A small outbreak of Ebola virus in Democratic Republic of the Congo is causing alarm among public health officials. A new study outlining containment strategies may help prevent an epidemic similar to the one that engulfed a number of western African countries two years ago.
In the timely report, published in the journal Proceedings of the National Academy of Sciences, an international team of researchers culled 37 studies for the most effective containment strategies.
Pennsylvania State University biology professor Katriona Shea, co-author of the study, said, “The best strategy that we found out of the five that we looked at were funeral containment and public information campaigns [for the] sort of care in the community.”
Ebola virus is spread through coming into contact with the bodily fluids of infected individuals.
Shea said investigators found the No. 1 way to prevent transmission was for loved ones to avoid washing bodies of the deceased prior to burial.
Shea said that information is best conveyed through public health campaigns that also stress the importance of handwashing, personal hygiene and self-quarantine in high-transmission areas.
Of all the models that the research team evaluated, the majority consistently ranked two commonly proposed management strategies as the most effective: reducing transmission rates at funerals and reducing transmission rates in the community.
For example, by ensuring safe burials, reducing risky behaviour, providing household sanitation kits, encouraging sick individuals to remain at home, and increased community awareness.
Strategies which focused on reducing transmission at hospitals and increasing hospitalisation rates, however, were not well ranked.
The new method provides a way to prioritise information gathering by applying a “value of information” analysis – a method used in economics and wildlife management to identify critical questions that need to be answered in order to improve decisions.
“Our approach synthesises data from many models and provides two important pieces of information,” said Shou-Li Li, postdoctoral researcher at Penn State. “It identifies the best course of action, given what we know now, and highlights the gaps in our knowledge that actually matter to the selection of intervention strategies.”
Because the approach can be used in real time as understanding of the outbreak evolves and as new models to understand outbreak dynamics are created, the researchers believe it can streamline the decision-making process for policymakers. “It could guide the management of outbreaks where rapid decision-making is critical, including diseases we know a lot about, like influenza, those that we don’t know a lot about, like Zika, and those that we don’t yet know exist,” Shea said.