Ebola historical perspective: Difference between revisions

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{{Ebola}}
{{Ebola}}
{{CMG}}; {{AE}} {{MJM}}, {{GRN}}
{{CMG}}; {{AE}} {{MJM}}; {{GRN}}; {{YD}}


==Overview==
==Overview==
The Ebola virus was named after the Ebola River Valley in the Democratic Republic of the Congo (formerly Zaïre), near the site of a 1976 [[outbreak]] at a mission run by Flemish nuns.<ref>{{cite journal |last=Bardi |first=Jason Socrates |authorlink= |coauthors= |year=2002 |month=|title=Death Called a River |journal=Scribbs Research Institute |volume=2 |issue=1 |pages= |id= |url=http://www.scripps.edu/newsandviews/e_20020114/ebola1.html|accessdate=2006-12-08 |quote= }}</ref> Since the initial discovery of the [[virus]], five subtypes have subsequently been identified.
Ebola virus was first discovered in 1976 when two simultaneous outbreaks occurred in Zaire and Sudan. The first description of Ebola virus was made by Ngoy Mushola in Yambuku, Zaire during the 1976 outbreak. During the outbreak, Peter Piot analyzed blood samples of an infected Belgian nun in Zaire and was the first to describe the virus morphology using electron microscopy. The Ebola virus was named after the Ebola River Valley in the Democratic Republic of the Congo (formerly Zaire).<ref>{{cite journal |last=Bardi |first=Jason Socrates |authorlink= |coauthors= |year=2002 |month=|title=Death Called a River |journal=Scribbs Research Institute |volume=2 |issue=1 |pages= |id= |url=http://www.scripps.edu/newsandviews/e_20020114/ebola1.html|accessdate=2006-12-08 |quote= }}</ref> Approximately 14 outbreaks of Ebola virus have been described since its discovery. The 2013-2014 outbreak marks the largest Ebola outbreak, involving Africa, Asia, Europe, and America and making the virus a worldwide disease.
 
==Historical Perspective==
==Historical Perspective==


===Discovery===
===Discovery===
* The Ebola virus was first discovered in 1976 following two simultaneous [[outbreaks]] of Ebola [[hemorrhagic fever]] between June and November in Zaire and between August and November in Sudan.<ref name="pmid307456">{{cite journal| author=| title=Ebola haemorrhagic fever in Zaire, 1976. | journal=Bull World Health Organ | year= 1978 | volume= 56 | issue= 2 | pages= 271-93 | pmid=307456 | doi= | pmc=PMC2395567 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=307456  }} </ref><ref name="pmid307455">{{cite journal| author=| title=Ebola haemorrhagic fever in Sudan, 1976. Report of a WHO/International Study Team. | journal=Bull World Health Organ |year= 1978 | volume= 56 | issue= 2 | pages= 247-70 | pmid=307455 | doi= | pmc=PMC2395561 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=307455  }} </ref>
* Nurse Mayinga N'Seka, a nurse in Zaire, is thought to be the [[index case]] in the first recognized [[Ebola]] [[epidemic]] in 1976. She was believed to be the only patient infected via airborne transmission of the [[Ebola virus]].
* The fist description of [[Ebola virus infection]] was made by Ngoy Mushola, who recorded the first case in Yambuku town in Zaire. In Dr. Mushola's daily log, he stated {{cquote| The [[illness]] is characterized by a [[high temperature]] of about 39 °C,[[hematemesis]], [[bloody diarrhea]], retrosternal [[abdominal pain]], prostration with "heavy" articulations, and rapid evolution [[death]] after a mean of three days...}}
* During the outbreak, blood samples of infected Belgian nuns in Zaire were refrigerated in non-secure thermos and sent to Europe for analysis. Peter Piot was the first to analyze and describe Ebola virus morphology using electron microscopy. He noted the presence of long, worm-like agents that resemble the Marburg virus that was associated with the death of laboratory workers in Germany.
* The virus was then named after the Ebola river located in the town Yambuku, Democratic Republic of the Congo (formerly Zaire), which is the site of the first recognized Ebola outbreak.
* The first outbreaks occurred almost simultaneously in Sudan on June - November 1976 due to the so-called Sudan ebolavirus and in the Democratic Republic of Congo (formerly Zaire) on August - November 1976 due the so-called Ebola Zaire.
* Ever since the initial discovery, 5 strains of Ebola virus have been identified.


* The Ebola virus was first recognized in 1976 as a result of [[outbreaks]] of Ebola [[hemorrhagic fever]] in Zaire and Sudan.
===Spread===
* The fist description of [[ebola virus disease]] was made by Doctor Ngoy Mushola, in his daily log:
*The first two recorded outbreaks of Ebola virus occurred in 1976, followed by a third outbreak in 1979.<ref name="pmid6370486">{{cite journal| author=Baron RC, McCormick JB, Zubeir OA| title=Ebola virus disease in southern Sudan: hospital dissemination and intrafamilial spread. | journal=Bull World Health Organ | year= 1983 | volume= 61 | issue= 6 | pages= 997-1003 | pmid=6370486 | doi= | pmc=PMC2536233 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6370486  }} </ref>
{{cquote| The [[illness]] is characterized with a [[high temperature]] of about 39°C, [[hematemesis]] [the vomiting of blood], [[diarrhea with blood]], retrosternal [[abdominal pain]], prostration with "heavy" articulations, and rapid evolution [[death]] after a mean of three days...}}
*For 15 years, no outbreaks of Ebola virus were recorded, until Ebola re-emerged in 1994 when a Swiss ethnologist was infected during a chimpanzee autopsy in Tai National Park in Ivory Coast.<ref name="pmid7746057">{{cite journal| author=Le Guenno B, Formenty P, Formentry P, Wyers M, Gounon P, Walker F et al.| title=Isolation and partial characterisation of a new strain of Ebola virus. | journal=Lancet | year= 1995 | volume= 345 | issue= 8960 | pages= 1271-4 | pmid=7746057 | doi= | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7746057  }} </ref><ref name="pmid9988164">{{cite journal| author=Formenty P, Hatz C, Le Guenno B, Stoll A, Rogenmoser P, Widmer A|title=Human infection due to Ebola virus, subtype Côte d'Ivoire: clinical and biologic presentation. | journal=J Infect Dis | year= 1999 | volume= 179 Suppl 1 | issue=  | pages= S48-53 | pmid=9988164 | doi=10.1086/514285 | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9988164  }} </ref> During the same period, 3 other outbreaks occurred in Mekouka, Mayibout, and Booue in Gabon between 1994 and 1997.<ref name="pmid9988168">{{cite journal| author=Khan AS, Tshioko FK, Heymann DL, Le Guenno B, Nabeth P, Kerstiëns B et al.| title=The reemergence of Ebola hemorrhagic fever, Democratic Republic of the Congo, 1995. Commission de Lutte contre les Epidémies à Kikwit. | journal=J Infect Dis | year= 1999 | volume= 179 Suppl 1 | issue=  | pages= S76-86 | pmid=9988168 | doi=10.1086/514306 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9988168  }} </ref><ref name="pmid9988167">{{cite journal| author=Georges AJ, Leroy EM, Renaut AA, Benissan CT, Nabias RJ, Ngoc MT et al.| title=Ebola hemorrhagic fever outbreaks in Gabon, 1994-1997: epidemiologic and health control issues. | journal=J Infect Dis | year= 1999 | volume= 179 Suppl 1 | issue=  | pages= S65-75 | pmid=9988167 | doi=10.1086/514290 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9988167  }} </ref><ref name="pmid9111553">{{cite journal| author=Amblard J, Obiang P, Edzang S, Prehaud C, Bouloy M, Guenno BL| title=Identification of the Ebola virus in Gabon in 1994. |journal=Lancet | year= 1997 | volume= 349 | issue= 9046 | pages= 181-2 | pmid=9111553 | doi=10.1016/S0140-6736(05)60984-1 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9111553  }} </ref>
* The virus was named after the Ebola river located in Yambuku, Democratic Republic of the Congo (formerly Zaire).  
*The period between 2000 and 2004 was remarkable for the emergence of multiple outbreaks among humans as well as among animals (gorillas and chimpanzees) in Gabon, the Republic of Congo, and Uganda.<ref name="pmid16002313">{{cite journal| author=Pourrut X, Kumulungui B, Wittmann T, Moussavou G, Délicat A, Yaba P et al.| title=The natural history of Ebola virus in Africa. | journal=Microbes Infect | year= 2005 | volume= 7 | issue= 7-8 | pages= 1005-14 | pmid=16002313 | doi=10.1016/j.micinf.2005.04.006 | pmc=| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16002313  }} </ref> At least 20 outbreaks were reported between the years 1976 (time of discovery) and 2013.
* The first outbreaks occurred almost simultaneously in Sudan between June and November 1976, due the so-called Sudan ebolavirus, and in Democratic Republic of the Congo (formerly Zaire) between August and November 1976 due the so-called Ebola Zaire.
*In March 23 2014, the Ministry of Health of Guinea notified the [[World Health Organization]] (WHO) of an emerging outbreak. The outbreak rapidly evolved to become the largest Ebola outbreak since its discovery in 1976. The first case of the Ebola outbreak was reported in Guinea in December 2013. The index case was thought to be a 2-year-old boy. The 2014 outbreak then involved Liberia, Sierra Leone, Senegal, and Nigeria before the virus was spread to Europe, Asia, and America, making Ebola virus a worldwide threat. On August 8 2014, the WHO declared the Ebola epidemic to be a Public Health Emergency of International Concern (PHEIC).<ref name="pmid25140855">{{cite journal| author=Briand S, Bertherat E, Cox P, Formenty P, Kieny MP, Myhre JK et al.| title=The international Ebola emergency. | journal=N Engl J Med | year= 2014 | volume= 371 | issue= 13 | pages= 1180-3 | pmid=25140855 | doi=10.1056/NEJMp1409858 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25140855  }} </ref>
* The table below summarizes the [[ebola virus]] strains identified until now:
 
{| style="border: 0px; font-size: 90%; margin: 0 18px;"
===Major Outbreaks===
! style="width: 250px; background: #4479BA; text-align: center;"| {{fontcolor|#FFF|Ebola Virus Strain}}
Until recently, [[Ebola]] outbreaks have been restricted to Africa, with the exception of [[Reston ebolavirus]]. The International Committee on Taxonomy of Viruses currently recognizes four species of the Ebola: Zaire virus (ZEBOV), Sudan ebolavirus (SEBOV), Reston ebolavirus (REBOV), and Cote d'Ivoire ebolavirus (CIEBOV).
! style="width: 250px; background: #4479BA; text-align: center;"| {{fontcolor|#FFF|Place of Discovery}}
 
! style="width: 250px; background: #4479BA; text-align: center;"| {{fontcolor|#FFF|Date Identified}}
{| style="border: 0px; font-size: 85%; margin: 3px;" align=center
|+'''''Known Cases and Outbreaks of Ebola Hemorrhagic Fever, in Chronological Order<ref name="outbreaks"> {{cite web| title= CDC Chronology of Ebola Hemorrhagic Fever Outbreaks| url=http://www.cdc.gov/vhf/ebola/resources/outbreak-table.html}} </ref>'''''
| align="center" style="background:#4479BA; width:100px"|{{fontcolor|#FFF|'''Year(s)'''}}
| align="center" style="background:#4479BA; width:100px"|{{fontcolor|#FFF|'''Country'''}}
| align="center" style="background:#4479BA; width:100px"|{{fontcolor|#FFF|'''Ebola subtype'''}}
| align="center" style="background:#4479BA; width:100px"|{{fontcolor|#FFF|'''Reported number of human cases'''}}
| align="center" style="background:#4479BA; width:100px"|{{fontcolor|#FFF|'''Reported number (%) of deaths among cases'''}}
| align="center" style="background:#4479BA; width:600px"|{{fontcolor|#FFF|'''Situation'''}}
|-
|style="padding: 5px 5px; background: #F5F5F5;" | 1976||style="padding: 5px 5px; background: #F5F5F5;" |Zaire (Democratic Republic of the Congo - DRC)||style="padding: 5px 5px; background: #F5F5F5;" |Ebola virus||style="padding: 5px 5px; background: #F5F5F5;" |318||style="padding: 5px 5px; background: #F5F5F5;" |280 (88%)||style="padding: 5px 5px; background: #F5F5F5;" |Occurred in Yambuku and surrounding area. Disease was spread by close personal contact and by use of contaminated needles and syringes in hospitals/clinics. This outbreak was the first recognition of the disease.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | 1976||style="padding: 5px 5px; background: #F5F5F5;" |Sudan (South Sudan)||style="padding: 5px 5px; background: #F5F5F5;" |Sudan virus||style="padding: 5px 5px; background: #F5F5F5;" |284||style="padding: 5px 5px; background: #F5F5F5;" |151 (53%)||style="padding: 5px 5px; background: #F5F5F5;" |Occurred in Nzara, Maridi and the surrounding area. Disease was spread mainly through close personal contact within hospitals. Many medical care personnel were infected.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | 1976||style="padding: 5px 5px; background: #F5F5F5;" |England||style="padding: 5px 5px; background: #F5F5F5;" |Sudan virus||style="padding: 5px 5px; background: #F5F5F5;" |1||style="padding: 5px 5px; background: #F5F5F5;" |0||style="padding: 5px 5px; background: #F5F5F5;" |Laboratory infection by accidental stick of contaminated needle.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | 1977||style="padding: 5px 5px; background: #F5F5F5;" |Zaire||style="padding: 5px 5px; background: #F5F5F5;" |Ebola virus||style="padding: 5px 5px; background: #F5F5F5;" |1||style="padding: 5px 5px; background: #F5F5F5;" |1 (100%)||style="padding: 5px 5px; background: #F5F5F5;" |Noted retrospectively in the village of Tandala.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | 1979||style="padding: 5px 5px; background: #F5F5F5;" |Sudan (South Sudan)||style="padding: 5px 5px; background: #F5F5F5;" |Sudan virus||style="padding: 5px 5px; background: #F5F5F5;" |34||style="padding: 5px 5px; background: #F5F5F5;" |22 (65%)||style="padding: 5px 5px; background: #F5F5F5;" |Occured in Nzara, Maridi. Recurrent outbreak at the same site as the 1976 Sudan epidemic.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | 1989||style="padding: 5px 5px; background: #F5F5F5;" |USA||style="padding: 5px 5px; background: #F5F5F5;" |Reston virus||style="padding: 5px 5px; background: #F5F5F5;" |0||style="padding: 5px 5px; background: #F5F5F5;" |0||style="padding: 5px 5px; background: #F5F5F5;" |Ebola-Reston virus was introduced into quarantine facilities in Virginia and Pennsylvania by monkeys imported from the Philippines.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | 1990||style="padding: 5px 5px; background: #F5F5F5;" |USA||style="padding: 5px 5px; background: #F5F5F5;" |Reston virus||style="padding: 5px 5px; background: #F5F5F5;" |4 (asymptomatic)||style="padding: 5px 5px; background: #F5F5F5;" |0||style="padding: 5px 5px; background: #F5F5F5;" |Ebola-Reston virus was introduced once again into quarantine facilities in Virginia, and Texas by monkeys imported from the Philippines. Four humans developed antibodies but did not get sick.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | 1989-1990||style="padding: 5px 5px; background: #F5F5F5;" |Philippines||style="padding: 5px 5px; background: #F5F5F5;" |Reston virus||style="padding: 5px 5px; background: #F5F5F5;" |3 (asymptomatic)||style="padding: 5px 5px; background: #F5F5F5;" |0||style="padding: 5px 5px; background: #F5F5F5;" |High mortality among cynomolgus macaques in a primate facility responsible for exporting animals in the USA. <br> Three workers in the animal facility developed antibodies but did not get sick.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | 1992||style="padding: 5px 5px; background: #F5F5F5;" |Italy||style="padding: 5px 5px; background: #F5F5F5;" |Reston virus||style="padding: 5px 5px; background: #F5F5F5;" |0||style="padding: 5px 5px; background: #F5F5F5;" |0||style="padding: 5px 5px; background: #F5F5F5;" |Ebola-Reston virus was introduced into quarantine facilities in Sienna by monkeys imported from the same export facility in the Philippines that was involved in the episodes in the United States. No humans were infected.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | 1994||style="padding: 5px 5px; background: #F5F5F5;" |Gabon||style="padding: 5px 5px; background: #F5F5F5;" |Ebola virus||style="padding: 5px 5px; background: #F5F5F5;" |52||style="padding: 5px 5px; background: #F5F5F5;" |31 (60%)||style="padding: 5px 5px; background: #F5F5F5;" |Occured in Mékouka and other gold-mining camps deep in the rain forest. Initially thought to be yellow fever; identified as Ebola hemorrhagic fever in 1995.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | 1994||style="padding: 5px 5px; background: #F5F5F5;" |Ivory Coast||style="padding: 5px 5px; background: #F5F5F5;" |Taï Forest virus||style="padding: 5px 5px; background: #F5F5F5;" |1||style="padding: 5px 5px; background: #F5F5F5;" |0||style="padding: 5px 5px; background: #F5F5F5;" |Scientist became ill after conducting an autopsy on a wild chimpanzee in the Tai Forest. The patient was treated in Switzerland.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | 1995||style="padding: 5px 5px; background: #F5F5F5;" |Democratic Republic of the Congo (formerly Zaire)||style="padding: 5px 5px; background: #F5F5F5;" |Ebola virus||style="padding: 5px 5px; background: #F5F5F5;" |315||style="padding: 5px 5px; background: #F5F5F5;" |250 (81%)||style="padding: 5px 5px; background: #F5F5F5;" |Occured in Kikwit and surrounding area. Traced to index case-patient who worked in forest adjoining the city. Epidemic spread through families and hospitals.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | 1996 (January-April)||style="padding: 5px 5px; background: #F5F5F5;" |Gabon||style="padding: 5px 5px; background: #F5F5F5;" |Ebola virus||style="padding: 5px 5px; background: #F5F5F5;" |37||style="padding: 5px 5px; background: #F5F5F5;" |21 (57%)||style="padding: 5px 5px; background: #F5F5F5;" |Occured in Mayibout area. A chimpanzee found dead in the forest was eaten by people hunting for food. Nineteen people who were involved in the butchery of the animal became ill; other cases occured in family members.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | 1996-1997 (July-January)||style="padding: 5px 5px; background: #F5F5F5;" |Gabon||style="padding: 5px 5px; background: #F5F5F5;" |Ebola virus||style="padding: 5px 5px; background: #F5F5F5;" |60||style="padding: 5px 5px; background: #F5F5F5;" |45 (74%)||style="padding: 5px 5px; background: #F5F5F5;" |Occurred in Booué area with transport of patients to Libreville. Index case-patient was a hunter who lived in a forest camp. Disease was spread by close contact with infected persons. A dead chimpanzee found in the forest at the time was determined to be infected.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | 1996||style="padding: 5px 5px; background: #F5F5F5;" |South Africa||style="padding: 5px 5px; background: #F5F5F5;" |Ebola virus||style="padding: 5px 5px; background: #F5F5F5;" |2||style="padding: 5px 5px; background: #F5F5F5;" |1 (50%)||style="padding: 5px 5px; background: #F5F5F5;" |A medical professional traveled from Gabon to Johannesburg, South Africa, after having treated Ebola virus-infected patients and thus having been exposed to the virus. He was hospitalized, and a nurse who took care of him became infected and died.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | 1996||style="padding: 5px 5px; background: #F5F5F5;" |USA||style="padding: 5px 5px; background: #F5F5F5;" |Reston virus||style="padding: 5px 5px; background: #F5F5F5;" |0||style="padding: 5px 5px; background: #F5F5F5;" |0||style="padding: 5px 5px; background: #F5F5F5;" |Ebola-Reston virus was introduced into a quarantine facility in Texas by monkeys imported from the Philippines. No human infections were identified.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | 1996||style="padding: 5px 5px; background: #F5F5F5;" |Philippines||style="padding: 5px 5px; background: #F5F5F5;" |Reston virus||style="padding: 5px 5px; background: #F5F5F5;" |0||style="padding: 5px 5px; background: #F5F5F5;" |0||style="padding: 5px 5px; background: #F5F5F5;" |Ebola-Reston virus was identified in a mokey export facility in the Philippines. No human infections were identified.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | 1996||style="padding: 5px 5px; background: #F5F5F5;" |Russia||style="padding: 5px 5px; background: #F5F5F5;" |Ebola virus||style="padding: 5px 5px; background: #F5F5F5;" |1||style="padding: 5px 5px; background: #F5F5F5;" |1 (100%)||style="padding: 5px 5px; background: #F5F5F5;" |Laboratory contamination
|-
|style="padding: 5px 5px; background: #F5F5F5;" | 2000-2001||style="padding: 5px 5px; background: #F5F5F5;" |Uganda||style="padding: 5px 5px; background: #F5F5F5;" |Sudan virus||style="padding: 5px 5px; background: #F5F5F5;" |425||style="padding: 5px 5px; background: #F5F5F5;" |224 (53%)||style="padding: 5px 5px; background: #F5F5F5;" |Occurred in Gulu, Masindi, and Mbarara districts of Uganda. The three most important risks associated with Ebola virus infection were attending funerals of Ebola hemorrhagic fever case-patients, having contact with case-patients in one's family, and providing medical care to Ebola case-patients without using adequate personal protective measures.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | October 2001-March 2002||style="padding: 5px 5px; background: #F5F5F5;" |Gabon||style="padding: 5px 5px; background: #F5F5F5;" |Ebola virus||style="padding: 5px 5px; background: #F5F5F5;" |65||style="padding: 5px 5px; background: #F5F5F5;" |53 (82%)||style="padding: 5px 5px; background: #F5F5F5;" |Outbreak occured over the border of Gabon and the Republic of the Congo.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | October 2001-March 2002||style="padding: 5px 5px; background: #F5F5F5;" |Republic of Congo||style="padding: 5px 5px; background: #F5F5F5;" |Ebola virus||style="padding: 5px 5px; background: #F5F5F5;" |57||style="padding: 5px 5px; background: #F5F5F5;" |43 (75%)||style="padding: 5px 5px; background: #F5F5F5;" |Outbreak occurred over the border of Gabon and the Republic of the Congo. This was the first time that Ebola hemorrhagic fever was reported in the Republic of the Congo.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | December 2002-April 2003||style="padding: 5px 5px; background: #F5F5F5;" |Republic of Congo||style="padding: 5px 5px; background: #F5F5F5;" |Ebola virus||style="padding: 5px 5px; background: #F5F5F5;" |143||style="padding: 5px 5px; background: #F5F5F5;" |128 (89%)||style="padding: 5px 5px; background: #F5F5F5;" |Outbreak occurred in the districts of Mbomo and Kéllé in Cuvette Ouest Département.
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;"| '''Sudan ebolavirus'''
|style="padding: 5px 5px; background: #F5F5F5;" | November-December 2003||style="padding: 5px 5px; background: #F5F5F5;" |Republic of Congo||style="padding: 5px 5px; background: #F5F5F5;" |Ebola virus||style="padding: 5px 5px; background: #F5F5F5;" |35||style="padding: 5px 5px; background: #F5F5F5;" |29 (83%)||style="padding: 5px 5px; background: #F5F5F5;" |Outbreak occured in Mbomo and Mbandza villages located in Mbomo distric, Cuvette Ouest Département.
| style="background: #DCDCDC; padding: 5px;"| Nzara and Maridi, Sudan
| style="background: #F5F5F5; padding: 5px;"| Between June and November 1976
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;"| '''Zaire ebolavirus'''
|style="padding: 5px 5px; background: #F5F5F5;" | 2004||style="padding: 5px 5px; background: #F5F5F5;" |Sudan (South Sudan)||style="padding: 5px 5px; background: #F5F5F5;" |Sudan virus||style="padding: 5px 5px; background: #F5F5F5;" |17||style="padding: 5px 5px; background: #F5F5F5;" |7 (41%)||style="padding: 5px 5px; background: #F5F5F5;" |Outbreak occurred in Yambio county of southern Sudan. This outbreak was concurrent with an outbreak of measles in the same area, and several suspected EHF cases were later reclassified as measeles cases.
| style="background: #DCDCDC; padding: 5px;"| Yambuku, Democratic Republic of the Congo
| style="background: #F5F5F5; padding: 5px;"| Between August and November 1976
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;"| '''Reston ebolavirus'''
|style="padding: 5px 5px; background: #F5F5F5;" | 2004||style="padding: 5px 5px; background: #F5F5F5;" |Russia||style="padding: 5px 5px; background: #F5F5F5;" |Ebola virus||style="padding: 5px 5px; background: #F5F5F5;" |1||style="padding: 5px 5px; background: #F5F5F5;" |1 (100%)||style="padding: 5px 5px; background: #F5F5F5;" |Laboratory contamination.
| style="background: #DCDCDC; padding: 5px;"| Reston, Virginia, US.
| style="background: #F5F5F5; padding: 5px;"| November 1989
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;"| '''Ivory Coast ebolavirus'''
|style="padding: 5px 5px; background: #F5F5F5;" | 2007||style="padding: 5px 5px; background: #F5F5F5;" |Democratic Republic of Congo||style="padding: 5px 5px; background: #F5F5F5;" |Ebola virus||style="padding: 5px 5px; background: #F5F5F5;" |264||style="padding: 5px 5px; background: #F5F5F5;" |187 (71%)||style="padding: 5px 5px; background: #F5F5F5;" |Outbreak occurred in Kasai Occidental Province. The outbreak was declared over November 20. Last confirmed case on October 4 and last death on October 10.
| style="background: #DCDCDC; padding: 5px;"| Tai Forest, Ivory Coast.
| style="background: #F5F5F5; padding: 5px;"| November 1994
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;"| '''Bundibugyo ebolavirus'''
|style="padding: 5px 5px; background: #F5F5F5;" | December 2007-January 2008||style="padding: 5px 5px; background: #F5F5F5;" |Uganda||style="padding: 5px 5px; background: #F5F5F5;" |Bundibugyo virus||style="padding: 5px 5px; background: #F5F5F5;" |149||style="padding: 5px 5px; background: #F5F5F5;" |37 (25%)||style="padding: 5px 5px; background: #F5F5F5;" |Outbreak occurred in Bundibugyo District in western Uganda. First reported occurance of a new strain.
| style="background: #DCDCDC; padding: 5px;"| Bundibugyo District, Uganda
|-
| style="background: #F5F5F5; padding: 5px;"| November 2007
|style="padding: 5px 5px; background: #F5F5F5;" |November 2008||style="padding: 5px 5px; background: #F5F5F5;" |Philippines||style="padding: 5px 5px; background: #F5F5F5;" |Reston virus||style="padding: 5px 5px; background: #F5F5F5;" |6 (asymptomatic)||style="padding: 5px 5px; background: #F5F5F5;" |0||style="padding: 5px 5px; background: #F5F5F5;" |First known occurrence of Ebola-Reston in pigs. Strain closely similar to earlier strains. Six workers from the pig farm and slaughterhouse developed antibodies but did not become sick.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | December 2008-February 2009||style="padding: 5px 5px; background: #F5F5F5;" |Democratic Republic of the Congo||style="padding: 5px 5px; background: #F5F5F5;" |Ebola virus||style="padding: 5px 5px; background: #F5F5F5;" |32||style="padding: 5px 5px; background: #F5F5F5;" |15 (47%)||style="padding: 5px 5px; background: #F5F5F5;" |Outbreak occurred in the Mweka and luebo health zones of the Province of Kasai Occidental.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | May-11||style="padding: 5px 5px; background: #F5F5F5;" |Uganda||style="padding: 5px 5px; background: #F5F5F5;" |Sudan virus||style="padding: 5px 5px; background: #F5F5F5;" |1||style="padding: 5px 5px; background: #F5F5F5;" |1 (100%)||style="padding: 5px 5px; background: #F5F5F5;" |The Ugandan Ministry of Health informed the public that a patient with suspected Ebola Hemorrhagic fever died on May 6, 2011 in the Luwero district, Uganda. The quick diagnosis from a blood sample of Ebola virus was provided by the new CDC Viral Hemorrhagic Fever laboratory installed at the Uganda Viral Research Institute (UVRI).
|-
|style="padding: 5px 5px; background: #F5F5F5;" | June-October 2012||style="padding: 5px 5px; background: #F5F5F5;" |Uganda||style="padding: 5px 5px; background: #F5F5F5;" |Sudan virus||style="padding: 5px 5px; background: #F5F5F5;" |11*||style="padding: 5px 5px; background: #F5F5F5;" |4* (36.4%)||style="padding: 5px 5px; background: #F5F5F5;" |Outbreak occurred in the Kibaale District of Uganda. Laboratory tests of blood samples were conducted by the UVRI and the U.S. Centers for Disease Control and Prevention (CDC).
|-
|style="padding: 5px 5px; background: #F5F5F5;" | June-November 2012||style="padding: 5px 5px; background: #F5F5F5;" |Democratic Republic of the Congo||style="padding: 5px 5px; background: #F5F5F5;" |Bundibugyo virus||style="padding: 5px 5px; background: #F5F5F5;" |36*||style="padding: 5px 5px; background: #F5F5F5;" |13* (36.1%)||style="padding: 5px 5px; background: #F5F5F5;" |Outbreak occurred in DRC’s Province Orientale. Laboratory support was provided through CDC and the Public Health Agency of Canada (PHAC)’s field laboratory in Isiro, and through the CDC/UVRI lab in Uganda. The outbreak in DRC has no epidemiologic link to the near contemporaneous Ebola outbreak in the Kibaale district of Uganda.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | November 2012-January 2013||style="padding: 5px 5px; background: #F5F5F5;" |Uganda||style="padding: 5px 5px; background: #F5F5F5;" |Sudan virus||style="padding: 5px 5px; background: #F5F5F5;" |6*||style="padding: 5px 5px; background: #F5F5F5;" |3* (50%)||style="padding: 5px 5px; background: #F5F5F5;" |Outbreak occurred in the Luwero District. CDC assisted the Ministry of Health in the epidemiologic and diagnostic aspects of the outbreak. Testing of samples by CDC's Viral Special Pathogens Branch occurred at UVRI in Entebbe.
|-
|style="padding: 5px 5px; background: #F5F5F5;" | March 2014-Present||style="padding: 5px 5px; background: #F5F5F5;" |Guinea, Liberia, and Sierra Leone||style="padding: 5px 5px; background: #F5F5F5;" |Ebola virus||style="padding: 5px 5px; background: #F5F5F5;" |9936||style="padding: 5px 5px; background: #F5F5F5;" |4878 (49.1%)||style="padding: 5px 5px; background: #F5F5F5;" |Outbreak across Guinea, northern Liberia, and now eastern Sierra Leone.
|-
|May 2017
|Democratic Republic of the Congo
|Not confirmed
|9
|1 (1.1%)
|In May 12, 2017, WHO declared a lab confirmed case in Bas-Uele region in the northeast Congo. Nine cases were hospitalized for hemorrhagic fever and three of them died. Only one case was confirmed to have Ebola virus.
Despite being a serious situation, it's considered a good sign that the outbreak struck in a remote and forested region
|}
|}
===Impact on Cultural History===
* Viruses that cause [[hemorrhagic fever]]s have been popularized by the media as fierce predators that threaten to devastate global populations.
* During the early- to mid-1990s, Ebola virus was portrayed as a global threat, a fierce predator emerging from tropical areas in Africa and spreading rapidly to the rest of the mobile and interconnected world. Therefore, cases of infection with [[Ebola virus]] required rapid international notification and response. Films and books, such as ''The coming plague'' by Laurie Garrett, ''The hot zone'' by Richard Preston and the movie ''Outbreak'' starring Dustin Hoffman, all created fear about Ebola virus disease in western populations.
* Some of these versions portrayed the [[Ebola virus]] as if it were an active agent going out on the attack, transmissible through air or touch, with no treatment available until a “high tech” scientist discovers a vaccine or other cure – otherwise everyone died. One of the key elements in these stories is the sense of scientific heroism, of individuals committed to discover, identify and conquer this virus. Panic, violence and competition are often portrayed as the common human responses to outbreaks of viral diseases. The perception that the 1995 outbreak in the Democratic Republic of the Congo “was going to spread to the rest of the world” was one of the factors that built political momentum leading to the revision of the International Health Regulations in 2005.
* Now, [[ebola virus disease]] is viewed as a deadly local disease requiring a universal kind of “rapid response,” based on standard public health strategies to halt transmission and control outbreaks at the source.
* [[Ebola virus disease]] has attracted a lot of attention for being a very fierce, rapidly lethal filoviral disease that causes death in 50–90% of clinically diagnosed cases. So far there is no antiviral or vaccine available against Ebola hemorrhagic fever – it is a disease with no cure. But when one look at African outbreaks, one notice that, despite their increasing frequency, the overall numbers of deaths are relatively small. The dramatic fear and perception of the global spread of Ebola virus has motivated international and some national health and government officials to develop policies based on this vision. Meanwhile, media coverage has increased public interest and support for tackling this disease. In this respect, [[Ebola hemorrhagic fever]] is kind of an “exceptional” or “master status” disease.
* Some commentators to suggest that Ebola fever is perhaps “much ado about nothing.” It is locally devastating but has little international importance. Lassa fever, on the other hand, seems to be an unheralded problem. The number of deaths and of infected cases is high and disproportional with the disease's international profile and the scale of western media attention. Lassa fever requires more sustained engagement of health teams and measures to deal with its more endemic character.
* There is evidence that Ebola fever has been around for hundreds of years in some communities. Local people living in disease-affected areas are often portrayed by the media as ignorant, mired in misguided tradition and dangerous cultural practices. There is certainly danger in some of these practices, such as remaining close to the sick family member to nurse him/her; touching the dead at funerals; and applying traditional healers’ treatments including cutting a patient’s skin with unsterilized knives and applying blood to the skin.
* There are also examples of beneficial practices. An example of a local approach to these [[diseases]] comes from the work of anthropologist Barry Hewlett, who learned how the Acholi people in Uganda deal withgemo (a word that means epidemic illness). Social protocols for prevention and control include isolating the patient in a house at least 100 metres from other houses; having a survivor of the epidemic feed and care for the patient; identifying houses with ill patients with two long poles of elephant grass; limiting general movement, advising people to stay within their household and not move between villages; and, finally, keeping patients who no longer have symptoms in isolation for one full lunar cycle before allowing them to move about freely in the village.
* [[Ebola virus disease]] is sensationalized because it is very scary. But there are ways in which we can harness the resources and experiences to address other health priorities, such as insisting on safe practices when handling body fluids for prevention of infectious diseases in general. Health care workers also must be careful that a [[disease]] [[outbreak]] does not distract from providing an integrated response to health problems. People who live in the areas that suddenly attract attention from the international community owing to an [[ebola virus disease]] outbreak may have been dealing with [[HIV infection]], [[malaria]], [[diarrhea]] and other health problems that are regarded as far more important to them in a day-to-day sense.<ref name=WHO>{{cite web | title = Time to put Ebola in context
  | url = http://www.who.int/bulletin/volumes/88/7/10-030710/en/ }}</ref>
===Notable Cases===
* Nurse Mayinga N'Seka was the [[index case]] in an [[Ebola]] [[epidemic]] in Democratic Republic of the Congo and may represent the only case of airborne [[ebola virus]] infection.
* The non-fatal case of a Swiss 34-year-old female ethologist, in the Taï National Park, Ivory Coast, was due to an infection by what was later recognized as a new strain of [[ebola virus]] after she performed a [[necropsy]] on a [[chimpanzee]] found dead with signs of [[hemorrhage]].<ref name="pmid9988164">{{cite journal| author=Formenty P, Hatz C, Le Guenno B, Stoll A, Rogenmoser P, Widmer A| title=Human infection due to Ebola virus, subtype Côte d'Ivoire: clinical and biologic presentation. | journal=J Infect Dis | year= 1999 | volume= 179 Suppl 1 | issue=  | pages= S48-53 | pmid=9988164 | doi=10.1086/514285 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9988164  }} </ref>


==References==
==References==
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[[Category:Disease]]
[[Category:Disease]]
[[Category:Hemorrhagic fevers]]
[[Category:Hemorrhagic fevers]]
[[Category:Infectious disease]]
 
[[Category:Mononegavirales]]
[[Category:Mononegavirales]]
[[Category:Viral diseases]]
[[Category:Viral diseases]]
[[Category:Zoonoses]]
[[Category:Zoonoses]]

Latest revision as of 17:37, 18 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Michael Maddaleni, B.S.; Guillermo Rodriguez Nava, M.D. [2]; Yazan Daaboul, M.D.

Overview

Ebola virus was first discovered in 1976 when two simultaneous outbreaks occurred in Zaire and Sudan. The first description of Ebola virus was made by Ngoy Mushola in Yambuku, Zaire during the 1976 outbreak. During the outbreak, Peter Piot analyzed blood samples of an infected Belgian nun in Zaire and was the first to describe the virus morphology using electron microscopy. The Ebola virus was named after the Ebola River Valley in the Democratic Republic of the Congo (formerly Zaire).[1] Approximately 14 outbreaks of Ebola virus have been described since its discovery. The 2013-2014 outbreak marks the largest Ebola outbreak, involving Africa, Asia, Europe, and America and making the virus a worldwide disease.

Historical Perspective

Discovery

  • The Ebola virus was first discovered in 1976 following two simultaneous outbreaks of Ebola hemorrhagic fever between June and November in Zaire and between August and November in Sudan.[2][3]
  • Nurse Mayinga N'Seka, a nurse in Zaire, is thought to be the index case in the first recognized Ebola epidemic in 1976. She was believed to be the only patient infected via airborne transmission of the Ebola virus.
  • The fist description of Ebola virus infection was made by Ngoy Mushola, who recorded the first case in Yambuku town in Zaire. In Dr. Mushola's daily log, he stated
“ The illness is characterized by a high temperature of about 39 °C,hematemesis, bloody diarrhea, retrosternal abdominal pain, prostration with "heavy" articulations, and rapid evolution death after a mean of three days... ”
  • During the outbreak, blood samples of infected Belgian nuns in Zaire were refrigerated in non-secure thermos and sent to Europe for analysis. Peter Piot was the first to analyze and describe Ebola virus morphology using electron microscopy. He noted the presence of long, worm-like agents that resemble the Marburg virus that was associated with the death of laboratory workers in Germany.
  • The virus was then named after the Ebola river located in the town Yambuku, Democratic Republic of the Congo (formerly Zaire), which is the site of the first recognized Ebola outbreak.
  • The first outbreaks occurred almost simultaneously in Sudan on June - November 1976 due to the so-called Sudan ebolavirus and in the Democratic Republic of Congo (formerly Zaire) on August - November 1976 due the so-called Ebola Zaire.
  • Ever since the initial discovery, 5 strains of Ebola virus have been identified.

Spread

  • The first two recorded outbreaks of Ebola virus occurred in 1976, followed by a third outbreak in 1979.[4]
  • For 15 years, no outbreaks of Ebola virus were recorded, until Ebola re-emerged in 1994 when a Swiss ethnologist was infected during a chimpanzee autopsy in Tai National Park in Ivory Coast.[5][6] During the same period, 3 other outbreaks occurred in Mekouka, Mayibout, and Booue in Gabon between 1994 and 1997.[7][8][9]
  • The period between 2000 and 2004 was remarkable for the emergence of multiple outbreaks among humans as well as among animals (gorillas and chimpanzees) in Gabon, the Republic of Congo, and Uganda.[10] At least 20 outbreaks were reported between the years 1976 (time of discovery) and 2013.
  • In March 23 2014, the Ministry of Health of Guinea notified the World Health Organization (WHO) of an emerging outbreak. The outbreak rapidly evolved to become the largest Ebola outbreak since its discovery in 1976. The first case of the Ebola outbreak was reported in Guinea in December 2013. The index case was thought to be a 2-year-old boy. The 2014 outbreak then involved Liberia, Sierra Leone, Senegal, and Nigeria before the virus was spread to Europe, Asia, and America, making Ebola virus a worldwide threat. On August 8 2014, the WHO declared the Ebola epidemic to be a Public Health Emergency of International Concern (PHEIC).[11]

Major Outbreaks

Until recently, Ebola outbreaks have been restricted to Africa, with the exception of Reston ebolavirus. The International Committee on Taxonomy of Viruses currently recognizes four species of the Ebola: Zaire virus (ZEBOV), Sudan ebolavirus (SEBOV), Reston ebolavirus (REBOV), and Cote d'Ivoire ebolavirus (CIEBOV).

Known Cases and Outbreaks of Ebola Hemorrhagic Fever, in Chronological Order[12]
Year(s) Country Ebola subtype Reported number of human cases Reported number (%) of deaths among cases Situation
1976 Zaire (Democratic Republic of the Congo - DRC) Ebola virus 318 280 (88%) Occurred in Yambuku and surrounding area. Disease was spread by close personal contact and by use of contaminated needles and syringes in hospitals/clinics. This outbreak was the first recognition of the disease.
1976 Sudan (South Sudan) Sudan virus 284 151 (53%) Occurred in Nzara, Maridi and the surrounding area. Disease was spread mainly through close personal contact within hospitals. Many medical care personnel were infected.
1976 England Sudan virus 1 0 Laboratory infection by accidental stick of contaminated needle.
1977 Zaire Ebola virus 1 1 (100%) Noted retrospectively in the village of Tandala.
1979 Sudan (South Sudan) Sudan virus 34 22 (65%) Occured in Nzara, Maridi. Recurrent outbreak at the same site as the 1976 Sudan epidemic.
1989 USA Reston virus 0 0 Ebola-Reston virus was introduced into quarantine facilities in Virginia and Pennsylvania by monkeys imported from the Philippines.
1990 USA Reston virus 4 (asymptomatic) 0 Ebola-Reston virus was introduced once again into quarantine facilities in Virginia, and Texas by monkeys imported from the Philippines. Four humans developed antibodies but did not get sick.
1989-1990 Philippines Reston virus 3 (asymptomatic) 0 High mortality among cynomolgus macaques in a primate facility responsible for exporting animals in the USA.
Three workers in the animal facility developed antibodies but did not get sick.
1992 Italy Reston virus 0 0 Ebola-Reston virus was introduced into quarantine facilities in Sienna by monkeys imported from the same export facility in the Philippines that was involved in the episodes in the United States. No humans were infected.
1994 Gabon Ebola virus 52 31 (60%) Occured in Mékouka and other gold-mining camps deep in the rain forest. Initially thought to be yellow fever; identified as Ebola hemorrhagic fever in 1995.
1994 Ivory Coast Taï Forest virus 1 0 Scientist became ill after conducting an autopsy on a wild chimpanzee in the Tai Forest. The patient was treated in Switzerland.
1995 Democratic Republic of the Congo (formerly Zaire) Ebola virus 315 250 (81%) Occured in Kikwit and surrounding area. Traced to index case-patient who worked in forest adjoining the city. Epidemic spread through families and hospitals.
1996 (January-April) Gabon Ebola virus 37 21 (57%) Occured in Mayibout area. A chimpanzee found dead in the forest was eaten by people hunting for food. Nineteen people who were involved in the butchery of the animal became ill; other cases occured in family members.
1996-1997 (July-January) Gabon Ebola virus 60 45 (74%) Occurred in Booué area with transport of patients to Libreville. Index case-patient was a hunter who lived in a forest camp. Disease was spread by close contact with infected persons. A dead chimpanzee found in the forest at the time was determined to be infected.
1996 South Africa Ebola virus 2 1 (50%) A medical professional traveled from Gabon to Johannesburg, South Africa, after having treated Ebola virus-infected patients and thus having been exposed to the virus. He was hospitalized, and a nurse who took care of him became infected and died.
1996 USA Reston virus 0 0 Ebola-Reston virus was introduced into a quarantine facility in Texas by monkeys imported from the Philippines. No human infections were identified.
1996 Philippines Reston virus 0 0 Ebola-Reston virus was identified in a mokey export facility in the Philippines. No human infections were identified.
1996 Russia Ebola virus 1 1 (100%) Laboratory contamination
2000-2001 Uganda Sudan virus 425 224 (53%) Occurred in Gulu, Masindi, and Mbarara districts of Uganda. The three most important risks associated with Ebola virus infection were attending funerals of Ebola hemorrhagic fever case-patients, having contact with case-patients in one's family, and providing medical care to Ebola case-patients without using adequate personal protective measures.
October 2001-March 2002 Gabon Ebola virus 65 53 (82%) Outbreak occured over the border of Gabon and the Republic of the Congo.
October 2001-March 2002 Republic of Congo Ebola virus 57 43 (75%) Outbreak occurred over the border of Gabon and the Republic of the Congo. This was the first time that Ebola hemorrhagic fever was reported in the Republic of the Congo.
December 2002-April 2003 Republic of Congo Ebola virus 143 128 (89%) Outbreak occurred in the districts of Mbomo and Kéllé in Cuvette Ouest Département.
November-December 2003 Republic of Congo Ebola virus 35 29 (83%) Outbreak occured in Mbomo and Mbandza villages located in Mbomo distric, Cuvette Ouest Département.
2004 Sudan (South Sudan) Sudan virus 17 7 (41%) Outbreak occurred in Yambio county of southern Sudan. This outbreak was concurrent with an outbreak of measles in the same area, and several suspected EHF cases were later reclassified as measeles cases.
2004 Russia Ebola virus 1 1 (100%) Laboratory contamination.
2007 Democratic Republic of Congo Ebola virus 264 187 (71%) Outbreak occurred in Kasai Occidental Province. The outbreak was declared over November 20. Last confirmed case on October 4 and last death on October 10.
December 2007-January 2008 Uganda Bundibugyo virus 149 37 (25%) Outbreak occurred in Bundibugyo District in western Uganda. First reported occurance of a new strain.
November 2008 Philippines Reston virus 6 (asymptomatic) 0 First known occurrence of Ebola-Reston in pigs. Strain closely similar to earlier strains. Six workers from the pig farm and slaughterhouse developed antibodies but did not become sick.
December 2008-February 2009 Democratic Republic of the Congo Ebola virus 32 15 (47%) Outbreak occurred in the Mweka and luebo health zones of the Province of Kasai Occidental.
May-11 Uganda Sudan virus 1 1 (100%) The Ugandan Ministry of Health informed the public that a patient with suspected Ebola Hemorrhagic fever died on May 6, 2011 in the Luwero district, Uganda. The quick diagnosis from a blood sample of Ebola virus was provided by the new CDC Viral Hemorrhagic Fever laboratory installed at the Uganda Viral Research Institute (UVRI).
June-October 2012 Uganda Sudan virus 11* 4* (36.4%) Outbreak occurred in the Kibaale District of Uganda. Laboratory tests of blood samples were conducted by the UVRI and the U.S. Centers for Disease Control and Prevention (CDC).
June-November 2012 Democratic Republic of the Congo Bundibugyo virus 36* 13* (36.1%) Outbreak occurred in DRC’s Province Orientale. Laboratory support was provided through CDC and the Public Health Agency of Canada (PHAC)’s field laboratory in Isiro, and through the CDC/UVRI lab in Uganda. The outbreak in DRC has no epidemiologic link to the near contemporaneous Ebola outbreak in the Kibaale district of Uganda.
November 2012-January 2013 Uganda Sudan virus 6* 3* (50%) Outbreak occurred in the Luwero District. CDC assisted the Ministry of Health in the epidemiologic and diagnostic aspects of the outbreak. Testing of samples by CDC's Viral Special Pathogens Branch occurred at UVRI in Entebbe.
March 2014-Present Guinea, Liberia, and Sierra Leone Ebola virus 9936 4878 (49.1%) Outbreak across Guinea, northern Liberia, and now eastern Sierra Leone.
May 2017 Democratic Republic of the Congo Not confirmed 9 1 (1.1%) In May 12, 2017, WHO declared a lab confirmed case in Bas-Uele region in the northeast Congo. Nine cases were hospitalized for hemorrhagic fever and three of them died. Only one case was confirmed to have Ebola virus.

Despite being a serious situation, it's considered a good sign that the outbreak struck in a remote and forested region

References

  1. ↑ Bardi, Jason Socrates (2002). "Death Called a River". Scribbs Research Institute. 2 (1). Retrieved 2006-12-08.
  2. ↑ "Ebola haemorrhagic fever in Zaire, 1976". Bull World Health Organ. 56 (2): 271–93. 1978. PMC 2395567. PMID 307456.
  3. ↑ "Ebola haemorrhagic fever in Sudan, 1976. Report of a WHO/International Study Team". Bull World Health Organ. 56 (2): 247–70. 1978. PMC 2395561. PMID 307455.
  4. ↑ Baron RC, McCormick JB, Zubeir OA (1983). "Ebola virus disease in southern Sudan: hospital dissemination and intrafamilial spread". Bull World Health Organ. 61 (6): 997–1003. PMC 2536233. PMID 6370486.
  5. ↑ Le Guenno B, Formenty P, Formentry P, Wyers M, Gounon P, Walker F; et al. (1995). "Isolation and partial characterisation of a new strain of Ebola virus". Lancet. 345 (8960): 1271–4. PMID 7746057.
  6. ↑ Formenty P, Hatz C, Le Guenno B, Stoll A, Rogenmoser P, Widmer A (1999). "Human infection due to Ebola virus, subtype Côte d'Ivoire: clinical and biologic presentation". J Infect Dis. 179 Suppl 1: S48–53. doi:10.1086/514285. PMID 9988164.
  7. ↑ Khan AS, Tshioko FK, Heymann DL, Le Guenno B, Nabeth P, Kerstiëns B; et al. (1999). "The reemergence of Ebola hemorrhagic fever, Democratic Republic of the Congo, 1995. Commission de Lutte contre les Epidémies à Kikwit". J Infect Dis. 179 Suppl 1: S76–86. doi:10.1086/514306. PMID 9988168.
  8. ↑ Georges AJ, Leroy EM, Renaut AA, Benissan CT, Nabias RJ, Ngoc MT; et al. (1999). "Ebola hemorrhagic fever outbreaks in Gabon, 1994-1997: epidemiologic and health control issues". J Infect Dis. 179 Suppl 1: S65–75. doi:10.1086/514290. PMID 9988167.
  9. ↑ Amblard J, Obiang P, Edzang S, Prehaud C, Bouloy M, Guenno BL (1997). "Identification of the Ebola virus in Gabon in 1994". Lancet. 349 (9046): 181–2. doi:10.1016/S0140-6736(05)60984-1. PMID 9111553.
  10. ↑ Pourrut X, Kumulungui B, Wittmann T, Moussavou G, Délicat A, Yaba P; et al. (2005). "The natural history of Ebola virus in Africa". Microbes Infect. 7 (7–8): 1005–14. doi:10.1016/j.micinf.2005.04.006. PMID 16002313.
  11. ↑ Briand S, Bertherat E, Cox P, Formenty P, Kieny MP, Myhre JK; et al. (2014). "The international Ebola emergency". N Engl J Med. 371 (13): 1180–3. doi:10.1056/NEJMp1409858. PMID 25140855.
  12. ↑ "CDC Chronology of Ebola Hemorrhagic Fever Outbreaks".
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