title: Long-term disease surveillance in Bandundu region, Democratic Republic of the Congo: a model for early detection and prevention of Ebola hemorrhagic fever.
abstract: After the large-scale outbreak of Ebola hemorrhagic fever (EHF) in Bandundu region, Democratic Republic of the Congo, a program was developed to help detect and prevent future outbreaks of EHF in the region. The long-term surveillance and prevention strategy is based on early recognition by physicians, immediate initiation of enhanced barrier-nursing practices, and the use of an immunohistochemical diagnostic test performed on formalin-fixed skin specimens of patients who die of suspected viral hemorrhagic fever. The program was implemented in September 1995 during a 4-day workshop with 28 local physicians representing 17 of 22 health zones in the region. Specimen collection kits were distributed to clinics in participating health zones, and a follow-up evaluation was conducted after 6 months. The use of a formalin-fixed skin specimen for laboratory confirmation of EHF can provide an appropriate method for EHF surveillance when linked with physician training, use of viral hemorrhagic fever isolation precautions, and follow-up investigation.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. pyr3@cdc.gov
authors.forename: E S
authors.initials: ES
authors.lastname: Lloyd
authors.forename: S R
authors.initials: SR
authors.lastname: Zaki
authors.forename: P E
authors.initials: PE
authors.lastname: Rollin
authors.forename: K
authors.initials: K
authors.lastname: Tshioko
authors.forename: M A
authors.initials: MA
authors.lastname: Bwaka
authors.forename: T G
authors.initials: TG
authors.lastname: Ksiazek
authors.forename: P
authors.initials: P
authors.lastname: Calain
authors.forename: W J
authors.initials: WJ
authors.lastname: Shieh
authors.forename: M K
authors.initials: MK
authors.lastname: Kondé
authors.forename: E
authors.initials: E
authors.lastname: Verchueren
authors.forename: H N
authors.initials: HN
authors.lastname: Perry
authors.forename: L
authors.initials: L
authors.lastname: Manguindula
authors.forename: J
authors.initials: J
authors.lastname: Kabwau
authors.forename: R
authors.initials: R
authors.lastname: Ndambi
authors.forename: C J
authors.initials: CJ
authors.lastname: Peters
mesh_terms: D000328:Adult; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D004196:Disease Outbreaks / Q000517:prevention & control; D029043:Ebolavirus / Q000302:isolation & purification; D019142:Hemorrhagic Fever, Ebola / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D017053:Infection Control; D008962:Models, Theoretical; D011159:Population Surveillance / Q000379:methods*; D012867:Skin / Q000821:virology; D012985:Software Design; D013997:Time Factors