miércoles, 17 de junio de 2015

Cluster of Ebola Virus Disease, Bong and Montserrado Counties, Liberia - Volume 21, Number 7—July 2015 - Emerging Infectious Disease journal - CDC

full-text ►

Cluster of Ebola Virus Disease, Bong and Montserrado Counties, Liberia - Volume 21, Number 7—July 2015 - Emerging Infectious Disease journal - CDC

Volume 21, Number 7—July 2015


Cluster of Ebola Virus Disease, Bong and Montserrado Counties, Liberia

Tolbert G. Nyenswah, Mosaka Fallah, Geoffrey M. Calvert, Stanley Duwor, E. Dutch Hamilton, Vishwesh Mokashi, Sampson Arzoaquoi, Emmanuel Dweh, Ryan Burbach, Diane Dlouhy, John E. Oeltmann, and Patrick K. MoonanComments to Author 
Author affiliations: Ministry of Health and Social Welfare, Monrovia, Liberia (T.G. Nyenswah, M. Fallah, S. Duwor)Centers for Disease Control and Prevention, Atlanta, Georgia, USA (G.M. Calvert, D. Dlouhy, J.E. Oeltmann, P.K. Moonan)United Nations International Children’s Emergency Fund, Monrovia (E.D. Hamilton);United States Navy, Silver Spring, Maryland, USA (V. Mokashi)Ministry of Health and Social Welfare–Bong County, Suokoko, Liberia (S. Arzoaquoi, E. Dweh)International Medical Corps, Los Angeles, California, USA (R. Burbach)


Lack of trust in government-supported services after the death of a health care worker with symptoms of Ebola resulted in ongoing Ebola transmission in 2 Liberia counties. Ebola transmission was facilitated by attempts to avoid cremation of the deceased patient and delays in identifying and monitoring contacts.
Reports of what has become the largest and longest epidemic of Ebola virus disease (EVD) began in March 2014 in West Africa (1). To interrupt Ebola transmission, health care authorities must promptly isolate and treat persons with EVD and identify and monitor exposed persons before symptoms develop (2). Effective contact tracing can limit the number of new cases; however, a single missed contact can result in many new cases (3). Gaps in contact tracing have been reported as challenges for infectious diseases such as sexually transmitted infections and tuberculosis (46). Because contact tracing requires patients to reveal names of persons with whom they have had contact and whom they may have exposed to illness, public health officials must quickly establish trust with sick persons and those at risk for disease (3,7).
We describe a cluster of EVD cases involving transmission across 2 jurisdictions in Liberia. Data for this report were derived from interviews, case reporting forms, treatment records, and laboratory results. This EVD cluster highlights the challenges associated with public health measures to interrupt transmission of Ebola.
Mr. Nyenswah is the Head Minister of Health for the Ministry of Health and Social Welfare, Monrovia, Liberia. He has led the Ebola response in Liberia since 2014.


We thank David Bell, Jacqueline Gindler, Olga Henao, Moses Kerkula-Jeuronlon, James Lange, Heather Lorenzen, Mutaawe Arthur Lubogo, Philip McKay, Sam Sampson, health care providers at the Bong County Ebola Treatment Unit, and the US Navy Mobile Laboratory (LCDR Micheal Gregory, LT James Regeimbal Jr., HM1 Yusupha Kah) stationed in Bong County.


  1. Dixon MGSchafer IJEbola viral disease outbreak—West Africa, 2014. MMWR Morb Mortal Wkly Rep2014;63:54851.PubMed
  2. Raabe VNMutyaba IRoddy PLutwama JJGeissler WBorchert MInfection control during filoviral hemorrhagic fever outbreaks: preferences of community members and health workers in Masindi, Uganda. Trans R Soc Trop Med Hyg2010;104:4850DOIPubMed
  3. World Health Organization. Contact tracing during an Ebola virus disease outbreak. 2014 [cited 2015 Apr 24].http://www.who.int/csr/resources/publications/ebola/contact-tracing-during-outbreak-of-ebola.pdf
  4. Oeltmann JEOren EHaddad MBLake LHarrington TAIjaz KTuberculosis outbreak in marijuana users, Seattle, Washington, 2004. Emerg Infect Dis2006;12:11569DOIPubMed
  5. Asghar RJPatlan DEMiner MCRhodes HDSolages AKatz DJLimited utility of name-based tuberculosis contact investigations among persons using illicit drugs: results of an outbreak investigation. J Urban Health2009;86:77680DOIPubMed
  6. Clarke JDistressed women take contact tracing seriously. BMJ2001;323:236DOIPubMed
  7. Oeltmann JEKammerer JSPevzner ESMoonan PKTuberculosis and substance abuse in the United States, 1997–2006. Arch Intern Med.2009;169:18997DOIPubMed
  8. Centers for Disease Control and Prevention. Rapid response to Ebola outbreaks in remote Areas—Liberia, August–December, 2014. MMWR Morb Mortal Wkly Rep. 2015;64:188–92.
  9. National Public Radio. ‘Ebola must go!’ —and so must prejudice against survivors. December 9, 2014[cited 2014 Dec 9].http://www.npr.org/blogs/goatsandsoda/2014/12/09/369382711/-ebola-must-go-and-so-must-prejudice-against-survivors



Suggested citation for this article: Nyenswah TG, Fallah M, Calvert GM, Duwor S, Hamilton ED, Mokashi V et al. Cluster of Ebola virus disease, Bong and Montserrado Counties, Liberia. Emerg Infect Dis. 2015 July [date cited]. http://dx.doi.org/10.3201/eid2107.150511
DOI: 10.3201/eid2107.150511

No hay comentarios:

Publicar un comentario