为它在人口稠密的城市环境中传播，影响了成千上万的人。因此，需要严格审查以前的建议和准则，特别是关于不同情况下的传播风险的建议和准则。 方法：检索科学文献和灰色文献中关于任何非洲丝状病毒的文章。对文章进行了筛选，以获取有关传播的信息（尤其是患病率或比值比）。从符合条件的文章中提取数据，并采用部分荟萃分析进行叙述性总结。研究质量也进行了评估。 结果：从初始检索的6552份报告中共选择了31份报告。8篇论文给出了感染丝状病毒疾病的数字几率;另外23篇文章提供了关于个人如何传播的支持性观察。许多形式的接触（交谈、共餐、同床、直接或间接接触）不太可能在潜伏期或早期疾病期间导致疾病传播。在报告直接接触病例的家庭接触者中，发病率为32% [95%置信区间（CI）26-38%]。无直接接触的家庭成员之间的疾病传播风险较低（1%; 95% CI 0-5%）。在社区中照顾病例，特别是直到死亡，以及参加传统的葬礼仪式与获得疾病密切相关，可能是由于与病例或尸体的高度直接身体接触。 结论：除非通过密切接触，否则丝状病毒不太可能传播，特别是在急性疾病的最严重阶段。需要更多关于环境、亲密度和接触时间的数据，以提高疾病传播的几率。可能需要确定城市环境特有的风险因素。
Background: The Ebola virus disease outbreak that started in Western Africa in 2013 was unprecedented because it spread within densely populated urban environments and affected many thousands of people. As a result, previous advice and guidelines need to be critically reviewed, especially with regard to transmission risks in different contexts. Methods: Scientific and grey literature were searched for articles about any African filovirus. Articles were screened for information about transmission (prevalence or odds ratios especially). Data were extracted from eligible articles and summarized narratively with partial meta-analysis. Study quality was also evaluated. Results: A total of 31 reports were selected from 6552 found in the initial search. Eight papers gave numerical odds for contracting filovirus illness; 23 further articles provided supporting anecdotal observations about how transmission probably occurred for individuals. Many forms of contact (conversation, sharing a meal, sharing a bed, direct or indirect touching) were unlikely to result in disease transmission during incubation or early illness. Among household contacts who reported directly touching a case, the attack rate was 32% [95% confidence interval (CI) 26–38%]. Risk of disease transmission between household members without direct contact was low (1%; 95% CI 0–5%). Caring for a case in the community, especially until death, and participation in traditional funeral rites were strongly associated with acquiring disease, probably due to a high degree of direct physical contact with case or cadaver. Conclusions: Transmission of filovirus is unlikely except through close contact, especially during the most severe stages of acute illness. More data are needed about the context, intimacy and timing of contact required to raise the odds of disease transmission. Risk factors specific to urban settings may need to be determined.