Western African Ebola epidemic

Western African Ebola epidemic
Simplified Ebola virus epidemic situation map
DateDecember 2013 – June 2016[1][2]
Casualties
Country Cases Deaths Outbreak end
Liberia 10,675 4,8099 Jun 2016[2]
Sierra Leone 14,124 3,95617 Mar 2016[3]
Guinea 3,811 2,5431 Jun 2016[4]
Nigeria 20 819 Oct 2014[5]
Mali 8 618 Jan 2015[6]
United States 4 121 Dec 2014[7]
Italy 1 020 Jul 2015[8]
United Kingdom 1 010 Mar 2015[9]
Senegal 1 017 Oct 2014[5]
Spain 1 02 Dec 2014[10]
Total 28,646 11,323 Jun 2016
Note: current estimates suggest that between 17 percent and 70 percent of Ebola cases were unreported,[11] suggesting a total number of cases between 34,513 and 94,486.

The 2013–2016 epidemic of Ebola virus disease, centered in West Africa, was the most widespread outbreak of the disease in history. It caused major loss of life and socioeconomic disruption in the region, mainly in Guinea, Liberia and Sierra Leone. The first cases were recorded in Guinea in December 2013; the disease spread to neighbouring Liberia and Sierra Leone,[12] with minor outbreaks occurring in Nigeria and Mali.[13][14] Secondary infections of medical workers occurred in the United States and Spain.[15][16] Isolated cases were recorded in Senegal,[17] the United Kingdom and Italy.[18][19] The number of cases peaked in October 2014 and then began to decline gradually, following the commitment of substantial international resources.

It caused significant mortality, with a considerable case fatality rate.[12][18][20][note 1] By the end of the epidemic, 28,616 people had been infected; of these, 11,310 had died, for a case-fatality rate of 40%.[21] As of 8 May 2016, the World Health Organization (WHO) and respective governments reported a total of 28,646 suspected cases and 11,323 deaths[22] (39.5%), though the WHO believes that this substantially understates the magnitude of the outbreak.[23][24] On 8 August 2014, a Public Health Emergency of International Concern was declared[25] and on 29 March 2016, the WHO terminated the Public Health Emergency of International Concern status of the outbreak.[26][27][28] Subsequent flare-ups occurred; the epidemic was finally declared over on 9 June 2016, 42 days after the last case tested negative on 28 April 2016 in Monrovia.[29]

The outbreak left about 17,000 survivors of the disease, many of whom report post-recovery symptoms termed post-Ebola syndrome, often severe enough to require medical care for months or even years. An additional cause for concern is the apparent ability of the virus to "hide" in a recovered survivor's body for an extended period and then become active months or years later, either in the same individual or in a sexual partner.[30] In December 2016, the WHO announced that a two-year trial of the rVSV-ZEBOV vaccine appeared to offer protection from the variant of EBOV responsible for the Western Africa outbreak. The vaccine is considered to be effective and is the only prophylactic that offers protection; hence, 300,000 doses have been stockpiled.[31][32] rVSV-ZEBOV received regulatory approval in 2019.[33][34]

  1. ^ "WHO Director-General addresses the Executive Board". Archived from the original on 26 January 2016. Retrieved 9 June 2016.
  2. ^ a b Brice, Makini (9 June 2016). "WHO declares Liberia free of active Ebola virus transmission". Thomson Reuters Foundation. Retrieved 16 October 2016.
  3. ^ "Ebola Situation Report – 16 March 2016 | Ebola". World Health Organization. Archived from the original on 18 March 2016. Retrieved 28 October 2016.
  4. ^ "End of Ebola transmission in Guinea". WHO Regional Office for Africa. 2015. Archived from the original on 2 June 2016. Retrieved 9 June 2016.
  5. ^ a b Cite error: The named reference WHO20141022 was invoked but never defined (see the help page).
  6. ^ "Ebola situation report" (PDF). World Health Organization. 21 January 2015. Retrieved 22 January 2015.
  7. ^ "Ebola response roadmap – Situation report 24 December 2014". World Health Organization. 26 December 2014. Archived from the original on 30 December 2014. Retrieved 29 December 2014.
  8. ^ "Ebola situation report". World Health Organization. 22 July 2015. Archived from the original on 26 July 2015.
  9. ^ Cite error: The named reference Uk_10_March was invoked but never defined (see the help page).
  10. ^ "Situation summary". World Health Organization. 5 December 2014. Retrieved 6 December 2014.
  11. ^ Donald G. McNeil Jr. (16 December 2015). "Fewer Ebola cases go unreported than thought, study finds". The New York Times. Retrieved 23 July 2015.
  12. ^ a b WHO Ebola Response Team (23 September 2014). "Ebola virus disease in West Africa – the first 9 months of the epidemic and forward projections". The New England Journal of Medicine. 371 (16): 1481–1495. doi:10.1056/NEJMoa1411100. PMC 4235004. PMID 25244186. ... we estimate that the case fatality rate is 70.8% (95% confidence interval [CI], 69 to 73) among persons with known clinical outcome of infection.
  13. ^ "End of Ebola transmission in Guinea" (Press release). World Health Organization, Africa. 1 June 2016. Retrieved 13 August 2024.
  14. ^ Penney, Joe; Diallo, Tiemoko (12 November 2014). "UPDATE 1—Mali confirms new case of Ebola, locks down Bamako clinic". Reuters. Writing and additional reporting by David Lewis; editing by Grant McCool and G Crosse. Archived from the original on 5 March 2016. Retrieved 15 November 2014.
  15. ^ "Una enfermera que atendió al misionero fallecido García Viejo, contagiada de ébola" [A nursing assistant who attended to the deceased missionary García Viejo, infected with Ebola]. El Mundo (in Spanish). 6 October 2014. Retrieved 13 August 2024.
  16. ^ Ebola outbreak situation report (PDF) (Report). WHO. 8 October 2014. Retrieved 15 October 2014.
  17. ^ Ebola response roadmap situation report update (PDF) (Report). WHO. 7 November 2014. Retrieved 7 November 2014.
  18. ^ a b Ebola response roadmap situation report (PDF) (Report). WHO. 31 December 2014. Archived from the original (PDF) on 31 December 2014. Retrieved 1 January 2015. The reported case fatality rate in the three intense-transmission countries among all cases for whom a definitive outcome is known is 71%.
  19. ^ "Ebola virus disease – Italy". WHO. Archived from the original on 16 May 2015. Retrieved 28 October 2016.
  20. ^ a b "Case Fatality Rate for ebolavirus". University of Edinburgh. 2015. Archived from the original on 29 August 2014. Retrieved 28 January 2015.
  21. ^ Wappes J. "US health worker monitored as DRC Ebola nears 600 cases". CIDRAP. Retrieved 23 January 2019.
  22. ^ Ebola virus disease (Report). World Health Organization. Retrieved 6 June 2019.
  23. ^ Meltzer, Martin I.; Atkins, Charisma Y.; Santibanez, Scott; et al. (26 September 2014). "Estimating the future number of cases in the Ebola epidemic – Liberia and Sierra Leone, 2014–2015". Morbidity and Mortality Weekly Report. 63 (3): 1–14. PMID 25254986.
  24. ^ Worl, Justin (2014). "New Ebola Cases Could Hit 10,000 Per Week". Time. Retrieved 28 October 2016.
  25. ^ Statement on the 1st meeting of the IHR Emergency Committee on the 2014 Ebola outbreak in West Africa (Report). WHO. Archived from the original on 8 August 2014. Retrieved 13 January 2019.
  26. ^ Cite error: The named reference EmergencyEnd was invoked but never defined (see the help page).
  27. ^ Interim advice on the sexual transmission of the Ebola virus disease (Report). WHO. Retrieved 28 October 2016.
  28. ^ WHO Director-General addresses the Executive Board (Report). WHO. Archived from the original on 26 January 2016. Retrieved 27 January 2016.
  29. ^ WHO (10 June 2016). Situation Report Ebola (PDF) (Report). WHO. Retrieved 11 November 2016.
  30. ^ Yasmin, Seema (29 February 2016). "Why Ebola Survivors Struggle with New Symptoms". Scientific American. Retrieved 9 September 2016.
  31. ^ Geisbert, Thomas W. (December 2016). "First Ebola virus vaccine to protect human beings?". The Lancet. 389 (10068): 479–480. doi:10.1016/S0140-6736(16)32618-6. PMID 28017402.
  32. ^ "Ebola vaccine results are encouraging – but preliminary". PBS. 23 December 2016.
  33. ^ "Ervebo". EMA. 12 December 2019. Retrieved 2 February 2020.
  34. ^ "First FDA-approved vaccine for the prevention of Ebola virus disease, marking a critical milestone in public health preparedness and response". FDA. 19 December 2019. Retrieved 2 February 2020.


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