Ebola hemorrhagic fever outbreaks: strategies for effective epidemic management, containment and control

Ebola hemorrhagic fever, caused by the highly virulent RNA virus of the filoviridae family, has become one of the world's most feared pathogens. The virus induces acute fever and death, often associated with hemorrhagic symptoms in up to 90% of infected patients. The known sub-types of the virus are Zaire, Sudan, Taï Forest, Bundibugyo and Reston Ebola viruses. In the past, outbreaks were limited to the East and Central African tropical belt with the exception of Ebola Reston outbreaks that occurred in animal facilities in the Philippines, USA and Italy. The on-going outbreak in West Africa that is causing numerous deaths and severe socio-economic challenges has resulted in widespread anxiety globally. This panic may be attributed to the intense media interest, the rapid spread of the virus to other countries like United States and Spain, and moreover, to the absence of an approved treatment or vaccine. Informed by this widespread fear and anxiety, we analyzed the commonly used strategies to manage and control Ebola outbreaks and proposed new approaches that could improve epidemic management and control during future outbreaks. We based our recommendations on epidemic management practices employed during recent outbreaks in East, Central and West Africa, and synthesis of peer-reviewed publications as well as published "field" information from individuals and organizations recently involved in the management of Ebola epidemics. The current epidemic management approaches are largely "reactive", with containment efforts aimed at halting spread of existing outbreaks. We recommend that for better outcomes, in addition to "reactive" interventions, "pre-emptive" strategies also need to be instituted. We conclude that emphasizing both "reactive" and "pre-emptive" strategies is more likely to lead to better epidemic preparedness and response at individual, community, institutional, and government levels, resulting in timely containment of future Ebola outbreaks.

Ébola: Epidemia en el Siglo XXI / Ebola: Epidemic in the twenty-first Century

La fiebre hemorrágica por virus Ébola, que pertenece a la familia de Filovirus, afecta tanto a animales como a humanos, estos ultimos llegan a ser huéspedes accidentales de dicho virus. Existen actualmente 4 especies de la familia Filoviridae, del cual el más mortal para la especie humana es el Zaire Ébola virus. La transmisión se da por contacto directo con tejido animal o humano infectado, a si mismo por el consumo de los mismos. El cuadro clínico se manifiesta después de un corto periodo de incubación (2-21 días), cursando con fiebre, malestar general, cefaleas, vómitos, diarreas y hemorragias generalizadas. Actualmente está en investigación el tratamiento mostrando resultados alentadores.

Ebola hemorrhagic fever virus, which belongs to the Filovirus famiia affects both animals and humans, this last become accidental hosts of the virus. There are currently 4 Filoviridae species of the family, of which the most deadly for the human species is the Zaire Ebola virus. Transmission occurs by direct contact with infected animal or human tissue itself by eating them. The symptoms appear after a short incubation period (2-21 days), studying with fever, malaise, headache, vomiting and diarrhea and bleeding generalized.