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​Local, national, and regional viral haemorrhagic fever pandemic potential in Africa: a multistage analysis (The Lancet, October 11, 2017)

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  • ​Local, national, and regional viral haemorrhagic fever pandemic potential in Africa: a multistage analysis (The Lancet, October 11, 2017)

    Local, national, and regional viral haemorrhagic fever pandemic potential in Africa: a multistage analysis

    David M Pigott, DPhil, Aniruddha Deshpande, MPH, Ian Letourneau, BA, Chloe Morozoff, MPH, Robert C Reiner Jr, PhD, Moritz U G Kraemer, DPhil, Shannon E Brent, MPH, Isaac I Bogoch, MD, Kamran Khan, MD, Molly H Biehl, MPH, Roy Burstein, BA, Lucas Earl, MSc, Nancy Fullman, MPH, Jane P Messina, PhD, Adrian Q N Mylne, MSc, Catherine L Moyes, PhD, Freya M Shearer, BSc, Samir Bhatt, DPhil, Oliver J Brady, DPhil, Peter W Gething, PhD, Daniel J Weiss, PhD, Andrew J Tatem, PhD, Luke Caley, MSc, Tom De Groeve, PhD, Luca Vernaccini, MSc, Nick Golding, DPhil, Prof Peter Horby, PhD, Jens H Kuhn, MD, Sandra J Laney, PhD, Edmond Ng, MSc, Prof Peter Piot, PhD, Prof Osman Sankoh, DSc, Prof Christopher J L Murray, PhD, Prof Simon I Hay, DSc'Correspondence information about the author Prof Simon I HayEmail the author Prof Simon I Hay
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    Published: 11 October 2017
    Open Access
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    DOI: http://dx.doi.org/10.1016/S0140-6736(17)32092-5 |
    Open access funded by Bill & Melinda Gates Foundation
    ...
    Background
    Predicting when and where pathogens will emerge is difficult, yet, as shown by the recent Ebola and Zika epidemics, effective and timely responses are key. It is therefore crucial to transition from reactive to proactive responses for these pathogens. To better identify priorities for outbreak mitigation and prevention, we developed a cohesive framework combining disparate methods and data sources, and assessed subnational pandemic potential for four viral haemorrhagic fevers in Africa, Crimean?Congo haemorrhagic fever, Ebola virus disease, Lassa fever, and Marburg virus disease.
    ...
    Findings
    We found epidemic potential to vary within Africa, with regions where viral haemorrhagic fever outbreaks have previously occurred (eg, western Africa) and areas currently considered non-endemic (eg, Cameroon and Ethiopia) both ranking highly. Tracking transitions between stages showed how an index case can escalate into a widespread epidemic in the absence of intervention (eg, Nigeria and Guinea). Our analysis showed Chad, Somalia, and South Sudan to be highly susceptible to any outbreak at subnational levels.
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