Factors underlying Ebola virus infection among health workers, Kenema, Sierra Leone, 2014-2015

Mikiko Senga; Kimberly Pringle; Andrew Ramsay; David M. Brett-Major; Robert A. Fowler; Issa French; Mohamed Vandi; Josephine Sellu; Christian Pratt; Josephine Saidu; Nahoko Shindo; Daniel G. Bausch; Sierra Leone Kenema District Task Force and Kenema General Hospital

doi:10.1093/cid/ciw327

Factors underlying Ebola virus infection among health workers, Kenema, Sierra Leone, 2014-2015

Mikiko Senga^*, Kimberly Pringle, Andrew Ramsay, David M. Brett-Major, Robert A. Fowler, Issa French, Mohamed Vandi, Josephine Sellu, Christian Pratt, Josephine Saidu, Nahoko Shindo, Daniel G. Bausch, Sierra Leone Kenema District Task Force and Kenema General Hospital

^*Corresponding author for this work

School of Medicine

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Abstract

Background. Ebola virus disease (EVD) in health workers (HWs) has been a major challenge during the 2014-2015 outbreak. We examined factors associated with Ebola virus exposure and mortality in HWs in Kenema District, Sierra Leone. Methods. We analyzed data from the Sierra Leone National Viral Hemorrhagic Fever Database, contact tracing records, Kenema Government Hospital (KGH) staff and Ebola Treatment Unit (ETU) rosters, and burial logs.Results. From May 2014 through January 2015, 600 cases of EVD originated in Kenema District, including 92 (15%) HWs, 66 (72%) of whom worked at KGH. Among KGH medical staff and international volunteers, 18 of 62 (29%) who worked in the ETU developed EVD, compared with 48 of 83 (58%) who worked elsewhere in the hospital. Thirteen percent of HWs with EVD reported contact with EVD patients, while 27% reported contact with other infected HWs. The number of HW EVD cases at KGH declined roughly 1 month after implementation of a new triage system at KGH and the opening of a second ETU within the district. The case fatality ratio for HWs and non-HWs with EVD was 69% and 74%, respectively.Conclusions. The cluster of HW EVD cases in Kenema District is one of the largest ever reported. Most HWs with EVD had potential virus exposure both inside and outside of hospitals. Prevention measures for HWs must address a spectrum of infection risks in both formal and informal care settings as well as in the community.

Original language	English
Pages (from-to)	454-459
Number of pages	6
Journal	Clinical Infectious Diseases
Volume	63
Issue number	4
Early online date	18 May 2016
DOIs	https://doi.org/10.1093/cid/ciw327
Publication status	Published - 15 Aug 2016

Keywords

Ebola
Health worker
Infection prevention and control
Outbreak
Viral hemorrhagic fever

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Senga, M., Pringle, K., Ramsay, A., Brett-Major, D. M., Fowler, R. A., French, I., Vandi, M., Sellu, J., Pratt, C., Saidu, J., Shindo, N., Bausch, D. G., & Sierra Leone Kenema District Task Force and Kenema General Hospital (2016). Factors underlying Ebola virus infection among health workers, Kenema, Sierra Leone, 2014-2015. Clinical Infectious Diseases, 63(4), 454-459. https://doi.org/10.1093/cid/ciw327

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title = "Factors underlying Ebola virus infection among health workers, Kenema, Sierra Leone, 2014-2015",

abstract = "Background. Ebola virus disease (EVD) in health workers (HWs) has been a major challenge during the 2014-2015 outbreak. We examined factors associated with Ebola virus exposure and mortality in HWs in Kenema District, Sierra Leone. Methods. We analyzed data from the Sierra Leone National Viral Hemorrhagic Fever Database, contact tracing records, Kenema Government Hospital (KGH) staff and Ebola Treatment Unit (ETU) rosters, and burial logs.Results. From May 2014 through January 2015, 600 cases of EVD originated in Kenema District, including 92 (15%) HWs, 66 (72%) of whom worked at KGH. Among KGH medical staff and international volunteers, 18 of 62 (29%) who worked in the ETU developed EVD, compared with 48 of 83 (58%) who worked elsewhere in the hospital. Thirteen percent of HWs with EVD reported contact with EVD patients, while 27% reported contact with other infected HWs. The number of HW EVD cases at KGH declined roughly 1 month after implementation of a new triage system at KGH and the opening of a second ETU within the district. The case fatality ratio for HWs and non-HWs with EVD was 69% and 74%, respectively.Conclusions. The cluster of HW EVD cases in Kenema District is one of the largest ever reported. Most HWs with EVD had potential virus exposure both inside and outside of hospitals. Prevention measures for HWs must address a spectrum of infection risks in both formal and informal care settings as well as in the community.",

keywords = "Ebola, Health worker, Infection prevention and control, Outbreak, Viral hemorrhagic fever",

author = "Mikiko Senga and Kimberly Pringle and Andrew Ramsay and Brett-Major, {David M.} and Fowler, {Robert A.} and Issa French and Mohamed Vandi and Josephine Sellu and Christian Pratt and Josephine Saidu and Nahoko Shindo and Bausch, {Daniel G.} and {Sierra Leone Kenema District Task Force and Kenema General Hospital}",

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Senga, M, Pringle, K, Ramsay, A, Brett-Major, DM, Fowler, RA, French, I, Vandi, M, Sellu, J, Pratt, C, Saidu, J, Shindo, N, Bausch, DG & Sierra Leone Kenema District Task Force and Kenema General Hospital 2016, 'Factors underlying Ebola virus infection among health workers, Kenema, Sierra Leone, 2014-2015', Clinical Infectious Diseases, vol. 63, no. 4, pp. 454-459. https://doi.org/10.1093/cid/ciw327

TY - JOUR

T1 - Factors underlying Ebola virus infection among health workers, Kenema, Sierra Leone, 2014-2015

AU - Senga, Mikiko

AU - Pringle, Kimberly

AU - Ramsay, Andrew

AU - Brett-Major, David M.

AU - Fowler, Robert A.

AU - French, Issa

AU - Vandi, Mohamed

AU - Sellu, Josephine

AU - Pratt, Christian

AU - Saidu, Josephine

AU - Shindo, Nahoko

AU - Bausch, Daniel G.

AU - Sierra Leone Kenema District Task Force and Kenema General Hospital

PY - 2016/8/15

Y1 - 2016/8/15

N2 - Background. Ebola virus disease (EVD) in health workers (HWs) has been a major challenge during the 2014-2015 outbreak. We examined factors associated with Ebola virus exposure and mortality in HWs in Kenema District, Sierra Leone. Methods. We analyzed data from the Sierra Leone National Viral Hemorrhagic Fever Database, contact tracing records, Kenema Government Hospital (KGH) staff and Ebola Treatment Unit (ETU) rosters, and burial logs.Results. From May 2014 through January 2015, 600 cases of EVD originated in Kenema District, including 92 (15%) HWs, 66 (72%) of whom worked at KGH. Among KGH medical staff and international volunteers, 18 of 62 (29%) who worked in the ETU developed EVD, compared with 48 of 83 (58%) who worked elsewhere in the hospital. Thirteen percent of HWs with EVD reported contact with EVD patients, while 27% reported contact with other infected HWs. The number of HW EVD cases at KGH declined roughly 1 month after implementation of a new triage system at KGH and the opening of a second ETU within the district. The case fatality ratio for HWs and non-HWs with EVD was 69% and 74%, respectively.Conclusions. The cluster of HW EVD cases in Kenema District is one of the largest ever reported. Most HWs with EVD had potential virus exposure both inside and outside of hospitals. Prevention measures for HWs must address a spectrum of infection risks in both formal and informal care settings as well as in the community.

AB - Background. Ebola virus disease (EVD) in health workers (HWs) has been a major challenge during the 2014-2015 outbreak. We examined factors associated with Ebola virus exposure and mortality in HWs in Kenema District, Sierra Leone. Methods. We analyzed data from the Sierra Leone National Viral Hemorrhagic Fever Database, contact tracing records, Kenema Government Hospital (KGH) staff and Ebola Treatment Unit (ETU) rosters, and burial logs.Results. From May 2014 through January 2015, 600 cases of EVD originated in Kenema District, including 92 (15%) HWs, 66 (72%) of whom worked at KGH. Among KGH medical staff and international volunteers, 18 of 62 (29%) who worked in the ETU developed EVD, compared with 48 of 83 (58%) who worked elsewhere in the hospital. Thirteen percent of HWs with EVD reported contact with EVD patients, while 27% reported contact with other infected HWs. The number of HW EVD cases at KGH declined roughly 1 month after implementation of a new triage system at KGH and the opening of a second ETU within the district. The case fatality ratio for HWs and non-HWs with EVD was 69% and 74%, respectively.Conclusions. The cluster of HW EVD cases in Kenema District is one of the largest ever reported. Most HWs with EVD had potential virus exposure both inside and outside of hospitals. Prevention measures for HWs must address a spectrum of infection risks in both formal and informal care settings as well as in the community.

KW - Ebola

KW - Health worker

KW - Infection prevention and control

KW - Outbreak

KW - Viral hemorrhagic fever

U2 - 10.1093/cid/ciw327

DO - 10.1093/cid/ciw327

M3 - Article

AN - SCOPUS:84982104795

SN - 1058-4838

VL - 63

SP - 454

EP - 459

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 4

ER -

Factors underlying Ebola virus infection among health workers, Kenema, Sierra Leone, 2014-2015

Abstract

Keywords

UN SDGs

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