Epidemiologists determined that the trigger event was the zoonotic infection of a small child in rural Guinea in December 2013, setting off multiple extended chains of infection. Īs context, the 2013–2016 EVD epidemic transcended all 24 preceding outbreaks that occurred in the 40-year interval since Ebola was first recognized in 1976. FRBs are defined as “individual or collective behaviors and actions initiated in response to fear reactions that are triggered by a perceived threat or actual exposure to a potentially traumatizing event. The focus of this review is on the crossroads linking fear-related behaviors (FRBs) to disease spread and downstream consequences. The 2013–2016 West Africa Ebola virus disease (EVD) outbreak set off two intermingled and interacting epidemic processes: disease transmission and fear propagation. Future directions include modeling the onset, operation, and perpetuation of fear-related behaviors and devising strategies to redirect behavioral responses to mass threats in a manner that reduces risks and promotes resilience. Particularly notable are behaviors such as treating Ebola patients in home or private clinic settings, the “laying of hands” on Ebola-infected individuals to perform faith-based healing, observing hands-on funeral and burial customs, foregoing available life-saving treatment, and stigmatizing Ebola survivors and health professionals. Fear-related behaviors are identified for each of these outcomes. FRBs modify the future risk of harm.” This review examines how fear-related behaviors were implicated in (1) accelerating the spread of Ebola, (2) impeding the utilization of life-saving Ebola treatment, (3) curtailing the availability of medical services for treatable conditions, (4) increasing the risks for new-onset psychological distress and psychiatric disorders, and (5) amplifying the downstream cascades of social problems. Fear-related behaviors are defined as “individual or collective behaviors and actions initiated in response to fear reactions that are triggered by a perceived threat or actual exposure to a potentially traumatizing event. Fear-related behaviors played an important role in shaping the outbreak. The 2013–2016 West Africa Ebola virus disease pandemic was the largest, longest, deadliest, and most geographically expansive outbreak in the 40-year interval since Ebola was first identified.
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