title: Decreased Ebola Transmission after Rapid Response to Outbreaks in Remote Areas, Liberia, 2014.
abstract: We measured the reproduction number before and after interventions were implemented to reduce Ebola transmission in 9 outbreaks in Liberia during 2014. We evaluated risk factors for secondary cases and the association between patient admission to an Ebola treatment unit (ETU) and survival. The reproduction number declined 94% from 1.7 (95% CI 1.1-2.6) to 0.1 (95% CI 0.02-0.6) after interventions began. The risk for secondary infections was 90% lower for patients admitted to an ETU (risk ratio 0.1, 95% CI 0.04-0.3) than for those who died in the community. The case-fatality rate was 68% (95% CI 60-74), and ETU admission was associated with a 50% reduction in death (hazard ratio 0.5, 95% CI 0.4-0.8). Isolation and treatment of Ebola patients had the dual benefit of interrupting community transmission and improving survival.
authors.forename: Kim A
authors.initials: KA
authors.lastname: Lindblade
authors.forename: Francis
authors.initials: F
authors.lastname: Kateh
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Nagbe
authors.forename: John C
authors.initials: JC
authors.lastname: Neatherlin
authors.forename: Satish K
authors.initials: SK
authors.lastname: Pillai
authors.forename: Kathleen R
authors.initials: KR
authors.lastname: Attfield
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Dweh
authors.forename: Danielle T
authors.initials: DT
authors.lastname: Barradas
authors.forename: Seymour G
authors.initials: SG
authors.lastname: Williams
authors.forename: David J
authors.initials: DJ
authors.lastname: Blackley
authors.forename: Hannah L
authors.initials: HL
authors.lastname: Kirking
authors.forename: Monita R
authors.initials: MR
authors.lastname: Patel
authors.forename: Monica
authors.initials: M
authors.lastname: Dea
authors.forename: Mehran S
authors.initials: MS
authors.lastname: Massoudi
authors.forename: Kathleen
authors.initials: K
authors.lastname: Wannemuehler
authors.forename: Albert E
authors.initials: AE
authors.lastname: Barskey
authors.forename: Shauna L Mettee
authors.initials: SL
authors.lastname: Zarecki
authors.forename: Moses
authors.initials: M
authors.lastname: Fomba
authors.forename: Steven
authors.initials: S
authors.lastname: Grube
authors.forename: Lisa
authors.initials: L
authors.lastname: Belcher
authors.forename: Laura N
authors.initials: LN
authors.lastname: Broyles
authors.forename: T Nikki
authors.initials: TN
authors.lastname: Maxwell
authors.forename: Jose E
authors.initials: JE
authors.lastname: Hagan
authors.forename: Kristin
authors.initials: K
authors.lastname: Yeoman
authors.forename: Matthew
authors.initials: M
authors.lastname: Westercamp
authors.forename: Joseph
authors.initials: J
authors.lastname: Forrester
authors.forename: Joshua
authors.initials: J
authors.lastname: Mott
authors.forename: Frank
authors.initials: F
authors.lastname: Mahoney
authors.forename: Laurence
authors.initials: L
authors.lastname: Slutsker
authors.forename: Kevin M
authors.initials: KM
authors.lastname: DeCock
authors.forename: Tolbert
authors.initials: T
authors.lastname: Nyenswah
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D029043:Ebolavirus / Q000472:pathogenicity*; D005260:Female; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology*; D006801:Humans; D007988:Liberia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors
keywords: Ebola; Ebolavirus Zaire; Liberia; basic reproduction number; case-fatality rate; disease outbreaks; epidemics; epidemiology; patient isolation; survival; viruses