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2017 ; 11
(6
): e0005491
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Estimating the number of secondary Ebola cases resulting from an unsafe burial
and risk factors for transmission during the West Africa Ebola epidemic
#MMPMID28640823
Tiffany A
; Dalziel BD
; Kagume Njenge H
; Johnson G
; Nugba Ballah R
; James D
; Wone A
; Bedford J
; McClelland A
PLoS Negl Trop Dis
2017[Jun]; 11
(6
): e0005491
PMID28640823
show ga
BACKGROUND: Safely burying Ebola infected individuals is acknowledged to be
important for controlling Ebola epidemics and was a major component of the
2013-2016 West Africa Ebola response. Yet, in order to understand the impact of
safe burial programs it is necessary to elucidate the role of unsafe burials in
sustaining chains of Ebola transmission and how the risk posed by activities
surrounding unsafe burials, including care provided at home prior to death, vary
with human behavior and geography. METHODOLOGY/PRINCIPAL FINDINGS: Interviews
with next of kin and community members were carried out for unsafe burials in
Sierra Leone, Liberia and Guinea, in six districts where the Red Cross was
responsible for safe and dignified burials (SDB). Districts were randomly
selected from a district-specific sampling frame comprised of villages and
neighborhoods that had experienced cases of Ebola. An average of 2.58 secondary
cases were potentially generated per unsafe burial and varied by district (range:
0-20). Contact before and after death was reported for 142 (46%) contacts.
Caregivers of a primary case were 2.63 to 5.92 times more likely to become EVD
infected compared to those with post-mortem contact only. Using these estimates,
the Red Cross SDB program potentially averted between 1,411 and 10,452 secondary
EVD cases, reducing the epidemic by 4.9% to 36.5%. CONCLUSIONS/SIGNIFICANCE: SDB
is a fundamental control measure that limits community transmission of Ebola;
however, for those individuals having contact before and after death, it was
impossible to ascertain the exposure that caused their infection. The number of
infections prevented through SDB is significant, yet greater impact would be
achieved by early hospitalization of the primary case during acute illness.