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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. The Ebola Epidemic in West Africa: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23653.
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THE EBOLA EPIDEMIC
IN WEST AFRICA

Proceedings of a Workshop

Allison Mack, Megan Reeve Snair, and Carmen Mundaca-Shah, Rapporteurs

Forum on Microbial Threats

Board on Global Health

Health and Medicine Division

images

THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. The Ebola Epidemic in West Africa: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23653.
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THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This project was supported by contracts between the National Academy of Sciences and American Society for Microbiology; Burroughs Wellcome Fund; Infectious Diseases Society of America; the Merck Company Foundation; Pfizer Inc.; Sanofi Pasteur; the U.S. Agency for International Development; the U.S. Department of Defense, Department of the Army: Defense Threat Reduction Agency, Global Emerging Infections Surveillance and Response System, and Medical Research and Materiel Command; the U.S. Department of Health and Human Services: Centers for Disease Control and Prevention, Food and Drug Administration, National Institute of Allergy and Infectious Diseases, and National Institutes of Health; the U.S. Department of Homeland Security; and the U.S. Department of Veterans Affairs. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for this project.

International Standard Book Number-13: 978-0-309-45006-5
International Standard Book Number-10: 0-309-45006-3
Digital Object Identifier: 10.17226/23653

Additional copies of this publication are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

Copyright 2016 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2016. The Ebola Epidemic in West Africa: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23653.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. The Ebola Epidemic in West Africa: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23653.
×

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The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.

The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. C. D. Mote, Jr., is president.

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Learn more about the National Academies of Sciences, Engineering, and Medicine at www.national-academies.org.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. The Ebola Epidemic in West Africa: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23653.
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Reports document the evidence-based consensus of an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and committee deliberations. Reports are peer reviewed and are approved by the National Academies of Sciences, Engineering, and Medicine.

Proceedings chronicle the presentations and discussions at a workshop, symposium, or other convening event. The statements and opinions contained in proceedings are those of the participants and have not been endorsed by other participants, the planning committee, or the National Academies of Sciences, Engineering, and Medicine.

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. The Ebola Epidemic in West Africa: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23653.
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PLANNING COMMITTEE FOR THE WORKSHOP ON THE EBOLA EPIDEMIC IN WEST AFRICA1

CHRIS BEYRER, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

REINHARD BURGER, Robert Koch Institute, Berlin, Germany

DAVID HEYMANN, Chairman, Public Health England, London, UK

JAMES HUGHES, Professor of Medicine and Public Health, Emory University, Atlanta, GA

RIMA KHABBAZ, Centers for Disease Control and Prevention, Atlanta, GA

LONNIE KING, College of Veterinary Medicine, The Ohio State University, Columbus, OH

MARK KORTEPETER, Uniformed Services University of the Health Sciences, Bethesda, MD

DAVID RELMAN, Professor of Immunology and Microbiology, Stanford University, CA

Health and Medicine Division Staff

EILEEN CHOFFNES, Scholar and Forum Director (until November 2015)

CARMEN MUNDACA-SHAH, Forum Director (from April 2016)

KATHERINE McCLURE, Associate Program Officer (until July 2015)

V. AYANO OGAWA, Associate Program Officer (from November 2015)

REBEKAH HUTTON, Research Associate (until July 2015)

PRIYANKA NALAMADA, Senior Program Assistant (until March 2015)

ELAINE HYNDS, Senior Program Assistant (from May 2016)

THU ANH TRAN, Senior Program Assistant (from August 2016)

PATRICK KELLEY, Director, Board on Global Health (until August 2016)

___________________

1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. The Ebola Epidemic in West Africa: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23653.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. The Ebola Epidemic in West Africa: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23653.
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Reviewers

This Proceedings of a Workshop has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published Proceedings of a Workshop as sound as possible and to ensure that the Proceedings of a Workshop meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this Proceedings of a Workshop:

Daniel G. Bausch, Tulane University

Joseph Fair, Fondation Mérieux USA

David Fitter, Centers for Disease Control and Prevention

James W. LeDuc, University of Texas Medical Branch

Suzet M. McKinney, Illinois Medical District

Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the proceedings of a workshop before its release. The review of this Proceedings of a Workshop was overseen by Mel Worth. He was responsible for making certain that an independent examination of this Proceedings of a Workshop was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this Proceedings of a Workshop rests entirely with the rapporteurs and the institution.

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. The Ebola Epidemic in West Africa: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23653.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. The Ebola Epidemic in West Africa: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23653.
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Acknowledgments

The Forum on Microbial Threats staff and planning committee deeply appreciate the many valuable contributions from individuals who assisted with this project. First, we offer our profound thanks to all of the presenters and discussants at the workshop who gave so generously of their time and expertise. These individuals are listed in full in the workshop agenda in Appendix E. We are also grateful to Carissa Etienne and her staff, including Fredy Aviles, Cesar Guevara, Bruce Leech, Alex Romero, and Lourdes Withrow, for graciously hosting the workshop at the Pan American Health Organization’s headquarters building.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. The Ebola Epidemic in West Africa: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23653.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. The Ebola Epidemic in West Africa: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23653.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. The Ebola Epidemic in West Africa: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23653.
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Acronyms and Abbreviations

AFRO World Health Organization Regional Office for Africa
BARDA Biomedical Advanced Research and Development Authority
BSL biosafety level
CDC U.S. Centers for Disease Control and Prevention
CSM cerebral spinal meningitis
DART Disaster Assistance Response Team
DoD U.S. Department of Defense
DRC Democratic Republic of Congo
ELISA enzyme-linked immunoabsorbent assay
EMT emergency medical technician
EMTALA Emergency Medical Treatment and Labor Act
EOC Emergency Operation Center
ETU Ebola treatment unit
EVD Ebola virus disease
FDA U.S. Food and Drug Administration
GP glycoprotein
GSK GlaxoSmithKline
HDI human development index
HEPA high-efficiency particulate air filter
HIV human immunodeficiency virus
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. The Ebola Epidemic in West Africa: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23653.
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HMD Health and Medicine Division
Ig immunoglobulin
IHR International Health Regulations
IOM Institute of Medicine
MAb monoclonal antibody
MERS-CoV Middle East respiratory syndrome coronavirus
MSF Médecins Sans Frontières
MVA modified vaccine Ankara
NAM National Academy of Medicine
NGO nongovernmental organization
NHP nonhuman primate
NIAID National Institute of Allergy and Infectious Diseases
NIH National Institutes of Health
PAHO Pan American Health Organization
PCR polymerase chain reaction
PHEIC public health emergency of international concern
PPE personal protective equipment
PUI person under investigation
qRT-PCR quantitative reverse transcriptase polymerase chain reaction
RITE rapid isolation and treatment of Ebola
RKI Robert Koch Institute
rNAP c2 recombinant nematode anticoagulant protein c2
RT-LAMP reverse transcription loop-mediated isothermal amplification
SARS severe acute respiratory syndrome
sGP truncated glycoprotein isoform
siRNA small interfering RNA
UN United Nations
USAID U.S. Agency for International Development
USAMRIID U.S. Army Medical Research Institute of Infectious Diseases
VIC Viral Hemorrhagic Fever Immunotherapeutic Consortium
VP viral protein
VSV vesicular stomatitis virus
WHO World Health Organization
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. The Ebola Epidemic in West Africa: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/23653.
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The Ebola Epidemic in West Africa: Proceedings of a Workshop Get This Book
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The most recent Ebola epidemic that began in late 2013 alerted the entire world to the gaps in infectious disease emergency preparedness and response. The regional outbreak that progressed to a significant public health emergency of international concern (PHEIC) in a matter of months killed 11,310 and infected more than 28,616. While this outbreak bears some unique distinctions to past outbreaks, many characteristics remain the same and contributed to tragic loss of human life and unnecessary expenditure of capital: insufficient knowledge of the disease, its reservoirs, and its transmission; delayed prevention efforts and treatment; poor control of the disease in hospital settings; and inadequate community and international responses.

Recognizing the opportunity to learn from the countless lessons of this epidemic, the National Academies of Sciences, Engineering, and Medicine convened a workshop in March 2015 to discuss the challenges to successful outbreak responses at the scientific, clinical, and global health levels. Workshop participants explored the epidemic from multiple perspectives, identified important questions about Ebola that remained unanswered, and sought to apply this understanding to the broad challenges posed by Ebola and other emerging pathogens, to prevent the international community from being taken by surprise once again in the face of these threats. This publication summarizes the presentations and discussions from the workshop.

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