Acquired immunity and asymptomatic reservoir impact on frontline and airport ebola outbreak syndromic surveillance and response

Infectious Diseases of Poverty

Zhou Xiao-Nong¹  Ernest Tambo² 

[1]WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, People’s Republic of China

[2]Département de Biochimie et Science Pharmaceutiques, Université des Montagnes, Bagangté, République du Cameroun

关键词: Response;    Ebola;    Surveillance;    Syndromic;    Reservoir;    Asymptomatic;    Immunity;   

Others  :  1136014
DOI  :  10.1186/2049-9957-3-41

 received in 2014-09-08, accepted in 2014-10-21,  发布年份 2014

【 摘 要 】

The number of surveillance networks for infectious disease diagnosis and response has been growing. In 2000, the World Health Organization (WHO) established the Global Outbreak Alert and Response Network, which has been endorsed by each of the 46 WHO African members since then. Yet, taming the dynamics and plague of the vicious Ebola virus disease (EVD) in African countries has been patchy and erratic due to inadequate surveillance and contact tracing, community defiance and resistance, a lack of detection and response systems, meager/weak knowledge and information on the disease, inadequacies in protective materials protocols, contact tracing nightmare and differing priorities at various levels of the public health system. Despite the widespread acceptance of syndromic surveillance (SS) systems, their ability to provide early warning alerts and notifications of outbreaks is still unverified. Information is often too limited for any outbreak, or emerging or otherwise unexpected disease, to be recognized at either the community or the national level. Indeed, little is known about the role and the interactions between the Ebola infection and exposure to other syndemics and the development of acquired immunity, asymptomatic reservoir, and Ebola seroconversion. Can lessons be learnt from smallpox, polio, and influenza immunity, and can immunization against these serve as a guide? In most endemic countries, community health centers and disease control and prevention at airports solely relies on passive routine immunization control and reactive syndromic response. The frontline and airport Ebola SS systems in West Africa have shown deficiencies in terms of responding with an alarming number of case fatalities, and suggest that more detailed insights into Ebola, and proactive actions, are needed. The quest for effective early indicators (EEE) in shifting the public and global health paradigm requires the development and implementation of a comprehensive and effective community or regional integrated pandemic preparedness and surveillance response systems tailored to local contexts. These systems must have mechanisms for early identification, rapid contact tracing and tracking, confirmation, and communication with the local population and the global community, and must endeavor to respond in a timely manner.

【 授权许可】

   
2014 Tambo and Xiao-Nong; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Chan M: Ebola virus disease in West Africa - no early end to the outbreak. N Engl J Med 2014, 371:1183-1185. doi:10.1056/NEJMp1409859
• [2]World Health Organization: No Early End to The Ebola Outbreak. Geneva, Switzerland: World Health Organization; 2014. Available at http://www.who.int/csr/disease/ebola/overview-20140814/en webcite, accessed on 30th September 2014
• [3]James W, Buehler JW, Berkelman RL, Hartley DM, Peters CJ: Syndromic surveillance and bioterrorism-related epidemics. Emerg Infect Dis 2003, 9(10):1197-1204.
• [4]Parren PWHI, Geisbert TW, Toshiaki M, Jahrling PB, Burton DR: Pre- and postexposure prophylaxis of ebola virus infection in an animal model by passive transfer of a neutralizing human antibody. J Virol 2002, 76:12. 6408–6412
• [5]Dórea F, Sanchez J, Revie C: Veterinary syndromic surveillance: current initiatives and potential for development. Prev Vet Med 2011, 101:1-17.
• [6]Drewe JA, Hoinville LJ, Cook AJC, Floyd T, Stärk KDC: Evaluation of animal and public health surveillance systems: a systematic review. Epidemiol Infect 2012, 140:575-590.
• [7]Samoff E, Fangman MT, Hakenewerth A, Ising A, Waller AE: Use of syndromic surveillance at local health departments: movement toward more effective systems. J Public Health Manag Pract 2014, 20(4):25-30.
• [8]Kaydos-Daniels SC1, Rojas Smith L, Farris TR: Biosurveillance in outbreak investigations. Biosecur Bioterror 2013, 11(1):20-28.
• [9]Josseran L, Fouillet A: Syndromic surveillance: review and prospect of a promising concept. Rev Epidemiol Sante Publique 2013, 61(2):163-170.
• [10]Sintchenko V, Gallego B: Laboratory-guided detection of disease outbreaks: three generations of surveillance systems. Arch Pathol Lab Med 2009, 133(6):916-925.
• [11]Campbell TC, Hodanics CJ, Babin SM, Poku AM, Wojcik RA, Skora JF, Coberly JS, Mistry ZS, Lewis SH: Developing open source, self-contained disease surveillance software applications for use in resource-limited settings. BMC Med Inform Decis Mak 2012, 12:99. BioMed Central Full Text
• [12]Rashid A, Jesse B, Stenger DA, Jacobsen KH: Ebola in Sierra Leone: a call for action. Lancet 2014, 384:9940. 303
• [13]WHO: Ebola Virus Disease, West Africa-Update (31st July). Disease Outbreak News. 2014. http://www.who.int/csr/don/2014_09_04_ebola/en/ webcite accessed on 8th September 2014
• [14]Kirsty H, Durrheim DN, D’Espaignet ET, Craig D: Syndromic surveillance: is it a useful tool for local outbreak detection? J Epidemiol Community Health 2006, 60(5):374-375.
• [15]Tambo E, Adedeji AA, Huang F, Chen Hu J, Zhou SS, Thang LH: Scaling up impact of malaria control programmes: a tale of events in Africa and People’s Republic of China from 1960–2011. Infect Dis Poverty J 2012, 1(7):42.
• [16]Zhou XN: Prioritizing research for “One health - One world”. Infect Dis Poverty J 2012, 1:1. BioMed Central Full Text
• [17]Choffnes ER, Sparling PF, Hamburg MA, Lemon SM: Global infectious disease surveillance and detection: assessing the challenges-finding solutions, workshop summary. Institute of Medicine, Washington Dc: The National Academic Press; 2007.
• [18]Gupta M, Mahanty S, Greer P, Towner JS, Shieh WJ, Zaki SR, Ahmed R, Rollin PE: Persistent infection with ebola virus under conditions of partial immunity. J Virol 2004, 78:2958-2967.
• [19]Ryan L, Nathaniel A, Brunsell & A. Townsend Peterson: Spatiotemporal environmental triggers of Ebola and Marburg virus transmission. Geocarto Int 2008, 23(6):451-466.
• [20]Tambo E, Ugwu EC, Ngogang JY: Need of surveillance response systems to combat Ebola outbreaks and other emerging infectious diseases in African countries. Infect Dis Poverty J 2014, 3:29. BioMed Central Full Text
• [21]Zhou XN, Bergquist R, Tanner M: Elimination of tropical disease through surveillance and response. Infect Dis Poverty 2013, 2:1. BioMed Central Full Text
• [22]Tambo E, Lin A, Xia Z, Jun-Hu C, Wei H, Bergquist R, Guo J-G, Jürg U, Marcel T, Xiao-Nong Z: Surveillance-response systems: the key to elimination of tropical diseases. Infect Dis Poverty 2014, 3:17. http://www.idpjournal.com/content/3/1/17 webcite BioMed Central Full Text