An outbreak inside an epidemic: managing an infectious disease outbreak while treating Ebola.
Even in the middle of an epidemic of a very serious illness, outbreaks of other infectious diseases will continue. Clinicians need to be able to make rapid decisions about the nature of the outbreak and how to manage it. A balance needs to be struck between managing all patients as if they have the worst-case scenario illness and the resultant risks to themselves, their colleagues and the mission. This paper reviews basic epidemiological tools that inform robust decision-making in the management of such outbreaks. It then describes how a pragmatic approach, combined with effective use of these techniques, rapid diagnostics and remote specialist support, allowed a large outbreak of gastroenteritis to be safely and effectively managed during the response to the Ebola virus disease epidemic in Sierra Leone.
Emergency Medicine, Royal Centre for Defence Medicine, Birmingham, UK.|16 Medical Regiment, Colchester, UK.
Simon
http://orcid.org/0000-0002-5098-7996
S
Horne
1st Bn Coldstream Guards, Windsor, UK.
K
K
Forbes
Department of Infection and Tropical Medicine, Birmingham Heartlands Hospital, Birmingham, UK.
D
D
Burns
Defence Health Strategy, Ministry of Defence, London, UK.
Jjh
J
Tuck
D004196:Disease Outbreaks / Q000517:prevention & control*; D058872:Epidemics; D019142:Hemorrhagic Fever, Ebola / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D012807:Sierra Leone / Q000453:epidemiology
INFECTIOUS DISEASES; PUBLIC HEALTH; ebola