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Estimating the number of secondary Ebola cases resulting from an unsafe burial and risk factors for transmission during the West Africa Ebola epidemic.

Abstract 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.
PMID
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Authors

Mayor MeshTerms

Burial

Keywords
Journal Title plos neglected tropical diseases
Publication Year Start




PMID- 28640823
OWN - NLM
STAT- MEDLINE
DA  - 20170622
DCOM- 20170714
LR  - 20170714
IS  - 1935-2735 (Electronic)
IS  - 1935-2727 (Linking)
VI  - 11
IP  - 6
DP  - 2017 Jun
TI  - Estimating the number of secondary Ebola cases resulting from an unsafe burial
      and risk factors for transmission during the West Africa Ebola epidemic.
PG  - e0005491
LID - 10.1371/journal.pntd.0005491 [doi]
AB  - 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.
FAU - Tiffany, Amanda
AU  - Tiffany A
AUID- ORCID: http://orcid.org/0000-0001-5827-5363
AD  - Epicentre, Geneva, Switzerland.
FAU - Dalziel, Benjamin D
AU  - Dalziel BD
AD  - Department of Integrative Biology, Oregon State University, Corvallis, Oregon,
      United States of America.
AD  - Department of Mathematics, Oregon State University, Corvallis, Oregon, United
      States of America.
FAU - Kagume Njenge, Hilary
AU  - Kagume Njenge H
AD  - International Federation of the Red Cross and Red Crescent Societies, Monrovia,
      Liberia.
FAU - Johnson, Ginger
AU  - Johnson G
AD  - Anthrologica, Dallas, Texas, United States of America.
FAU - Nugba Ballah, Roselyn
AU  - Nugba Ballah R
AD  - Liberian Red Cross, Monrovia, Liberia.
FAU - James, Daniel
AU  - James D
AD  - Sierra Leone Red Cross Society, Freetown, Sierra Leone.
FAU - Wone, Abdoulaye
AU  - Wone A
AD  - International Federation of the Red Cross and Red Crescent Societies, Conakry,
      Guinea.
FAU - Bedford, Juliet
AU  - Bedford J
AD  - Anthrologica, Oxford, United Kingdom.
FAU - McClelland, Amanda
AU  - McClelland A
AD  - International Federation of the Red Cross and Red Crescent Societies, Geneva,
      Switzerland.
LA  - eng
PT  - Journal Article
DEP - 20170622
PL  - United States
TA  - PLoS Negl Trop Dis
JT  - PLoS neglected tropical diseases
JID - 101291488
SB  - IM
MH  - Adult
MH  - Africa, Western/epidemiology
MH  - *Burial/methods/standards
MH  - Female
MH  - Hemorrhagic Fever, Ebola/*epidemiology/*transmission
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Risk Factors
MH  - Young Adult
PMC - PMC5480832
EDAT- 2017/06/24 06:00
MHDA- 2017/07/15 06:00
CRDT- 2017/06/23 06:00
PHST- 2017/01/04 [received]
PHST- 2017/03/14 [accepted]
AID - 10.1371/journal.pntd.0005491 [doi]
AID - PNTD-D-16-02270 [pii]
PST - epublish
SO  - PLoS Negl Trop Dis. 2017 Jun 22;11(6):e0005491. doi:
      10.1371/journal.pntd.0005491. eCollection 2017 Jun.