Jennifer J. Hemingway-Foday, MPH, MSW, is a Research Epidemiologist, and Kristen B. Stolka, MPH, and Kathryn E. L. Grimes, MPH, are Research Public Health Analysts; all at RTI International, Research Triangle Park, NC. Bonaventure Fuamba Ngoyi, MD, is a Field Epidemiologist, and Christian Tunda, ME, is an Information Communication Technology Specialist, working as a consultant; both at RTI International, Kinshasa, Democratic Republic of Congo. Léopold Lubula, MD, MPH, is Surveillance Manager; Mathias Mossoko, MSc, is Data Manager; and Benoit Ilunga Kebela, MD, is Director; all at the Ministry of Public Health, Kinshasa, Democratic Republic of Congo. Linda M. Brown, PhD, is Senior Research Epidemiologist, RTI International, Rockville, MD. Pia D. M. MacDonald, PhD, is Senior Director/Senior Epidemiologist, RTI International, Berkeley, CA.
Health Secur. 2020 Jan;18(S1):S81-S91. doi: 10.1089/hs.2019.0065.
On May 12, 2017, the Democratic Republic of Congo (DRC) publicly declared an outbreak of Ebola virus disease (EVD) in the Likati District of the Bas-Uélé Province, 46 days after the index case became symptomatic. The delayed EVD case detection and reporting highlights the importance of establishing real-time surveillance, consistent with the Global Health Security Agenda. We describe lessons learned from implementing improved EVD case detection and reporting strategies at the outbreak epicenter and make recommendations for future response efforts. The strategies included daily coordination meetings to enhance effective and efficient outbreak response activities, assessment and adaptation of case definitions and reporting tools, establishment of a community alert system using context-appropriate technology, training facility and community health workers on adapted case definitions and reporting procedures, development of context-specific plans for outbreak data management, and strengthened operational support for communications and information-sharing networks. Post-outbreak, surveillance officials should preemptively plan for the next outbreak by developing emergency response plans, evaluating the case definitions and reporting tools used, retraining on revised case definitions, and developing responsive strategies for overcoming telecommunications and technology challenges. The ongoing EVD outbreak in the North Kivu and Ituri provinces of DRC, currently the second largest EVD outbreak in history, demonstrates that documentation of successful context-specific strategies and tools are needed to combat the next outbreak. The lessons learned from the rapid containment of the EVD outbreak in Likati can be applied to the DRC and other rural low-resource settings to ensure readiness for future zoonotic disease outbreaks.
2017 年 5 月 12 日，刚果民主共和国（DRC）在巴苏埃勒省利卡蒂区公开宣布爆发埃博拉病毒病（EVD），距离首例病例出现症状 46 天后。EVD 病例的发现和报告延迟突出表明，必须按照全球卫生安全议程建立实时监测系统。我们描述了在疫情中心实施改进的 EVD 病例发现和报告策略方面所吸取的经验教训，并为未来的应对工作提出了建议。这些策略包括：每天举行协调会议，以加强有效的疫情应对活动；评估和调整病例定义和报告工具；利用适合当地情况的技术建立社区警报系统；对适应后的病例定义和报告程序对培训设施和社区卫生工作者进行培训；制定特定于疫情的爆发数据管理计划；以及为通信和信息共享网络提供强化的运营支持。疫情过后，监测官员应通过制定应急计划、评估所使用的病例定义和报告工具、对修订后的病例定义进行再培训以及制定应对电信和技术挑战的策略，为下一次疫情的爆发做好前瞻性规划。刚果民主共和国北基伍省和伊图里省目前正在发生的埃博拉疫情是历史上第二大的疫情，这表明需要记录成功的特定于疫情的策略和工具，以应对下一次疫情。从利卡蒂迅速遏制埃博拉疫情中吸取的经验教训可适用于刚果民主共和国和其他农村资源匮乏地区，以确保为未来的人畜共患疾病疫情做好准备。
