DOI: 10.1101/485821Dec 7, 2018Paper

Rigorous surveillance is necessary for high confidence in end-of-outbreak declarations for Ebola and other infectious diseases

BioRxiv : the Preprint Server for Biology
Robin ThompsonKatri Jalava

Abstract

The World Health Organization considers an Ebola outbreak to have ended once 42 days have passed since the last possible exposure to a confirmed case. Benefits of a quick end-of-outbreak declaration, such as reductions in trade/travel restrictions, must be balanced against the chance of flare-ups from undetected residual cases. We show how epidemiological modelling can be used to estimate the surveillance level required for decision-makers to be confident that an outbreak is over. Results from a simple model characterising an Ebola outbreak suggest that a surveillance sensitivity (i.e. case reporting percentage) of 79% is necessary for 95% confidence that an outbreak is over after 42 days without symptomatic cases. With weaker surveillance, unrecognised transmission may still occur: if the surveillance sensitivity is only 40%, then 62 days must be waited for 95% certainty. By quantifying the certainty in end-of-outbreak declarations, public health decision-makers can plan and communicate more effectively.

Related Concepts

Epidemiologic Studies
Ebola virus
Kidney Failure, Chronic
World Health Organization
Disease Transmission
Infection Surveillance
Decision

Related Feeds

BioRxiv & MedRxiv Preprints

BioRxiv and MedRxiv are the preprint servers for biology and health sciences respectively, operated by Cold Spring Harbor Laboratory. Here are the latest preprint articles (which are not peer-reviewed) from BioRxiv and MedRxiv.

Related Papers

JAMA : the Journal of the American Medical Association
Lawrence O Gostin
Disaster Medicine and Public Health Preparedness
Charles W BeadlingTrueman W Sharp
© 2021 Meta ULC. All rights reserved