title: The 1995 Kikwit Ebola outbreak: lessons hospitals and physicians can apply to future viral epidemics.
abstract: OBJECTIVE
  This article looks at lessons learned from the 1995 Kikwit Ebola outbreak and suggests how modern hospitals should apply these lessons to the next lethal viral epidemic that occurs.
  
  
  METHODS
  The 1995 Kikwit Ebola outbreak in the Democratic Republic of the Congo (formally Zaire) is one of the most well studied epidemics to have occurred to date. Many of the lessons learned from identifying, containing and treating that epidemic are applicable to future viral outbreaks, natural disasters and bioterrorist attacks. This is due to Ebola's highly contagious nature and high mortality rate.
  
  
  RESULTS
  When an outbreak occurs, it often produces fear in the community and causes the basic practice of medicine to be altered. Changes seen at Kikwit included limited physical examinations, hesitance to give intravenous medications and closure of supporting hospital facilities. The Kikwit Ebola outbreak also provided beneficial psychological insight into how patients, staff and the general community respond to a biological crisis and how this will affect physicians working in an epidemic.
  
  
  CONCLUSIONS
  General lessons from the outbreak include the importance of having simple, well-defined triage procedures; staff who are flexible and able to adapt to situations with unknowns; and the need to protect staff physically and emotionally to ensure a sustained effort to provide care.
authors.affiliation: Case Western Reserve University, Cleveland, OH 44106, USA. rcwh@att.net
authors.forename: Ryan C W
authors.initials: RC
authors.lastname: Hall
authors.forename: Richard C W
authors.initials: RC
authors.lastname: Hall
authors.forename: Marcia J
authors.initials: MJ
authors.lastname: Chapman
mesh_terms: D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D015023:Democratic Republic of the Congo; D003906:Developing Countries; D004196:Disease Outbreaks / Q000517:prevention & control; D005239:Fear / Q000523:psychology; D006271:Health Facility Closure / Q000706:statistics & numerical data; D019142:Hemorrhagic Fever, Ebola / Q000401:mortality / Q000517:prevention & control / Q000523:psychology* / Q000635:transmission; D006760:Hospitalization; D006801:Humans; D055809:Illness Behavior; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control / Q000706:statistics & numerical data; D009723:Nurse-Patient Relations; D010356:Patient Isolation / Q000523:psychology; D010819:Physician's Role / Q000523:psychology*; D010817:Physician-Patient Relations; D016079:Refusal to Treat / Q000706:statistics & numerical data; D012066:Relief Work / Q000458:organization & administration; D013317:Strikes, Employee / Q000706:statistics & numerical data; D014218:Triage / Q000458:organization & administration
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