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Dembek Z, Hadeed S, Tigabu B, Schwartz-Watjen K, Glass M, Dressner M, Frankel D, Blaney D, Eccles Iii TG, Chekol T, Owens A, Wu A. Ebola Virus Disease Outbreaks: Lessons Learned From Past and Facing Future Challenges. Mil Med 2024:usae204. [PMID: 38743575 DOI: 10.1093/milmed/usae204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/27/2024] [Accepted: 04/05/2024] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION The purpose of this review is to examine African Ebola outbreaks from their first discovery to the present, to determine how the medical and public health response has changed and identify the causes for those changes. We sought to describe what is now known about the epidemiology and spread of Ebola virus disease (EVD) from the significant outbreaks that have occurred and outbreak control methods applied under often challenging circumstances. Given the substantial role that the U.S. Government and the U.S. DoD have played in the 2014 to 2016 West African Ebola outbreak, the role of the DoD and the U.S. African Command in controlling EVD is described. MATERIALS AND METHODS A descriptive method design was used to collect and analyze all available Ebola outbreak literature using the PubMed database. An initial literature search was conducted by searching for, obtaining, and reading original source articles on all major global Ebola outbreaks. To conduct a focused search, we used initial search terms "Ebola outbreak," "Ebola virus disease," "Ebola response," "Ebola countermeasures," and also included each country's name where Ebola cases are known to have occurred. From the 4,673 unique articles obtained from this search and subsequent article title review, 307 articles were identified for potential inclusion. Following abstract and article review, 45 original source articles were used to compile the history of significant Ebola outbreaks. From this compilation, articles focused on each respective subsection of this review to delineate and describe the history of EVD and response, identifying fundamental changes, were obtained and incorporated. RESULTS We present known Ebola virus and disease attributes, including a general description, seasonality and location, transmission capacity, clinical symptoms, surveillance, virology, historical EVD outbreaks and response, international support for Ebola outbreak response, U.S. DoD support, medical countermeasures supporting outbreak response, remaining gaps to include policy limitations, regional instability, climate change, migration, and urbanization, public health education and infrastructure, and virus persistence and public awareness. CONCLUSIONS The health and societal impacts of EVD on Africa has been far-reaching, with about 35,000 cases and over 15,000 deaths, with small numbers of cases spreading globally. However, the history of combatting EVD reveals that there is considerable hope for African nations to quickly and successfully respond to Ebola outbreaks, through use of endemic resources including Africa CDC and African Partner Outbreak Response Alliance and the U.S. African Command with greater DoD reachback. Although there remains much to be learned about the Ebola virus and EVD including whether the potential for novel strains to become deadly emerging infections, invaluable vaccines, antivirals, and public health measures are now part of the resources that can be used to combat this disease.
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Affiliation(s)
- Zygmunt Dembek
- Support to DTRA Technical Reachback, Battelle Memorial Institute, Columbus, OH 43201, USA
| | - Steven Hadeed
- Support to DTRA Technical Reachback, Battelle Memorial Institute, Columbus, OH 43201, USA
| | - Bersabeh Tigabu
- Support to DTRA Technical Reachback, Global Systems Engineering (GSE), Alexandria, VA 22312, USA
| | - Kierstyn Schwartz-Watjen
- Support to DTRA Technical Reachback, Applied Research Associates (ARA), Albuquerque, NM 87110, USA
| | - Michael Glass
- SME Support to DTRA Technical Reachback, Manta Solutions, Charlottesville, VA 22901, USA
| | - Michelle Dressner
- Office of the Command Surgeon, U.S. Africa Command, APO, AE 09751, USA
| | - Dianne Frankel
- Office of the Command Surgeon, U.S. Africa Command, APO, AE 09751, USA
| | - David Blaney
- Office of the Command Surgeon, U.S. Africa Command, APO, AE 09751, USA
- Office of Readiness and Response, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | | | - Tesema Chekol
- Support to DTRA Technical Reachback, Battelle Memorial Institute, Columbus, OH 43201, USA
| | - Akeisha Owens
- Technical Reachback, Defense Threat Reduction Agency (DTRA), Fort Belvoir, VA 22060, USA
| | - Aiguo Wu
- Technical Reachback, Defense Threat Reduction Agency (DTRA), Fort Belvoir, VA 22060, USA
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Cooksey E, Verhougstraete M, Sneed SJ, Joseph CN, Blohm J, Paukgana M, Joshweseoma L, Sehongva G, Hadeed S, Harris R, O’Rourke MK. Drinking water and health assessment in a Northern Arizona community. Hum Ecol Risk Assess 2022; 29:157-173. [PMID: 37502498 PMCID: PMC10373582 DOI: 10.1080/10807039.2022.2146575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 07/29/2023]
Abstract
Arizona is a mineral rich state that relies on a mix of surface and ground water supplies for drinking water requirements. Small, rural water systems relying on groundwater frequently encounter elevated metal(loid) measures, particularly inorganic arsenic (As +3, +5). Such contaminant occurrences can be associated with adverse health outcomes including cancers. The Hopi Environmental Health Project examined drinking water quality and water consumption behaviors from 76 homes on Hopi lands over a four-year period. Water samples were analyzed for 28 elements and compared to US Environmental Protection Agengy (EPA) maximum contaminant levels (MCL). Only municipal/piped water had a mean arsenic concentration (11.01 μg/L) exceeding the MCL (10.0 μg/L). All other water types and elements occurred below MCL when detected. A lifetime cancer and hazard quotient associated with arsenic consumption through each water type was performed and piped/municipal water was found to carry the greatest risks (9.96 cases per 10,000 people). Results from this study showed the potential for multiple contaminants to be present in drinking water from Hopi lands and the need for further health assessment of routine exposure to low doses of contaminant mixtures through drinking water.
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Affiliation(s)
- Emily Cooksey
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Marc Verhougstraete
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Sam J. Sneed
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Carrie Nuva Joseph
- School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, AZ, USA
| | - Jonathan Blohm
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | | | | | | | - Steven Hadeed
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Robin Harris
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Mary Kay O’Rourke
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
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Lakshmanan S, Holda M, Shekar C, Dahal S, Onuegbu A, Kinninger A, Cai A, Golub I, Cherukuri L, Birudaraju D, Hamal S, Hadeed S, Roy S, Nelson J, Bhatt D, Budoff M. Association Of Thoracic And Pericardial Fat Volumes With Burden Of Baseline Coronary Plaque Components: Evaporate Trial. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Lakshmanan S, Dahal S, Onuegbu A, Cai A, Kinninger A, Golub I, Birudaraju D, Hadeed S, Cherukuri L, Roy S, Budoff M. Gender Differences In Coronary Plaque Volumes Across Age Groups In Type 2 Diabetes Mellitus. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Joseph B, Hadeed S, Haider AA, Ditillo M, Joseph A, Pandit V, Kulvatunyou N, Tang A, Latifi R, Rhee P. Obesity and trauma mortality: Sizing up the risks in motor vehicle crashes. Obes Res Clin Pract 2016; 11:72-78. [PMID: 26996285 DOI: 10.1016/j.orcp.2016.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 12/18/2015] [Accepted: 03/05/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Protective effects of safety devices in obese motorists in motor vehicle collisions (MVC) remain unclear. Aim of our study is to assess the association between morbid obesity and mortality in MVC, and to determine the efficacy of protective devices. We hypothesised that patients with morbid obesity will be at greater risk of death after MVC. METHODS A retrospective analysis of MVC patients (age ≥16 y.o.) was performed using the National Trauma Data Bank from 2007 to 2010. Patients with recorded comorbidity of morbid obesity (BMI≥40) were identified. Patients dead on arrival, with isolated traumatic brain injury, or incomplete data were excluded. The primary outcome was in-hospital mortality. Multivariate logistic regression was performed. RESULTS Our sample of 214,306 MVC occupants included 10,260 (4.8%) morbidly obese patients. Mortality risk was greatest among occupants with morbid obesity (ORcrude 1.74 [1.54-1.98]). After adjusting for patient demographics, safety device and physiological severity, odds of death was 1.52 [1.33-1.74] times greater in motorists with morbid obesity. Motorists with morbid obesity were at greater risk of death if no restraint (OR 1.84 [1.47-2.31]), seatbelt only (OR 1.48 [1.17-1.86]), or both seatbelt and airbag were present (OR 1.49 [1.13-1.97]). No significant differences in the odds of death exist between drivers with morbid obesity and non-morbidly obese drivers with only airbag deployment (OR 0.99 [0.65-1.51]). CONCLUSIONS Motorists with morbid obesity are at greater risk of MVC. Regardless of safety device use, occupants with morbid obesity remained at greater risk of death. Further research examining the effectiveness of vehicle restraints in drivers with morbid obesity is warranted.
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Affiliation(s)
- Bellal Joseph
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, United States.
| | - Steven Hadeed
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, United States
| | - Ansab A Haider
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, United States
| | - Michael Ditillo
- Department of Surgery, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA, United States
| | - Aly Joseph
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, United States
| | - Viraj Pandit
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, United States
| | - Narong Kulvatunyou
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, United States
| | - Andrew Tang
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, United States
| | - Rifat Latifi
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, United States
| | - Peter Rhee
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, United States
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Ditillo MF, Joseph B, Rhee PM, Pandit V, Castanon L, Hadeed S, Zangbar B, Friese RS, Philip A. Morbidly obese patients and motor vehicle collisions: are protective devices really protective? J Am Coll Surg 2014. [DOI: 10.1016/j.jamcollsurg.2014.07.789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Campen C, Armstrong E, Christian J, Hadeed S, Yeager A. Comparative Cost-Effectiveness Of Plerixafor Plus Granulocyte-Colony Stimulating Factor Versus Cyclophosphamide Plus Granulocyte-Colony Stimulating For Autologous Peripheral Blood Stem Cell Mobilization In Patients With Non-Hodgkin's Lymphoma. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.160] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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