What is Ebola?

Patterns and conversational structure of knowledge sharing on Ebola virus disease among healthcare practitioners: Observations from a pilot study

This pilot study was designed to determine the conversational structure on Ebola Virus Disease (EVD), pattern of knowledge sharing and knowledge sharing behaviour of healthcare practitioners (HCP) on Medscape online network. The study was guided by Conversation Theory, and deployed a retrospective document/content analysis research design. Ninety-two comments from healthcare practitioners including 16 EVD newsposts out of 37 EVD news were randomly extracted from the network between 2014 and 2018. Extracted data were analysed using NVivo and Microsoft Excel applications. An EVD knowledge taxonomy was developed from the content mapping of EVD topics posted on the network. Results from the pilot study revealed that news on EVD were mostly on EVD outbreak management at the peak period of EVD outbreak in 2014. Also, the HCPs mostly engaged in knowledge sharing on issues relating to EVD risk. Findings revealed that the entire (37) newsposts were of interest to HCPs and they responded to 16 newsposts. There were three active and influential HCPs on the network. The novelty of this study stems from its focus on conversation patterns of HCP on online knowledge sharing using the variables of Conversation theory to examine their knowledge sharing behaviours. The outcome of the study could serve as a model for other studies on other trending viral diseases such as Coronavirus, Lassa Fever, Monkey pox, etc. This study thus recommends replicate analysis in the main study with a larger data set with further findings using network analysis and other statistical tools to examine the conversational structure on EVD and pattern of knowledge sharing among the HCPs.

The International Red Cross and Red Crescent Movement Response to the West African Ebola Outbreak 2014

The International Health Regulations 2005 (IHR) are the most up to date international legal rules on the control of infectious diseases and provide a unified code for infectious disease control. The IHR name the International Federation of the Red Cross (IFRC) as one of the international organisations with whom the WHO must cooperate and co-ordinate in implementing the IHR. It was organisations like the IFRC and MSF, that worked to stop the spread of Ebola following the outbreak in 2014. The focus of this chapter is the work of the IFRC during the Ebola outbreak. The IFRC carries out relief operations to assist victims of disasters, and combines this with development work to strengthen the capacities of its member National Societies. The IFRC’s work focuses on four core areas: promoting humanitarian values, disaster response, disaster preparedness, and health and community care. Combining a study of the IFRC as an organisation with a legal mandate of its own, elucidated in the Statutes of the International Red Cross and Red Crescent Movement, and the more general international legal framework, this chapter uses international law as a framework to reflect on the limits and effectiveness of legal measures in responding to Ebola. To this end, international law provides a logical and global method to respond to infectious diseases. This chapter finds that the mandate and practice of the IFRC in the response to Ebola provides material to critically analyse each of these parts in light of infectious disease proliferation in 2014–2016. Since outbreak was announced in early 2014 more than 10,000 Red Cross volunteers were trained in Ebola response. IFRC supported emergency operations in Guinea, Liberia, and Sierra Leone have targeted 23 million people.

Effects of vaccines in protecting against Ebola virus disease: protocol for a systematic review

INTRODUCTION

Ebola virus disease is one of the most devastating infectious diseases in the world with up to 90% case fatality observed. There are at least 13 candidate vaccines developed and being tested to prevent the occurrence of the Ebola virus disease. While none of these candidate vaccines has received regulatory approval for use, one candidate vaccine (rVSVΔG-ZEBOV-GP) has been granted access for emergency use. Two other candidate vaccines (GamEvac-Combi and Ad5-EBOV) have been licensed for emergency use in their countries of origin. The objective of this systematic review is to summarise the effects of the Ebola candidate vaccines in humans.

METHODS AND ANALYSIS

We will search for potentially eligible studies, with no language or date restrictions, in the Cochrane Central Register of Controlled Trials, PubMed, Scopus, the WHO International Clinical Trial Registry Platform, and reference lists of relevant publications. The Cochrane Database of Systematic Reviews (CDSR) and the Database of Abstracts of Reviews of Effect (DARE) will be searched for related reviews. Two review authors will independently screen search records, assess study eligibility, perform data extraction, and assess the risk of bias; and reconcile their findings. We will pool data from similar studies using Mantel-Haenszel's fixed-effect model.

ETHICS AND DISSEMINATION

This study is exempted from ethical consideration since the data collected are publicly available and at no point will confidential information from human participants be used. We will disseminate our results through publications in peer-reviewed journals and relevant conferences.

PROSPERO REGISTRATION NUMBER

CRD42018110505.

Ebola crisis response in the USA: Communication management and SOPs

This research focuses on the 2014 Ebola crisis response by emergency managers in the Dallas-Fort Worth (DFW) Metropolitan region in the State of Texas, U.S.A. It examines the patterns of crisis communication and the use of Standard Operating Procedures (SOPs) during the first month of the crisis. Primary data collected from 24 face-to-face interviews and 12 online surveys are analyzed. The research identifies elements contributing to organizational failures, which by their very nature gain public and media attention, and also explicates the less mentioned successful decisions made by response agencies in the DFW region. It is important to investigate both failures and successes to help inform organizational learning for better preparedness to future health crises. Findings suggest that, although there was a breakdown in communication between small city governments/ municipalities and higher levels of government at the State and Federal levels, prior training and collaborative relationships helped in improvised decision-making. Takeaways for practitioners include reiterating the importance of establishing SOPs, merits of flexibility, and improvisational decisions for shared learning.

The Impact of a Case of Ebola Virus Disease on Emergency Department Visits in Metropolitan Dallas-Fort Worth, TX, July, 2013-July, 2015: An Interrupted Time Series Analysis

Background:

The first Ebola virus disease (EVD) case in the United States (US) was confirmed September 30, 2014 in a man 45 years old. This event created considerable media attention and there was fear of an EVD outbreak in the US.

Methods:

This study examined whether emergency department (ED) visits changed in metropolitan Dallas-Fort Worth­­, Texas (DFW) after this EVD case was confirmed. Using Texas Health Services Region 2/3 syndromic surveillance data and focusing on DFW, interrupted time series analyses were conducted using segmented regression models with autoregressive errors for overall ED visits and rates of several chief complaints, including fever with gastrointestinal distress (FGI). Date of fatal case confirmation was the “event.”

Results:

Results indicated the event was highly significant for ED visits overall (P<0.05) and for the rate of FGI visits (P<0.0001). An immediate increase in total ED visits of 1,023 visits per day (95% CI: 797.0, 1,252.8) was observed, equivalent to 11.8% (95% CI: 9.2%, 14.4%) increase ED visits overall. Visits and the rate of FGI visits in DFW increased significantly immediately after confirmation of the EVD case and remained elevated for several months even adjusting for seasonality both within symptom specific chief complaints as well as overall.

Conclusions:

These results have implications for ED surge capacity as well as for public health messaging in the wake of a public health emergency.

Ebola virus - from neglected threat to global emergency state

OBJECTIVE

This review aims to update knowledge about Ebola virus disease (EVD) and recent advances in its diagnosis, treatment and prevention.

METHOD

A literature review was performed using the following databases: ISI Web of Knowledge, PubMed, IRIS, Scopus and the websites of the CDC and the WHO. Additionally, we have included articles and reports referenced in the basic literature search, and news that were considered relevant.

RESULTS

The Ebola virus, endemic in some parts of Africa, is responsible for a severe form of hemorrhagic fever in humans; bats are probably its natural reservoir. It is an extremely virulent virus and easily transmitted by bodily fluids. EVD's complex pathophysiology, characterized by immunosuppression as well as stimulation of an intense inflammatory response, results in a syndrome similar to septic shock. The diagnosis is difficult due to the initial symptoms that mimic other diseases. Despite the high mortality rates that can amount to 90%, a prophylaxis (chemical or vaccine) or effective treatment does not exist. Two vaccines and experimental therapies are being developed for the prevention and treatment of EVD.

CONCLUSION

Although the virus is known for about 40 years, the lack of knowledge obtained and the disinterest of government authorities in the countries involved justify the state of emergency currently exists regarding this infectious agent. Only the coordination of multiple entities and the effective commitment of the international community will facilitate the control and effective prevention of EVD.

Antibody-dependent-cellular-cytotoxicity-inducing antibodies significantly affect the post-exposure treatment of Ebola virus infection

Passive immunotherapy with monoclonal antibodies (mAbs) is an efficacious treatment for Ebola virus (EBOV) infections in animal models and humans. Understanding what constitutes a protective response is critical for the development of novel therapeutic strategies. We generated an EBOV-glycoprotein-pseudotyped Human immunodeficiency virus to develop sensitive neutralizing and antibody-dependent cellular cytotoxicity (ADCC) assays as well as a bioluminescent-imaging-based mouse infection model that does not require biosafety level 4 containment. The in vivo treatment efficiencies of three novel anti-EBOV mAbs at 12 h post-infection correlated with their in vitro anti-EBOV ADCC activities, without neutralizing activity. When they were treated with these mAbs, natural killer cell (NK)-deficient mice had lower viral clearance than WT mice, indicating that the anti-EBOV mechanism of the ADCC activity of these mAbs is predominantly mediated by NK cells. One potent anti-EBOV mAb (M318) displayed unprecedented neutralizing and ADCC activities (neutralization IC₅₀, 0.018 μg/ml; ADCC EC₅₀, 0.095 μg/ml). These results have important implications for the efficacy of antiviral drugs and vaccines as well as for pathogenicity studies of EBOV.