Western African Ebola virus epidemic

Western African Ebola virus epidemic

Simplified Ebola virus epidemic situation map
Date	December 2013 – June 2016[1][2]
Casualties
Country Cases Deaths Outbreak end Liberia 10,675 4,809 9 Jun 2016[2] Sierra Leone 14,124 3,956 17 Mar 2016[3] Guinea 3,811 2,543 1 Jun 2016[4] Nigeria 20 8 19 Oct 2014[5] Mali 8 6 18 Jan 2015[6] United States 4 1 21 Dec 2014[7] Italy 1 0 20 Jul 2015[8] United Kingdom 1 0 10 Mar 2015[9] Senegal 1 0 17 Oct 2014[5] Spain 1 0 2 Dec 2014[10] Total 28,646 11,323 Jun 2016 Note: current estimates suggest that between 17 per cent and 70 per cent 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 Western 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; later, 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] In addition, 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^[update], 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 of time 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 which offers protection; hence, 300,000 doses have been stockpiled.^[31][32] rVSV-ZEBOV received regulatory approval in 2019.^[33][34]

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