Transmissibility and Pathogenicity of Ebola Virus: A Systematic Review and Meta-analysis of Household Secondary Attack Rate and Asymptomatic Infection

被引：68

作者：

Dean, Natalie E. ^{[1
]}

Halloran, M. Elizabeth ^{[2
,3
]}

Yang, Yang ^{[1
]}

Longini, Ira M. ^{[1
]}

机构：

[1] Univ Florida, Dept Biostat, POB 117450, Gainesville, FL 32611 USA

[2] Univ Washington, Dept Biostat, Seattle, WA 98195 USA

[3] Fred Hutchinson Canc Res Ctr, Vaccine & Infect Dis Div, 1124 Columbia St, Seattle, WA 98104 USA

来源：

CLINICAL INFECTIOUS DISEASES | 2016年 / 62卷 / 10期

基金：

美国国家卫生研究院;

关键词：

Ebola; household; secondary attack rate; asymptomatic infection; HEMORRHAGIC-FEVER; RISK-FACTORS; VIRAL LOAD; OUTBREAK; DISEASE; KIKWIT; CONGO; ANTIBODIES; DIAGNOSIS; CONTACTS;

D O I：

10.1093/cid/ciw114

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Factors affecting our ability to control an Ebola outbreak include transmissibility of the virus and the proportion of transmissions occurring asymptomatically. We performed a meta-analysis of Ebola household secondary attack rate (SAR), disaggregating by type of exposure (direct contact, no direct contact, nursing care, direct contact but no nursing care). The estimated overall household SAR is 12.5% (95% confidence interval [CI], 8.6%-16.3%). Transmission was driven by direct contact, with little transmission occurring in its absence (SAR, 0.8% [95% CI, 0%-2.3%]). The greatest risk factor was the provision of nursing care (SAR, 47.9% [95% CI, 23.3%-72.6%]). There was evidence of a decline in household SAR for direct contact between 1976 and 2014 (P = .018). We estimate that 27.1% (95% CI, 14.5%-39.6%) of Ebola infections are asymptomatic. Our findings suggest that surveillance and containment measures should be effective for controlling Ebola.

引用

页码：1277 / 1286

页数：10

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