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Transmissibility and Pathogenicity of Ebola Virus: A Systematic Review and
Meta-analysis of Household Secondary Attack Rate and Asymptomatic Infection
#MMPMID26932131
Dean NE
; Halloran ME
; Yang Y
; Longini IM
Clin Infect Dis
2016[May]; 62
(10
): 1277-1286
PMID26932131
show ga
Factors affecting our ability to control an Ebola outbreak include
transmissibility of the virus and the proportion of transmissions occurring
asymptomatically. We performed a meta-analysis of Ebola household secondary
attack rate (SAR), disaggregating by type of exposure (direct contact, no direct
contact, nursing care, direct contact but no nursing care). The estimated overall
household SAR is 12.5% (95% confidence interval [CI], 8.6%-16.3%). Transmission
was driven by direct contact, with little transmission occurring in its absence
(SAR, 0.8% [95% CI, 0%-2.3%]). The greatest risk factor was the provision of
nursing care (SAR, 47.9% [95% CI, 23.3%-72.6%]). There was evidence of a decline
in household SAR for direct contact between 1976 and 2014 (P = .018). We estimate
that 27.1% (95% CI, 14.5%-39.6%) of Ebola infections are asymptomatic. Our
findings suggest that surveillance and containment measures should be effective
for controlling Ebola.
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