Document Type

Capstone Experience

Graduation Date

5-2023

Degree Name

Master of Public Health

Department

Epidemiology

First Committee Member

David Brett-Major

Second Committee Member

M. Jana Broadhurst

Third Committee Member

John Lowe

Abstract

Background: Indirect transmission of Ebola virus disease (EVD) is not uncommon but is poorly understood. Improving the understanding of the potential risk of EVD transmission from fomites should result in new or updated prevention or control measures for suspected or confirmed EVD cases or outbreaks.

Objective: This study aims to compile and understand pertinent data from peer-reviewed literature, establish the dose-response relationship between inoculum doses introduced to mucous membranes, and finally estimate the risk of EVD transmission from fomites.

Methods: A literature search was conducted through PubMed to obtain relevant data. This study employed this data to perform Poisson regression analyses to understand the dose-response relationships of interest. Finally, provided the results of the Poisson and additional data from the literature, this study aims to establish the risk of EVD transmission from fomites.

Results: Data was accumulated to assess animal outcomes from EVD inoculum offered to ocular, nasal, or oral mucosa, clinical aspects of human EVD cases or outbreaks, and virus persistence in the environment. The initial run of the Poisson model did not meet the equidispersion assumption, signaling the need for model adjustments, thus halting the use of QMRA methods.

Conclusions: This novel investigation produced EVD literature to understand the risk of EVD transmission from fomites. Furthermore, this study provides a framework for utilizing the described methods that could be used to estimate transmission risk from different simulation conditions. Despite limitations seen with the use of specified scenarios, this research is the first step to addressing this significant gap in EVD literature. The current work should continue, addressing issues with the current Poisson model to obtain what is needed to employ QMRA to understand the risk of EVD transmission from fomites.

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