Ebola virus transmission among healthcare workers: genomic epidemiological analysis of the 2014 Kenema Government Hospital outbreak

Healthcare worker infections at Kenema Government Hospital in Sierra Leone were linked to healthcare worker-to-healthcare worker transmission, with 22 candidate links exceeding a 5% posterior threshold.

• Why it matters: In 2014, many healthcare worker infections disrupted care, but it was unclear whether they mainly came from repeated patient exposure or from colleague transmission under capacity constraints.
• What they did: The team analyzed 279 Ebola virus genomes from Kenema District, including 35 from infected healthcare workers, using Bayesian transmission inference with juniper and expanded surveillance plus staff accounts.
• The result: Healthcare workers made up 33.2% of expected onward transmissions at their peak in the two-week window beginning June 23, 2014, supporting interconnected workforce spread across wards and departments.