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Focus on reducing Superspreader Events. Funerals are the leading cause of spread in West-Africa

Research shows that the key element to decrease the spread of Ebola is to change funeral practices. Current funerals are now serving as Superspreader events where people touch or kiss the bodies at the most infectious time. This open online paper shows that a change in funeral practices is the imperative change needed to stop the spread of the disease.:

Photo of Gunnar Johannsson
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I wanted to know why this outbreak of Ebola was so much worse than previous outbreaks. How is it spreading and which actions could possibly limit the spread the fastest?
**How infectious is Ebola?**
The basic reproduction number (R0), or how many people get infected from each infected individual, is low in the case of Ebola and this outbreak is no exception. On average 1,63 people get infected from each sick person and that is even less than in previous outbreaks where numbers ranged from 1,8-2,7. If this number stays above 1 then more people are getting sick. If we bring it under 1 then the outbreak will slowly stop. For comparison measles has an R0 of 12-18 and influenza has an R0 of 2-3. 
**How does Ebola spread**
Ebola is a virus that only spreads through bodily fluids that have a high enough viral load. It is not until at later stages of the disease that people have enough viral load and weak skin that they infect people directly during touch. Thus people are the most infectious when dying or dead. 

Recent research has calculated the expected impact of different routes of spread. Their results were:
1) If we stop all spread of the disease between Hospital patients and staff the R0 will drop to 1,44.
2) If we stop the spread of the disease from sick people out in the community we could drop the R0 to 1.39.
3) If we could stop the spread of the disease during funerals we could drop the spread of the disease to 0,93.
This means that if we could only stop all the spread during funerals we could slowly stop the outbreak, even if nothing else is done. 
Although the fight against Ebola should be fought on all fronts this shows us an area where Return On Investment might be the highest.


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Photo of OB Roy

Absolutely! Please refer to my own contribution 'The Power of the People' and let's work together on this. We are developing a core network of local volunteers (piloting in Liberia) who are known and trusted by their communities - to inform them in Ebola and what steps they can take. For some isolated communities this can be the first time anyone (they trust and know) has reached out to them and our volunteers are thanked for their efforts. One of our core volunteer coordinators from Cape Mount a district previously unaffected with 1 case, tells the story of how his father died 3 weeks ago: last week 7 people died including his sister who left 5 children whom they relatives were to fearful to care for. This week only 2 of the children are alive, with Ebola symptoms and 1 brother and his household have all died. 3 weeks ago Hessle estimated that at least 50% of infections were due to traditional practices, in caring for the sick , the dying and the dead. There is much work to do in taking action now to reach out and help people through Ebola Action: Educate, Sanitise, Prevent, Survey. Please join me. Your contribution will be most welcome and put to immediate use.

Photo of Gunnar Johannsson

Wow, great work duly applauded!