1. Ebola: Towards establishing a holistic approach to achieve effective management and control
1Muhammed Afolabi, 1Anna Roca, 1Kalifa Bojang, 2Egeruan Imoukhuede, 1Umberto D’Alessandro, 1,3 Beate Kampmann
1Medical Research Council Unit, Fajara, The Gambia.2 The Jenner Institute, University of Oxford, United Kingdom, 3 Imperial College, London, United Kingdom.
Introduction
Model for potential strategies for holistic management
Hypothesis of Ebola virus transmission at the
human-animal interface
Methods
The current Ebola outbreak in West Africa has already caused substantial mortality and dire human and economic consequences
Represents an alarming public health threat in the region and beyond
Precise factors that result in an Ebola virus outbreak are less understood
The effect of environmental changes on the Ebola outbreak in West Africa and disease dynamic is also unclear
Broad examination of the complex and interwoven ecology and socio-economic factors may improve understanding on the current and future trends of EVD
Comprehensive search of available current evidence on the Ebola virus, its disease pathogenesis, risk factors, dynamics of transmission, and epidemic control
Experiential learning during emergency preparedness planning for EVD documented
Evidence analyzed and a model for holistic management developed
Priority areas of future research identified
Findings
Knowledge of the virus transmission and its transmission dynamics is still evolving
Need for prioritized use of experimental drugs in the face of limited supply
Changing dogma to accelerate development of vaccines and therapeutics
Removing obstacles to accelerate the pace of Ebola vaccine and treatment trials
Strengthening health systems and enforcing safe burial practices
Area of future research: identification of surrogate markers for tracing bodily fluids, host immune mechanism in viral shedding, correlates of protection, effect of genetic modification on the virus, appropriate risk communication strategies, development of more effective contact tracing strategies
Conclusions
Epidemic curves in humans and animals at the
human-animal interface
Socio-cultural factors are the critical determinants for the success and failure of the control efforts
Integration of research with capacity development of HCPs will facilitate the discovery, development, manufacture and delivery of quality, easy to use, affordable interventions and technologies for effective management and control
Multi-pronged holistic approach appears to be more pragmatic in addressing the Ebola epidemic
Bibliography
Roca A, Afolabi MO, Saidu Y, Kampmann B. Ebola: A holistic approach is required to achieve effective management and control. Journal of Allergy and Clinical Immunology.2015;135:856-67
Geographical distribution of outbreaks in Africa