Abstract
The West Africa Ebola virus epidemic now appears to be coming to an end. In the proposed model, we simulate changes in population behavior that help to explain the observed transmission dynamics. We introduce an EVD transmission model accompanied by a model of social mobilization. The model was fit to Lofa County, Liberia through October 2014, using weekly counts of new cases reported by the US CDC. In simulation studies, we analyze the dynamics of the disease transmission with and without population behavior change, given the availability of beds in Ebola treatment units (ETUs) estimated from observed data. Only the model scenario that included individuals' behavioral change achieved a good fit to the observed case counts. Although the capacity of the Lofa County ETUs greatly increased in mid-August, our simulations show that the expansion was insufficient to alone control the outbreak. Modeling the entire outbreak without considering behavior change fit the data poorly, and extrapolating from early data without taking behavioral changes into account led to a prediction of exponential outbreak growth, contrary to the observed decline. Education and awareness-induced behavior change in the population was instrumental in curtailing the Ebola outbreak in Lofa County and is likely playing an important role in stopping the West Africa epidemic altogether.
Highlights
It has long been recognized that human behavior can have a dramatic influence on the spread of infectious disease [1,2]
Scenario 3 took into account gradually increasing awareness of Ebola virus disease (EVD) in the community, in addition to the expansion of the Lofa County Ebola Treatment Units (ETUs), achieving an excellent fit to the observed weekly cases
Our findings suggest that behavioral change in the population of Lofa County was instrumental in bringing the outbreak under control
Summary
It has long been recognized that human behavior can have a dramatic influence on the spread of infectious disease [1,2]. Ebola virus outbreaks are brought under control by rapidly isolating symptomatic individuals, tracing their contacts, safely burying or cremating fatalities 9, and changing population behavior toward better protective practices These infection control measures require increased medical staff and hospital capacity and the support and cooperation of the population [10,11]. We present a networkbased model of EVD transmission, in which we combine isolation of cases in ETUs with a change in the public’s cooperation with preventative measures to control EVD spread This model builds upon previous models that merge disease transmission and social processes [16,17,18,19], including several models that address social processes affecting emerging infectious disease transmission [20,21,22]. We can isolate the effect of social mobilization efforts aimed at increasing treatmentseeking behavior
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