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The Epidemiological Presentation Pattern of Ebola Virus Disease Outbreaks: Changes from 1976 to 2019

Published online by Cambridge University Press:  18 March 2020

Pedro Arcos González Open the ORCID record for Pedro Arcos González [Opens in a new window] ,
Ángel Fernández Camporro ,
Anneli Eriksson Open the ORCID record for Anneli Eriksson [Opens in a new window]  and
Carmen Alonso Llada
Pedro Arcos González*
Affiliation:
Unit for Research in Emergency and Disaster, Faculty of Medicine, University of Oviedo, Oviedo, Spain
Ángel Fernández Camporro
Affiliation:
Unit for Research in Emergency and Disaster, Faculty of Medicine, University of Oviedo, Oviedo, Spain
Anneli Eriksson
Affiliation:
Centre for Research on Health Care in Disasters, Karolinska Institutet, Stockholm, Sweden
Carmen Alonso Llada
Affiliation:
Unit for Research in Emergency and Disaster, Faculty of Medicine, University of Oviedo, Oviedo, Spain
*
Correspondence: Prof. Pedro Arcos González, MD, PhD, Unit for Research in Emergency and Disaster, Faculty of Medicine, University of Oviedo, Campus del Cristo, E-33006 – Oviedo, Spain, E-mail: arcos@uniovi.es
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Abstract

Introduction:

Ebola Virus Disease (EVD) is the international health emergency paradigm due to its epidemiological presentation pattern, impact on public health, resources necessary for its control, and need for a national and international response.

Study Objective:

The objective of this work is to study the evolution and progression of the epidemiological presentation profile of Ebola disease outbreaks since its discovery in 1976 to the present, and to explore the possible reasons for this evolution from different perspectives.

Methods:

Retrospective observational study of 38 outbreaks of Ebola disease occurred from 1976 through 2019, excluding laboratory accidents. United Nations agencies and programs; Ministries of Health; the US Centers for Disease Control and Prevention (CDC); ReliefWeb; emergency nongovernmental organizations; and publications indexed in PubMed, EmBase, and Clinical Key have been used as sources of data. Information on the year of the outbreak, date of beginning and end, duration of the outbreak in days, number of cases, number of deaths, population at risk, geographic extension affected in Km2, and time of notification of the first cases to the World Health Organization (WHO) have been searched and analyzed.

Results:

Populations at risk have increased (P = .024) and the geographical extent of Ebola outbreaks has grown (P = .004). Reporting time of the first cases of Ebola to WHO has been reduced (P = .017) and case fatality (P = .028) has gone from 88% to 62% in the period studied. There have been differences (P = .04) between the outbreaks produced by the Sudan and Zaire strains of the virus, both in terms of duration and case fatality ratio (Sudan strain 74.5 days on average and 62.7% of case fatality ratio versus Zaire strain with 150 days on average and 55.4% case fatality ratio).

Conclusion:

There has been a change in the epidemiological profile of the Ebola outbreaks from 1976 through 2019 with an increase in the geographical extent of the outbreaks and the population at risk, as well as a significant decrease in the outbreaks case fatality rate. There have been advances in the detection and management capacity of outbreaks, and the notification time to the WHO has been reduced. However, there are social, economic, cultural, and political obstacles that continue to greatly hinder a more efficient epidemiological approach to Ebola disease, mainly in Central Africa.

Keywords

Ebola diseaseepidemiologyoutbreak
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 35 , Issue 3 , June 2020 , pp. 247 - 253
Copyright
© World Association for Disaster and Emergency Medicine 2020

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