Sources and symptoms of stress among nurses in the first Chinese anti-Ebola medical team during the Sierra Leone aid mission: A qualitative study

Liu, Chunzi; Wang, Huaming; Zhou, Lin; Xie, Hui; Yang, Huiyin; Yu, Yanbo; Sha, Huayan; Yang, Ying; Zhang, Xin

Caused by the virus from which it is named, Ebola virus disease (EVD) is deadly and infectious. In past outbreaks, the death rates have varied from 45% to 90% (50% on average) [1] . The West Africa Ebola outbreak that began in March 2014 mainly affected Liberia, Sierra Leone, Guinea, and Nigeria [2] . By December 17, 2014 , the total number of confirmed, possible, and suspected EVD cases was 18,603 worldwide, 6,915 of which were fatal [3] . From an epidemiological perspective, infected humans and primates were the major sources of infection. Humans were infected from contact through broken skin or mucous membranes with blood, secretions, excretions, organs, and other bodily fluids of infected animals. Soiled surfaces and materials (such as bedding items and clothes) can likewise cause infection [4] . The virus then spread through human-to-human transmission with an incubation period of 2e21 days (average: 8e10 days). Schieffelin et al. [5] observed an incubation period of 6e16 days. Most patients died of hemorrhage and multi-organ dysfunction within two weeks of infection. Laboratory tests found that patients developed a variable degree of multiorgan dysfunction, including liver and kidney damage [5e7]. As of December 2014, specific EVD treatment protocols have not been established [8e10] . As of the time of this study, Ebola virus vaccines have been the focus of research and development; however, none of them have been licensed.