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Ebola 2014 ? New Challenges, New Global Response and Responsibility (August 20, 2014)
Thomas R. Frieden, M.D., M.P.H., Inger Damon, M.D., Ph.D., Beth P. Bell, M.D., M.P.H., Thomas Kenyon, M.D., M.P.H., and Stuart Nichol, Ph.D.
August 20, 2014DOI: 10.1056/NEJMp1409903
Excerpts
Since Ebola virus was first identified in 1976, no previous Ebola outbreak has been as large or persistent as the current epidemic, and none has spread beyond East and Central Africa.1 To date, more than 1000 people, including numerous health care workers, have been killed by Ebola virus disease (EVD) in 2014, and the number of cases in the current outbreak now exceeds the number from all previous outbreaks combined. . .
Stopping the outbreak at the source in Africa will take many months. Three core interventions have stopped every previous outbreak and can stop this one as well: exhaustive case and contact finding, effective response to patients and the community, and preventive interventions.
Identifying infected persons quickly requires accessible diagnostic and treatment facilities. In the current outbreak, the number of patients has far exceeded local capacity, which has resulted in a vicious cycle in which more cases lead to overloading of facilities which leads to more cases. . . .
Responding to cases involves isolation and treatment of patients, contact tracing, and monitoring each contact for 21 days after exposure. It is difficult to isolate and care for patients with EVD, not because the disease is particularly infectious or the virus particularly hardy, but because a single lapse can be devastating. Neither negative air flow nor special respirators are essential; meticulous attention to gown, glove, mask, and eye protection and great care while removing protective equipment are key. . . .
There are three key preventive interventions. The first is meticulous infection control in health care settings. The greatest risk of transmission is not from patients with diagnosed infection but from delayed detection and isolation. . . .
These are straightforward interventions, but Ebola virus is a formidable enemy. If a single case is missed, a single contact becomes ill and isn't isolated, or a single lapse in infection control or funeral-practice safety occurs, another chain of transmission can start. . . .
link:http://www.nejm.org/doi/full/10.1056/NEJMp1409903?query=featured_infectious-disease#t=article
Thomas R. Frieden, M.D., M.P.H., Inger Damon, M.D., Ph.D., Beth P. Bell, M.D., M.P.H., Thomas Kenyon, M.D., M.P.H., and Stuart Nichol, Ph.D.
August 20, 2014DOI: 10.1056/NEJMp1409903
Excerpts
Since Ebola virus was first identified in 1976, no previous Ebola outbreak has been as large or persistent as the current epidemic, and none has spread beyond East and Central Africa.1 To date, more than 1000 people, including numerous health care workers, have been killed by Ebola virus disease (EVD) in 2014, and the number of cases in the current outbreak now exceeds the number from all previous outbreaks combined. . .
Stopping the outbreak at the source in Africa will take many months. Three core interventions have stopped every previous outbreak and can stop this one as well: exhaustive case and contact finding, effective response to patients and the community, and preventive interventions.
Identifying infected persons quickly requires accessible diagnostic and treatment facilities. In the current outbreak, the number of patients has far exceeded local capacity, which has resulted in a vicious cycle in which more cases lead to overloading of facilities which leads to more cases. . . .
Responding to cases involves isolation and treatment of patients, contact tracing, and monitoring each contact for 21 days after exposure. It is difficult to isolate and care for patients with EVD, not because the disease is particularly infectious or the virus particularly hardy, but because a single lapse can be devastating. Neither negative air flow nor special respirators are essential; meticulous attention to gown, glove, mask, and eye protection and great care while removing protective equipment are key. . . .
There are three key preventive interventions. The first is meticulous infection control in health care settings. The greatest risk of transmission is not from patients with diagnosed infection but from delayed detection and isolation. . . .
These are straightforward interventions, but Ebola virus is a formidable enemy. If a single case is missed, a single contact becomes ill and isn't isolated, or a single lapse in infection control or funeral-practice safety occurs, another chain of transmission can start. . . .
link:http://www.nejm.org/doi/full/10.1056/NEJMp1409903?query=featured_infectious-disease#t=article