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4.
J Infect Public Health ; 14(3): 293-305, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33610938

RESUMO

BACKGROUND: Ebola virus (EBOV); a public health emergency of international concern,is known to pose threat of global outbreaks. EBOV has spread in African continent and due to unchecked international travel, importation of cases has been reported in different countries. In this alarming scenario, developing countries need to evaluate and upgrade their preparedness plan to contain the spread of EBOV. The present review lays down the updated preparedness plan for developing countries to contain future EBOV outbreaks. METHODS: The literature on EBOV outbreaks and preparedness strategies reported were searched on Pubmed and Google Scholar using the MeSH terms such as "Ebola virus disease, Epidemic, Outbreak, Imported case, Preparedness, Public health interventions" combined with Boolean operator (OR) for the period of 2011-2020. Additionally, World Health organization (WHO) and Centers for Disease Control & Prevention (CDC) websites were searched for the guidelines, reports, containment strategies, containment plan of countries, actions taken by countries and international partners, etc. RESULTS: The present review analyzed the EBOV outbreaks between 2011-2020 and containment strategies used by the affected countries. Based on the lessons learned from EBOV outbreaks and personal experience in infectious disease management, we have recommended a preparedness and response plan for EBOV containment in developing countries. CONCLUSION: Developing countries are particularly vulnerable to major outbreaks of EBOV due to increased international travel and unchecked transmission. The recommended preparedness plan will help developing counties to contain EBOV outbreaks in future.


Assuntos
Surtos de Doenças/prevenção & controle , Ebolavirus , Epidemias/prevenção & controle , Doença pelo Vírus Ebola/prevenção & controle , Vigilância em Saúde Pública/métodos , Defesa Civil , Busca de Comunicante , Países em Desenvolvimento , Doença pelo Vírus Ebola/epidemiologia , Humanos , Testes Imediatos
5.
Drugs Today (Barc) ; 57(1): 27-45, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33594388

RESUMO

Ebola virus (EBOV) causes outbreaks of lethal febrile illness in Africa, the largest of which resulted in over 11,000 deaths and represented a global public health threat. A new biomedical countermeasure, the recombinant vesicular stomatitis virus expressing EBOV glycoprotein (rVSV-EBOV) has been licensed (Ervebo; Merck & Co.). rVSV-EBOV is a replicative viral vaccine engineered to express EBOV antigen. Following rapid development stimulated by the large West African epidemic, an open-label, cluster-randomized ring vaccination trial called Ebola Ça Suffit! in Guinea and Sierra Leone demonstrated strong efficacy. The vaccine has a good safety profile, but is associated with self-limited arthritis and rash in a minority of recipients. rVSV-EBOV is highly immunogenic after a single intramuscular dose with antibody titers persisting for at least 2 years. In the recent outbreak in the Democratic Republic of the Congo, rVSV-EBOV was administered to more than 300,000 individuals and may have contributed, at least in part, to controlling the epidemic.


Assuntos
Vacinas contra Ebola , Ebolavirus , Doença pelo Vírus Ebola , Estomatite Vesicular , Animais , Glicoproteínas , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/prevenção & controle , Humanos
6.
Nature ; 590(7846): 468-472, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33505020

RESUMO

Neutralizing antibody function provides a foundation for the efficacy of vaccines and therapies1-3. Here, using a robust in vitro Ebola virus (EBOV) pseudo-particle infection assay and a well-defined set of solid-phase assays, we describe a wide spectrum of antibody responses in a cohort of healthy survivors of the Sierra Leone EBOV outbreak of 2013-2016. Pseudo-particle virus-neutralizing antibodies correlated with total anti-EBOV reactivity and neutralizing antibodies against live EBOV. Variant EBOV glycoproteins (1995 and 2014 strains) were similarly neutralized. During longitudinal follow-up, antibody responses fluctuated in a 'decay-stimulation-decay' pattern that suggests de novo restimulation by EBOV antigens after recovery. A pharmacodynamic model of antibody reactivity identified a decay half-life of 77-100 days and a doubling time of 46-86 days in a high proportion of survivors. The highest antibody reactivity was observed around 200 days after an individual had recovered. The model suggests that EBOV antibody reactivity declines over 0.5-2 years after recovery. In a high proportion of healthy survivors, antibody responses undergo rapid restimulation. Vigilant follow-up of survivors and possible elective de novo antigenic stimulation by vaccine immunization should be considered in order to prevent EBOV viral recrudescence in recovering individuals and thereby to mitigate the potential risk of reseeding an outbreak.


Assuntos
Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Convalescença , Ebolavirus/imunologia , Doença pelo Vírus Ebola/imunologia , Sobreviventes , Adolescente , Adulto , África Ocidental/epidemiologia , Anticorpos Neutralizantes/sangue , Anticorpos Neutralizantes/imunologia , Estudos de Coortes , Feminino , Meia-Vida , Doença pelo Vírus Ebola/sangue , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Testes de Neutralização , Fatores de Tempo , Viremia/sangue , Viremia/imunologia , Adulto Jovem
7.
Health Secur ; 19(1): 13-20, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33497272

RESUMO

Risk communication and community engagement are critical elements of epidemic response. Despite progress made in this area, few examples of regional feedback mechanisms in Africa provide information on community concerns and perceptions in real time. To enable humanitarian responders to move beyond disseminating messages, work in partnership with communities, listen to their ideas, identify community-led solutions, and support implementation of solutions systems need to be in place for documenting, analyzing, and acting on community feedback. This article describes how the International Federation of Red Cross and Red Crescent Societies and its national societies in sub-Saharan Africa have worked to establish and strengthen systems to ensure local intelligence and community insights inform operational decision making. As part of the COVID-19 response, a system was set up to collect, compile, and analyze unstructured community feedback from across the region. We describe how this system was set up based on a system piloted in the response to Ebola in the Democratic Republic of the Congo, which tools were adapted and shared across the region, and how the information gathered was used to shape and adapt the response of the Red Cross and Red Crescent Societies and the broader humanitarian response.


Assuntos
Participação da Comunidade/métodos , Retroalimentação , Cruz Vermelha , África ao Sul do Saara , Comunicação , Tomada de Decisões Gerenciais , Doença pelo Vírus Ebola/prevenção & controle , Humanos
8.
MMWR Recomm Rep ; 70(1): 1-12, 2021 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-33417593

RESUMO

This report summarizes the recommendations of the Advisory Committee on Immunization Practices (ACIP) for use of the rVSVΔG-ZEBOV-GP Ebola vaccine (Ervebo) in the United States. The vaccine contains rice-derived recombinant human serum albumin and live attenuated recombinant vesicular stomatitis virus (VSV) in which the gene encoding the glycoprotein of VSV was replaced with the gene encoding the glycoprotein of Ebola virus species Zaire ebolavirus. Persons with a history of severe allergic reaction (e.g., anaphylaxis) to rice protein should not receive Ervebo. This is the first and only vaccine currently licensed by the Food and Drug Administration for the prevention of Ebola virus disease (EVD). These guidelines will be updated based on availability of new data or as new vaccines are licensed to protect against EVD.ACIP recommends preexposure vaccination with Ervebo for adults aged ≥18 years in the U.S. population who are at highest risk for potential occupational exposure to Ebola virus species Zaire ebolavirus because they are responding to an outbreak of EVD, work as health care personnel at federally designated Ebola treatment centers in the United States, or work as laboratorians or other staff at biosafety level 4 facilities in the United States. Recommendations for use of Ervebo in additional populations at risk for exposure and other settings will be considered and discussed by ACIP in the future.


Assuntos
Vacinas contra Ebola/administração & dosagem , Doença pelo Vírus Ebola/prevenção & controle , Adulto , Comitês Consultivos , Doença pelo Vírus Ebola/epidemiologia , Humanos , Estados Unidos/epidemiologia , United States Food and Drug Administration
12.
Yale J Biol Med ; 93(4): 579-585, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-33005122

RESUMO

Not only do epidemics such as HIV/AIDS, Ebola Virus Disease (EVD), and the current Coronavirus Disease (COVID-19) cause the loss of millions of lives, but they also cost the global economy billions of dollars. Consequently, there is an urgent need to formulate interventions that will help control their spread and impact when they emerge. The education of young girls and women is one such historical approach. They are usually the vulnerable targets of disease outbreaks - they are most likely to be vehicles for the spread of epidemics due to their assigned traditional roles in resource-limited countries. Based on our work and the work of others on educational interventions, we propose six critical components of a cost-effective and sustainable response to promote girl-child education in resource-limited settings.


Assuntos
Doenças Transmissíveis Emergentes , Infecções por Coronavirus , Identidade de Gênero , Saúde Global , Educação em Saúde , Pandemias , Pneumonia Viral , Betacoronavirus , Criança , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/prevenção & controle , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Países em Desenvolvimento , Feminino , Saúde Global/economia , Saúde Global/educação , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Educação em Saúde/métodos , Educação em Saúde/organização & administração , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/prevenção & controle , Humanos , Determinação de Necessidades de Cuidados de Saúde , Pandemias/economia , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle
15.
PLoS Negl Trop Dis ; 14(9): e0008539, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32956374

RESUMO

During the initial phase of the 2014-2016 Ebola virus disease (EVD) outbreak in Monrovia, Liberia, all hospitals' isolation capacities were overwhelmed by the sheer caseload. As a stop-gap measure to halt transmission, Medecins sans Frontieres (MSF) distributed household disinfection kits to those who were at high risk of EVD contamination. The kit contained chlorine and personal protective materials to be used for the care of a sick person or the handling of a dead body. This intervention was novel and controversial for MSF. This paper shed the light on this experience of distribution in Monrovia and assess if kits were properly used by recipients. Targeted distribution was conducted to those at high risk of EVD (relatives of confirmed EVD cases) and health staff. Mass distributions were also conducted to households in the most EVD affected urban districts. A health promotion strategy focused on the purpose and use of the kit was integrated into the distribution. Follow-up phone calls to recipients were conducted to enquire about the use of the kit. Overall, 65,609 kits were distributed between September and November 2014. A total of 1,386 recipients were reached by phone. A total of 60 cases of sickness and/or death occurred in households who received a kit. The majority of these (46, 10%) were in households of relatives of confirmed EVD cases. Overall, usage of the kits was documented in 56 out of 60 affected households. Out of the 1322 households that did not experience sickness and/or death after the distribution, 583 (44%) made use of elements of the kit, mainly (94%) chlorine for hand-washing. At the peak of an EVD outbreak, the distribution of household disinfection kits was feasible and kits were appropriately used by the majority of recipients. In similar circumstances in the future, the intervention should be considered.


Assuntos
Desinfetantes , Promoção da Saúde/métodos , Doença pelo Vírus Ebola/prevenção & controle , Equipamento de Proteção Individual , Compostos Clorados , Surtos de Doenças/prevenção & controle , Ebolavirus , Humanos , Controle de Infecções/instrumentação , Controle de Infecções/métodos , Libéria
17.
PLoS Negl Trop Dis ; 14(9): e0008556, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32925964

RESUMO

Sexual transmission of Ebola virus (EBOV) is well established and has been implicated in multiple resurgences during the West African Ebola epidemic. Given the persistence of viral RNA in semen, guidelines from the World Health Organization (WHO) recommend abstinence or condom use for at least 1 year or until two semen PCR tests are negative. To better understand the impact of semen testing on sexual behavior, male EVD survivors were surveyed regarding their sexual behavior before and after semen testing. Of the 171 men who enrolled, 148 reported being sexually active following discharge from an ETU with 59% reporting episodes of condomless sex. At least one semen sample for testing was provided by 149 men and 13 of these men had EBOV RNA detected in their semen. When comparing sexual behaviors before and after semen testing, a positive semen test result had limited impact on behavior. Of those with seminal EBOV RNA detected, 61% reported no change in behavior pre- and post-semen testing with 46% engaging in condomless sex before and after testing and only 1 adopted safer sex behaviors following receipt of a positive result. Similarly, among men with undetectable EBOV in their semen, 66% reported no change in sexual behaviors with semen testing, with 55% forgoing condoms during sex. In only 11% was a negative semen result followed by abandoning condoms. There were no known sexual transmission events of Ebola virus in this cohort despite viral presence in semen during periods of condomless sex. This highlights the need to better understand the infectious potential of viral RNA persistence and determine what constitutes effective counseling for survivors and their partners.


Assuntos
Aconselhamento , RNA Viral/análise , Sêmen/virologia , Comportamento Sexual/psicologia , Adolescente , Adulto , Portador Sadio , Criança , Preservativos/estatística & dados numéricos , Ebolavirus , Doença pelo Vírus Ebola/prevenção & controle , Doença pelo Vírus Ebola/transmissão , Humanos , Libéria/epidemiologia , Masculino , Pessoa de Meia-Idade , Comportamento Sexual/estatística & dados numéricos , Inquéritos e Questionários , Sobreviventes
20.
Syst Rev ; 9(1): 173, 2020 08 08.
Artigo em Inglês | MEDLINE | ID: mdl-32771035

RESUMO

BACKGROUND: Healthcare workers (HCWs) are at particular risk during pandemics and epidemics of highly virulent diseases with significant morbidity and case fatality rate. These diseases include severe acute respiratory syndrome coronaviruses, SARS-CoV-1 and SARS-CoV-2, Middle Eastern Respiratory Syndrome (MERS), and Ebola. With the current (SARS-CoV-2) global pandemic, it is critical to delineate appropriate contextual respiratory protection for HCWs. The aim of this systematic review was to evaluate the effect of powered air-purifying respirators (PAPRs) as part of respiratory protection versus another device (egN95/FFP2) on HCW infection rates and contamination. METHODS: Our primary outcomes included HCW infection rates with SARS-CoV-2, SARS-CoV-1, Ebola, or MERS when utilizing PAPR. We included randomized controlled trials, non-randomized controlled trials, and observational studies. We searched the following databases: MEDLINE, EMBASE, and Cochrane Library (Cochrane Database of Systematic Reviews and CENTRAL). Two reviewers independently screened all citations, full-text articles, and abstracted data. Due to clinical and methodological heterogeneity, we did not conduct a meta-analysis. Where applicable, we constructed evidence profile (EP) tables for each individual outcome. Confidence in cumulative evidence for each outcome was classified according to the GRADE system. RESULTS: We identified 689 studies during literature searches. We included 10 full-text studies. A narrative synthesis was provided. Two on-field studies reported no difference in the rates of healthcare workers performing airway procedures during the care of critical patients with SARS-CoV-2. A single simulation trial reported a lower level of cross-contamination of participants using PAPR compared to alternative respiratory protection. There is moderate quality evidence that PAPR use is associated with greater heat tolerance but lower scores for mobility and communication ability. We identified a trend towards greater self-reported wearer comfort with PAPR technology in low-quality observational simulation studies. CONCLUSION: Field observational studies do not indicate a difference in healthcare worker infection utilizing PAPR devices versus other compliant respiratory equipment. Greater heat tolerance accompanied by lower scores of mobility and audibility in PAPR was identified. Further pragmatic studies are needed in order to delineate actual effectiveness and provider satisfaction with PAPR technology. SYSTEMATIC REVIEW REGISTRATION: The protocol for this review was prospectively registered with the International Register of Systematic Reviews identification number CRD42020184724 .


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Pessoal de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Dispositivos de Proteção Respiratória , Doenças Transmissíveis , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Doença pelo Vírus Ebola/prevenção & controle , Humanos , Pneumonia Viral/transmissão , Pneumonia Viral/virologia
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