西非涉及几内亚，利比里亚和塞拉利昂国家的西非埃博拉病毒疾病（EVD）的史无前例的2013 - 15年流行病一直是traced backto a single cross-species transmission event from a fruit bat in the forested region of the district of Guéckédou in Guinea in December 2013.
Chains of Ebola transmission were not reported to the World Health Organization untillate March 2014when the virus had already reached neighboring Sierra Leone and Liberia.
由于缺乏针对埃博拉病毒的药物干预措施，基本的公共卫生干预措施，包括在医疗保健环境中有效隔离传染性人士和接触追踪活动以迅速识别有症状的人在控制西非这种流行病方面发挥了关键作用。
尽管流行病尚未结束，但在控制流行病方面取得了实质性进展。截至2015年12月9日，自2015年4月以来，在西非报告的三个受影响最高的国家（WHO）的三个受影响最高的国家（WHO）总共有28,601例和11,300例死亡。2015年10月至11月在几内亚和利比里亚报道。
虽然最近的研究（例如here和here) have improved our understanding of the epidemiological and clinical characteristics of EVD, datasets on the spatial-temporal characteristics of the contact networks over which the virus spread remain limited.
此类数据对于改善数学传输模型非常重要，以产生可靠的流行病预测，指导公共卫生控制策略并评估控制干预措施的效果。
为了有助于我们理解EVD的传输特征和控制干预措施的作用，阿杰利等。in BMC Medicineprovide a detailed analysis of the EVD outbreak in Pujehun, Sierra Leone during July-November 2014.
具体而言，作者分析了医院记录的合并数据集，并联系跟踪数据以及当地人口访谈，以重建暴发的详细传输链。
研究人员还评估了使用基于代理的传输模型，包括案例隔离，安全埋葬和接触跟踪的各种控制干预措施的影响。这same modeling frameworkhas been successfully employed to characterize the transmission dynamics of the Ebola epidemic in Liberia.
阿杰利等。发现大多数暴露是源于与居住在同一家庭或大家庭中的家庭成员的接触（74.3％），17.9％的传播事件发生在社区中，大部分是朋友之间的接触，只有7.7％事件与医疗机构有关（只有两名医疗保健工作者和一名患者受到影响）。
Overall, the transmission patterns reported by Ajelli等。reflect the impact of the rapid implementation of control interventions (effective isolation of symptomatic individuals and contact tracing activities) in Pujehun district and three months after the epidemic was reported to WHO.
By contrast,funeral exposure和医院传播likely drove Ebola transmission in West Africa during the early epidemic months until approximately July 2014, both of which rapidly declined after the implementation of control interventions.
Data from Guineareported by Faye等。covering 152 Ebola cases from three areas of Guinea between February and August 2014 indicated predominance of community exposure (72% through family), followed by 13% of hospital exposure, and 13% of funeral exposure.
这项研究还报道了传输树中的卫生保健工人比例为14％。Faye报告的住院率等。(80%) was slightly lower to that reported by Ajelli等。for the outbreak in Pujehun in Sierra Leone (89%). Another limited outbreak of EVD occurred in Nigeria during July-September 2014.
A common feature of the temporal evolution of the reproduction number across local Ebola outbreaks including that of Pujehun is its rapid decline after just a few generations of infections.
这initial reproduction number estimate of the Ebola outbreak in Pujehun, Sierra Leone estimated by Ajelli等。using an individual-based transmission model displayed substantial uncertainty (R=2.2, 95 %CI: 1.5,4.5) and is broadly in agreement with published estimates of the reproduction number for EVD.
A common feature of the temporal evolution of the reproduction number across local Ebola outbreaks including that of Pujehun is its rapid decline after just a few generations of infections.
This可以解释either as the natural history of disease transmission in a highly clustered network combined with the effects of control measures/ interventions and the rapid onset of behavior changes in the population.
这modeling analyses carried out by Ajelli等。进一步支持联合公共卫生干预措施对快速减轻EVD传播的巨大积极影响。
注释