Potential for large outbreaks of Ebola virus disease.
Bottom Line: By fitting a mathematical model to time series stratified by disease onset, outcome and source of infection, we were able to estimate several epidemiological quantities that have previously proved challenging to measure, including the contribution of hospital and community infection to transmission.Our analysis suggests that the person-to-person reproduction number was 1.34 (95% CI: 0.92-2.11) in the early part of the outbreak.Using stochastic simulations we demonstrate that the same epidemiological conditions that were present in 1976 could have generated a large outbreak purely by chance.
Affiliation: Centre for the Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom. Electronic address: email@example.com.Show MeSH
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Mentions: To examine the possible range of dynamics for an outbreak with the same characteristics as the one observed in the 1976 Yambuku outbreak, we ran 10,000 stochastic simulations of our model under the maximum a posteriori probability estimates of the parameters (Fig. 5). We found that although most simulated epidemics were of similar size to the one in 1976, major outbreaks could also occur. Although only 3% of simulations resulted in a major outbreak (i.e. more than 1000 cases), the cumulated number of cases could reach up to several thousands in the worst-case scenario (Fig. 6A). In the context of the 1976 epidemic, such a major outbreak could have arisen if – by chance – a sufficiently high number of infections had occurred before the change of community contact and hospital seeking behaviours.
Affiliation: Centre for the Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom. Electronic address: firstname.lastname@example.org.