埃博拉病毒病小常识

自2014年3月以来,西非四国——几内亚、利比里亚、塞拉利昂和尼日利亚相继出现了埃博拉病毒病疫情（以往称为埃博拉病毒性出血热）。截至2014年8月15日,全球共报告病例2127例,死亡1145例。埃博拉病毒病是世界上最凶猛的疾病之一,病死率高达90％。以下就埃博拉病毒病常见的问题作一简单介绍。     

援塞医疗队抗击埃博拉疫情的做法

目的：总结第二批中国援塞医疗队执行抗击埃博拉疫情任务的经验教训,为日后医疗分队执行类似任务提供参考。方法以第二批中国援塞医疗队的抽组、训练、派遣、执行任务等各环节的信息记录为基本资料,采用回顾性研究方法,对开展工作的情况进行分析和归纳。结果第二批援塞医疗队先期抽组参训65人,后方培训工作23天,实际派出41人,其中先遣队8人,在疫区工作66天,累计接诊疑似患者372人次,治疗确诊病例130例,其中治愈14例。结论科学合理的人员配置是完成任务的基本前提;全面严格的教育培训是完成任务的必备基础;细致充分的物资准备是完成任务的重要保障;打破常规、因地制宜的工作模式是完成任务的制胜法宝。     

西非埃博拉病毒病疫情的反思与启示

概述了西非埃博拉病毒病疫情流行现状及其特点,并进一步分析了疫情大规模流行的原因和不良影响。通过回顾和分析文献,认真反思此次西非埃博拉病毒病疫情从发生、传播、暴发、流行和应急处置的各环节中,疫情发生当事国及国际社会的反应及其应对措施,进而从中吸取教训,获得有益启示,为有效应对区域性和国际性重大突发公共卫生事件提供科学依据。     

埃博拉病毒病的发病机制和诊疗策略

埃博拉病毒是一种强致死性病原体,可引起类似于感染性休克的严重出血热——埃博拉病毒病。埃博拉病毒病在2014年西非地区发生历史上最大的大流行疫情,其临床特点为凝血功能障碍、毛细血管渗漏综合征和休克。迄今为止尚无针对性抗病毒药物治疗。本文从病原学、感染途径、发病机制、临床特征、辅助检查、诊断及治疗特点等方面探讨埃博拉病毒病的机制和诊疗策略。     

美国疾病预防控制中心(CDC)对埃博拉病毒病疫情的主要防控措施概述

2014年西非地区出现埃博拉病毒病暴发疫情之后,美国疾病预防控制中心(Centers for Disease Control and Prevention,CDC)作为其国内主要的公共卫生机构采取了多项措施在境内外控制疫情。本文分析美国CDC的主要措施,从而得出对我国公共卫生机构的启示。     

埃博拉病毒病患者围手术期医务人员感染防护方案探讨

<正>西非地区暴发的埃博拉病毒病(Ebola virus disease,EVD)是一次全球性的公共卫生灾难,截至2015年3月8日,仅西非3国已报道感染24 247人,其中840名医护人员感染,死亡491名,医务人员的病死率达58.45%[1]。面对威胁,我们应全面地分析如何降低医护人员感染的风险,特别是针对外科高危操作环节。一方面,一定数量的EVD确诊患     

Post-Ebola Syndrome,Sierra Leone

Thousands of persons have survived Ebola virus disease. Almost all survivors describe symptoms that persist or develop after hospital discharge. A cross-sectional survey of the symptoms of all survivors from the Ebola treatment unit (ETU) at 34th Regimental Military Hospital, Freetown, Sierra Leone (MH34), was conducted after discharge at their initial follow-up appointment within 3 weeks after their second negative PCR result. From its opening on December 1, 2014, through March 31, 2015, the MH34 ETU treated 84 persons (8–70 years of age) with PCR-confirmed Ebola virus disease, of whom 44 survived. Survivors reported musculoskeletal pain (70%), headache (48%), and ocular problems (14%). Those who reported headache had had lower admission cycle threshold Ebola PCR than did those who did not (p<0.03). This complete survivor cohort from 1 ETU enables analysis of the proportion of symptoms of post-Ebola syndrome. The Ebola epidemic is waning, but the effects of the disease will remain.     

Ebola Virus Glycoprotein IgG Seroprevalence in Community Previously Affected by Ebola,Sierra Leone

We explored the association of Ebola virus antibody seropositivity and concentration with potential risk factors for infection. Among 1,282 adults and children from a community affected by the 2014–2016 Ebola outbreak in Sierra Leone, 8% were seropositive for virus antibodies but never experienced disease symptoms. Antibody concentration increased with age.     

Knowledge and attitudes about Ebola vaccine among the general population in Sierra Leone

BackgroundClinical trials of Ebola vaccine are ongoing. Before it becomes commercially available, understanding the Ebola vaccine-related knowledge and attitude of the general population is imperative to developing an effective vaccine coverage strategy.MethodsWe conducted a survey including 400 participants from general communities of the West Area Rural District, Sierra Leone. Knowledge and attitudes about Ebola vaccine were investigated, and the determinants of having knowledge and a positive attitude toward accepting vaccination were identified.ResultsOver half (55.8%) of the participants were aware of Ebola vaccine. About 60% of the participants were willing to be study subjects if the Ebola vaccine clinical trial were conducted in their communities. Most of the participants (72.5%) were willing to take Ebola vaccination if it was free of charge. Given that the vaccination was not free, the proportion willing to pay a fee to take the vaccination declined dramatically to 26.6%. Using a forward step-wise logistic model, monthly salary was identified as the single determinant (OR for every 100,000 Leones increase: 1.17, 95%CI: 1.04–1.31) for awareness of Ebola vaccine, which was identified as the determinant (OR: 1.88, 95%CI: 1.17–3.02) for free vaccination uptake willingness. The combination of monthly salary, monthly average income of family members and their interaction was found to be associated with charged vaccination uptake willingness.DiscussionMeasures are still needed to promote the Ebola vaccine awareness and knowledge updating. Free or low-priced vaccine could increase the vaccination acceptability of the general community population significantly.     

Evaluation of the Benefits and Risks of Introducing Ebola Community Care Centers,Sierra Leone

In some parts of western Africa, Ebola treatment centers (ETCs) have reached capacity. Unless capacity is rapidly scaled up, the chance to avoid a generalized Ebola epidemic will soon diminish. The World Health Organization and partners are considering additional Ebola patient care options, including community care centers (CCCs), small, lightly staffed units that could be used to isolate patients outside the home and get them into care sooner than otherwise possible. Using a transmission model, we evaluated the benefits and risks of introducing CCCs into Sierra Leone’s Western Area, where most ETCs are at capacity. We found that use of CCCs could lead to a decline in cases, even if virus transmission occurs between CCC patients and the community. However, to prevent CCC amplification of the epidemic, the risk of Ebola virus–negative persons being exposed to virus within CCCs would have to be offset by a reduction in community transmission resulting from CCC use.     

Perceptions and acceptability of an experimental Ebola vaccine among health care workers,frontline staff,and the general public during the 2014–2015 Ebola outbreak in Sierra Leone

Introduction

Experimental Ebola vaccines were introduced during the 2014–2015 Ebola outbreak in West Africa. Planning for the Sierra Leone Trial to Introduce a Vaccine against Ebola (STRIVE) was underway in late 2014. We examined hypothetical acceptability and perceptions of experimental Ebola vaccines among health care workers (HCWs), frontline workers, and the general public to guide ethical communication of risks and benefits of any experimental Ebola vaccine.