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. 2016 Nov 9:6:36301.
doi: 10.1038/srep36301.

Emergence of Ebola virus disease in a french acute care setting: a simulation study based on documented inter-individual contacts

Philippe Vanhems  1   2   3 , Rosette Von Raesfeldt  3   4   5   6 , René Ecochard  3   4   5   6 , Nicolas Voirin  3   4   5   6
Affiliations

Emergence of Ebola virus disease in a french acute care setting: a simulation study based on documented inter-individual contacts

Philippe Vanhems et al. Sci Rep. .

Abstract

The potential spread of nosocomial Ebola virus disease (EVD) in non-outbreak areas is not known. The objective was to use detailed contact data on patients and healthcare workers (HCW) to estimate emergence probability and secondary incident cases (SIC) of EVD after hospitalization of an index case with undetected EVD. Contact data were collected through RFID devices used by patients and HCW during hospital care. A "susceptible-exposed-infected" model was used. Emergence probability, ranged from 7% to 84%. A plateau around 84% was observed. Emergence probability was proportional to time exposed to the dry phase of patients with nonspecific symptoms. Nurses were at higher risk of nosocomial EVD than physicians with around 60% emergence probability in this subgroup. The risk of nosocomial EVD in non-outbreak areas might be substantial if no preventive measures are implemented when asymptomatic patients or those with mild symptoms are hospitalized.

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Figures

Figure 1
Figure 1. Schematic diagram of the “susceptible -infected” model of EVD emergence in a single hospital ward.
The index patient may transmit the disease to S individuals while in I1 but as soon as he/she enters the I2 stage, he/she is assumed to be 100% detected and isolated with no delay. In other words, once the index case enters the I2 compartment, we consider that he/she do not participate in transmission anymore because of 100% effective control measures implemented.
Figure 2
Figure 2. Overall emergence probability and overall number of SIC in a single hospital ward according to EVD transmission probability.
Figure 3
Figure 3. Emergence probability of EVD in a single hospital ward according to transmission probability and number of nurse (NUR) contacts with patients (PAT) by population.
Figure 4
Figure 4. Emergence probability of EVD in a single hospital ward according to transmission probability and duration of the dry phase of the index case.
See this image and copyright information in PMC

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