Gilbert Gwendolyn L
Marie Bashir Institute for Emerging Infectious Disease and Biosecurity, The University of Sydney, NSW, Australia,
Public Health Res Pract. 2016 Dec 14;26(5):2651661. doi: 10.17061/phrp2651661.
In March 2016, the World Health Organization declared the 2014-15 Ebola virus disease (EVD) outbreak officially over. With around 29 000 cases and 11 000 deaths in 27 months, this EVD outbreak was more than 60 times larger than any before, and unique in its cross-border spread and involvement of urban centres. Local and international responses were slow and initially inadequate, but establishment of the United Nations Mission for Ebola Emergency Response, 9 months after the outbreak began, allowed a coordinated effort that slowed and eventually controlled the spread of disease. Internationally, there were fears that EVD would spread widely beyond Africa, despite reassurances from public health authorities. However, after nurses in the US became infected, public fear and concern for the safety of healthcare workers led to political intervention and varied, sometimes excessive, border controls, quarantine arrangements and hospital preparations. Altogether, fewer than 30 EVD cases were managed in countries outside Africa, all but three of which were acquired in West Africa. In Australia, the Australian Health Protection Principal Committee led the internal response, including enhanced screening of incoming passengers at international airports and development of public health and laboratory testing protocols by expert subcommittees. States and territories nominated designated hospitals to care for EVD patients. Development of EVD infection prevention and control (IPC) guidelines was initially poorly coordinated within and between jurisdictions, often with significant discrepancies, causing confusion and fear among healthcare workers. The Infection Prevention and Control Expert Advisory Group was established to develop national IPC guidelines. There were no confirmed cases in Australia, but investigation of several people with suspected EVD provided valuable experience in use of protocols and high-level containment facilities. The Australian Government was initially reluctant to send aid workers to West Africa, but later contracted a private company to staff and manage a treatment centre in Sierra Leone, which treated 91 patients with EVD during 4 months of operation. Among the lessons learnt for Australia was the need to increase awareness of routine IPC practices in hospitals, where significant deficiencies were exposed, and to maintain a high enough level of preparedness to protect healthcare workers and the public from the next, inevitable, infectious disease emergency.
2016年3月，世界卫生组织宣布2014 - 15年埃博拉病毒病疫情正式结束。此次疫情历时27个月，报告病例约29000例，死亡11000例，规模超过以往任何一次疫情的60多倍，其跨境传播及涉及城市中心的情况也十分独特。地方和国际社会的应对行动起初迟缓且力度不足，但在疫情爆发9个月后成立了联合国埃博拉应急特派团，从而得以开展协调行动，减缓并最终控制了疾病传播。在国际上，尽管公共卫生当局再三保证，但人们仍担心埃博拉病毒病会广泛传播至非洲以外地区。然而，在美国护士感染病毒后，公众对医护人员安全的恐惧和担忧引发了政治干预以及多样、有时甚至过度的边境管控、检疫安排和医院准备工作。在非洲以外国家，总共处理的埃博拉病毒病病例不到30例，其中除3例之外，其余均在西非感染。在澳大利亚，澳大利亚卫生保护主要委员会领导国内应对工作，包括加强对国际机场入境旅客的筛查，以及由专家小组制定公共卫生和实验室检测方案。各州和领地指定了专门医院来收治埃博拉病毒病患者。埃博拉病毒感染预防与控制（IPC）指南的制定工作在各辖区内部及相互之间起初协调不善，常常存在重大差异，导致医护人员困惑和恐慌。为此成立了感染预防与控制专家咨询小组来制定国家IPC指南。澳大利亚没有确诊病例，但对几名疑似埃博拉病毒病患者的调查为 protocols 和高级隔离设施的使用提供了宝贵经验。澳大利亚政府起初不愿向西非派遣援助人员，但后来与一家私人公司签约，由其为塞拉利昂的一个治疗中心配备人员并进行管理，该中心在运营的4个月里共治疗了91例埃博拉病毒病患者。澳大利亚从中吸取的教训包括，需要提高医院对常规IPC措施的认识，因为医院暴露出了严重不足，同时要保持足够高的防范水平，以保护医护人员和公众免受下一次不可避免的传染病紧急情况的影响。
