Trying to care for family members with Ebola at home was one of the main risk factors for disease transmission, according to a new UK-led analysis.
The findings came as an international group of experts criticise the World Health Organisation today for its delay in declaring the outbreak in West Africa an emergency.
University of East Anglia specialists analysed risk factors for disease transmission and concluded there was little evidence of community transmission of the disease.
Their study confirms that funeral traditions were also a key risk factor in spread of disease.
The researchers from Norwich Medical School say theirs is the first systematic review of the risk factors for disease. It has been published in the International Journal of Epidemiology.
Professor Paul Hunter, who led the research, said: “This research strengthens the evidence base for dealing with this deadly disease. Importantly, we provide a more nuanced understanding of the risks – and particularly the risks associated with indirect contact.
“Our research shows that Ebola is not very infectious in the general community, and that it does require close contact with a known case.
“We found no evidence of risk associated with casual community contact with individuals who are not yet showing symptoms.
“Even living in the same house is not that risky providing you avoid direct contact.
“Many forms of contact such as conversation, sharing a meal, sharing a bed, and direct or indirect touching, are unlikely to result in disease transmission during incubation or early illness.”
He added: “Urgent diagnosis and hospitalisation really is the key to stopping the spread of this disease at least until a vaccine is widely available.
“Our work also shows that vaccination strategies in future outbreaks only need to be targeted at relatively close contacts of cases and health care workers.”
* In The Lancet today a group of 19 experts, led by Professor Peter Piot, director of the London School of Hygiene & Tropical Medicine, report their analysis of the handling of the outbreak.
They call for “major reform” of national and global systems to respond to epidemics.
One of the authors, Professor Ashish Ja, of the Harvard Medical School, Massachusetts, USA, said: “The most egregious failure was by WHO in the delay in sounding the alarm.
“People at WHO were aware that there was an Ebola outbreak that was getting out of control by spring and yet, it took until August to declare a public health emergency. The cost of the delay was enormous.”
Risk Factors for community Transmission of Filovirus infections (Ebola and Marburg): A Systematic Review and Meta-analysis International Journal of Epidemiology November 2015, 1�-15; doi: 10.1093/ije/dyv30
Will Ebola change the game? Ten essential reforms before the next pandemic. The report of the Harvard-LSHTM Independent Panel on the Global Response to Ebola. The Lancet 23 November 2015; doi: 10.1016/S0140-6736(15)00946-0 [abstract]
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