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It is indeed a relief for many to know that this outbreak is finally under control.
My query, however, relates to the numbers of the reported cases and the numbers of deaths from ebola virus disease in the 3 most affected countries, namely Sierra Leone, Liberia and Guinea.
The article states that there were 14 122 reported cases of ebola and 3955 deaths in Sierra Leone. In Liberia 10 675 cases were reported and 4809 deaths. The numbers for the same were 3804 cases reported, with 2536 deaths in Guinea.
This equates to 28%, 45% and, 67% of deaths in reported cases in Sierra Leone, Liberia and Guinea respectfully.
Does this difference in the proportion of deaths from ebola virus disease in the 3 countries, actually refect differences in the prevention and management, accessibility and uptake of care in the these countries, or are extraneous variables at work?
For example, we know that if many new cases are being reported, then the number of deaths will be proportionately lower. This may be a factor manifested in the figures seen in Sierra Leone. Likewise, if only severe cases are reported, then it is likely that the number of deaths will be proprtionately higher, which may be in part responsible for the figures seen in Guinea.
'A Case Fatality Rate (CFR) /Risk, is a property of an infectious disease in a population, which states the risk of fatality due to the disease per case' (1). This will be, or should be governed by the factors of the infectios agent e.g its virulence - and we know that the Ebola vius is one of the most virulent pathogens of humans (2) and, factors to do with the population and the individual case e.g their education, health status and behaviours etc. It removes the bias on reporting as mentioned above, but should take into consideration other factors such as the number of recoveries being made.
Despite the potential for inaccurate reporting, it is still true that this epidemic has been the cause of tremendous suffering, pressure on the medical services, public sector services, volunteers and families and has required a global response to the disaster.
All should therefore endeavour, as is practicable, to be aware of this disease and do what is reasonable in their remit/sphere to work towards the prevention of another outbreak.
Re: Ebola outbreak in west Africa is officially over
Many thanks for including this article.
It is indeed a relief for many to know that this outbreak is finally under control.
My query, however, relates to the numbers of the reported cases and the numbers of deaths from ebola virus disease in the 3 most affected countries, namely Sierra Leone, Liberia and Guinea.
The article states that there were 14 122 reported cases of ebola and 3955 deaths in Sierra Leone. In Liberia 10 675 cases were reported and 4809 deaths. The numbers for the same were 3804 cases reported, with 2536 deaths in Guinea.
This equates to 28%, 45% and, 67% of deaths in reported cases in Sierra Leone, Liberia and Guinea respectfully.
Does this difference in the proportion of deaths from ebola virus disease in the 3 countries, actually refect differences in the prevention and management, accessibility and uptake of care in the these countries, or are extraneous variables at work?
For example, we know that if many new cases are being reported, then the number of deaths will be proportionately lower. This may be a factor manifested in the figures seen in Sierra Leone. Likewise, if only severe cases are reported, then it is likely that the number of deaths will be proprtionately higher, which may be in part responsible for the figures seen in Guinea.
'A Case Fatality Rate (CFR) /Risk, is a property of an infectious disease in a population, which states the risk of fatality due to the disease per case' (1). This will be, or should be governed by the factors of the infectios agent e.g its virulence - and we know that the Ebola vius is one of the most virulent pathogens of humans (2) and, factors to do with the population and the individual case e.g their education, health status and behaviours etc. It removes the bias on reporting as mentioned above, but should take into consideration other factors such as the number of recoveries being made.
Despite the potential for inaccurate reporting, it is still true that this epidemic has been the cause of tremendous suffering, pressure on the medical services, public sector services, volunteers and families and has required a global response to the disaster.
All should therefore endeavour, as is practicable, to be aware of this disease and do what is reasonable in their remit/sphere to work towards the prevention of another outbreak.
1. http:/epidemic.bio.ed.ac.uk/ebolvirus_fatality_rate
2. Feldman H, Geisbert TW. Ebola Haemorrhagic Fever. Lancet 2011; 377:849
Competing interests: No competing interests