Abstract
Author SummaryThere is considerable uncertainty regarding the steps needed to contain the ongoing Ebola crisis in West Africa, the timeline required to achieve control, and the projected burden of mortality. To address these issues, we develop a branching process model for Ebola transmission that focuses on offspring distributions (i.e., the numbers of new infections caused by each case). We use the model to assess the likely progression of Ebola in Liberia. The model assesses the feedback between new cases and hospital demand under a range of plausible intervention scenarios, particularly ramping-up of treatment facilities over time and increasing the number of individuals seeking hospital treatment through outreach and education. Transmission scenarios—to health care workers in hospitals, to caregivers in the community, to hospital visitors, and to individuals preparing bodies for funerals—are described by distinct offspring distributions based on available data. Results suggest that the outcome of the epidemic depends on both hospital capacity and individual behavior. Additionally, the model highlights the conditions under which transmission might have outpaced hospital capacity, and projects possible epidemic trajectories into 2015.
Highlights
The 2014 epidemic of Ebola virus in West Africa is an emerging public health and humanitarian crisis of epic dimensions [1]
We develop a branching process model for Ebola transmission that focuses on offspring distributions
Transmission scenarios—to health care workers in hospitals, to caregivers in the community, to hospital visitors, and to individuals preparing bodies for funerals— are described by distinct offspring distributions based on available data
Summary
The 2014 epidemic of Ebola virus in West Africa is an emerging public health and humanitarian crisis of epic dimensions [1]. This epidemic originated in an outbreak in Guéckédou, Guinea in December 2013. On 8 August 2014, WHO determined the epidemic to be a “Public Health Emergency of International Concern.”. This declaration obligated 194 signatory nations to participate in disease prevention, surveillance, control, response, and reporting [9]. Due to widespread under-reporting, the true number of cases is widely believed to be considerably higher
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