Global Health

Introduction: The 2014 Ebola outbreak in West Africa raised many questions about the control of infectious disease in an increasingly connected global society. Limited availability of contact information made contact tracing diffcult or impractical in combating the outbreak. 

Methods: We consider the development of multi-scale public health strategies that act on individual and community levels. We simulate policies for community-level response aimed at early screening all members of a community, as well as travel restrictions to prevent inter-community transmission. 

Non-invasive contact with Ebola survivors 6 weeks after the virus has been cleared poses little risk for healthcare workers, though contact with semen, ocular humor, and cerebrospinal fluid requires Ebola-appropriate precautions, according to a study yesterday in The Lancet Infectious Diseases.

A cross-sectional cohort study evaluated 555 specimens from 112 Ebola survivors without fever seeking follow-up care at a clinic in Freetown, Sierra Leone, from Apr 2 to Jun 16, 2015. Almost one third of survivors (34, or 30%) were under the age of 16, and 50 (40%) were male.

Samples were obtained from the armpit (103 specimens), blood (93), conjunctiva (92), forehead (54), mouth (105), rectum (17), semen (1), urine (69), and vagina (21). The median time from Ebola treatment unit discharge to specimen collection was 142 days.

Some of the final cases of Ebola in Sierra Leone were transmitted via unconventional routes, such as semen and breastmilk, according to the largest analysis to date of the tail-end of the epidemic.

An international team of researchers has produced a detailed picture of the latter stages of the outbreak in Sierra Leone, using real-time sequencing of Ebola virus genomes carried out in a temporary laboratory in the country.

The deadly virus is passed on through contact with body fluids and killed more than 11,000 in ravaged western Africa and the US in 2014 and 2015.

The epidemic has now been declared over but researchers have monitored 450 survivors of both sexes for a year, testing tears, saliva, faeces, vaginal fluids and semen every three months thereafter.