{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T08:06:48Z","timestamp":1772179608467,"version":"3.50.1"},"update-to":[{"DOI":"10.1371\/journal.pntd.0011955","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T00:00:00Z","timestamp":1718841600000}}],"reference-count":53,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T00:00:00Z","timestamp":1717718400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Government-wide R&D Fund Project for Infectious Disease Research","award":["HG23C1629"],"award-info":[{"award-number":["HG23C1629"]}]},{"DOI":"10.13039\/501100003725","name":"Korea National Research Foundation","doi-asserted-by":"crossref","award":["NRF-2021M3E5E308120711"],"award-info":[{"award-number":["NRF-2021M3E5E308120711"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>Ebolavirus disease (EVD) outbreaks have intermittently occurred since the first documented case in the 1970s. Due to its transmission characteristics, large outbreaks have not been observed outside Africa. However, within the continent, significant outbreaks have been attributed to factors such as endemic diseases with similar symptoms and inadequate medical infrastructure, which complicate timely diagnosis. In this study, we employed a stochastic modeling approach to analyze the spread of EVD during the early stages of an outbreak, with an emphasis on inherent risks. We developed a model that considers healthcare workers and unreported cases, and assessed the effect of non-pharmaceutical interventions (NPIs) using actual data. Our results indicate that the implementation of NPIs led to a decrease in the transmission rate and infectious period by 30% and 40% respectively, following the declaration of the outbreak. We also investigated the risks associated with delayed outbreak recognition. Our simulations suggest that, when accounting for NPIs and recognition delays, prompt detection could have resulted in a similar outbreak scale, with approximately 50% of the baseline NPIs effect. Finally, we discussed the potential effects of a vaccination strategy as a follow-up measure after the outbreak declaration. Our findings suggest that a vaccination strategy can reduce both the burden of NPIs and the scale of the outbreak.<\/jats:p>","DOI":"10.1371\/journal.pntd.0011955","type":"journal-article","created":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T14:20:49Z","timestamp":1717770049000},"page":"e0011955","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["A comprehensive analysis of non-pharmaceutical interventions and vaccination on Ebolavirus disease outbreak: Stochastic modeling approach"],"prefix":"10.1371","volume":"18","author":[{"given":"Youngsuk","family":"Ko","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yubin","family":"Seo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7411-3134","authenticated-orcid":true,"given":"Eunok","family":"Jung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,6,7]]},"reference":[{"issue":"2","key":"pntd.0011955.ref001","first-page":"247","article-title":"Ebola haemorrhagic fever in Sudan, 1976","volume":"56","author":"Report of a WHO\/International Study Team","year":"1978","journal-title":"Bulletin of the World Health Organization"},{"issue":"2","key":"pntd.0011955.ref002","first-page":"271","article-title":"Ebola haemorrhagic fever in Zaire, 1976","volume":"56","author":"Report of an International Commission","year":"1978","journal-title":"Bulletin of the World Health Organization"},{"key":"pntd.0011955.ref003","unstructured":"World Health Organization. Ebola outbreak 2014-2016\u2014West Africa [Internet]. [cited 2024 Jan 12]. Available from: https:\/\/www.who.int\/emergencies\/situations\/ebola-outbreak-2014-2016-West-Africa"},{"key":"pntd.0011955.ref004","unstructured":"World Health Organization. Ebola Disease caused by Sudan virus\u2014Uganda [Internet]. 2022 [cited 2024 Jan 12]. Available from: https:\/\/www.who.int\/emergencies\/disease-outbreak-news\/item\/2022-DON410"},{"key":"pntd.0011955.ref005","doi-asserted-by":"crossref","DOI":"10.7591\/cornell\/9780801449413.001.0001","volume-title":"Divining without seeds: the case for strengthening laboratory medicine in Africa","author":"IN Okeke","year":"2011"},{"issue":"4","key":"pntd.0011955.ref006","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1097\/QCO.0000000000000183","article-title":"Risks to healthcare workers with emerging diseases: lessons from MERS-CoV, Ebola, SARS, and avian flu","volume":"28","author":"N Suwantarat","year":"2015","journal-title":"Current opinion in infectious diseases"},{"issue":"7","key":"pntd.0011955.ref007","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1093\/cid\/ciu1131","article-title":"Epidemiological and viral genomic sequence analysis of the 2014 Ebola outbreak reveals clustered transmission","volume":"60","author":"SV Scarpino","year":"2015","journal-title":"Clinical Infectious Diseases"},{"key":"pntd.0011955.ref008","unstructured":"World Health Organization. Ebola virus disease: Vaccines [Internet]. 2020 [cited 2024 Jan 12]. Available from: https:\/\/www.who.int\/news-room\/questions-and-answers\/item\/ebola-vaccines"},{"issue":"10068","key":"pntd.0011955.ref009","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/S0140-6736(16)32621-6","article-title":"Efficacy and effectiveness of an rVSV-vectored vaccine in preventing Ebola virus disease: final results from the Guinea ring vaccination, open-label, cluster-randomised trial (Ebola \u00c7a Suffit!)","volume":"389","author":"AM Henao-Restrepo","year":"2017","journal-title":"The Lancet"},{"issue":"12","key":"pntd.0011955.ref010","doi-asserted-by":"crossref","first-page":"e1010078","DOI":"10.1371\/journal.ppat.1010078","article-title":"Current state of Ebola virus vaccines: A snapshot","volume":"17","author":"C Woolsey","year":"2021","journal-title":"PLoS pathogens"},{"issue":"9996","key":"pntd.0011955.ref011","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1016\/S0140-6736(15)61117-5","article-title":"Efficacy and effectiveness of an rVSV-vectored vaccine expressing Ebola surface glycoprotein: interim results from the Guinea ring vaccination cluster-randomised trial","volume":"386","author":"AM Henao-Restrepo","year":"2015","journal-title":"The Lancet"},{"key":"pntd.0011955.ref012","unstructured":"World Health Organization. Ebola virus disease Democratic Republic of Congo: external situation report 98\/ 2020 [Internet]. 2020 [Cited 2024 Jan 12]. Available from: https:\/\/www.who.int\/publications\/i\/item\/10665-332654"},{"issue":"9","key":"pntd.0011955.ref013","doi-asserted-by":"crossref","first-page":"e0223104","DOI":"10.1371\/journal.pone.0223104","article-title":"Social resistance drives persistent transmission of Ebola virus disease in Eastern Democratic Republic of Congo: a mixed-methods study","volume":"14","author":"K Masumbuko Claude","year":"2019","journal-title":"PLoS One"},{"issue":"5","key":"pntd.0011955.ref014","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/S1473-3099(19)30063-5","article-title":"Institutional trust and misinformation in the response to the 2018\u201319 Ebola outbreak in North Kivu, DR Congo: a population-based survey","volume":"19","author":"P Vinck","year":"2019","journal-title":"The Lancet Infectious Diseases"},{"issue":"6424","key":"pntd.0011955.ref015","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1126\/science.363.6424.213","article-title":"In Congo, fighting a virus and a groundswell of fake news","volume":"363","author":"L Spinney","year":"2019","journal-title":"Science"},{"key":"pntd.0011955.ref016","unstructured":"World Health Organization. Ebola virus disease- Fact sheets [Internet]. 2023 [Cited 2024 May 10]. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/ebola-virus-disease"},{"issue":"01","key":"pntd.0011955.ref017","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s40249-022-00935-7","article-title":"Feasibility, acceptability, and effectiveness of non-pharmaceutical interventions against infectious diseases among crisis-affected populations: a scoping review","volume":"11","author":"JA Polonsky","year":"2022","journal-title":"Infectious diseases of poverty"},{"key":"pntd.0011955.ref018","volume-title":"Modeling Infectious Diseases in Humans and Animals By Matthew James Keeling and Pejman Rohani","author":"GP Wormser","year":"2008"},{"issue":"1","key":"pntd.0011955.ref019","doi-asserted-by":"crossref","first-page":"e1003018","DOI":"10.1371\/journal.pmed.1003018","article-title":"Infectious disease pandemic planning and response: Incorporating decision analysis","volume":"17","author":"FM Shearer","year":"2020","journal-title":"PLoS medicine"},{"issue":"1","key":"pntd.0011955.ref020","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-020-08671-z","article-title":"Can mathematical modelling solve the current Covid-19 crisis?","volume":"20","author":"J Panovska-Griffiths","year":"2020","journal-title":"BMC Public Health"},{"key":"pntd.0011955.ref021","unstructured":"Science News. A mathematical model to help optimize vaccine development [Internet]. 2021 [Cited 2024 Jan 12]. Available from: https:\/\/www.sciencedaily.com\/releases\/2021\/10\/211027134956.htm"},{"key":"pntd.0011955.ref022","article-title":"Better modelling of infectious diseases: lessons from covid-19 in China","volume":"375","author":"Y Wei","year":"2021","journal-title":"bmj"},{"issue":"36","key":"pntd.0011955.ref023","doi-asserted-by":"crossref","first-page":"20894","DOI":"10.2807\/1560-7917.ES2014.19.36.20894","article-title":"Early transmission dynamics of Ebola virus disease (EVD), West Africa, March to August 2014","volume":"19","author":"H Nishiura","year":"2014","journal-title":"Eurosurveillance"},{"key":"pntd.0011955.ref024","doi-asserted-by":"crossref","first-page":"e09186","DOI":"10.7554\/eLife.09186","article-title":"Mathematical modeling of the West Africa Ebola epidemic","volume":"4","author":"JP Chretien","year":"2015","journal-title":"Elife"},{"issue":"6","key":"pntd.0011955.ref025","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1016\/j.tmaid.2014.10.015","article-title":"Risk of imported Ebola virus disease in China","volume":"12","author":"T Chen","year":"2014","journal-title":"Travel medicine and infectious disease"},{"key":"pntd.0011955.ref026","article-title":"Ebola virus disease outbreak in Korea: use of a mathematical model and stochastic simulation to estimate risk","volume":"41","author":"Y Ko","year":"2019","journal-title":"Epidemiology and Health"},{"issue":"4","key":"pntd.0011955.ref027","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1111\/j.1541-0420.2006.00609.x","article-title":"Statistical inference in a stochastic epidemic SEIR model with control intervention: Ebola as a case study","volume":"62","author":"PE Lekone","year":"2006","journal-title":"Biometrics"},{"issue":"1","key":"pntd.0011955.ref028","doi-asserted-by":"crossref","first-page":"e1002057","DOI":"10.1371\/journal.pbio.1002057","article-title":"Characterizing the transmission dynamics and control of ebola virus disease","volume":"13","author":"G Chowell","year":"2015","journal-title":"PLoS biology"},{"key":"pntd.0011955.ref029","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.3389\/fimmu.2018.01025","article-title":"Herd immunity to ebolaviruses is not a realistic target for current vaccination strategies","volume":"9","author":"SG Masterson","year":"2018","journal-title":"Frontiers in immunology"},{"issue":"11","key":"pntd.0011955.ref030","doi-asserted-by":"crossref","first-page":"e0007814","DOI":"10.1371\/journal.pntd.0007814","article-title":"Vaccination strategies to control Ebola epidemics in the context of variable household inaccessibility levels","volume":"13","author":"G Chowell","year":"2019","journal-title":"PLOS Neglected Tropical Diseases"},{"issue":"20","key":"pntd.0011955.ref031","doi-asserted-by":"crossref","first-page":"10178","DOI":"10.1073\/pnas.1817329116","article-title":"Ebola vaccination in the Democratic Republic of the Congo","volume":"116","author":"CR Wells","year":"2019","journal-title":"Proceedings of the National Academy of Sciences"},{"issue":"4","key":"pntd.0011955.ref032","doi-asserted-by":"crossref","first-page":"e0230406","DOI":"10.1371\/journal.pone.0230406","article-title":"Impact of prophylactic vaccination strategies on Ebola virus transmission: a modeling analysis","volume":"15","author":"R Potluri","year":"2020","journal-title":"Plos one"},{"issue":"3","key":"pntd.0011955.ref033","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1016\/j.vaccine.2022.11.036","article-title":"Targeted preventive vaccination campaigns to reduce Ebola outbreaks: An individual-based modeling study","volume":"41","author":"D Bisanzio","year":"2023","journal-title":"Vaccine"},{"key":"pntd.0011955.ref034","article-title":"Estimating the reproduction number of Ebola virus (EBOV) during the 2014 outbreak in West Africa","volume":"6","author":"CL Althaus","year":"2014","journal-title":"PLoS currents"},{"issue":"4","key":"pntd.0011955.ref035","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1093\/cid\/civ319","article-title":"Clinical features of patients with Ebola virus disease in Sierra Leone","volume":"61","author":"E Qin","year":"2015","journal-title":"Clinical infectious diseases"},{"issue":"1","key":"pntd.0011955.ref036","first-page":"1","article-title":"Clinical presentations and outcomes of patients with Ebola virus disease in Freetown, Sierra Leone","volume":"5","author":"YJ Ji","year":"2016","journal-title":"Infectious diseases of poverty"},{"key":"pntd.0011955.ref037","unstructured":"Ministry of Health, Republic of Uganda. Ebolavirus Disease Situation Report 49 [Internet]. 2022 [Cited 2024 Jan 12]. Available from: https:\/\/www.afro.who.int\/sites\/default\/files\/2022-11\/Ug_EVD_SitRep%2349.pdf"},{"issue":"21","key":"pntd.0011955.ref038","doi-asserted-by":"crossref","DOI":"10.1063\/1.2799998","article-title":"A modified next reaction method for simulating chemical systems with time dependent propensities and delays","volume":"127","author":"DF Anderson","year":"2007","journal-title":"The Journal of chemical physics"},{"key":"pntd.0011955.ref039","unstructured":"Brinkhoff T. Uganda: Cities, Towns & Urban Localities. City Population; c2023 [Internet]. 2020 [Cited 2024 Jan 12]. Available from: https:\/\/www.citypopulation.de\/en\/uganda\/cities\/"},{"key":"pntd.0011955.ref040","unstructured":"Wemos, ACHEST. Uganda\u2019s human resources for health: paradoxes and dilemmas [Internet]. 2019 [Cited 2024 Jan 12]. Available from: https:\/\/www.wemos.org\/wp-content\/uploads\/2023\/03\/Advocacy-brief-Ugandas-human-resources-for-health_paradoxes-and-dilemmas-2019.pdf"},{"key":"pntd.0011955.ref041","unstructured":"Mercy Corps. Chapter 5: Ebola\u2019s effect on healthcare systems in Africa [Internet]. 2019 [cited 2024 Apr 1]. Available from: https:\/\/www.mercycorps.org\/blog\/ebola-outbreaks-africa-guide\/chapter-5"},{"issue":"1","key":"pntd.0011955.ref042","doi-asserted-by":"crossref","first-page":"1650","DOI":"10.1186\/s12889-023-16562-2","article-title":"Assessment of healthcare workers' knowledge and attitude on Ebola virus disease in Somalia: a multicenter nationwide survey","volume":"23","author":"AK Mohamud","year":"2023","journal-title":"BMC Public Health"},{"issue":"1","key":"pntd.0011955.ref043","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.phrp.2011.04.001","article-title":"Incubation period of Ebola hemorrhagic virus subtype Zaire","volume":"2","author":"M Eichner","year":"2011","journal-title":"Osong public health and research perspectives"},{"issue":"1","key":"pntd.0011955.ref044","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/sdata.2015.19","article-title":"A review of epidemiological parameters from Ebola outbreaks to inform early public health decision-making","volume":"2","author":"MD Van Kerkhove","year":"2015","journal-title":"Scientific data"},{"key":"pntd.0011955.ref045","unstructured":"Centers for Disease Control and Prevention. Ebola Disease: Signs and Symptoms [Internet]. 2023 [cited 2024 Apr 1]. Available from: https:\/\/www.cdc.gov\/vhf\/ebola\/symptoms\/index.html"},{"key":"pntd.0011955.ref046","unstructured":"Rothman KJ, Greenland S, Lash TL. Modern epidemiology. Philadelphia: Wolters Kluwer Health\/Lippincott Williams & Wilkins; 2008."},{"key":"pntd.0011955.ref047","unstructured":"World Health Organization. EBOLA VIRUS DISEASE OUTBREAK RESPONSE ACCOUNTABILITY FORUM\u201410 January 2023 [Internet]. 2023 [Cited 2024 Jan 12]. Available from: https:\/\/www.afro.who.int\/sites\/default\/files\/2023-01\/EBOLA%20VIRUS%20DISEASE%20OUTBREAK%20RESPONSE%20ACCOUNTABILITY%20FORUM%20-%2010%20January%202023.pdf"},{"key":"pntd.0011955.ref048","unstructured":"Ministry of Health, Government of Uganda. Uganda national response plan for Ebolavirus disease outbreak [Internet]. 2022 [cited 2024 Jan 12]. Available from: https:\/\/www.afro.who.int\/sites\/default\/files\/2022-11\/National%20Sudan%20Ebolavirus%20Response%20Plan_UGA_07102022.pdf"},{"key":"pntd.0011955.ref049","unstructured":"Ministry of Health, Government of Uganda. Ebolavirus Disease Situation Report 10 [Internet]. 2022 [cited 2024 Jan 12]. Available from: https:\/\/reliefweb.int\/report\/uganda\/uganda-ebola-virus-disease-situation-report-no-10"},{"issue":"1","key":"pntd.0011955.ref050","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.jtbi.2008.04.011","article-title":"A methodology for performing global uncertainty and sensitivity analysis in systems biology","volume":"254","author":"S Marino","year":"2008","journal-title":"Journal of theoretical biology"},{"key":"pntd.0011955.ref051","doi-asserted-by":"crossref","first-page":"S65","DOI":"10.1086\/514290","article-title":"Ebola hemorrhagic fever outbreaks in Gabon, 1994\u20131997: epidemiologic and health control issues","volume":"179","author":"AJ Georges","year":"1999","journal-title":"The Journal of infectious diseases"},{"key":"pntd.0011955.ref052","unstructured":"The United States Food and Drug Administration. FDA NEWS RELEASE, FDA Roundup: July 28, 2023 [Internet]. 2023 [cited 2024 Jan 12]. Available from: https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-roundup-july-28-2023"},{"key":"pntd.0011955.ref053","first-page":"103958","article-title":"Ebola virus outbreak returns to the Democratic Republic of Congo: an urgent rising concern","volume":"79","author":"J Sun","year":"2022","journal-title":"Annals of medicine and surgery"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0011955","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T00:00:00Z","timestamp":1718841600000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0011955","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T13:51:12Z","timestamp":1718891472000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0011955"}},"subtitle":[],"editor":[{"given":"Aleksandra","family":"Inic-Kanada","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,6,7]]},"references-count":53,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,6,7]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0011955","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2024.02.25.24302269","asserted-by":"object"}]},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,7]]}}}