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The basic reproductive number of Ebola and the effects of public health measures: the cases of Congo and Uganda

Authors
Journal
Journal of Theoretical Biology
0022-5193
Publisher
Elsevier
Publication Date
Identifiers
DOI: 10.1016/j.jtbi.2004.03.006
Keywords
  • Ebola
  • Reproductive Number
  • Congo
  • Uganda
  • Outbreak
  • Interventions
Disciplines
  • Education
  • Medicine

Abstract

Abstract Despite improved control measures, Ebola remains a serious public health risk in African regions where recurrent outbreaks have been observed since the initial epidemic in 1976. Using epidemic modeling and data from two well-documented Ebola outbreaks (Congo 1995 and Uganda 2000), we estimate the number of secondary cases generated by an index case in the absence of control interventions ( R 0). Our estimate of R 0 is 1.83 ( sd 0.06) for Congo (1995) and 1.34 ( sd 0.03) for Uganda (2000). We model the course of the outbreaks via an SEIR (susceptible-exposed-infectious-removed) epidemic model that includes a smooth transition in the transmission rate after control interventions are put in place. We perform an uncertainty analysis of the basic reproductive number R 0 to quantify its sensitivity to other disease-related parameters. We also analyse the sensitivity of the final epidemic size to the time interventions begin and provide a distribution for the final epidemic size. The control measures implemented during these two outbreaks (including education and contact tracing followed by quarantine) reduce the final epidemic size by a factor of 2 relative the final size with a 2-week delay in their implementation.

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