The basic reproductive number of Ebola and the effects of public health measures: the cases of Congo and Uganda

Despite improved control measures, Ebola remains a serious public health risk in African regions where recurrent outbreaks have been observed since the initial epidemic in 1976. Using epidemic modeling and data from two well-documented Ebola outbreaks (Congo 1995 and Uganda 2000), we estimate the nu...

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Published inJournal of theoretical biology Vol. 229; no. 1; pp. 119 - 126
Main Authors Chowell, G., Hengartner, N.W., Castillo-Chavez, C., Fenimore, P.W., Hyman, J.M.
Format Journal Article
LanguageEnglish
Published England Elsevier Ltd 07.07.2004
Subjects
Congo
Disease Outbreaks
Ebola
Ebola virus
Ebolavirus - physiology
Hemorrhagic Fever, Ebola - prevention & control
Hemorrhagic Fever, Ebola - transmission
Humans
Interventions
Least-Squares Analysis
Models, Biological
Outbreak
Public Health Practice
Reproductive number
Time Factors
Uganda
Uganda
Congo
Congo, Dem. Rep
Reproductive number
Uganda
Outbreak
Interventions
Ebola
Congo
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Summary:Despite improved control measures, Ebola remains a serious public health risk in African regions where recurrent outbreaks have been observed since the initial epidemic in 1976. Using epidemic modeling and data from two well-documented Ebola outbreaks (Congo 1995 and Uganda 2000), we estimate the number of secondary cases generated by an index case in the absence of control interventions ( R 0). Our estimate of R 0 is 1.83 ( sd 0.06) for Congo (1995) and 1.34 ( sd 0.03) for Uganda (2000). We model the course of the outbreaks via an SEIR (susceptible-exposed-infectious-removed) epidemic model that includes a smooth transition in the transmission rate after control interventions are put in place. We perform an uncertainty analysis of the basic reproductive number R 0 to quantify its sensitivity to other disease-related parameters. We also analyse the sensitivity of the final epidemic size to the time interventions begin and provide a distribution for the final epidemic size. The control measures implemented during these two outbreaks (including education and contact tracing followed by quarantine) reduce the final epidemic size by a factor of 2 relative the final size with a 2-week delay in their implementation.
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ISSN:0022-5193
1095-8541
DOI:10.1016/j.jtbi.2004.03.006