Imperial College London


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BibTex format

author = {International, Ebola Response Team and Agua-Agum, J and Ariyarajah, A and Aylward, B and Bawo, L and Bilivogui, P and Blake, IM and Brennan, RJ and Cawthorne, A and Cleary, E and Clement, P and Conteh, R and Cori, A and Dafae, F and Dahl, B and Dangou, JM and Diallo, B and Donnelly, CA and Dorigatti, I and Dye, C and Eckmanns, T and Fallah, M and Ferguson, NM and Fiebig, L and Fraser, C and Garske, T and Gonzalez, L and Hamblion, E and Hamid, N and Hersey, S and Hinsley, W and Jambei, A and Jombart, T and Kargbo, D and Keita, S and Kinzer, M and George, FK and Godefroy, B and Gutierrez, G and Kannangarage, N and Mills, HL and Moller, T and Meijers, S and Mohamed, Y and Morgan, O and Nedjati-Gilani, G and Newton, E and Nouvellet, P and Nyenswah, T and Perea, W and Perkins, D and Riley, S and Rodier, G and Rondy, M and Sagrado, M and Savulescu, C and Schafer, IJ and Schumacher, D and Seyler, T and Shah, A and Van, Kerkhove MD and Wesseh, CS and Yoti, Z},
doi = {10.1371/journal.pmed.1002170},
journal = {PLOS Medicine},
title = {Exposure patterns driving Ebola transmissions in West Africa: a retrospective observational study},
url = {},
volume = {13},
year = {2016}

RIS format (EndNote, RefMan)

AB - BACKGROUND: The ongoing West African Ebola epidemic began in December 2013 in Guinea, probably from a single zoonotic introduction. As a result of ineffective initial control efforts, an Ebola outbreak of unprecedented scale emerged. As of 4 May 2015, it had resulted in more than 19,000 probable and confirmed Ebola cases, mainly in Guinea (3,529), Liberia (5,343), and Sierra Leone (10,746). Here, we present analyses of data collected during the outbreak identifying drivers of transmission and highlighting areas where control could be improved.METHODS AND FINDINGS: Over 19,000 confirmed and probable Ebola cases were reported in West Africa by 4 May 2015. Individuals with confirmed or probable Ebola ("cases") were asked if they had exposure to other potential Ebola cases ("potential source contacts") in a funeral or non-funeral context prior to becoming ill. We performed retrospective analyses of a case line-list, collated from national databases of case investigation forms that have been reported to WHO. These analyses were initially performed to assist WHO's response during the epidemic, and have been updated for publication. We analysed data from 3,529 cases in Guinea, 5,343 in Liberia, and 10,746 in Sierra Leone; exposures were reported by 33% of cases. The proportion of cases reporting a funeral exposure decreased over time. We found a positive correlation (r = 0.35, p < 0.001) between this proportion in a given district for a given month and the within-district transmission intensity, quantified by the estimated reproduction number (R). We also found a negative correlation (r = -0.37, p < 0.001) between R and the district proportion of hospitalised cases admitted within ≤4 days of symptom onset. These two proportions were not correlated, suggesting that reduced funeral attendance and faster hospitalisation independently influenced local transmission intensity. We were able to identify 14% of potential source contacts as cases in the
AU - International,Ebola Response Team
AU - Agua-Agum,J
AU - Ariyarajah,A
AU - Aylward,B
AU - Bawo,L
AU - Bilivogui,P
AU - Blake,IM
AU - Brennan,RJ
AU - Cawthorne,A
AU - Cleary,E
AU - Clement,P
AU - Conteh,R
AU - Cori,A
AU - Dafae,F
AU - Dahl,B
AU - Dangou,JM
AU - Diallo,B
AU - Donnelly,CA
AU - Dorigatti,I
AU - Dye,C
AU - Eckmanns,T
AU - Fallah,M
AU - Ferguson,NM
AU - Fiebig,L
AU - Fraser,C
AU - Garske,T
AU - Gonzalez,L
AU - Hamblion,E
AU - Hamid,N
AU - Hersey,S
AU - Hinsley,W
AU - Jambei,A
AU - Jombart,T
AU - Kargbo,D
AU - Keita,S
AU - Kinzer,M
AU - George,FK
AU - Godefroy,B
AU - Gutierrez,G
AU - Kannangarage,N
AU - Mills,HL
AU - Moller,T
AU - Meijers,S
AU - Mohamed,Y
AU - Morgan,O
AU - Nedjati-Gilani,G
AU - Newton,E
AU - Nouvellet,P
AU - Nyenswah,T
AU - Perea,W
AU - Perkins,D
AU - Riley,S
AU - Rodier,G
AU - Rondy,M
AU - Sagrado,M
AU - Savulescu,C
AU - Schafer,IJ
AU - Schumacher,D
AU - Seyler,T
AU - Shah,A
AU - Van,Kerkhove MD
AU - Wesseh,CS
AU - Yoti,Z
DO - 10.1371/journal.pmed.1002170
PY - 2016///
SN - 1549-1277
TI - Exposure patterns driving Ebola transmissions in West Africa: a retrospective observational study
T2 - PLOS Medicine
UR -
UR -
UR -
VL - 13
ER -