Strategies for containing Ebola in West Africa

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Science  21 Nov 2014:
Vol. 346, Issue 6212, pp. 991-995
DOI: 10.1126/science.1260612

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The ongoing Ebola outbreak poses an alarming risk to the countries of West Africa and beyond. To assess the effectiveness of containment strategies, we developed a stochastic model of Ebola transmission between and within the general community, hospitals, and funerals, calibrated to incidence data from Liberia. We find that a combined approach of case isolation, contact-tracing with quarantine, and sanitary funeral practices must be implemented with utmost urgency in order to reverse the growth of the outbreak. As of 19 September, under status quo, our model predicts that the epidemic will continue to spread, generating a predicted 224 (134 to 358) daily cases by 1 December, 280 (184 to 441) by 15 December, and 348 (249 to 545) by 30 December.

Recharging Ebola mitigation measures

Effective drugs and vaccines for Ebola virus are not available, so what can be done? Pandey et al. used a mathematical model to analyze transmission in different scenarios: the community, hospitals, and at funerals. Achieving full compliance with any single control measure, such as case isolation, is impossible under prevailing conditions. However, with a minimum of 60% compliance, a combination of case isolation, hygienic burial, and contact tracing could reduce daily case numbers to single figures in 5 to 6 months. Success will also require persistence and sensitivity to local customs.

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