Emergence of Ebola virus disease in a french acute care setting: a simulation study based on documented inter-individual contacts.
The potential spread of nosocomial Ebola virus disease (EVD) in non-outbreak areas is not known. The objective was to use detailed contact data on patients and healthcare workers (HCW) to estimate emergence probability and secondary incident cases (SIC) of EVD after hospitalization of an index case with undetected EVD. Contact data were collected through RFID devices used by patients and HCW during hospital care. A "susceptible-exposed-infected" model was used. Emergence probability, ranged from 7% to 84%. A plateau around 84% was observed. Emergence probability was proportional to time exposed to the dry phase of patients with nonspecific symptoms. Nurses were at higher risk of nosocomial EVD than physicians with around 60% emergence probability in this subgroup. The risk of nosocomial EVD in non-outbreak areas might be substantial if no preventive measures are implemented when asymptomatic patients or those with mild symptoms are hospitalized.
Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon, F-69437 Lyon, France.|Laboratoire des Pathogènes Emergents - Fondation Mérieux, Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale U1111, Centre National de la Recherche Scientifique, UMR5308, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon 1, 21, Avenue Tony Garnier, 69007 Lyon, France.|Université de Lyon, F-69000 Lyon, France.
Philippe
P
Vanhems
Université de Lyon, F-69000 Lyon, France.|Université Lyon 1, F-69100 Villeurbanne, France.|Service de Biostatistique, Hospices Civils de Lyon, F-69003 Lyon, France.|Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Centre National de la Recherche Scientifique, UMR5558, F-69100 Villeurbanne, France.
Rosette
R
Von Raesfeldt
Université de Lyon, F-69000 Lyon, France.|Université Lyon 1, F-69100 Villeurbanne, France.|Service de Biostatistique, Hospices Civils de Lyon, F-69003 Lyon, France.|Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Centre National de la Recherche Scientifique, UMR5558, F-69100 Villeurbanne, France.
René
R
Ecochard
Université de Lyon, F-69000 Lyon, France.|Université Lyon 1, F-69100 Villeurbanne, France.|Service de Biostatistique, Hospices Civils de Lyon, F-69003 Lyon, France.|Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Centre National de la Recherche Scientifique, UMR5558, F-69100 Villeurbanne, France.
Nicolas
N
Voirin
D003422:Critical Care; D003428:Cross Infection / Q000145:classification / Q000453:epidemiology / Q000821:virology*; D005602:France / Q000453:epidemiology; D006282:Health Personnel / Q000145:classification*; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology*; D006760:Hospitalization; D006801:Humans; D015233:Models, Statistical