Skip to main content
Top
Published in: Globalization and Health 1/2018

Open Access 01-12-2018 | Research

Managing emerging transnational public health security threats: lessons learned from the 2014 West African Ebola outbreak

Authors: Aaron M. Wendelboe, Micah McCumber, Julie Erb-Alvarez, Nicholas Mould, Richard W. Childs, James L. Regens

Published in: Globalization and Health | Issue 1/2018

Login to get access

Abstract

Background

Pandemics pose significant security/stability risks to nations with fragile infrastructures. We evaluated characteristics of the 2014 West African Ebola outbreak to elucidate lessons learned for managing transnational public health security threats.

Methods

We used publically available data to compare demographic and outbreak-specific data for Guinea, Sierra Leone, and Liberia, including key indicator data by the World Health Organization. Pearson correlation statistics were calculated to compare country-level infrastructure characteristics with outbreak size and duration.

Results

Hospital bed density was inversely correlated with longer EVD outbreak duration (r = − 0.99). Country-specific funding amount allocations were more likely associated with number of incident cases than the population at-risk or infrastructure needs. Key indicators demonstrating challenges for Guinea included: number of unsafe burials, percent of EVD-positive samples, and days between symptom onset and case hospitalization. Sierra Leone’s primary key indicator was the number of districts with ≥1 security incident. Liberia controlled their outbreak before much of the key-indicator data were collected.

Conclusion

Many of the country-level factors, particularly the WHO key indicators were associated with controlling the epidemic. The infrastructure of countries affected by communicable diseases should be assessed by international political and public health leaders.
Literature
1.
go back to reference Bernard KW. Health and national security: a contemporary collision of cultures. Biosecur Bioterror. 2013;11(2):157–62.CrossRef Bernard KW. Health and national security: a contemporary collision of cultures. Biosecur Bioterror. 2013;11(2):157–62.CrossRef
2.
go back to reference Burgess JP. The Routledge handbook of new security studies. London: Routledge; 2010.CrossRef Burgess JP. The Routledge handbook of new security studies. London: Routledge; 2010.CrossRef
3.
go back to reference Aldis W. Health security as a public health concept: a critical analysis. Health Policy Plan. 2008;23(6):369–75.CrossRef Aldis W. Health security as a public health concept: a critical analysis. Health Policy Plan. 2008;23(6):369–75.CrossRef
4.
go back to reference Garrett L. The coming plague. New York: Penguin; 1994. Garrett L. The coming plague. New York: Penguin; 1994.
5.
go back to reference Elbe S. Pandemics on the radar screen: health security, infectious disease and the medicalisation of insecurity. Political Studies. 2011;59(4):848–66.CrossRef Elbe S. Pandemics on the radar screen: health security, infectious disease and the medicalisation of insecurity. Political Studies. 2011;59(4):848–66.CrossRef
6.
go back to reference W. H. O. Ebola Response Team. Ebola virus disease in West Africa--the first 9 months of the epidemic and forward projections. N Engl J Med. 2014;371(16):1481–95.CrossRef W. H. O. Ebola Response Team. Ebola virus disease in West Africa--the first 9 months of the epidemic and forward projections. N Engl J Med. 2014;371(16):1481–95.CrossRef
10.
go back to reference W. H. O. Ebola Response Team. After Ebola in West Africa--unpredictable risks, preventable epidemics. N Engl J Med. 2016;375(6):587–96.CrossRef W. H. O. Ebola Response Team. After Ebola in West Africa--unpredictable risks, preventable epidemics. N Engl J Med. 2016;375(6):587–96.CrossRef
11.
go back to reference Meltzer MI, Atkins CY, Santibanez S, Knust B, Petersen BW, Ervin ED, Nichol ST, Damon IK, Washington ML. Estimating the future number of cases in the Ebola epidemic--Liberia and Sierra Leone, 2014-2015. MMWR Suppl. 2014;63(3):1–14.PubMed Meltzer MI, Atkins CY, Santibanez S, Knust B, Petersen BW, Ervin ED, Nichol ST, Damon IK, Washington ML. Estimating the future number of cases in the Ebola epidemic--Liberia and Sierra Leone, 2014-2015. MMWR Suppl. 2014;63(3):1–14.PubMed
13.
go back to reference Saez A, Weiss S, Nowak K, Lapeyre V, Zimmermann F, Dux A, Kuhl H, Kaba M. Investigating the zoonotic origin of the west African Ebola epidemic. EMBO Mol Med. 2015;7(1):17–23.CrossRef Saez A, Weiss S, Nowak K, Lapeyre V, Zimmermann F, Dux A, Kuhl H, Kaba M. Investigating the zoonotic origin of the west African Ebola epidemic. EMBO Mol Med. 2015;7(1):17–23.CrossRef
14.
go back to reference Vogel G. Bat-filled tree may have been ground zero for the Ebola epidemic. Science. 2014;12 Vogel G. Bat-filled tree may have been ground zero for the Ebola epidemic. Science. 2014;12
15.
go back to reference Hersey S, Martel LD, Jambai A, Keita S, Yoti Z, Meyer E, Seeman S, Bennett S, Ratto J, Morgan O, et al. Ebola virus disease--Sierra Leone and Guinea, august 2015. MMWR Morb Mortal Wkly Rep. 2015;64(35):981–4.CrossRef Hersey S, Martel LD, Jambai A, Keita S, Yoti Z, Meyer E, Seeman S, Bennett S, Ratto J, Morgan O, et al. Ebola virus disease--Sierra Leone and Guinea, august 2015. MMWR Morb Mortal Wkly Rep. 2015;64(35):981–4.CrossRef
24.
go back to reference Ashkenas J, Buchanan L, Burgess J, Fairfield H, Grady D, Keller J, Lai KKR, Lyons PJ, Murphy H, Park H, et al. How many Ebola patients have been treated outside of Africa? New York: In: New York Times; 2015. Ashkenas J, Buchanan L, Burgess J, Fairfield H, Grady D, Keller J, Lai KKR, Lyons PJ, Murphy H, Park H, et al. How many Ebola patients have been treated outside of Africa? New York: In: New York Times; 2015.
29.
go back to reference World Health Organization. Factors that contributed to undetected spread of the Ebola virus and impeded rapid containment. In: One year into the Ebola epidemic. Geneva: World Health Organization; 2015. World Health Organization. Factors that contributed to undetected spread of the Ebola virus and impeded rapid containment. In: One year into the Ebola epidemic. Geneva: World Health Organization; 2015.
30.
go back to reference Frieden TR, Damon I, Bell BP, Kenyon T, Nichol S. Ebola 2014--new challenges, new global response and responsibility. N Engl J Med. 2014;371(13):1177–80.CrossRef Frieden TR, Damon I, Bell BP, Kenyon T, Nichol S. Ebola 2014--new challenges, new global response and responsibility. N Engl J Med. 2014;371(13):1177–80.CrossRef
31.
go back to reference Coltart CE, Lindsey B, Ghinai I, Johnson AM, Heymann DL. The Ebola outbreak, 2013-2016: old lessons for new epidemics. Philos Trans R Soc Lond Ser B Biol Sci. 2017;372(1721) Coltart CE, Lindsey B, Ghinai I, Johnson AM, Heymann DL. The Ebola outbreak, 2013-2016: old lessons for new epidemics. Philos Trans R Soc Lond Ser B Biol Sci. 2017;372(1721)
32.
go back to reference Kucharski AJ, Camacho A, Flasche S, Glover RE, Edmunds WJ, Funk S. Measuring the impact of Ebola control measures in Sierra Leone. Proc Natl Acad Sci U S A. 2015;112(46):14366–71.CrossRef Kucharski AJ, Camacho A, Flasche S, Glover RE, Edmunds WJ, Funk S. Measuring the impact of Ebola control measures in Sierra Leone. Proc Natl Acad Sci U S A. 2015;112(46):14366–71.CrossRef
33.
go back to reference Townsend JP, Skrip LA, Galvani AP. Impact of bed capacity on spatiotemporal shifts in Ebola transmission. Proc Natl Acad Sci U S A. 2015;112(46):14125–6.CrossRef Townsend JP, Skrip LA, Galvani AP. Impact of bed capacity on spatiotemporal shifts in Ebola transmission. Proc Natl Acad Sci U S A. 2015;112(46):14125–6.CrossRef
34.
go back to reference Kirsch TD, Moseson H, Massaquoi M, Nyenswah TG, Goodermote R, Rodriguez-Barraquer I, Lessler J, Cumings DA, Peters DH. Impact of interventions and the incidence of ebola virus disease in Liberia-implications for future epidemics. Health Policy Plan. 2017;32(2):205–14.CrossRef Kirsch TD, Moseson H, Massaquoi M, Nyenswah TG, Goodermote R, Rodriguez-Barraquer I, Lessler J, Cumings DA, Peters DH. Impact of interventions and the incidence of ebola virus disease in Liberia-implications for future epidemics. Health Policy Plan. 2017;32(2):205–14.CrossRef
35.
go back to reference Onishi N. Empty Ebola clinics in Liberia are seen as misstep in U.S. relief effort. In: The New York times; 2015. Onishi N. Empty Ebola clinics in Liberia are seen as misstep in U.S. relief effort. In: The New York times; 2015.
37.
go back to reference Wilkinson A, Parker M, Martineau F, Leach M. Engaging 'communities': anthropological insights from the west African Ebola epidemic. Philos Trans R Soc Lond Ser B Biol Sci. 2017;372(1721) Wilkinson A, Parker M, Martineau F, Leach M. Engaging 'communities': anthropological insights from the west African Ebola epidemic. Philos Trans R Soc Lond Ser B Biol Sci. 2017;372(1721)
Metadata
Title
Managing emerging transnational public health security threats: lessons learned from the 2014 West African Ebola outbreak
Authors
Aaron M. Wendelboe
Micah McCumber
Julie Erb-Alvarez
Nicholas Mould
Richard W. Childs
James L. Regens
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Globalization and Health / Issue 1/2018
Electronic ISSN: 1744-8603
DOI
https://doi.org/10.1186/s12992-018-0396-z

Other articles of this Issue 1/2018

Globalization and Health 1/2018 Go to the issue