| Revision as of 17:22, 6 October 2014 editRichard Yin (talk | contribs)Extended confirmed users, Rollbackers4,307 editsm Reverted edits by 66.31.2.104 (talk) to last version by Dawn Bard← Previous edit | Revision as of 17:24, 6 October 2014 edit undo66.31.2.104 (talk) ←Replaced content with 'The government's of the world have done this! Beware!'Tag: possible vandalismNext edit → | ||
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| {{current|date=October 2014}} | |||
| {{Use dmy dates|date=June 2014}} | |||
| {{Use British English|date=August 2014}}<!--Sierra Leonean & Nigerian English are based on British English--> | |||
| {{Infobox event | |||
| |image = ] | |||
| |caption = Situation map of the outbreak <small>Note: Totals exclude US case</small> | |||
| |date = December 2013 – present<ref name="Tracing Ebola’s Breakout to an African 2-Year-Old">{{cite news |issn=0362-4331 |last1=Grady |first1=Denise |first2=Sheri |last2=Fink |title=Tracing Ebola's Breakout to an African 2-Year-Old |work=The New York Times |date=9 August 2014 |url=http://www.nytimes.com/2014/08/10/world/africa/tracing-ebolas-breakout-to-an-african-2-year-old.html |deadurl=no |accessdate=14 August 2014}}</ref> | |||
| |place = ], ], ], ], ], ]<ref name="CDC American Ebola">{{Cite web|title=CDC confirms first case of Ebola in the U.S.|url=http://www.cdc.gov/media/releases/2014/s930-ebola-confirmed-case.html/|accessdate=2014-09-30|date=2014-09-30|publisher=CDC}}</ref><!-- One case of Ebola constitutes an outbreak by definition. See: http://www.who.int/topics/disease_outbreaks/en--> | |||
| |casualties1= <!-- Please do not add a mortality percentage here because it is misleading and cannot reflect real mortality until the outbreak has ceased (see ]) --> | |||
| <!-- Please ensure this Casualty list ONLY includes data as reported in the WHO, OCHA or governments reports. Also note a DRN has concluded that WHO reports are erroneous hence it may not tie up with reports, but are correlated with government reports.--> | |||
| <!-- Please update the WHO numbers and As-Of date consistently in 5 parts of this article: (1) Infobox (here), (2) lead section, (3) Subsequent Spread section, (4) Timeline table, (5) Timeline graph(s). --> | |||
| {{plainlist| | |||
| * Reported '''Cases / Deaths'''<small> ({{As of |2014|10|3|lc=y}})</small><ref name=Ebola_Outbreak_total_WHO_3_Oct /> | |||
| * <!--Template for padding-->{{noflag}}Total: 7,492 / 3,439 | |||
| * <!--Liberia-->{{flagicon|LBR}} ]: 3,834 / 2,069<ref name=Ebola_Outbreak_total_WHO_3_Oct /> | |||
| * <!--Sierra Leone-->{{flagicon|SLE}} ]: 2,437 / 623<ref name=Ebola_Outbreak_total_WHO_3_Oct /> | |||
| * <!--Guinea-->{{flagicon|GIN}} ]: 1,199 / 739<ref name=Ebola_Outbreak_total_WHO_3_Oct /> | |||
| * <!--Nigeria-->{{flagicon|NGA}} ]: 20 / 8<ref name=Ebola_Outbreak_total_WHO_3_Oct /> | |||
| * <!--Senegal-->{{flagicon|SEN}} ]: 1 / 0<ref name=Ebola_Outbreak_total_WHO_3_Oct /> | |||
| * <!--United States-->{{flagicon|USA}} ]: 1 / 0<ref name=Ebola_Outbreak_total_WHO_3_Oct />}} | |||
| <small>See notes for 1 October on ]</small> | |||
| }} | |||
| <!-- Per MOS:BOLDTITLE and WP:SBE, neither the article's title nor related text appears in bold. --> | |||
| {{As of|2014}}, an ] of ] (EVD) is ongoing in some ]n<!--West Africa consists of about 20 countries, using solely "West Africa" for five countries in the region is too vague.--> countries. The epidemic began in ] in December 2013.<ref name="Ebola Virus Disease in West Africa — The First 9 Months of the Epidemic and Forward Projections"/> It then spread to ], ], ], ] and ] was confirmed on 30 September 2014.<ref>{{cite web|title=CDC confirms first case of Ebola in the U.S.|url=http://www.cdc.gov/media/releases/2014/s930-ebola-confirmed-case.html/|accessdate=2014-09-30|date=2014-09-30|publisher=CDC}}</ref> The outbreak was formally designated as a ] on 8 August.<ref name=WHO_PHEIC_8Aug2014>{{cite web |url=http://www.who.int/mediacentre/news/statements/2014/ebola-20140808/en/ |title=Statement on the Meeting of the International Health Regulations Emergency Committee Regarding the 2014 Ebola Outbreak in West Africa |publisher=World Health Organization |date=8 August 2014 |accessdate=8 August 2014}}</ref> This is a legal designation used only twice before (for the ] and the 2014 resurgence of ]) and invokes legal measures on disease prevention, surveillance, control, and response, by 194 signatory countries.<ref name="Reuters">{{cite news |url=http://www.reuters.com/article/2014/08/28/us-health-ebola-who-plan-idUSKBN0GS0XC20140828|title=WHO says Ebola outbreak could strike 20,000 people|publisher=Reuters|date=28 August 2014|accessdate=28 August 2014}}</ref><ref name="urlInside Justice-WHO-PHEIC">{{cite web |url=http://www.insidejustice.com/intl/2009/04/30/swine_flu_who_pheic/ |work=Inside Justice |title=Swine Flu: Legal Obligations and Consequences When the World Health Organization Declares a "Public Health Emergency of International Concern" |first=Renée |last=Dopplick |date=29 April 2009 |accessdate=6 June 2014}}</ref> | |||
| The disease is caused by the '']'' (EBOV). It is the most severe ] since the discovery of the virus in 1976.<ref>{{cite web |url= http://www.cdc.gov/vhf/ebola/resources/outbreak-table.html |title=Chronology of Ebola Hemorrhagic Fever Outbreaks |publisher=Centers for Disease Control and Prevention |date=24 June 2014 |accessdate =25 June 2014}}</ref> By September 2014 ] of EVD from this single outbreak exceeded the total of all cases from previous known outbreaks.<ref>{{cite web|url=http://www.nejm.org/doi/full/10.1056/NEJMp1409903?query=featured_home&|title=Ebola 2014 — New Challenges, New Global Response and Responsibility|publisher=The New England Journal of Medicine|accessdate=18 September 2014}}</ref> The ] has been determined to be unrelated.<ref name="WHO update 2014-12-09">{{cite web |url=http://www.afro.who.int/index.php?option=com_docman&task=doc_download&gid=9443&Itemid=2593 |title=WHO Response to the Ebola Virus Disease (EVD) Outbreak - 12 September 2014 |publisher=WHO |accessdate=17 September 2014}}</ref><ref name="who.int">{{cite web|url=http://www.who.int/mediacentre/news/ebola/2-september-2014/en/|title=Virological analysis: no link between Ebola outbreaks in west Africa and Democratic Republic of Congo|publisher=WHO|accessdate=28 September 2014}}</ref> | |||
| {{As of|2014|10|1}}, the ] (WHO), the United States ] (CDC) and local governments reported a total of 7,492 suspected cases and 3,439 deaths (4,108 cases and 2,078 deaths having been ] confirmed).<ref name=Ebola_Outbreak_total_WHO_3_Oct /> Many experts believe that the official numbers substantially understate the size of the outbreak, due in part to community resistance to reporting cases, and a lack of personnel and equipment to investigate reports of the disease.<ref>{{cite web|title=As Ebola outbreak grows, WHO notes case-count difficulties|url=http://www.cidrap.umn.edu/news-perspective/2014/08/ebola-outbreak-grows-who-notes-case-count-difficulties|publisher=University of Minnesota CIDRAP|accessdate=21 September 2014}}</ref> As of 21 September WHO estimated that region's capacity for treating EVD is insufficient by the equivalent of 2,122 beds.<ref name=sitrep_24Sept2014>{{cite web|title=Ebola Response Roadmap Situation Report|url=http://apps.who.int/iris/bitstream/10665/134771/1/roadmapsitrep_24Sept2014_eng.pdf?ua=1|publisher=World Heath Organisation|accessdate=25 September 2014|page=6}}</ref> The ] (CFR) was reported on 23 September to be 70%, derived using data from patients with definitive clinical outcomes.<ref name="doi10.1056/NEJMoa1411100">{{cite doi|10.1056/NEJMoa1411100}}</ref> | |||
| Affected countries have encountered many difficulties in their control efforts. In some areas, people have become suspicious of both the government and hospitals; some hospitals have been attacked by angry protestors who believe that the disease is a hoax or that the hospitals are responsible for the disease. Many of the areas that are seriously affected with the outbreak are areas of extreme poverty with limited access to soap or running water to help control the spread of disease.<ref name="Diallo">{{cite web |title=Ebola en Guinée : l’ONG Plan Guinée craint une aggravation de l’épidemie|url=http://www.africaguinee.com/articles/2014/03/30/ebola-en-guinee-l-ong-plan-guinee-craint-une-aggravation-de-l-epidemie |language=fr |trans_title=Ebola in Guinea: the NGO Plan Guinea fears a worsening of the epidemic |publisher=Africa guinée |date=29 March 2014 |accessdate=31 March 2014|first=Boubacar |last=Diallo}}</ref> Other factors include belief in traditional ], and cultural practices that predispose to physical contact with the deceased, especially ]s such as ].<ref name="World Health Organisation">{{cite web |url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4216-ebola-virus-disease-west-africa-3-july-2014.html |title=Ebola virus disease, West Africa – update 3 July 2014 |publisher=World Health Organisation |date=3 July 2014 |accessdate=4 July 2014}}</ref><ref name="Global Post">{{cite web |url=http://www.globalpost.com/dispatch/news/xinhua-news-agency/140527/8-ebola-suspects-freed-relatives-sierra-leone |title=8 Ebola suspects freed by relatives in Sierra Leone |work=Global Post |date=28 May 2014 |accessdate=21 June 2014}}</ref><ref name="Today Health">{{cite web |url=http://www.today.com/health/growing-ebola-outbreak-threatens-overwhelm-volunteers-2D79775266 |title=Growing Ebola Outbreak Threatens to Overwhelm Volunteers|publisher=Today Health|date=8 June 2014 |accessdate=21 June 2014}}</ref> Some hospitals lack basic supplies and are understaffed. This has increased the chance of staff catching the virus themselves. In August, the WHO reported that ten percent of the dead have been health care workers.<ref name="As Ebola Outbreak Surges, Health Officials Slam International 'Coalition of Inaction'">{{cite web |url=http://www.commondreams.org/news/2014/09/03/ebola-outbreak-surges-health-officials-slam-international-coalition-inaction |title=As Ebola Outbreak Surges, Health Officials Slam International 'Coalition of Inaction' |publisher=Common Dreams |work=As Ebola Outbreak Surges, Health Officials Slam International 'Coalition of Inaction' |date=3 September 2014 |accessdate=7 September 2014 |author=McCauley, Lauren}}</ref> | |||
| By the end of August, the WHO reported that the loss of so many health workers was making it difficult for them to provide sufficient numbers of foreign medical staff.<ref name="WHO ">{{cite web |url=http://www.who.int/mediacentre/news/ebola/25-august-2014/en/ |title=Unprecedented number of medical staff infected with Ebola |publisher=WHO |work=Situation assessment |date=25 August 2014 |accessdate=27 August 2014}}</ref> By September 2014, ], the largest ] working in the affected regions, had grown increasingly critical of the international response. Speaking on 3 September, the international president spoke out concerning the lack of assistance from the ] member countries saying, "Six months into the worst Ebola epidemic in history, the world is losing the battle to contain it."<ref name="Ebola: the failures of the international outbreak response">{{cite web |url=http://www.msf.org/article/ebola-failures-international-outbreak-response |title=Ebola: the failures of the international outbreak response |publisher=Médecins Sans Frontières |date=29 August 2014 |accessdate=7 September 2014}}</ref> A United Nations spokesperson stated "they could stop the Ebola outbreak in West Africa in 6 to 9 months, but only if a 'massive' global response is implemented."<ref name="UN senior leaders outline needs for global Ebola response " /> <!-- the nbsp is one way to prevent an unexpected and unwanted paragraph break -->The Director-General of the WHO, ], called the outbreak "the largest, most complex and most severe we've ever seen" and said that it "is racing ahead of control efforts".<ref name="UN senior leaders outline needs for global Ebola response">{{cite web |url=http://www.who.int/mediacentre/news/releases/2014/ebola-response-needs/en/ |title=UN senior leaders outline needs for global Ebola response |publisher=WHO |date=3 September 2014 |accessdate=7 September 2014 |author=news release}}</ref> By 12 September, there was not a single Ebola treatment bed available in all of Liberia<ref name="West African health centers can't keep up with Ebola outbreak, WHO says">{{cite web |url=http://www.cnn.com/2014/09/12/health/ebola-outbreak/index.html |title=West African health centers can't keep up with Ebola outbreak, WHO says |publisher=CNN Health |date=12 September 2014 |accessdate=15 September 2014 |author=Payne, Ed}}</ref> and as of 23 September, in the three hardest hit countries, Liberia, Sierra Leone, and Guinea, there were only 893 treatment beds available while the current need was 2,122. In a 26 September statement, the WHO said, "The Ebola epidemic ravaging parts of West Africa is the most severe acute public health emergency seen in modern times. Never before in recorded history has a ] four pathogen infected so many people so quickly, over such a broad geographical area, for so long."<ref name="Ebola situation assessment ">{{cite web |url=http://www.who.int/mediacentre/news/ebola/26-september-2014/en/ |title=http://www.who.int/mediacentre/news/ebola/26-september-2014/en/ |publisher=WHO |date=26 September 2014 |accessdate=28 September 2014 |author=statement}}</ref> | |||
| {{TOC limit|3}} | |||
| ==Epidemiology== | |||
| ===Outbreak=== | |||
| Researchers believe that a 2-year-old boy was the ] of the current ] epidemic. He died on 6 December 2013 in the village of ], ], ]. His mother, sister, and grandmother then became ill with similar symptoms and also died. People infected by those victims spread the disease to other villages. Although Ebola represents a major public health issue in sub-Saharan Africa, no cases had ever been reported in West Africa and the early cases were diagnosed as diseases more common to the area. Thus, the disease had several months to spread before it was recognized as Ebola.<ref name="Tracing Ebola’s Breakout to an African 2-Year-Old"/><ref name="1st Chain">{{cite web|title=The first cases of this Ebola outbreak traced by WHO|url=http://who.int/csr/disease/ebola/ebola-6-months/guinea-chart-big.png?ua=1|website=who.int|publisher=]|ref=1st-chain|format=png|year=2014}}</ref><ref name="Baize-2014">{{cite journal|url=http://www.nejm.org/doi/full/10.1056/NEJMoa1404505|title=Emergence of Zaire Ebola Virus Disease in Guinea — Preliminary Report|date=16 April 2014 |DOI=10.1056/NEJMoa1404505 |last=Baize |first=Sylvain |last2=Pannetier |first2=Delphine |last3=Oestereich|first3=Lisa|last4=Rieger|first4=Toni|journal=New England Journal of Medicine}}</ref> | |||
| On 19 March, the Guinean Ministry of Health acknowledged a local outbreak of an undetermined ] that had sickened at least 35 people and killed 23. "We thought it was ] or another form of cholera but this disease seems to strike like lightning. We are looking at all possibilities, including Ebola, because ] is consumed in that region and Guinea is in the Ebola belt."<ref>{{cite web |url=http://www.reuters.com/article/2014/03/19/us-guinea-fever-idUSBREA2I0QM20140319 |title=Mystery hemorrhagic fever kills 23 in Guinea |publisher=Reuters |date=19 March 2014|accessdate=9 August 2014}}</ref> On 25 March, the ] (WHO) reported that Guinea's Ministry of Health had reported an outbreak of Ebola virus disease in four southeastern districts, with suspected cases in the neighbouring countries of ] and ] being investigated. In Guinea, a total of 86 suspected cases, including 59 deaths (case fatality ratio: 68.5%), had been reported as of 24 March.<ref name=Previous_Updates_2014_West_Africa_Outbreak>{{cite web|url=http://www.cdc.gov/vhf/ebola/outbreaks/guinea/recent_updates.html |title=Previous Updates: 2014 West Africa Outbreak |publisher=Centers for Disease Control and Prevention}}</ref> | |||
| On 31 March, the ] (CDC) sent a five-person team to assist Guinea's Ministry of Health and the WHO to lead an international response to the Ebola outbreak. On that date, the WHO reported 112 suspected and confirmed cases including 70 deaths. Two cases were reported from Liberia of people who had recently traveled to Guinea, and suspected cases in Liberia and Sierra Leone were being investigated.<ref name=Previous_Updates_2014_West_Africa_Outbreak /> On 30 April, Guinea's Ministry of Health reported 221 suspected and confirmed cases including 146 deaths. The cases included 25 health care workers with 16 deaths. By late May, the outbreak had spread to ], Guinea's capital, a city of about two million inhabitants.<ref name=Previous_Updates_2014_West_Africa_Outbreak /> On 28 May, the total cases reported had reached 281 with 186 deaths.<ref name=Previous_Updates_2014_West_Africa_Outbreak /> | |||
| ] | |||
| In ], the disease was reported in ] and ] counties in late March.<ref name="liberianobserver.com">{{cite news |url=http://www.liberianobserver.com/security-health/2-5-test-positive-ebola-liberia |title=2 of 5 Test Positive for Ebola in Liberia |newspaper=] |date=31 March 2014 |accessdate=6 July 2014}}</ref> The ] recorded possible cases in ] and ] counties in mid-April.<ref name= mohsw>{{cite web |url=http://www.mohsw.gov.lr/documents/13aprilEbola%20Virus%20Disease%20Epidemic%20in%20Liberia.%20Sitrep%20No.11(1).pdf |title=Ebola Virus Disease Epidemic in Liberia: Situation Report 11 |publisher=Ministry of Health and Social Welfare |date=13 April 2014 |place=] |accessdate=6 July 2014 |format=PDF}}</ref> The first cases in Liberia's capital ] were reported in mid-June.<ref>{{cite web |url=http://www.bbc.co.uk/news/world-africa-27888363 |title=Seven die in Monrovia Ebola outbreak |work=BBC News |date=17 June 2014 |accessdate=28 July 2014}}</ref><ref>{{cite web |url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4100-ebola-virus-disease-west-africa-16-april-2014.html |title=Ebola Haemorrhagic Fever, West Africa (Situation) |date=16 April 2014 |publisher=WHO |accessdate=16 April 2014}}</ref><ref>{{cite web |url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4150-ebola-virus-disease-west-africa-27-may-2014.html |title= Ebola Haemorrhagic Fever, West Africa (Situation) |date=27 April 2014 |publisher=WHO |accessdate=27 April 2014}}</ref> | |||
| The outbreak then spread into Sierra Leone and rapidly progressed. A study of the virus genomes determined that twelve residents, when attending a funeral in Guinea, became infected. They then carried the virus back home.<ref name="Gire 2014"/> On 25 May, the first cases in the ], near the border with Guéckédou in Guinea, were reported.<ref>{{cite web |url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4143-ebola-virus-disease-west-africa-26-may-2014.html |title=Ebola virus disease, West Africa (Update of 26 May 2014) |publisher=WHO |date=26 May 2014 |accessdate=28 July 2014}}</ref> By 20 June, there were 158 suspected cases, mainly in Kailahun and the adjacent district of ]. Others were reported in the ], ], and ] districts in the northwest of the country.<ref>{{cite web |url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4172-ebola-virus-disease-west-africa-23-june-2014.html |title=Ebola virus disease, West Africa – update 23 June 2014 |publisher=WHO |date=23 June 2014 |accessdate=28 July 2014}}</ref> By 17 July, the total number of suspected cases in the country stood at 442, and had overtaken those in Guinea and Liberia.<ref name=WHO_18_July_2014>{{cite web |url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4225-ebola-virus-disease-west-africa-18-july-2014.html |title=Ebola virus disease, West Africa – update 18 July 2014 |publisher=WHO |date=18 July 2014 |accessdate=27 July 2014}}</ref> By 20 July, cases of the disease had additionally been reported in the ].<ref>{{cite web |url=http://www.cdc.gov/vhf/ebola/outbreaks/guinea/ |title=Outbreak of Ebola in Guinea, Liberia, and Sierra Leone |publisher=Centers for Disease Control and Prevention |accessdate=27 July 2014}}</ref> The first case in ], Sierra Leone's capital, was reported in late July.<ref name=BBC_Freetown>{{cite web |url=http://www.bbc.co.uk/news/world-africa-28485041 |title=Sierra Leone hunts Ebola patient kidnapped in Freetown |publisher=BBC News |date=25 July 2014 |accessdate=27 July 2014}}</ref><ref>{{cite web |url=http://www.bbc.co.uk/news/world-africa-28505061 |title=Ebola outbreak: Sierra Leone escaped patient dies |publisher=BBC News |date=27 July 2014 |accessdate=27 July 2014}}</ref> | |||
| The first death in ] was reported on 25 July.<ref name=WHO_25_July_2014>{{cite web |url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4233-ebola-virus-disease-west-africa-25-july-2014.html |title=Ebola virus disease, West Africa – update 25 July 2014 |publisher=WHO |date=25 July 2014 |accessdate=27 July 2014}}</ref> A Liberian-American with Ebola flew from Liberia to Nigeria and died in ] soon after arrival.<ref>{{cite news|last=Wesee|first=Ben P.|url=http://www.thenewdawnliberia.com/index.php?view=article&id=12289|title=I'm ok - Nigerian Ambassador Assures Public|publisher=The New Dawn, Monrovia|date=4 August 2014|accessdate=7 August 2014}}</ref> As part of the containment efforts, 353 possible contacts were monitored in Lagos and 451 in Port Harcourt.<span class="plainlinks"></span><ref name=cbc1.2767239>{{cite web|title=Worst-ever Ebola outbreak, by the numbers|url=http://www.cbc.ca/news/health/worst-ever-ebola-outbreak-by-the-numbers-1.2767239|publisher=CBC News|accessdate=16 September 2014}}</ref> As of 22 September, the WHO reported a total of 20 cases with 8 deaths. They continue to monitor a few contacts, but the disease appears to now be contained in Nigeria.<ref name=Seeman,>{{cite web |url=http://www.huffingtonpost.ca/neil-seeman/nigeria-ebola_b_5869680.html |title=Nigeria's Optimism Amid Ebola's Threat |date=24 September 2014 |accessdate=25 September 2014}}</ref> | |||
| On 29 August, the ] Health minister Awa Marie Coll Seck announced the first case in Senegal. This was subsequently identified as a Guinean national who had been exposed to the virus and had been under surveillance, but had travelled to Dakar by road and fallen ill after arriving.<ref>{{cite web|title=Ebola virus disease update Senegal 30 August 2014|url=http://www.who.int/csr/don/2014_08_30_ebola/en/|publisher=World Health Organisation|accessdate=17 September 2014}}</ref><ref name=2014_Ebola_Senegal /><ref name=2014_Ebola_Senegal_1 /> This case subsequently recovered and on 22 September the WHO announced that all contacts had completed a 21-day follow-up with no further cases of Ebola in Senegal.<ref name=cbc1.2767239 /> | |||
| <ref name="Ebola_Outbreak_total_20_Sept">{{cite web|url=http://apps.who.int/iris/bitstream/10665/134449/1/roadmapupdate22sept14_eng.pdf?ua=1|title=Ebola Response Roadmap Update, 22 September 2014 |publisher=WHO|date=22 September 2014| accessdate=22 September 2014}}</ref> | |||
| ===Countries with widespread transmission=== | |||
| <!-- {{Infobox event | |||
| | title = Quality of core services: Ebola treatment centres | |||
| | image = | |||
| | caption = Quality of core services: Ebola treatment centres <small>{{as of|2014|9|19|lc=y}}</small><ref>{{cite web |url=https://wca.humanitarianresponse.info/en/node/2135 |title=Ebola Crisis – Quality of Core Services: Ebola Treatment Centers (as of 19 Sept 2014) |publisher=OCHA |date=19 September 2014 |accessdate=22 September 2014}}</ref> | |||
| }} --> | |||
| ====Guinea==== | |||
| {{Main|2014 Ebola virus epidemic in Guinea}} | |||
| On 25 March, the ] (WHO) reported that Guinea's Ministry of Health had reported an outbreak of Ebola virus disease in four southeastern districts. In Guinea, a total of 86 suspected cases, including 59 deaths (case fatality ratio: 68.5%), had been reported as of 24 March.<ref name=Previous_Updates_2014_West_Africa_Outbreak>{{cite web|url=http://www.cdc.gov/vhf/ebola/outbreaks/guinea/recent_updates.html |title=Previous Updates: 2014 West Africa Outbreak |publisher=Centers for Disease Control and Prevention}}</ref> On 31 March, the ] (CDC) sent a five-person team to assist Guinea's Ministry of Health and the WHO to lead an international response to the Ebola outbreak.<ref name=Previous_Updates_2014_West_Africa_Outbreak /> | |||
| Thinking that the virus was contained, Médecins Sans Frontières closed its treatment centers in May leaving only a small skeleton staff to handle the ] region. However, high numbers of new cases reappeared in the region in late August. According to Marc Poncin, a coordinator for MSF, the new cases were related to persons returning to Guinea from neighbouring Liberia or Sierra Leone.<ref name=Guinea_Ebola_Sep_Update>{{cite news |url=http://www.ctvnews.ca/health/ebola-virus-is-surging-in-places-where-it-was-beaten-back-experts-1.1996179 |title=Ebola virus is surging in places where it was beaten back: experts |publisher=CTV News |date=8 September 2014 |accessdate=8 September 2014}}</ref> | |||
| On 18 September, it was reported that the bodies of a team of Guinean health and government officials, accompanied by journalists, who had been distributing Ebola information and doing disinfection work were found in a latrine in the town of ] near ].<ref>{{cite news|url=http://online.wsj.com/articles/arrests-made-in-killings-of-guinea-ebola-education-team-1411144837|title=Arrests Made in Killings of Guinea Ebola Education Team|work=Wall Street Journal|date=Sept. 19, 2014|accessdate=30 September 2014}}</ref> The workers had been murdered by residents of the village after they initially went missing after a riot against the presence of the health education team. Government officials said "the bodies showed signs of being attacked with machetes and clubs" and "three of them had their throats slit."<ref>{{cite web |url=http://www.washingtonpost.com/news/to-your-health/wp/2014/09/18/missing-health-workers-in-guinea-were-educating-villagers-about-ebola-when-they-were-attacked/ |title=Eight dead in attack on Ebola team in Guinea. ‘Killed in cold blood.’ |work=The Washington Post |date=18 September 2014 |accessdate=19 September 2014 |author=Phillip, Abby}}</ref> | |||
| It has been reported that some people in this area believe that health workers have been purposely spreading the disease to the people, while others believe that the disease does not exist. Riots recently broke out in the regional capital, ], when rumors were spread that people were being contaminated when health workers were spraying a market area to decontaminate it.<ref name="Guinea Outbreak: Guinea Health Team Killed">{{cite web |url=http://www.bbc.com/news/world-africa-29256443 |title=Guinea Outbreak: Guinea Health Team Killed |publisher=BBC News |date=19 September 2014 |accessdate=19 September 2014}}</ref> | |||
| WHO estimated on 21 September that Guinea's capacity to treat EVD cases falls short by the equivalent of 40 beds.<ref name=sitrep_24Sept2014 /> | |||
| ====Liberia==== | |||
| {{Main|2014 Ebola virus epidemic in Liberia}} | |||
| In Liberia, the disease was reported in ] and ] counties in late March.<ref name="liberianobserver.com" /> By 23 July, the health ministry implemented measures to improve the country's response.<ref name=WHO_23_July_2014>{{cite web |url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4230-ebola-virus-disease-west-africa-23-july-2014.html |title=Ebola virus disease, West Africa – update 23 July 2014 |publisher=WHO |date=23 July 2014 |accessdate=27 July 2014}}</ref> On 27 July, ], the Liberian president, announced that Liberia would close its borders, with the exception of a few crossing points, such as the airport, where screening centres would be established, and the worst-affected areas in the country would be placed under ].<ref name=BBC_28_July_2014>{{cite web |url=http://www.bbc.co.uk/news/world-africa-28522824 |title=Ebola outbreak: Liberia shuts most border points |publisher=BBC News |date=28 July 2014 |accessdate=28 July 2014}}</ref> ] events were banned, because large gatherings and the nature of the sport increase transmission risks.<ref>{{cite web|url=http://www.bbc.com/news/world-africa-28550906|title=Ebola outbreak: Asky bans flights in West Africa|publisher=BBC News|date=29 July 2014|accessdate=29 July 2014}}</ref> Three days after the borders were closed, Sirleaf announced the closure of all schools nationwide, including the ],<ref>{{cite news|last=Kwanue|first=C.Y.|url=http://www.liberianobserver.com/security/compliance-sirleaf%E2%80%99s-mandate-ul-closed|title=In Compliance with Sirleaf's Mandate, UL Closed|work=Liberian Observer|date=1 August 2014|accessdate=2 August 2014}}</ref> and a few communities were to be quarantined.<ref>{{cite web|url=http://www.reuters.com/article/2014/07/30/health-ebola-africa-idUSL6N0Q56DX20140730|title=Liberia shuts schools, quarantines communities in bid to halt Ebola|publisher=Reuters|date=30 July 2014|accessdate=30 July 2014}}</ref> | |||
| Sirleaf declared a state of emergency on 6 August, partly because the disease's weakening of the health care system has the potential to reduce the system's ability to treat routine diseases such as malaria; she noted that the state of emergency might require the "suspensions of certain rights and privileges".<ref>{{cite web|url=http://www.news.heritageliberia.net/index.php/inside-heritage/general-news/78-slides/3611-ellen-declares-state-of-emergency|title=Ellen Declares State of Emergency|publisher=Executive Mansion via ''Heritage''|date=6 August 2014|accessdate=7 August 2014}}</ref> <!-- please remove the following sentence once postponement is enacted or rejected by the Legislature --> On the same day, the ] announced that it would be unable to conduct the scheduled October 2014 ] election and requested postponement,<ref>"", ''Heritage'', 7 August 2014. Accessed 7 August 2014.</ref> one week after the leaders of various opposition parties had publicly taken different sides on the question.<ref>{{cite news|last=Daygbor|first=E.J. Nathaniel|url=http://www.thenewdawnliberia.com/index.php?option=com_content&view=article&id=12266|title=Senatorial Election Faces Postponement as Political Leaders Debate|work=The New Dawn|date=31 July 2014|accessdate=7 August 2014}}</ref> On 30 August, Liberia's ] cancelled all "shore passes" for sailors from ships coming into the country's four seaports.<ref>{{cite news |url=https://au.news.yahoo.com/world/a/24856656/ebola-hit-liberia-bans-sailors-from-disembarking/ |title=Ebola-hit Liberia bans sailors from disembarking |publisher=Yahoo News |date=31 August 2014 |accessdate=30 August 2014}}</ref> | |||
| On 20 September, Liberia opened a new 150 bed treatment unit clinic in Monrovia. At the opening ceremony of the Old Island Clinic on ] six ambulances were already waiting with potential patients. More patients were waiting by the clinic after making their way on foot with the help of relatives.<ref>{{cite news |url=http://allafrica.com/stories/201409221723.html |title=Liberia: 120-Bed Ebola Treatment Center Opens in Liberia |publisher=All Africa |date=22 September 2014 |accessdate=22 September 2014}}</ref> Two days later 112 beds were already filled with 46 patients testing positive for Ebola, while the rest were admitted for observation.<ref>{{cite news |url=http://www.washingtonpost.com/world/africa/has-sierra-leone-shutdown-slowed-ebolas-spread/2014/09/22/69e8df48-4244-11e4-8042-aaff1640082e_story.html |title=Streets bustling after Sierra Leone shutdown ends |publisher=The Washington Post|date=22 September 2014|accessdate=22 September 2014}}</ref> | |||
| As of 8 September, Ebola had been identified in 14 of Liberia's 15 counties.<ref>{{cite web|url=http://news.sciencemag.org/africa/2014/09/liberias-ebola-problem-far-worse-imagined-says-who|title=Liberia's Ebola problem far worse than imagined, says WHO|publisher=|accessdate=30 September 2014}}</ref> WHO estimated on 21 September that Liberia's capacity to treat EVD cases falls short by the equivalent of 1,550 beds.<ref name=sitrep_24Sept2014 /> | |||
| On 25 September Liberia's chief medical official went on a self enforced quarantine after she was potentially exposed to the Ebola virus.<ref>{{cite web|url=http://www.cnn.com/2014/09/27/world/africa/ebola-liberia/index.html|title=Liberia's top medical officer is in quarantine|date=27 September 2014|publisher=CNN|accessdate=30 September 2014}}</ref> By the 29th of September 2014, it was announced she tested negative for Ebola, but government officials praised her for following the self quarantine rules.<ref>{{cite web|url=http://allafrica.com/stories/201409291917.html|title=Liberia's Top Medical Officer Under Self-Imposed Ebola Quarantine|publisher=allAfrica.com|accessdate=30 September 2014}}</ref> | |||
| ====Sierra Leone==== | |||
| {{Main|2014 Ebola virus epidemic in Sierra Leone}} | |||
| The first person reported infected in the spread to Sierra Leone was a ]. She had treated one or more infected people and died on 26 May. According to tribal tradition, her body was washed for burial and this appears to have led to infections in women from neighboring towns.<ref name="Fox News">{{cite web |url=http://www.foxnews.com/health/2014/08/25/sierra-leone-hero-doctor-death-exposes-slow-ebola-response/ |title=Sierra Leone 'hero' doctor's death exposes slow Ebola response |publisher=Fox News |work=Sierra Leone 'hero' doctor's death exposes slow Ebola response |date=25 August 2014 |accessdate=25 August 2014}}</ref> On 31 March, ] declared a ] and instituted measures to screen travelers from Guinea and Liberia.<ref>{{cite news |url=http://www.bbc.com/news/world-africa-26816438 |title=Ebola: Liberia confirms cases, Senegal shuts border |publisher=BBC News |date=31 March 2014}}</ref> On 30 July, the government began to deploy troops to implement quarantines.<ref>{{cite news |url=http://www.news24.com/Africa/News/Sierra-Leone-Liberia-deploy-troops-for-Ebola-20140804 |title=Sierra Leone, Liberia deploy troops for Ebola|publisher=News 24 |date=4 August 2014}}</ref> | |||
| On 29 July, well-known physician Sheik Umar Khan, Sierra Leone's only expert on hemorrhagic fever, died after contacting Ebola at his clinic in ]. Khan had long worked with ], a disease that kills over 5,000 a year in Africa. He had expanded his clinic to accept Ebola patients. Sierra Leone's President, ], celebrated Khan as a "national hero".<ref name="Fox News" /> | |||
| In August, awareness campaigns in ], Sierra Leone's capital, were delivered over the radio and through loudspeakers.<ref>{{cite web|url=http://wvxu.org/post/skeptics-sierra-leone-doubt-ebola-virus-exists|title=Skeptics In Sierra Leone Doubt Ebola Virus Exists|publisher=WVXU|date=6 August 2014|author=Ofeibea Quist-Arcton}}</ref> Also in August, Sierra Leone passed a law that subjected anyone hiding someone believed to be infected to two years in jail. At the time the law was enacted, a top parliamentarian was critical of failures by neighboring countries to stop the outbreak.<ref>{{cite news |url=http://ibnlive.in.com/news/two-year-jail-terms-for-hiding-ebola-victims-in--sierra-leone/493712-17.html |title=Two year jail terms for hiding Ebola victims in Sierra Leone |publisher=IBNLIVE |date=22 August 2014 |accessdate=23 August 2014}}</ref> | |||
| In an attempt to control the disease, Sierra Leone imposed a three-day lockdown on its population from 19 to 21 September. During this period 28,500 trained community workers and volunteers went door-to-door providing information on how to prevent infection, as well as setting up community Ebola surveillance teams.<ref>{{cite web|title=Sierra Leone launches three-day, door-to-door Ebola prevention campaign|url=http://www.unicef.org/media/media_75963.html|publisher=UNICEF|accessdate=24 September 2014}}</ref> On 22 September, government officials said that the three day lock down had obtained its objective and would not be extended. Eighty percent of targeted households were reached in the operation. A total of around 150 new cases were uncovered, although reports from remote locations had not yet been received.<ref name="SL_locdown_22sept">{{cite news |url=http://www.cbc.ca/news/health/ebola-virus-shutdown-in-sierra-leone-yields-massive-awareness-1.2774082 |title=Ebola virus shutdown in Sierra Leone yields 'massive awareness' |publisher=CBC News |date=22 September 2014 |accessdate=22 September 2014}}</ref> | |||
| On 25 September, the government added three more districts under "isolation," in an effort to contain the spread. The districts include ], ], and ]. This brings the total areas under isolation to five, including the outbreak "hot spots" Kenema and Kailahun which were already in isolation. Only deliveries and essential services were to be allowed in and out. A sharp rise in cases in these areas was noted by the WHO.<ref>{{cite news |url=http://www.washingtonpost.com/world/africa/sierra-leone-to-cordon-off-3-areas-to-stop-ebola/2014/09/25/13dad80e-4492-11e4-8042-aaff1640082e_story.html |title=Sierra Leone cordons off 3 areas to control Ebola |work=The Washington Post |date=25 September 2014 |accessdate=25 September 2014}}</ref> | |||
| WHO estimated on 21 September that Sierra Leone's capacity to treat EVD cases falls short by the equivalent of 532 beds.<ref name=sitrep_24Sept2014 /> There have been reports that political interference and administrative incompetence have hindered the flow of medical supplies into the country.<ref>{{cite web|title=Ebola Help for Sierra Leone Delayed on the Docks|url=http://www.nytimes.com/2014/10/06/world/africa/sierra-leone-ebola-medical-supplies-delayed-docks.html?_r=0|work=New York Times|accessdate=6 October 2014}}</ref> On Oct. 4, Sierra Leone recorded 121 fatalities <ref>http://www.reuters.com/article/2014/10/06/us-health-ebola-leone-idUSKCN0HU0ZT20141006</ref> the most in a single day. | |||
| ===Countries with local transmission=== | |||
| ====Nigeria==== | |||
| {{Infobox event | |||
| |title = Nigeria Ebola areas – 2014 | |||
| |image = File:Nigeria_Map_Ebola_2014.png | |||
| |caption = Nigeria Situation Map {{as of|2014|9|5|lc=y}}<ref name="2014_Ebola_Outbreak_in_West_Africa">{{cite news |url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4263-ebola-virus-disease-drc.html |work=Epidemic & Pandemic Alert and Response (EPR) - Outbreak News |title=Ebola virus disease – Democratic Republic of Congo |publisher=WHO |accessdate=27 August 2014}}</ref> | |||
| | date = July 2014 – present<ref>{{cite web|url=http://who.int/csr/don/2014_09_04_ebola/en/|title=Ebola virus disease outbreak – west Africa|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |casualties1= <!-- Change to WHO Map when available --> | |||
| {{plainlist| | |||
| * '''Cases / Deaths''' <small>({{As of |2014|9|21|lc=y}})</small> | |||
| * <!--Nigeria-->{{NGA}}: 20 / 8<ref name=Ebola_Outbreak_total_21_WHO_Sept /> | |||
| }} | |||
| }} | |||
| The first case in Nigeria was a Liberian-American, ], who flew from Liberia to Nigeria's former capital ] on 20 July. Sawyer became violently ill upon arriving at the airport and died five days later. In response, the Nigerian government observed all of Sawyer's contacts for signs of infection and increased surveillance at all entry points to the country.<ref>{{cite web |url=http://www.bbc.co.uk/news/world-africa-28498665 |title=Nigeria 'on red alert' over Ebola death in Lagos |publisher=BBC News |date=26 July 2014 |accessdate=27 July 2014}}</ref> On 6 August, the Nigerian health minister told reporters, "Yesterday the first known Nigerian to die of Ebola was recorded. This was one of the nurses that attended to the Liberian. The other five cases are being treated at an isolation ward."<ref name="theguardian1">{{cite news|last=Mark|first=Monica|url=http://www.theguardian.com/world/2014/aug/06/ebola-outbreak-nurse-nigeria-dies|title=Ebola Outbreak: Nurse who Treated First Victim in Nigeria Dies|work=]|date=6 August 2014|accessdate=7 August 2014}}</ref> | |||
| On 9 August, the ] issued a statement waiving the regular administrative requirements that limit the international shipment of any biological samples out of Nigeria<ref name="NHREC">{{cite news|url=http://nhrec.net/nhrec/statement-on-the-use-of-innovative-or-non-validated-medical-treatment-in-nigeria/|title=NHREC Statement on Ebola Care|publisher=Nigerian National Health Research Ethics Committee|date=9 August 2014|accessdate=12 August 2014}}</ref> and supporting the use of non-validated treatments without prior review and approval by a health ].<ref name="NHREC" /> Other than increased surveillance at the country’s borders, the Nigerian government states that they have also made attempts to control the spread of disease through an improvement in tracking, providing education to avert disinformation and increase accurate information, and the teaching of appropriate hygiene measures.<ref name=2014_Ebola_Outbreak_in_West_Africa /> | |||
| On 19 August, it was reported that the doctor who treated Sawyer, ], had also died of Ebola disease. Adadevoh was posthumously praised for preventing the index case (Sawyer) from leaving the hospital at the time of diagnosis, thereby playing a key role in curbing the spread of the virus in Nigeria.<ref name="reuters1">{{cite web|url=http://www.reuters.com/article/2014/08/04/us-health-ebola-nigeria-idUSKBN0G413H20140804|author=Reuters|title=Lagos records second Ebola case in doctor who treated victim: Nigerian health minister|date=4 August 2014}}</ref><ref>{{cite web|website=Thisday|url=http://www.thisdaylive.com/articles/ebola-strikes-at-the-heart-of-nigeria-ameyo-daughter-of-kwaku-adadevoh-great-grand-daughter-of-herbert-macaulay-dies/186843/|title=Ebola strikes at the heart of Nigeria: Ameyo, daughter of Kwaku Adadevoh, grand daughter of Herbert Macaulay dies|accessdate=22 August 2014}}</ref> | |||
| On 19 August, the Commissioner of Health in Lagos announced that Nigeria had seen twelve confirmed cases; four died (including the index case) while another five, including two doctors and a nurse, were declared disease-free and released.<ref name="2014_Ebola_Outbreak_in_West_Africa"/><ref>{{cite web|author=Sola Ogundipe, Chioma Obinna, Olasunkanmi Akoni, Peter Duru, Victoria Ojeme, Monsur Olowoopejo and Gabriel Olawale |title=Ebola Latest: 3 new cases as 4 more victims are discharged |work=Vanguard |date=19 August 2014 |accessdate=2014-08-20}}</ref> On 22 September, the Nigeria health ministry announced "As of today, there is no case of Ebola in Nigeria. All listed contacts who were under surveillance have been followed up for 21 days."<ref name="Nigeria in first step towards all-clear on Ebola">{{cite web |url=http://news.yahoo.com/nigeria-first-step-towards-clear-ebola-203222268.html |title=Nigeria in first step towards all-clear on Ebola |publisher=Yahoo News |date=23 September 2014 |accessdate=26 September 2014}}</ref><ref>{{cite web |url=http://www.thisdaylive.com/articles/no-single-case-of-ebola-in-nigeria-says-chukwu/188681/ |title=No Single Case of Ebola in Nigeria, Says Chukwu |work=] |accessdate=12 September 2014}}</ref> The WHO stated that Nigeria had not reported any new cases since 8 September and if no further cases are reported, Nigeria will be declared Ebola-free on 20 October.<ref name="Ebola_Outbreak_total_20_Sept">{{cite web|url=http://apps.who.int/iris/bitstream/10665/134449/1/roadmapupdate22sept14_eng.pdf?ua=1|title=WHO: Ebola Response Roadmap Update, 22 September 2014 |publisher=WHO|date=22 September 2014|accessdate=22 September 2014}}</ref> | |||
| ===Countries with an initial case or cases=== | |||
| ====Senegal==== | |||
| In March, the ] Ministry of Interior closed the southern border with Guinea,<ref>{{cite web |url=http://www.bloomberg.com/news/2014-03-29/ebola-virus-death-toll-in-guinea-outbreak-rises-to-70-people.html|title=Ebola Death Toll in Guinea Rises to 70 as Senegal Closes Border |publisher=]|date=29 March 2014 |accessdate=31 March 2014}}</ref> but on 29 August the Senegal health minister announced Senegal's first case, a university student from Guinea who was being treated in ].<ref name=2014_Ebola_Senegal>{{cite news |url=http://www.washingtonpost.com/world/africa/senegalese-minister-of-health-confirms-1st-case-of-ebola-virus-in-the-west-african-country/2014/08/29/7996179a-2f79-11e4-be9e-60cc44c01e7f_story.html |title=Senegalese minister of health confirms 1st case of Ebola virus in the West African country |work=Washington Post |date=29 August 2014 |accessdate=29 August 2014}}</ref><ref name=2014_Ebola_Senegal_1>{{cite news |url=http://www.itv.com/news/story/2014-08-29/first-case-of-ebola-virus-is-confirmed-in-senegal/ |title=First case of Ebola virus is confirmed in Senegal |publisher=ITV |date=29 August 2014 |accessdate=29 August 2014}}</ref> The WHO was informed on 30 August.<ref>{{cite news |url=http://abcnews.go.com/International/wireStory/ebola-cases-past-week-25172474|title=Senegal Confirms Its 1st Case of Ebola |publisher=ABC News |date=29 August 2014 |accessdate=31 August 2014}}</ref><ref name="Ebola virus disease – Senegal">{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4265-ebola-virus-disease-senegal.html|title= Ebola virus disease – Senegal |publisher=World Health Organization|date=29 March 2014 |accessdate=1 September 2014}}</ref> According to the WHO, the case was a native of Guinea who had traveled by road to Dakar, arriving on 20 August. On 23 August, he sought medical care for symptoms including fever, diarrhoea, and vomiting. He received treatment for malaria, but did not improve and left the facility. Still experiencing the same symptoms, on 26 August he was referred to a specialized facility for infectious diseases, and was subsequently hospitalized.<ref name="Ebola virus disease – Senegal" /> | |||
| On 27 August, authorities in Guinea issued an alert informing medical services in Guinea and neighbouring countries that a person who had been in close contact with an Ebola infected patient had escaped their surveillance system. The alert prompted testing for Ebola at the Dakar laboratory, and the positive result launched an investigation and triggered urgent contact tracing.<ref name="Ebola virus disease – Senegal" /> On 10 September, it was reported that the student had recovered but health officials would continue to monitor his contacts for 21 days.<ref>{{cite web|title=Guinean Who Brought Ebola To Senegal Recovers From Virus Read more: http://www.businessinsider.com/r-guinean-who-brought-ebola-to-senegal-recovers-from-virus-2014-9#ixzz3DtMDjfCU|url=http://www.businessinsider.com/r-guinean-who-brought-ebola-to-senegal-recovers-from-virus-2014-9#ixzz3DtJJVcyg|accessdate=20 September 2014}}</ref> On 22 September, the WHO announced that all contacts had completed the 21-day follow-up with no further cases of Ebola in Senegal, however they require a 42 day waiting period before a country can be called disease-free.<ref name=Ebola_Outbreak_total_20_Sept /> | |||
| ====United States==== | |||
| {{Main|2014 Ebola virus cases in the United States}} | |||
| On 30 September, the United States ] (CDC) declared its first case of Ebola disease. A CDC spokesperson said, "The patient is a man who became infected in Liberia and traveled to ], where he was hospitalized with symptoms that were confirmed to be caused by Ebola."<ref>{{cite web|url=http://www.afp.com/en/node/2894301|title=First case of Ebola diagnosed in US: health officials |publisher=AFP|accessdate=1 October 2014}}</ref> The patient arrived in ] on 20 September. Four days later he fell ill and sought medical treatment on 26 September. Despite telling a nurse that he had arrived in the US from West Africa, he was sent home with antibiotics. The hospital later blamed a flaw in their health records system for releasing the man.<ref>{{cite web|url=http://abcnews.go.com/Health/ebola-patients-texas-contacts-zoom-80-authorities/story?id=25912405|title=Texas Hospital Blames Records Flaw as Reason Ebola Patient was First Released|publisher=ABC News|accessdate=3 October 2014}}</ref> He returned to the hospital by ambulance on 28 September and was placed in isolation.<ref name=First_Us_case /><ref>{{cite news| url=http://www.telegraph.co.uk/news/worldnews/ebola/11132475/First-Ebola-victim-in-America-was-sent-home-with-antibiotics.html| author=Nick Allen| title=First Ebola victim in America was sent home with antibiotics|work=The Telegraph| date=October 1, 2014}}</ref><ref name="First_Us_case">{{cite news|url=http://www.cdc.gov/media/releases/2014/s930-ebola-confirmed-case.html|title= CDC and Texas Health Department Confirm First Ebola Case Diagnosed in the U.S.|publisher=cdc.gov |date=1 October 2014| accessdate=1 October 2014}}</ref><ref>{{cite web|title=The first U.S. case of Ebola travelled via Brussels, Belgium|url=http://www.reuters.com/article/2014/10/01/us-health-ebola-usa-travel-idUSKCN0HQ4IY20141001/|accessdate=2014-10-01|date=2014-10-01|publisher=Reuters}}</ref> The patient is currently in critical condition.<ref>{{cite news|url=http://www.cnn.com/2014/10/04/health/ebola-us/index.html?hpt=hp_t2|title=Hospital: Dallas Ebola patient in critical condition |date=4 October 2014|publisher=CNN|accessdate=5 October 2014}}</ref> | |||
| On 1 October, the Director of Dallas County's health department confirmed that a second person is being closely monitored for Ebola. More contacts of the infected patient are under watch and will be monitored for 21 days and placed in isolation if necessary.<ref>{{cite news|url= http://www.usatoday.com/story/news/nation/2014/10/01/texas-ebola-patient/16525649/|title=Officials: Second person being monitored for Ebola|work=USA Today |date=1 October 2014| accessdate=1 October 2014}}</ref> Four relatives of the patient were placed legally under strict quarantine. Texas health officials have ordered them to stay at home and be available to undergo regular testing until 19 October, the end of the 21-day incubation period.<ref>{{cite news|url=http://www.cnbc.com/id/102052914 | |||
| |title= 80 People Came Into Contact With Ebola Patient Thomas Eric Duncan|publisher=CNBC |date=2 October 2014| accessdate=2 October 2014}}</ref> | |||
| ===Countries with medically evacuated cases=== | |||
| A number of healthcare workers who had become infected with Ebola virus disease have been ] to treatment in ]s in their country of origin. | |||
| ====France==== | |||
| A French volunteer health worker, working for MSF in Liberia, contracted EVD and was flown to France on 18 September. After successful treatment at a military hospital near Paris, she was discharged on 4 October.<ref>{{cite web|title=French MSF nurse cured of Ebola|url=http://www.france24.com/en/20141004-french-nurse-cured-ebola-health-minister-msf-touraine/|accessdate=4 October 2014}}</ref> | |||
| ====Germany==== | |||
| ] set up an isolation ward to care for six patients at the ]. On 27 August, a ] ] working for the WHO in Sierra Leone became the first patient. On 4 October he was discharged after successful treatment.<ref>{{cite web|title=Hamburg clinic dismisses Ebola patient|url=http://www.berliner-zeitung.de/panorama/universitaetsklinikum-eppendorf-klinik-entlaesst-hamburger-ebola-patient,10808334,28645204.html|accessdate=4 October 2014|language=German}}</ref> | |||
| The WHO requested that a Ugandan doctor working in Sierra Leone, who contracted the disease, be treated in Germany. The request was granted by Germany and he was flown to the country on 3 October. The patient is being treated in an isolation unit at the University Hospital in ]. The doctor was working for an ] NGO in Sierra Leone according to Stefan Gruettner, the State Health Minister of Hessen.<ref>{{cite news |url=http://www.reuters.com/article/2014/10/03/health-ebola-germany-idUSL6N0RY11E20141003 |title=Ebola patient arrives in Germany from Sierra Leone -local officials |publisher=Reuters |date=4 October 2014 |accessdate=4 October 2014}}</ref> | |||
| ====Spain==== | |||
| On 5 August, the ] confirmed that Brother Miguel Pajares, who had been volunteering in Liberia, had become infected. The Spanish military helped with his transfer on 6 August 2014.<ref name="autogenerated3">{{cite news|url=http://www.cnn.com/2014/08/07/health/africa-ebola-outbreak/ |title=Ebola patient's husband feels 'the comfort of God' |publisher=CNN |date=7 August 2014 |accessdate=8 August 2014}}</ref> Brother Pajares died from the virus on 12 August.<ref>{{cite web |title=Muere el religioso español Miguel Pajares a causa del ébola |url=http://www.rtve.es/noticias/20140812/muere-religioso-espanol-miguel-pajares-causa-del-ebola/991420.shtml |publisher=RTVE |date=12 August 2014 |accessdate=12 August 2014}}</ref> | |||
| On 21 September the Spanish Ministry of Health released a press statement stating that Brother Manuel Garcia Viejo,a medical director at the ] in ], had been evacuated to Spain from Sierra Leone after being infected with the virus. His death was announced on 25 September.<ref>{{cite news|url=http://www.ibtimes.co.uk/ebola-outbreak-spanish-missionary-manuel-garcia-viejo-dies-deadly-virus-madrid-1467233|title=Ebola Outbreak: Spanish Missionary Manuel Garcia Viejo Dies of Deadly Virus in Madrid|date=25 September 2014|accessdate=25 September 2014|work=International Business Times}}</ref> | |||
| On October 6th a nurse who took care of the previous patient tested positive. Confirmation of this test is pending.<ref>{{cite news|title=Nurse 'infected with Ebola' in Spain|url=http://www.bbc.com/news/world-europe-29514920|accessdate=6 October 2014|agency=BBC}}</ref> | |||
| ====Switzerland==== | |||
| On Monday 22 September a ] health worker was flown by a private airline to ]. The nurse was bitten by an Ebola-infected child on Saturday, 20 September in Sierra Leone. The unidentified male nurse will remain in isolation for 21 days at ]. The health ministry says it is unlikely that he was infected, but are monitoring him as a potential Ebola patient until the incubation period has passed.<ref>{{cite news|url=http://abcnews.go.com/Health/wireStory/man-bitten-ebola-patient-flown-switzerland-25677039|title=Man Bitten by Ebola Patient Flown to Switzerland|date=22 September 2014|accessdate=22 September 2014|work=The Guardian}}</ref> | |||
| ====United Kingdom==== | |||
| An isolation unit at the ] received its first case on 24 August. ], a British nurse, was evacuated from Sierra Leone. He was released on 3 September.<ref name=united_Kingdom_Ebola>{{cite news|url=http://www.bbc.com/news/uk-28919831 |title=British Ebola patient arrives in UK for hospital treatment |publisher=BBC News |date=24 August 2014|accessdate=25 August 2014}}</ref><ref>{{cite news|url=http://www.theweek.co.uk/world-news/ebola/57952/ebola-british-nurse-makes-full-recovery-and-leaves-hospital |title=Ebola:British nurse makes 'full recovery' and leaves hospital|publisher=he Week |date=3 September 2014|accessdate=5 September 2014}}</ref> | |||
| ====United States==== | |||
| {{Main|2014 Ebola virus cases in the United States#Evacuated}} | |||
| A number of US citizens who contracted EVD while working in the affected areas have been evacuated to the US for treatment; see main article. | |||
| ===Democratic Republic of the Congo=== | |||
| {{main|2014 Democratic Republic of the Congo Ebola virus outbreak}} | |||
| {{Infobox event | |||
| |title = Democratic Republic of Congo – 2014 | |||
| |image = File:DRC Ebola Map.png | |||
| |caption = DRC Ebola area {{as of|2014|9|06|lc=y}}<ref name="DRC_Ebola_case_spread">{{cite news |url=http://www.news24.com/Africa/News/Ebola-kills-31-in-DRC-says-WHO-20140902 |title=Ebola kills 31 in DRC, says WHO |publisher=News24 |date=2 September 2014 |accessdate=2 September 2014}}</ref> | |||
| |casualties1= <!-- Change to WHO reference when available --> | |||
| {{plainlist| | |||
| * '''Cases / Deaths''' <small>({{As of |2014|9|23|lc=y}})</small><ref name=Ebola_Outbreak_total_WHO_23_Sept /> | |||
| *{{flag|DR Congo}}: 70 / 42}} | |||
| }} | |||
| In August 2014, the WHO reported an outbreak of Ebola Virus in the Boende District, ]. They confirmed that the current strain of the virus is the Zaire Ebola species, which is common in the country. The virology results and epidemiological findings indicate no connection to the current epidemic in West Africa. This is the country's seventh Ebola outbreak since 1976.<ref>{{cite web |url=http://www.who.int/mediacentre/news/ebola/2-september-2014/en/ |title=Virological analysis: no link between Ebola outbreaks in west Africa and Democratic Republic of Congo |publisher=WHO |date=2 September 2014 |accessdate=7 September 2014}}</ref><ref name=DRC_Ebola_case /> | |||
| In August, 13 people were reported to have died of Ebola-like symptoms in the remote northern ] province, a province that lies about 750 miles north of the capital ].<ref name=DRC_Ebola_case /> The initial case was a woman from Ikanamongo Village who became ill with symptoms of Ebola after she had butchered a bush animal that her husband had killed. The following week, relatives of the woman, several health-care workers who had treated the woman, and individuals with whom they had been in contact came down with similar symptoms.<ref name=DRC_Ebola_case /> On 26 August, the Équateur Province Ministry of Health notified the WHO of an outbreak of Ebola.<ref name=DRC_Ebola_case>{{cite web |url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4263-ebola-virus-disease-drc.html |title=Ebola virus disease – Democratic Republic of Congo |publisher=World Health Organization |date=26 August 2014 |accessdate=27 August 2014}}</ref> As of 23 September, the WHO has confirmed the number of cases at 70 and the death toll at 42 from possible or confirmed Ebola cases. Among this group are 8 health care workers.<ref name=Ebola_Outbreak_total_WHO_23_Sept /> | |||
| ==Virology== | |||
| ] is caused by four of five viruses classified in the genus '']''. Of the four disease-causing viruses, ] (formerly and often still called the Zaire virus), is the most dangerous and is the strain responsible for the ongoing epidemic in West Africa.<ref name=KuhnArch>{{cite journal |author=Kuhn JH, Becker S, Ebihara H, Geisbert TW, Johnson KM, Kawaoka Y, Lipkin WI, Negredo AI, Netesov SV, Nichol ST, Palacios G, Peters CJ, Tenorio A, Volchkov VE, Jahrling PB |title=Proposal for a revised taxonomy of the family Filoviridae: Classification, names of taxa and viruses, and virus abbreviations |journal=Archives of Virology |volume=155 |issue=12 |pages=2083–103 |year=2010 |pmid=21046175 |pmc=3074192 |doi=10.1007/s00705-010-0814-x |displayauthors=3 }}</ref><ref name="Dudas 2014">{{cite journal|first1=G.|last1=Dudas|first2=A.|last2=Rambaut|title=Phylogenetic Analysis of Guinea 2014 EBOV Ebolavirus Outbreak|journal=PLOS Current Outbreaks|DOI= 10.1371/currents.outbreaks.84eefe5ce43ec9dc0bf0670f7b8b417d|date=2 May 2014}}</ref> | |||
| Since the discovery of the virus in 1976 when an outbreak occurred in the Democratic Republic of Congo (then called Zaire), Ebola disease has been confined to areas in Central Africa, where it is endemic. With the current outbreak, it was initially thought that a new strain endemic to Guinea might be the cause, rather than being imported from central to West Africa.<ref name="Baize-2014" /> However, further studies have shown that the current outbreak is likely caused by an Ebola virus lineage that has spread from Central Africa into West Africa, with the first viral transfer to humans in Guinea.<ref name="Dudas 2014" /><ref name="plosx">{{cite news|url=http://currents.plos.org/outbreaks/article/clock-rooting-further-demonstrates-that-guinea-2014-ebov-is-a-member-of-the-zaire-lineage/|title=Clock Rooting Further Demonstrates that Guinea 2014 EBOV is a Member of the Zaïre Lineage|website=PLOS Current Outbreaks|date=16 June 2014}}</ref> | |||
| In a study done by the ] and ], in partnership with the Sierra Leone Ministry of Health and Sanitation, researchers may have provided information about the origin and transmission of the Ebola virus that sets this outbreak apart from previous outbreaks. For this study, 99 Ebola virus ] were collected and ] from 78 patients diagnosed with the Ebola virus during the first 24 days of the outbreak in Sierra Leone. The team found more than 300 genetic changes that make the 2014 Ebola virus distinct from previous outbreaks. It is still unclear whether these differences are related to the severity of the current outbreak.<ref name="Gire 2014">{{cite journal |first1=S. |last1=Gire |last2=et al|title=Genomic surveillance elucidates Ebola virus origin and transmission during the 2014 outbreak|journal=Science|DOI=10.1126/science.1259657 |date=28 August 2014 |url=http://www.sciencemag.org/content/early/2014/08/27/science.1259657}}</ref><ref>{{cite news|url=http://www.ibtimes.co.uk/ebola-outbreak-scientists-sequence-virus-genomes-find-clues-about-origin-transmission-disease-1462866 |title=Ebola Outbreak: Scientists Sequence Virus Genomes and Find Clues About Origin and Transmission of Disease |work=International Business Times |date=27 August 2014 |accessdate=27 August 2014}}</ref> Five members of the research team became ill and died from Ebola before the study was published in August.<ref name="Gire 2014"/><ref name="Science">{{cite web |url=http://news.sciencemag.org/health/2014/08/ebolas-heavy-toll-study-authors |title=Ebola's heavy toll on study authors |work=Ebola's heavy toll on study authors |date=28 August 2014 |accessdate=2 September 2014 |author=Vogel, Gretchen}}</ref> | |||
| ==Transmission== | |||
| ]]] | |||
| It is not entirely clear how an Ebola outbreak is initially started.<ref name=CDC2014P>{{cite web|title=Ebola Hemorrhagic Fever Prevention|url=http://www.cdc.gov/vhf/ebola/prevention/index.html|publisher=CDC|accessdate=2014-08-02|date=July 31, 2014}}</ref> The initial infection is believed to occur after an Ebola virus is transmitted to a human by contact with an infected animal's body fluids. Evidence strongly implicates bats as the reservoir hosts for ebolaviruses. Bats drop partially eaten fruits and pulp, then land mammals such as gorillas and ]s feed on these fallen fruits. This chain of events forms a possible indirect means of transmission from the natural host to animal populations.<ref>{{cite journal |author=Gonzalez JP, Pourrut X, Leroy E |title=Ebolavirus and other filoviruses |journal=Current topics in microbiology and immunology |volume=315 |pages=363–387 |year=2007 |pmid=17848072 |doi=10.1007/978-3-540-70962-6_15 |isbn=978-3-540-70961-9 |series=Current Topics in Microbiology and Immunology }}</ref> | |||
| Human-to-human transmission can occur via direct contact with blood or bodily fluids from an infected person or by contact with objects contaminated by the virus.<ref name=CDCPress2014 /> When adequate infection control measures are utilized, the potential for widespread Ebola infections is considered low as the disease is only spread by direct contact with the secretions from someone who is showing signs of infection.<ref name=CDCPress2014>{{cite web|title=CDC Telebriefing on Ebola outbreak in West Africa|url=http://www.cdc.gov/media/releases/2014/t0728-ebola.html|website=CDC|accessdate=2014-08-03|date=2014-07-28}}</ref> Airborne transmission has not been documented during Ebola outbreaks. The time interval from infection with the virus to onset of symptoms is 2 to 21 days. Because dead bodies are still infectious, local traditional burial rituals may spread the disease.<ref name="nyt">{{cite news|first=Blaine|last=Harden|title=Dr. Matthew's Passion|url=http://www.nytimes.com/library/magazine/home/20010218mag%2debola.html|work=] Magazine|date=2001-02-18|accessdate=2008-02-25}}</ref> Semen and possibly other body fluids (e.g., breast milk) may be infectious in survivors for months.<ref name="Ebola media centre fact sheets">{{cite web |url=http://www.who.int/mediacentre/factsheets/fs103/en/ |title=Ebola media centre fact sheets |publisher=WHO |work=Ebola media centre fact sheets |accessdate=21 September 2014}}</ref><ref name=CDCQA2014>{{cite web |url=http://www.cdc.gov/vhf/ebola/outbreaks/guinea/qa.html |title=Questions and Answers on Ebola | Ebola Hemorrhagic Fever |publisher=CDC}}</ref> | |||
| One of the primary reasons for spread is that the health systems in the part of Africa where the disease occurs function poorly.<ref>{{cite web|author1=Tiaji Salaam-Blyther|title=The 2014 Ebola Outbreak: International and U.S. Responses|url=http://fas.org/sgp/crs/row/R43697.pdf|accessdate=9 September 2014|format=pdf|date=August 26, 2014}}</ref> The risk of transmission is increased among those caring for people infected. Recommended measures when caring for those who are infected include ] them, ], and wearing protective clothing including masks, gloves, gowns, and goggles.<ref name=CDC2014P /> However, even with proper isolation equipment available, working conditions such as no running water, no climate control, and no floors, continue to make direct care dangerous. Two American health workers who had contracted the disease and later recovered said that their team of workers had been following "to the letter all of the protocols for safety that were developed by the CDC and WHO", including a full body coverall, several layers of gloves, and face protection including goggles. One of the two, a physician, had worked with patients, but the other was working to help workers get in and out of their protective gear, while wearing protective gear herself.<ref name="nbcnews.com">{{cite web |url=http://www.nbcnews.com/storyline/ebola-virus-outbreak/two-americans-stricken-deadly-ebola-virus-liberia-n166281 |title=Two Americans Stricken With Deadly Ebola Virus in Liberia |publisher=NBC News |date=28 July 2014 |accessdate=2 August 2014}}</ref> | |||
| ==Prevention== | |||
| {{See also|Ebola virus disease#Infection control and containment}} | |||
| Comparing the present Ebola outbreak to ], the WHO notes that many of the most recent districts in which epidemics have occurred were in remote areas where the transmission had been easier to track and break. This outbreak is different in that large cities have been affected as well, where tracking has been difficult. Furthermore, without past Ebola experience medical staff did not suspect Ebola when they made a diagnosis, mistaking the symptoms for more familiar diseases such as ] and ], which are common to the area. Not aware that they were dealing with such a highly contagious disease, strict isolation and contact tracing techniques were not deemed necessary.<ref name="WHO " /> Also, without recent past experience with the disease, some people have become intensely fearful and have denied that the disease even exists and, in some cases, attacked medical staff, believing that they cause the disease.<ref name="WHO " /> | |||
| ===Contact tracing=== | |||
| ] is an essential method to tamp down the spread of the disease. It involves finding everyone who had close contact with an Ebola case, and tracking them for 21 days. However, this requires careful record keeping by properly trained and equipped staff.<ref>{{cite web|title=The reason Ebola isn't being stopped|url=http://edition.cnn.com/2014/09/11/health/ebola-contact-tracing/|publisher=CNN|accessdate=16 September 2014}}</ref> WHO Assistant Director-General for Global Health Security, Keiji Fukuda, said on 3 September, "We don’t have enough health workers, doctors, nurses, drivers, and contact tracers to handle the increasing number of cases."<ref>{{cite web|title=UN senior leaders outline needs for global Ebola response|url=http://www.who.int/mediacentre/news/releases/2014/ebola-response-needs/en/|publisher=WHO|accessdate=16 September 2014}}</ref> This is a massive ongoing effort to volunteers and health workers. According to reports, 12,315 from Sierra Leone and 11,911 from Liberia are listed and being traced as of 23 September. Figures for Guinea are not known.<ref name=Ebola_Outbreak_total_sl_23_Sept /><ref>{{cite web|title=New Liberia Ebola SitRep no. 131|url=http://www.mohsw.gov.lr/documents/Liberia%20Ebola%20SitRep%20131Sept%2023,%202014.pptx%20New_1.pdf|publisher=MOH Liberia|accessdate=28 September 2014}}</ref> | |||
| ===Travel restrictions and quarantines=== | |||
| Difficulties faced in attempting to contain the outbreak include the outbreak's multiple locations across country borders,<ref name="Control" /> ], the scientist who co-discovered the Ebola virus, has stated that the present outbreak is not following its usual linear patterns as mapped out in previous outbreaks. This time the virus is "hopping" all over the West African epidemic region.<ref name=Guinea_Ebola_Sep_Update /> Furthermore, past epidemics have occurred in remote regions, but this outbreak has spread to large urban areas which has increased the number of contacts an infected person may have and has also made transmission harder to track and break.<ref name="WHO "/> | |||
| On 8 August, a '']'', a disease fighting practice that forcibly isolates affected regions, was established in the triangular area where Guinea, Liberia, and Sierra Leone are separated only by porous borders and where 70 percent of the known cases had been found.<ref name=cordon>{{cite news |url=http://www.nytimes.com/2014/08/13/science/using-a-tactic-unseen-in-a-century-countries-cordon-off-ebola-racked-areas.html |last=McNeil |first=Donald G., Jr. |title=Using a Tactic Unseen in a Century, Countries Cordon Off Ebola-Racked Areas |work=The New York Times |date=13 August 2014 |accessdate=14 August 2014}}</ref> By September, the closure of borders had caused a collapse of cross-border trade and was having a devastating effect on the economies of the involved countries. A United Nations spokesperson reported that the price of some food staples had increased by as much as 150% and warned that if they continue to rise widespread food shortages can be expected. | |||
| On 2 September, WHO Director-General Margaret Chan advised against travel restrictions saying that they are not justified and that they are preventing medical experts from entering the affected areas and "marginalizing the affected population and potentially worsening ". UN officials working on the ground have also criticized the travel restrictions saying the solution is "not in travel restrictions but in ensuring that effective preventive and curative health measures are put in place."<ref name="As Ebola Outbreak Surges, Health Officials Slam International 'Coalition of Inaction'" /> Médecins Sans Frontières, also speaking out against the closure of international borders, called it "another layer of collective irresponsibility": "The international community must ensure that those who try to contain the outbreak can enter and leave the affected countries if need be. A functional system of medical evacuation has to be set up urgently."<ref name="Ebola: the failures of the international outbreak response" /> | |||
| ====Deaths of healthcare workers==== | |||
| In August, it was reported that healthcare workers represented nearly 10 percent of the cases and fatalities, significantly impairing the ability to respond to the outbreak in an area which already faces a severe shortage of doctors.<ref>{{cite web |url=http://www.who.int/dg/speeches/2014/ebola-briefing/en/ |title=WHO Director-General briefs Geneva UN missions on the Ebola outbreak |last=Chan |first=Margaret |publisher=WHO |date=12 August 2014 |accessdate=14 August 2014}}</ref> In the hardest hit areas there have historically been only one or two doctors available to treat 100,000 people, and these doctors are heavily concentrated in urban areas.<ref name="WHO "/> Healthcare providers caring for people with Ebola and family and friends in close contact with people with Ebola are at the highest risk of getting infected because they may come in direct contact with the blood or body fluids of the sick person. In some places affected by the current outbreak, care may be provided in clinics with limited resources, and workers could be in these areas for several hours with a number of Ebola infected patients.<ref name="CDC">{{cite web |url=http://www.cdc.gov/vhf/ebola/outbreaks/guinea/qa.html |title=Questions and answers on Ebola |publisher=CDC |work=Ebola Hemorrhagic Fever 2014 West Africa Outbreak |date=26 August 2014 |accessdate=27 August 2014}}</ref> According to the WHO, the high proportion of infected medical staff can be explained by lack of the number of medical staff needed to manage such a large outbreak, shortages of protective equipment, or improperly using what is available, and "the compassion that causes medical staff to work in isolation wards far beyond the number of hours recommended as safe".<ref name="WHO " /> | |||
| Among the fatalities is Samuel Brisbane, a former advisor to the Liberian Ministry of Health and Social Welfare, described as "one of Liberia's most high-profile doctors."<ref name=guardian_27_July_2014>{{cite web |url=http://www.theguardian.com/world/2014/jul/27/liberia-ebola-first-doctor-dies-brisbane-virus-outbreak |title=Liberia: top doctor becomes latest Ebola victim |work=The Guardian |date=27 July 2014 |accessdate=28 July 2014}}</ref> In July, leading Ebola doctor ] from Sierra Leone died in the outbreak. His death was followed by two more deaths in Sierra Leone: Modupe Cole, a senior physician at the country`s main referral facility,<ref>{{cite news |url=http://www.africareview.com/News/Another-Sierra-Leone-doctor-contracts-Ebola/-/979180/2414158/-/kfkk7cz/-/index.html |title=Another Sierra Leone doctor contracts Ebola |last=Cham |first=Kemo |work=Africa Review |date=10 August 2014 |accessdate=14 August 2014}}</ref> and Sahr Rogers, who worked in ].<ref name="CBC News">{{cite news |url=http://www.cbc.ca/news/health/ebola-infected-doctor-in-sierra-leone-sahr-rogers-dies-1.2748090 |title=Ebola-infected doctor in Sierra Leone, Sahr Rogers, dies |publisher=CBC News |date=27 August 2014 |accessdate=28 August 2014}}</ref><ref name="CBC News"/><ref name="Dr. Khan Daily News">{{cite news |url=http://www.nydailynews.com/life-style/health/top-ebola-doctor-dead-african-outbreak-local-airline-suspends-flights-article-1.1884545?false |title=Top Ebola doctor dead in African outbreak; local airline suspends flights |work=New York Daily News |agency=Associated Press |date=29 July 2014 |accessdate=29 July 2014}}</ref><ref>{{cite news |url=http://www.foxnews.com/health/2014/08/02/dr-kent-brantly-named-first-ebola-patient-on-plane-back-to-us/ |title=Dr. Kent Brantly, one of two American Ebola patients, arrives safely at Emory University |publisher=Fox News |date=2 August 2014}}</ref> In August, a well-known Nigerian physician, ], died. She was posthumously praised for preventing the Nigerian index case from leaving the hospital at the time of diagnosis, thereby playing a key role in curbing the spread of the virus in Nigeria.<ref name="reuters1">{{cite web|url=http://www.reuters.com/article/2014/08/04/us-health-ebola-nigeria-idUSKBN0G413H20140804|publisher=Reuters|title=Lagos records second Ebola case in doctor who treated victim: Nigerian health minister|date=4 August 2014}}</ref> | |||
| By 1 October, the WHO reported 382 workers had been infected and 216 had died. Liberia has been especially hard hit with almost half the total cases (188 with 94 deaths) reported. Sierra Leone registered 114 cases with 82 fatalities, thus indicating a death toll of seven out of ten. Guinea reported 69 infected cases with 35 deaths. In Nigeria 11 healthcare workers were also infected and 5 deaths were recorded.<ref name=Ebola_Outbreak_total_WHO_3_Oct /> | |||
| ====Community==== | |||
| In order to reduce the spread, the ] recommends raising community awareness of the risk factors for Ebola infection and the protective measures individuals can take.<ref name=WHOFS103>{{cite web|title= Ebola virus disease Fact sheet N°103 |url=http://www.who.int/mediacentre/factsheets/fs103/en/|website=WHO|accessdate=2014-09-06 }}</ref> These include avoiding contact with infected people and regular ] using soap and water.<ref>{{cite web |url=https://plan-international.org/about-plan/resources/news/ebola-outbreak-5-tips-to-avoid-the-deadly-disease/|title=Ebola – 5 tips to avoid the deadly disease |publisher= Plan International|date=2014-09-06}}</ref> A condition of dire poverty exists in many of the areas that have experienced a high incidence of infections. According to the director of the ] ] in Guinea, "The poor ] and lack of ] and ] in most districts of Conakry pose a serious risk that the epidemic escalates into a crisis. People do not think to ] when they do not have enough ]."<ref name="Diallo" /> | |||
| Containment efforts have been hindered because there is reluctance among residents of rural areas to recognize the danger of infection related to person-to-person spread of disease, such as burial practices which include ].<ref name="World Health Organisation" /><ref name="Global Post"/><ref name="Today Health" /><ref name=BBC_Freetown /> A 2014 study found that nearly two thirds of cases of Ebola in Guinea are believed to be due to burial practices.<ref>{{cite journal|last1=Chan|first1=M|title=Ebola Virus Disease in West Africa - No Early End to the Outbreak.|journal=The New England Journal of Medicine|date=Aug 20, 2014|pmid=25140856}}</ref> | |||
| Denial in some affected countries has often made containment efforts difficult.<ref>{{cite web|author=Ofeibea Quist-Arcton|url=http://www.npr.org/blogs/goatsandsoda/2014/08/06/338234063/skeptics-in-sierra-leone-doubt-ebola-virus-exists|title=Skeptics In Sierra Leone Doubt Ebola Virus Exists|publisher=NPR|date=6 August 2014}}</ref> Language barriers and the appearance of medical teams in protective suits has sometimes increased fears of the virus.<ref>{{cite web |author=Anja Wolz|url=http://www.newscientist.com/article/mg22329774.600-fighting-fear-denial-and-death-on-ebola-frontline.html|title=Fighting fear, denial and death on Ebola frontline|work=New Scientist |date=15 July 2014}}</ref> There are reports that some people believe that the disease is caused by ] and that doctors are killing patients.<ref>{{cite web |url=http://www.ifrc.org/en/news-and-media/news-stories/africa/sierra-leone/ebola-snakes-and-witchcraft-stopping-the-deadly-disease-in-its-tracks-in-west-africa-66215 |title=Ebola, snakes and witchcraft: Stopping the deadly disease in its tracks in West Africa |publisher=International Federation of Red Cross and Red Crescent Societies |date=24 June 2014 |accessdate=28 June 2014}}</ref> In late July, the former Liberian health minister, Peter Coleman, stated that "people don't seem to believe anything the government now says."<ref name=BBC_28_July_2014 /> | |||
| Acting on a rumor that the virus was invented to conceal "cannibalistic rituals" (due to medical workers preventing families from viewing the dead), demonstrations were staged outside of the main hospital treating Ebola patients in ], Sierra Leone. The demonstrations were broken up by the police and resulted in the need to use armed guards at the hospital.<ref>{{cite news |url=http://www.reuters.com/article/2014/07/26/us-health-ebola-africa-idUSKBN0FV0NL20140726 |title=Ebola center in Sierra Leona under guard after protest march |publisher=Reuters |date=26 July 2014 |accessdate=27 July 2014}}</ref> In Liberia, a mob attacked an Ebola isolation centre stealing equipment and "freeing" patients while shouting, "There's no Ebola."<ref>{{cite web |url=http://www.theage.com.au/world/patients-reported-missing-after-ebola-clinic-attacked-in-liberia-20140818-10573f.html |title=Patients reported missing after Ebola clinic attacked in Liberia|work=The Age |date=18 August 2014 |accessdate=18 August 2014}}</ref> Red Cross staff were forced to suspend operations in southeast Guinea after they were threatened by a group of men armed with knives.<ref>{{cite web |url=http://www.reuters.com/article/2014/07/02/health-ebola-westafrica-redcross-idUSL6N0PD2GH20140702 |title=Red Cross suspends Ebola operations in southeast Guinea after threats |publisher=Reuters |date=2 July 2014 |accessdate=4 July 2014}}</ref> | |||
| In the town of ] in Guinea, at least eight aid workers were murdered by suspicious inhabitants with machetes and their bodies dumped in a latrine on September 18.<ref>{{cite web|url=http://www.foxnews.com/world/2014/09/19/at-least-8-ebola-aid-workers-reportedly-killed-in-cold-blood-by-villagers-in/|title=At least 8 Ebola aid workers reportedly killed 'in cold blood' by villagers in Guinea|publisher=Fox News|accessdate=19 September 2014}}</ref> | |||
| ==Treatment== | |||
| {{See also|Ebola virus disease#Research|l1=Research into the Ebola virus disease|Ebola virus disease#Treatment|l2=Treatment of the Ebola virus disease}} | |||
| {{Infobox event | |||
| |title = Treatment facilities in West Africa | |||
| |image = ] | |||
| |caption = Treatment facilities and responses in the West African region {{as of|2014|10|1|lc=y}}<ref name=Ebola_Outbreak_total_WHO_28_Sept /> | |||
| }} | |||
| No proven Ebola virus-specific treatment exists as of August 2014.<ref name=Choi-2013>{{cite journal |author=Choi JH, Croyle MA |title=Emerging targets and novel approaches to Ebola virus prophylaxis and treatment |journal=BioDrugs |volume=27 |issue=6 |pages=565–83 |date=December 2013 |pmid=23813435 |doi=10.1007/s40259-013-0046-1 |url=http://link.springer.com/article/10.1007/s40259-013-0046-1#page-1}}</ref> Treatment is primarily supportive in nature and includes minimizing invasive procedures, balancing fluids and ]s to counter ], administration of ] early in infection to prevent or control ], administration of ] late in infection to control ], ] levels, ], and the use of medications to treat bacterial or fungal secondary infections.<ref>{{cite journal|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3499825/|title=Clinical Management of Filovirus-Infected Patients|journal=Viruses|author=Danielle V. Clark, Peter B. Jahrling, and James V. Lawler|accessdate=30 September 2014}}</ref><ref>{{cite journal|url=http://jid.oxfordjournals.org/content/196/Supplement_2/S136.ful|title=Outbreaks of Filovirus Hemorrhagic Fever: Time to Refocus on the Patient|author=Daniel G. Bausch|work=Journal of Infectious Diseases|accessdate=30 September 2014}}</ref><ref>{{cite journal |author=Bausch DG, Feldmann H, Geisbert TW, Bray M, Sprecher AG, Boumandouki P, Rollin PE, Roth C |title=Outbreaks of Filovirus Hemorrhagic Fever: Time to Refocus on the Patient |journal=The Journal of Infectious Diseases |volume=196 |pages=S136–S141 |year=2007 |pmid=17940941 |doi=10.1086/520542 |author9=Winnipeg Filovirus Clinical Working Group }}</ref><ref>{{cite journal |author=Jeffs B |title=A clinical guide to viral haemorrhagic fevers: Ebola, Marburg and Lassa |journal=Tropical Doctor |volume=36 |issue=1 |pages=1–4 |year=2006 |pmid=16483416 |doi=10.1258/004947506775598914}}</ref><ref>{{cite journal |author=Nkoghé D, Formenty P, Nnégué S, Mvé MT, Hypolite I, Léonard P, Leroy E |title=Practical guidelines for the management of Ebola infected patients in the field |journal=Medecine tropicale : revue du Corps de sante colonial |volume=64 |issue=2 |pages=199–204 |year=2004 |pmid=15460155 |author8=Comité International de Coordination Technique et Scientifique}}</ref> Early treatment may increase the chance of survival.<ref>{{cite web |author= Makiko Kitamura |title=Sierra Leone Is Epicenter of Ebola as Guinea Clinic Shut |date=8 June 2014 |url=http://www.businessweek.com/news/2014-07-29/sierra-leone-is-epicenter-of-ebola-as-guinea-clinic-shut |accessdate=30 July 2014}}</ref> | |||
| ===Level of care=== | |||
| Local authorities have not had resources to contain the disease, with health centres closing and hospitals overwhelmed.<ref>{{cite web|title=Sierra Leone`s main referral hospital has been overwhelmed|url=http://en.starafrica.com/news/sleones-main-referral-hospital-overwhelmed.html|publisher=StarAfrica|accessdate=1 October 2014}}</ref> In late June, the Director-General of Médecins Sans Frontières said, "Countries affected to date simply do not have the capacity to manage an outbreak of this size and complexity on their own. I urge the international community to provide this support on the most urgent basis possible."<ref name="Control">{{cite web |url=http://www.ctvnews.ca/health/west-africa-s-ebola-outbreak-is-totally-out-of-control-1.1878133 |title=Doctors Without Borders: West Africa's Ebola Outbreak is Totally Out of Control |publisher=CTVNews |date=20 June 2014 |accessdate=21 June 2014}}</ref> Adequate equipment has not been provided for medical personnel,<ref>{{cite web |url=http://allafrica.com/stories/201406190779.html|title=Liberia: Unheralded Fear - Ebola Pose Risks for Liberia Health Workers |work=] |via=] |date=19 June 2014 |accessdate=21 June 2014}}</ref> with even a lack of soap and water for hand-washing and disinfection.<ref>{{cite web|url=http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.php |title=Ebola virus - Pathogen Safety Data Sheets |publisher=Phac-aspc.gc.ca |date=1 August 2014 |accessdate=20 August 2014}}</ref> | |||
| In late August, Médecins Sans Frontières (MSF) called the situation "chaotic" and the medical response "inadequate". They reported that they had expanded their operations but were unable to keep up with the rapidly increasing need for assistance which had forced them to reduce the level of care they were able to offer: "It is not currently possible, for example, to administer intravenous treatments." Calling the situation "an emergency within the emergency", MSF reported that many hospitals have had to shut down due to lack of staff or fears of the virus among patients and staff which has left people with other health problems without any care at all. Speaking from a remote region, a MSF worker said that a shortage of protective equipment was making the medical management of the disease difficult and that they had limited capacity to safely bury bodies.<ref name="doctorswithoutborders.org">{{cite web|url=http://www.doctorswithoutborders.org/news-stories/field-news/liberia-msfs-new-ebola-management-centers-already-overwhelmed|title=MSFs new ebola management centers already overwhelmed|publisher=MSF}}</ref> | |||
| By September, treatment for Ebola patients had become unavailable in some areas. Speaking on 12 September, WHO director-general Margaret Chan said, "In the three hardest hit countries, Guinea, Liberia and Sierra Leone, the number of new cases is moving far faster than the capacity to manage them in the Ebola-specific treatment centers. Today, there is not one single bed available for the treatment of an Ebola patient in the entire country of Liberia."<ref name="West African health centers can't keep up with Ebola outbreak, WHO says"/> According to a WHO report released on 19 September, Sierra Leone is currently meeting only 25% of its need for patient beds, and Liberia and Guinea are meeting only 20% of their needs.<ref name="apps.who.int">{{cite web|url=http://apps.who.int/iris/bitstream/10665/133833/1/roadmapsitrep4_eng.pdf?ua=1|title=WHO: Ebola Response Roadmap Situation Report 18 September 2014|publisher=WHO |date=18 September 2014 |accessdate=19 September 2014}}</ref> | |||
| {|class="wikitable" style="text-align: right;" | |||
| |+Current bed capacity for patients in countries with active cases as at 21 Sep 2014.<ref name=Ebola_Outbreak_total_21_WHO_Sept /> | |||
| |- | |||
| ! Countries ||Existing beds || Beds to be set up with partner || Additional beds required | |||
| |- | |||
| |style="text-align: left;"| '''Guinea''' || 180|| 0 || 40 | |||
| |- | |||
| |style="text-align: left;"| '''Liberia'''|| 345 || 440 || 1,550 | |||
| |- | |||
| |style="text-align: left;"| '''Sierra Leone''' || 323|| 297|| 532 | |||
| |- | |||
| |style="text-align: center;"| '''Total'''|| '''848''' || '''763'''|| '''2,122''' | |||
| |} | |||
| ===Healthcare settings=== | |||
| A number of Ebola Treatment Centres have been set up in the area, supported by international aid organisations and staffed by a combination of local and international staff. Each treatment centre is divided into a number of distinct and rigorously separate areas. For patients, there is a ] area, and low & high risk care wards. For staff, there are areas for preparation and decontamination. An important part of each centre is an arrangement for safe burial or cremation of bodies, required to prevent further infection.<ref>{{cite news|title=An Ebola treatment center|url=http://apps.washingtonpost.com/g/page/national/an-ebola-treatment-center/1333/|work=Washington Post|accessdate=1 October 2014}}</ref><ref>{{cite web|title=Guidance for Safe Handling of Human Remains of Ebola Patients in U. S. Hospitals and Mortuaries|url=http://www.cdc.gov/vhf/ebola/hcp/guidance-safe-handling-human-remains-ebola-patients-us-hospitals-mortuaries.html|publisher=Centers for Disease Control|accessdate=1 October 2014}}</ref> | |||
| Although the WHO does not advise caring for Ebola patients at home, it is an option and even a necessity when no hospital treatment beds are available. For those being treated at home, the WHO advises informing the local public health authority and acquiring appropriate training and equipment.<ref>{{cite web|url=http://www.who.int/csr/disease/ebola/faq-ebola/en/|title=Frequently asked questions on Ebola virus disease|publisher=WHO|date=8 August 2014|accessdate=3 October 2014}}</ref> ], ] and the ] ] have begun to take measures to provide support for families that are forced to care for patients at home by supplying caregiver kits intended for interim home-based interventions. The kits include protective clothing, hydration items, medicines, and disinfectant, among other items.<ref>{{cite web|url=http://www.samaritanspurse.org/article/hope-takes-flight-across-the-atlantic/|title=Ebola Supplies Arrive in Liberia|publisher=Samaritan's Purse|date=2 October 2014|accessdate=3 October 2014}}</ref><ref>{{cite web|url=http://www.liberianobserver.com/news/order-contain-ebola-9000-household-kits-arrive/|title=In Order To Contain Ebola 9,000 Household Kits Arrive|work=Daily Observer|date=25 September 2014|accessdate=4 October 2014}}</ref> Even where hospital beds are available, it has been debated whether conventional hospitals are the best place to care for Ebola patients, as the risk of spreading the infection is high.<ref>{{cite web|url=http://www.nbcnews.com/storyline/ebola-virus-outbreak/are-hospitals-part-ebola-problem-charity-wants-new-strategy-n202486|title=Are Hospitals Part of the Ebola Problem? Charity Wants New Strategy|publisher=NBC News|date=15 September 2013|accessdate=03 October 2014}}</ref> The WHO and non-profit partners have launched a program in Liberia to move infected people out of their homes into Ad Hoc Centers that will provide rudimentary care.<ref>{{cite web|url=http://www.washingtonpost.com/national/health-science/new-effort-to-fight-ebola-in-liberia-would-move-infected-patients-out-of-their-homes/2014/09/22/f869dc08-4281-11e4-b47c-f5889e061e5f_story.html|title=New effort to fight Ebola in Liberia would move infected patients out of their homes|work=The Washington Post|date=22 September 2014|accessdate=2 October 2014}}</ref> | |||
| ===Experimental treatments=== | |||
| ] to avoid infection]] | |||
| The unavailability of treatments in the most-affected regions has spurred controversy, with some calling for experimental drugs to be made more widely available in Africa on a humanitarian basis, and others warning that making unproven drugs widely available would be unethical, especially in light of past experimentation conducted in developing countries by Western drug companies.<ref name=LAtimes>{{cite web|date=6 August 2014|url=http://www.latimes.com/world/africa/la-fg-three-ebola-experts-release-drugs-20140806-story.html|title=Three leading Ebola experts call for release of experimental drug|work=Los Angeles Times}}</ref><ref name=NYTwho>{{cite news|url=http://www.nytimes.com/2014/08/09/health/in-ebola-outbreak-who-should-get-experimental-drug.html|date=8 August 2014|work=The New York Times|title=In Ebola Outbreak, Who Should Get Experimental Drug?}}</ref> As a result of the controversy, on 12 August an expert panel of the WHO endorsed the use of interventions with as-yet-unknown effects for both treatment and prevention of Ebola, and also said that deciding which treatments should be used and how to distribute them equitably were matters that needed further discussion.<ref>{{cite web|url=http://www.who.int/mediacentre/news/statements/2014/ebola-ethical-review-summary/en/|title=Ethical considerations for use of unregistered interventions for Ebola viral disease (EVD)|date=12 August 2014|publisher=World Health Organization}}</ref> | |||
| The WHO has recognised that transfusion of whole blood or purified ] from Ebola survivors is the therapy with the greatest potential to be implemented immediately, although there is little information its efficacy.<ref>{{cite web|title=Blood transfusion named as priority treatment for Ebola|url=http://www.nature.com/news/blood-transfusion-named-as-priority-treatment-for-ebola-1.15854|publisher=Nature|accessdate=11 September 2014}}</ref> At the end of September, WHO issued an interim guideline for this therapy.<ref>{{cite web|title=Use of convalescent whole blood or plasma collected from patients recovered from Ebola virus disease Empirical treatment during outbreaks|url=http://www.who.int/csr/resources/publications/ebola/convalescent-treatment/en/|publisher=WHO|accessdate=4 October 2014}}</ref> During September, there were reports of blood from survivors of the disease being offered for sale on the black market. Health professionals have warned that patients buying blood on the black market could expose themselves to a number of risks, including infection with HIV or hepatitis.<ref>{{cite web|title=Black market sale of Ebola survivors' blood raises concerns|url=http://www.ctvnews.ca/health/health-headlines/black-market-sale-of-ebola-survivors-blood-raises-concerns-1.2023892|publisher=CTV news|accessdate=4 October 2014}}</ref> | |||
| A number of experimental treatments are being studied or will undergo trials soon:<ref>Briggs, Helen (7 August 2014) , BBC News, Health, Retrieved 8 August 2014</ref> | |||
| * ], a monoclonal antibody vaccine. The limited supply of the drug has been used to treat a small number of individuals infected with the Ebola virus. Although some of these have recovered the outcome is not considered ].<ref>{{cite web|title=How Will We Know If The Ebola Drugs Worked?|url=http://www.forbes.com/sites/davidkroll/2014/08/26/how-will-we-know-if-the-ebola-drugs-worked/|work=Forbes|accessdate=10 September 2014}}</ref> ZMapp has proved highly effective in a trial involving rhesus macaque monkeys.<ref>{{cite web|title=ZMapp drug fully protects monkeys against Ebola virus|url=https://www.sciencenews.org/article/zmapp-drug-fully-protects-monkeys-against-ebola-virus|publisher=Science News|accessdate=10 September 2014}}</ref> | |||
| * ], an ] drug.<ref name="NYTimes08082014">{{cite news |author=Andrew Pollack |title=Second Drug Is Allowed for Treatment of Ebola |work=The New York Times |date=7 August 2014 |url=http://www.nytimes.com/2014/08/08/health/second-experimental-drug-allowed-for-treating-ebola.html?_r=1 |accessdate=2014-08-22}}</ref> This drug is well-tolerated by patients.<ref>{{cite web|url=http://online.wsj.com/articles/experimental-ebola-drug-gets-nod-from-fda-1411423058|title=Experimental Ebola Drug Gets Nod From FDA|date=22 September 2014|work=Wall Street Journal|accessdate=4 October 2014}}</ref> | |||
| * ] (Avigan), a drug approved in ] for stockpiling against influenza pandemics.<ref>{{cite web|url=http://www.bloomberg.com/news/2014-08-07/ebola-drug-from-japan-may-emerge-among-key-candidates.html|title=Ebola Drug From Japan May Emerge Among Key Candidates|date=7 August 2014|publisher=Bloomberg.com}}</ref> The drug appears to be useful in a mouse model of the disease<ref name="Gatherer 2014">{{cite journal |author=Gatherer D |title=The 2014 Ebola virus disease outbreak in West Africa |journal=J. Gen. Virol. |volume=95 |issue=Pt 8 |pages=1619–1624 |year=2014 |pmid=24795448 |doi=10.1099/vir.0.067199-0 }}</ref><ref>{{cite pmid|24583123}}</ref> and Japan has offered to supply the drug if requested by the WHO.<ref>{{cite web|url=http://www.cbc.ca/news/health/ebola-outbreak-japan-offers-anti-influenza-drug-for-treatment-1.2745915|title=Ebola outbreak: Japan offers anti-influenza drug for treatment|date=25 August 2014|publisher=CBC News Health}}</ref> | |||
| * ] is a broad-spectrum ] developed by ] and currently being researched as a potential treatment for Ebola by ].<ref>{{cite web|url=http://www.forbes.com/sites/davidkroll/2014/08/29/biocryst-to-launch-nhp-ebola-drug-safety-studies-within-weeks/|title=BioCryst to Launch NHP Ebola Drug Safety, Efficacy Studies 'Within Weeks'. David Kroll, Forbes Magazine. 29 August 2014|date=29 August 2014|work=Forbes|accessdate=5 October 2014}}</ref> The drug has been approved to progress to ] trials, expected late in 2014.<ref>{{cite web|url=http://www.wncn.com/story/26569197/biocryst-receives-additional-money-to-ramp-development-of-ebola-drug|title=DURHAM: BioCryst receives additional funding for Ebola drug - WNCN: News, Weather|date=18 September 2014|publisher=WNCN|accessdate=5 October 2014}}</ref> | |||
| * In September, an experimental vaccine, now known as the cAd3-ZEBOV vaccine, commenced simultaneous ] trials in Oxford and Bethesda. The vaccine was developed jointly by ] and the ]. If this phase is completed successfully, the vaccine will be fast tracked for use in West Africa. In preparation for this, GSK is preparing a stockpile of 10,000 doses.<ref>{{cite news|title=First British volunteer injected with trial Ebola vaccine in Oxford|url=http://www.theguardian.com/society/2014/sep/17/ruth-atkins-first-british-volunteer-injected-trial-ebola-vaccine-oxford|accessdate=17 September 2014|work=Guardian}}</ref><ref>{{cite web|title=An Ebola vaccine was given to 10 volunteers, and there are ‘no red flags’ yet|url=http://www.washingtonpost.com/news/to-your-health/wp/2014/09/16/an-ebola-vaccine-was-given-to-10-volunteers-and-there-are-no-red-flags-yet/|work=Washington Post|accessdate=17 September 2014}}</ref> A second vaccine candidate, rVSV-ZEBOV, developed by the Public Health Agency of Canada is about to undergo Phase 1 trials.<ref>{{cite web|title=Researchers rushing to test and ready Ebola vaccines Read more: http://www.ctvnews.ca/health/researchers-rushing-to-test-and-ready-ebola-vaccines-1.2034165#ixzz3EwEdzut3|url=http://www.ctvnews.ca/health/researchers-rushing-to-test-and-ready-ebola-vaccines-1.2034165|accessdate=1 October 2014}}</ref> | |||
| ==Prognosis== | |||
| {{See also|Ebola virus disease#Prognosis}} | |||
| ===Statistical measures=== | |||
| Early in the outbreak, attempts to calculate an accurate ] (CFR) had been unreliable due to differences in testing policies, the inclusion of probable and suspected cases, and the inclusion of new cases that have not run their course.<ref>{{cite news|url=http://epidemic.bio.ed.ac.uk/ebolavirus_fatality_rate |title=Case Fatality Rate for ebolavirus |website=Epidemic: Molecular Epidemiology and Evolution of Viral Pathogens|date=7 August 2014}}</ref> In late August, the WHO made an initial CFR estimate of 52%.<ref name="Disease Outbreak News">{{cite web |url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news.html |title=Disease Outbreak News |publisher=WHO |work=Disease Outbreak News |date=28 August 2014 |accessdate=29 August 2014}}</ref><ref>{{cite web|title=Case Fatality Rate for ebolavirus|url=http://epidemic.bio.ed.ac.uk/ebolavirus_fatality_rate|publisher=epidemic|accessdate=16 September 2014}}</ref><ref name="Vogel">{{cite web|last=Vogel|first=Gretchen|title=How deadly is Ebola? Statistical challenges may be inflating survival rate|work=Science Mag|accessdate=2014-09-09|date=2014 |url=http://news.sciencemag.org/africa/2014/09/how-deadly-ebola-statistical-challenges-may-be-inflating-survival-rate}}</ref> On 23 September, the WHO released a revised and far more accurate CFR of 70%, derived using data from patients with definitive clinical outcomes.<ref name="doi10.1056/NEJMoa1411100" /> | |||
| The ] (BRN) is a statistical measure of the number of people who are expected to be infected by one person who has the disease in question. If the rate is less than 1, the infection will die out in the long run and if the rate is greater than 1, the infection will continue to spread in a population.<ref>{{cite web|title=Basic Reproductive Rate (Ro)|url=http://practice.sph.umich.edu/micphp/epicentral/basic_reproduc_rate.php|publisher=University of Michigan|accessdate=16 September 2014}}</ref> A study published on 23 September found the BRN of the current outbreak to be between 1.71 and 2.02.<ref name="Ebola Virus Disease in West Africa — The First 9 Months of the Epidemic and Forward Projections">{{cite web |url=http://www.nejm.org/doi/full/10.1056/NEJMoa1411100?query=featured_home |title=Ebola Virus Disease in West Africa — The First 9 Months of the Epidemic and Forward Projections |journal=New England Journal of Medicine |date=23 September 2014 |accessdate=23 September 2014 |author=WHO Ebola Response Team}}</ref> | |||
| ===Projections of future cases=== | |||
| On 28 August, the WHO released its first estimate of the possible total cases (20,000) from the outbreak as part of its roadmap for stopping the transmission of the virus.<ref>{{cite web|url=http://www.who.int/csr/disease/ebola/ebola-response-roadmap/en/|title=Press release: WHO issues roadmap for scaled-up response to the Ebola outbreak |date=28 August 2014|publisher=WHO|accessdate=18 September 2014}}</ref><ref name=28_August_2014_WHO_roadmap></ref> The WHO roadmap states "his Roadmap assumes that in many areas of intense transmission the actual number of cases may be two- to fourfold higher than that currently reported. It acknowledges that the aggregate case load of EVD could exceed 20,000 over the course of this emergency. The Roadmap assumes that a rapid escalation of the complementary strategies in intense transmission, resource-constrained areas will allow the comprehensive application of more standard containment strategies within 3 months."<ref name=28_August_2014_WHO_roadmap /> It includes an assumption that some country or countries will pay the required cost of their plan, estimated at half a billion dollars.<ref name=28_August_2014_WHO_roadmap /> | |||
| When the WHO released its first estimated projected number of cases, a number of epidemiologists presented data to show that the WHO's projection of a total of 20,000 cases was likely an underestimate. On August 31, the journal '']'' quoted Christian Althaus, a mathematical epidemiologist at the ] in Switzerland, as saying that if the epidemic were to continue in this way until December, the cumulative number of cases would exceed 100,000 in Liberia alone.<ref>{{cite web|last1=Kupferschmidt|first1=Kai|title=Disease modelers project a rapidly rising toll from Ebola|url=http://news.sciencemag.org/health/2014/08/disease-modelers-project-rapidly-rising-toll-ebola|work=Science}}</ref> According to a research paper released in early September, in the hypothetical worst-case scenario, if a BRN of over 1.0 continues for the remainder of the year we would expect to observe a total of 77,181 to 277,124 additional cases within 2014.<ref name=Nishiura2014>{{cite journal|last1=Nishiura|first1=H|last2=Chowell|first2=G|title=Early transmission dynamics of Ebola virus disease (EVD), West Africa, March to August 2014.|journal=Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin|date=Sep 11, 2014|volume=19|issue=36|pmid=25232919}}</ref> On 9 September, Jonas Schmidt-Chanasit of the ] controversially announced that the containment fight in Sierra Leone and Liberia has already been "lost" and that the disease would "burn itself out".<ref>{{cite news|title=Virologist: Fight against Ebola in Sierra Leone and Liberia is lost|url=http://www.dw.de/virologist-fight-against-ebola-in-sierra-leone-and-liberia-is-lost/a-17915090|date=11 September 2014|accessdate=11 September 2014|publisher=]}}</ref> Writing in the ''New York Times'' on 12 September, Bryan Lewis, an epidemiologist at the Virginia Bioinformatics Institute at Virginia Tech, said that researchers at various universities who have been using computer models to track the growth rate say that at the virus's present rate of growth, there could easily be close to 20,000 cases in one month, not in nine.<ref name="U.S. Scientists See Long Fight Against Ebola">{{cite web |url=http://www.nytimes.com/2014/09/13/world/africa/us-scientists-see-long-fight-against-ebola.html |title=U.S. Scientists See Long Fight Against Ebola |work=New York Times |date=12 September 2014 |accessdate=13 September 2014 |author=Grady, Denise}}</ref> | |||
| On 8 September, the WHO warned that the number of new cases in Liberia was increasing exponentially, and would increase by "many thousands" in the following three weeks. In a 23 September WHO report, the WHO revised their previous projection, stating that they expect there to be an excess of 20,000 Ebola cases in West Africa by 2 November.<ref>{{cite web|url=http://www.nejm.org/doi/full/10.1056/NEJMoa1411100|title=Ebola Virus Disease in West Africa — The First 9 Months of the Epidemic and Forward Projections|work=The New England Journal of Medicine|accessdate=28 September 2014}}</ref> They further stated, that if the disease is not adequately contained it could become ] in Guinea, Sierra Leone and Liberia,<ref name="U.S. Scientists See Long Fight Against Ebola">{{cite web |url=http://www.washingtonpost.com/national/health-science/ebola-cases-could-cross-20000-by-november-who-report-says/2014/09/22/eff7982e-42c9-11e4-9a15-137aa0153527_story.html |title=Ebola cases could cross 20,000 by November, report says |work=Washington Post |date=22 September 2014 |accessdate=23 September 2014 |author=Dennis, Brady}}</ref> "spreading as routinely as malaria or the flu",<ref>{{cite web|last1=Szabo|first1=Liz|title=Could the Ebola outbreak last forever?|url=http://www.usatoday.com/story/news/nation/2014/09/22/ebola-last-forever/16072019/|website=USA Today|accessdate=22 September 2014}}</ref> and according to an editorial in the New England Journal of Medicine, eventually to other parts of Africa and beyond.<ref name="The Ebola Emergency — Immediate Action, Ongoing Strategy">{{cite web |url=http://www.nejm.org/doi/full/10.1056/NEJMe1411471?query=featured_home |title=The Ebola Emergency — Immediate Action, Ongoing Strategy |work=New England Journal of Medicine |author=Farrar, Jeremy J. |date=23 September 2014 |accessdate=23 September 2014}}</ref> | |||
| In a 23 September CDC report, a projection calculates a potential underreporting which is corrected by a factor of 2.5. With this correction factor, approximately 21,000 total cases are the estimate for the end of September 2014 in Liberia and Sierra Leone alone. The same report predicted that total cases, including unreported cases, could reach 1.4 million in Liberia and Sierra Leone by 20 January 2015 if no improvement in intervention or community behaviour occurred.<ref name="Estimating the Future Number of Cases in the Ebola Epidemic — Liberia and Sierra Leone, 2014–2015">{{cite web |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/su63e0923a1.htm?s_cid=su63e0923a1_w |title=Estimating the Future Number of Cases in the Ebola Epidemic — Liberia and Sierra Leone, 2014–2015 |publisher=Centers for Disease Control and Prevention |date=23 September 2014 |accessdate=24 September 2014 |author=Martin I. Meltzer, PhD, et al.}}</ref> | |||
| ==Economic effects== | |||
| In addition to the loss of life, the outbreak is having a number of significant economic impacts. | |||
| * Markets and shops are closing, due to travel restrictions, '']'', or fear of human contact, leading to loss of income for producers and traders.<ref>{{cite web|url=http://www.npr.org/2014/07/17/332351578/ebola-wreaks-economic-woe-in-west-africa |title=Ebola Wreaks Economic Woe In West Africa |publisher=NPR |date=2014-07-17 |accessdate=2014-08-25}}</ref> | |||
| * Movement of people away from affected areas has disturbed agricultural activities.<ref>{{cite web|last=Lomax |first=Selma |url=http://allafrica.com/stories/201408200742.html |title=Liberia: Ebola Outbreak Affects Agriculture in Lofa County |publisher=allAfrica.com |date=2014-08-20 |accessdate=2014-08-25}}</ref><ref name="rappler1">{{cite web|url=http://www.rappler.com/world/regions/africa/67128-who-un-first-staff-ebola-infection |title=First WHO worker infected by Ebola, DR Congo reports cases |publisher=Rappler.com |date=2014-08-15 |accessdate=2014-08-25}}</ref> The UN ] (FAO) has warned that the outbreak could endanger harvest and food security in West Africa.<ref>{{cite web |url=http://uk.reuters.com/article/2014/09/02/us-health-ebola-food-idUKKBN0GX0HB20140902 |title=Ebola threatens food security in West Africa: FAO |accessdate=3 September 2014}}</ref> | |||
| * Tourism is directly impacted in affected countries.<ref>{{cite web|url=http://afkinsider.com/69855/ebola-virus-eats-west-africas-economic-growth/ |title=Ebola Virus Eats Into West Africa's Economic Growth |publisher=AFKInsider |date=2014-08-21 |accessdate=2014-08-25}}</ref> Other countries in Africa which are not directly affected by the virus have also reported adverse effects on tourism.<ref>{{cite web|last=Brock |first=Joe |url=http://uk.reuters.com/article/2014/08/20/us-health-ebola-africatourism-idUKKBN0GK1GG20140820 |title=Ebola fears slowing tourist flow to Africa |publisher=Reuters |date=20 August 2014 |accessdate=2014-08-25}}</ref> | |||
| * Foreign mining companies have withdrawn non-essential personnel, deferred new investment, and cut back operations.<ref name="rappler1"/><ref>{{cite web|url=http://www.bbc.co.uk/news/uk-27675747 |title=UK employees leave Sierra Leone over Ebola threat |publisher=BBC News |date=2014-06-03 |accessdate=2014-08-25}}</ref><ref>{{cite web|url=http://www.mining.com/west-africa-ebola-outbreak-forces-miners-to-lock-down-operations-delay-projects-69246/ |title=West Africa Ebola outbreak forces miners to lock down operations, delay projects |publisher=MINING.com |date=2014-08-10 |accessdate=2014-08-25}}</ref> | |||
| * Many airlines have experienced reduced traffic. Some airlines have suspended flights to the area.<ref>{{cite web|author=Mark Anderson and agencies |url=http://www.theguardian.com/society/2014/aug/22/ebola-airlines-cancel-flights-guinea-liberia-sierra-leone |title=Ebola: airlines cancel more flights to affected countries |work=The Guardian |date=22 August 2014 |accessdate=2014-08-25}}</ref> | |||
| * Forecasts of economic growth have been reduced.<ref>{{cite web|last=Kay |first=Chris |url=http://www.bloomberg.com/news/2014-08-14/ebola-threatens-growth-as-costs-squeeze-budgets-moody-s-says.html |title=Ebola Threatens West Africa GDP as Companies Slow Production |publisher=Bloomberg |date=2014-08-14 |accessdate=2014-08-25}}</ref> A 4 August ]-IMF assessment for Guinea projected a full percentage point fall in GDP growth from 4.5 percent to 3.5 percent<ref name="worldbank1">{{cite web|url=http://www.worldbank.org/en/news/press-release/2014/08/04/ebola-world-bank-group-mobilizes-emergency-funding-for-guinea-liberia-and-sierra-leone-to-fight-epidemic |title=Ebola: World Bank Group Mobilizes Emergency Funding to Fight Epidemic in West Africa |publisher=Worldbank.org |date=2014-08-04 |accessdate=2014-08-20}}</ref> and on 17 September, they reported that if the epidemic continues to grow, the affected countries could see the economic impact grow eight-fold, "dealing a potentially catastrophic blow to the already fragile states."<ref name="Ebola: Economic Impact Already Serious; Could Be “Catastrophic” Without Swift Response">{{cite web |url=http://www.worldbank.org/en/news/press-release/2014/09/17/ebola-economic-impact-serious-catastrophic-swift-response-countries-international-community-world-bank |title=Ebola: Economic Impact Already Serious; Could Be "Catastrophic" Without Swift Response |publisher=The World Bank |work=press release |date=17 September 2014 |accessdate=19 September 2014}}</ref> | |||
| * The outbreak is straining the finances of governments, with Sierra Leone using Treasury bills to fund the fight against the virus.<ref>{{cite web|author=Chris Kay |url=http://www.bdlive.co.za/africa/africanbusiness/2014/08/20/africa-nations-sell-debt-for-ebola-fight |title=Africa nations sell debt for Ebola fight|publisher=BDlive |date=2014-08-20 |accessdate=2014-08-25}}</ref> | |||
| * The IMF is considering expanding assistance to Guinea, Sierra Leone, and Liberia as their national deficits are ballooning and their economies contract sharply.<ref>{{cite web|url=http://www.australiannews.net/index.php/sid/225466201|publisher=Australian News.Net|title=IMF says Ebola impacted West African nations may need economic assistance}}</ref> | |||
| ==Responses== | |||
| {{Main|Responses to the Ebola virus epidemic in West Africa}} | |||
| In July, the ] convened an emergency meeting with health ministers from eleven countries and announced collaboration on a strategy to co-ordinate technical support to combat the epidemic. In August, they declared the outbreak an international public health emergency and published a roadmap to guide and coordinate the international response to the outbreak, aiming to stop ongoing Ebola transmission worldwide within 6–9 months. In September, the ] declared the Ebola virus outbreak in West Africa a "threat to international peace and security" and unanimously adopted a resolution urging UN member states to provide more resources to fight the outbreak; the WHO stated that the cost for combating the epidemic will be a minimum of $1 billion.<ref>{{cite news|url=http://www.bbc.com/news/world-africa-29262968|title=Ebola 'threat to world security'- UN Security Council|date=18 September 2014|publisher=BBC News|accessdate=18 September 2014}}</ref><ref>{{cite news|url=http://thehill.com/policy/healthcare/217853-who-warns-ebola-to-cost-to-1-billion |title=WHO warns Ebola response could cost $1B|work=The Hill |date=16 September 2014 |accessdate=16 September 2014}}</ref> The ] and the ] have pledged aid money and the ] announced plans to mobilize food assistance for an estimated 1 million people living in restricted access areas. Several ] have provided assistance in the efforts to control the spread of the disease. The ] organisation ] (''Doctors Without Borders'') is the leading organization responding to the crisis. Currently it has five treatment centers in the area.<ref name="apps.who.int" /> ] is providing direct patient care in multiple locations in Liberia.<ref>{{cite web|url=http://www.samaritans-purse.org.uk/battling-an-ebola-outbreak/|title=Battling an Ebola Outbreak|publisher=Samaritan's Purse}}</ref> Many nations and charitable organizations, foundations, and individuals have also pledged assistance to control the epidemic. | |||
| ==Popular culture== | |||
| "Ebola in Town", a ] by a group of West African rappers warning people of the dangers of the Ebola virus and explaining how to react, became popular in Guinea and Liberia during the first quarter of 2014.<ref>{{cite web|url=http://www.theguardian.com/world/2014/may/27/ebola-virus-outbreak-infectious-dance-tune|title=Ebola virus causes outbreak of infectious dance tune|date=27 May 2014|author=Monica Mark|work=The Guardian}}</ref><ref>{{cite web|url=http://www.telegraph.co.uk/news/worldnews/africaandindianocean/liberia/10860045/Ebola-rap-warns-West-Africans-of-viruss-dangers.html|title=Ebola rap warns West Africans of virus's dangers |work=Daily Telegraph|date=28 May 2014|author=Mike Pflanz}}</ref> | |||
| In August 2014, ] and Ghanaian musician Sidney produced a song to raise awareness about Ebola.<ref>{{cite web|title=Liberian soccer star George Weah records Ebola song|url=http://www.capitalfm.co.ke/lifestyle/2014/08/12/liberian-soccer-star-george-weah-records-ebola-song/|publisher=Capital Group Limited|accessdate=19 August 2014|date=12 August 2014}}</ref> | |||
| There are a number of Ebola-themed jokes circulating in West Africa to spread awareness.<ref>{{cite web|title=Tell Me the One About Ebola: How Jokes Spread Awareness|url=http://www.bloomberg.com/news/2014-08-27/tell-me-the-one-about-ebola-how-jokes-spread-awareness.html|website=Bloomberg|accessdate=31 August 2014}}</ref> | |||
| ==Timeline of cases and deaths== | |||
| Data comes from reports by the Centers for Disease Control and Prevention<ref>{{cite web| url=http://who.int/csr/don/en/ |title=Disease Outbreak News (DONs)|publisher=CDC}}</ref> and the WHO.<ref name="autogenerated2">{{cite news| url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news.html |title=Disease Outbreak News|publisher=WHO}}</ref> All numbers are correlated with United Nations Office for the Coordination of Humanitarian Affairs (OCHA) if available.<ref>{{cite web| url=https://wca.humanitarianresponse.info/en |title=https://wca.humanitarianresponse.info/en|publisher=OCHA}}</ref> The table includes suspected cases that have not yet been confirmed. The reports are sourced from official information from the affected countries' health ministries. WHO has stated the reported numbers "vastly underestimate the magnitude of the outbreak",<ref>{{cite news|url=http://www.bbc.com/news/world-africa-28798542 |title=Ebola crisis vastly underestimated, says WHO |publisher=BBC |date=14 August 2014 |accessdate=14 August 2014}}</ref> saying there may be 2.5 times as many cases as officially reported.<ref>{{cite web |url=https://news.yahoo.com/ebola-cases-could-reach-between-550-000-1-144829039.html |title=Ebola cases could reach between 550,000 and 1.4 mln by late Jan-CDC |publisher=] |agency=Reuters |date=September 23, 2014 |accessdate=September 23, 2014}}</ref> Cases in remote areas may also be missed.<ref>{{cite news |first1=Stephanie |last1=Nebehay |first2=Clair |last2=MacDougall |title=WHO warns of 'shadow zones' and unreported Ebola cases |date=22 August 2014 |publisher=Reuters |url=http://www.reuters.com/article/2014/08/22/us-health-ebola-who-idUSKBN0GM0RW20140822}}</ref> | |||
| As of October 1st, the equation for the epidemic is ''c''=372.53*EXP(0.02547''d''), where ''c'' is the number of cases and ''d'' the number of days since the start; so, for 100,000 cases the estimated date is circa January 10, 2015; as the growing is exponential, 1,000,000 cases is circa April 10, 2015. | |||
| The case numbers reported may include probable or suspected cases. Numbers are revised downward if a case is later found to be negative. <small>(Numbers may differ from reports as per respective Government reports. See notes at the bottom for stated source file.)</small> | |||
| <gallery mode="packed" perrow=3 heights=200px> | |||
| File:Diseased Ebola 2014.png|Cumulative totals of cases and deaths over time | |||
| File:Evolution of the 2014 Ebola outbreak in semiLog plot..png| Cumulative totals in log scale | |||
| File:Deceased per day Ebola 2014.png|Average new cases and deaths per day (between WHO reporting dates) | |||
| </gallery> | |||
| <gallery mode="packed" perrow=2 heights=200px> | |||
| File:West Africa Ebola 2014 actual case and death linear scale.png|Cumulative number of cases and deaths by country, using a linear scale | |||
| File:West Africa Ebola 2014 actual case and death log scale.png|Cumulative number of cases and deaths by country, using a logarithmic scale | |||
| File:West Africa Ebola 2014 case and death rate by country as of september 23rd linear scale.png|Cases and death based on population, using a linear scale | |||
| File:West Africa Ebola 2014 case and death rate by country as of september 23rd logharithmic scale.png|Cases and death based on population, using a logarithmic scale | |||
| </gallery> | |||
| {{clear}} | |||
| {|class="wikitable" style="text-align: right;" width=950px | |||
| |+Ebola cases and deaths by country and by date – 1 August to present | |||
| |- | |||
| ! rowspan=2 |Date ||colspan=2 | Total || colspan=2 | Guinea || colspan=2 | Liberia || colspan=2 | Sierra Leone || colspan=2 | Nigeria || colspan=2 | Senegal || colspan=2 | United States || rowspan=2 |Refs | |||
| |- | |||
| ! style="color: red;" | Cases || Deaths || style="color: red;" | Cases || Deaths || style="color: red;" | Cases || Deaths || style="color: red;" | Cases || Deaths || style="color: red;" | Cases || Deaths || style="color: red;" | Cases || Deaths || style="color: red;" | Cases || Deaths | |||
| |- | |||
| | 1 Oct 2014 || 7,492 || 3,439 || 1,199 || 739 || 3,834 || 2,069 || 2,437 || 623 || 20 || 8 || 1 || 0 || 1 || 0 || ✓{{efn|group=note|1 October as per reports WHO. Liberia subject to change.<ref name=Ebola_Outbreak_total_WHO_3_Oct />}}<ref name="Ebola_Outbreak_total_WHO_3_Oct"></ref> | |||
| |- | |||
| | 28 Sep 2014 || 7,192 || 3,286 || 1,157 || 710 || 3,696 || 1,998 || 2,317 || 570 || 20 || 8 || 1 || 0 || 1 || 0 || ✓{{efn|group=note|28 September Liberia and Guinea reports as per respective WHO<ref name=Ebola_Outbreak_total_WHO_28_Sept /><ref name=Ebola_Outbreak_total_sl_25_Sept /> and Sierra Leone as per government<ref name=Ebola_Outbreak_total_sl_28_Sept />(2304 cases and 622 deaths according to WHO report). Nigeria and Senegal stat. Note US case only dated 29 September but been in US since 28 September}} <ref name="CDC American Ebola" /><ref name="Ebola_Outbreak_total_WHO_28_Sept"></ref><ref name="Ebola_Outbreak_total_sl_28_Sept"></ref> | |||
| |- | |||
| | 25 Sep 2014 || 6,808 || 3,159 || 1,103 || 668 || 3,564 || 1,922 || 2,120 || 561 || 20 || 8 || 1 || 0 || || || ✓{{efn|group=note|25 September Liberia and Sierra Leone reports as per respective governments<ref name=Ebola_Outbreak_total_sl_25_Sept /><ref name=Ebola_Outbreak_total_lr_25_Sept /> and OCHA for Guinea.<ref name=Ebola_Outbreak_total_gn_25_Sept /> Nigeria and Senegal stat.}} <ref name="Ebola_Outbreak_total_sl_25_Sept"></ref><ref name="Ebola_Outbreak_total_lr_25_Sept"></ref><ref name="Ebola_Outbreak_total_gn_25_Sept"></ref> | |||
| |- | |||
| | 23 Sep 2014 || 6,574 || 3,043 || 1,074 || 648 || 3,458 || 1,830 || 2,021 || 557|| 20 || 8 || 1 || 0 || || || ✓{{efn|group=note|23 Sept Liberia, Guinea,Nigeria and Senegal as per WHO report.<ref name=Ebola_Outbreak_total_WHO_23_Sept /> Modified with Sierra Leone death toll as per Gov which is lower than WHO death toll (605).<ref name=Ebola_Outbreak_total_sl_23_Sept />}}<ref name="Ebola_Outbreak_total_WHO_23_Sept">{{cite web|url=http://apps.who.int/iris/bitstream/10665/135029/1/roadmapupdate26sept14_eng.pdf?ua=1|title=WHO: Ebola Response Roadmap Situation Report -26 September 2014|publisher=WHO|date=27 September 2014| accessdate=27 September 2014}}</ref><ref name="Ebola_Outbreak_total_sl_23_Sept"></ref> | |||
| |- | |||
| | 21 Sep 2014 || 6,263 || 2,900 || 1,022 || 635 || 3,280 || 1,707 || 1,940 || 550 || 20 || 8 || 1 || 0 || || || ✓{{efn|group=note|21 September Liberia, Guinea as per WHO report.<ref name=Ebola_Outbreak_total_21_WHO_Sept /> modified with Sierra Leone death toll as per Gov which is lower than WHO death toll (597)<ref name=Ebola_Outbreak_total_sl_21_Sept />}}<ref name="Ebola_Outbreak_total_21_WHO_Sept">{{cite web|url=http://apps.who.int/iris/bitstream/10665/134771/1/roadmapsitrep_24Sept2014_eng.pdf?ua=1|title=WHO: Ebola Response Roadmap Situation Report -24 September 2014|publisher=WHO|date=25 September 2014| accessdate=25 September 2014}}</ref><ref name="Ebola_Outbreak_total_sl_21_Sept"></ref> | |||
| |- | |||
| | 17 Sep 2014 || 5,762 || 2,746 || 965 || 623 || 3,022 || 1,578 || 1,753 || 537 || 21 || 8 || 1 || 0 || || || ✓{{efn|group=note|17 September Guinea and Senegal as per OCHA report.<ref name=Ebola_Outbreak_total_17_Sept /> Updated with Liberia numbers as per Gov.<ref name=Ebola_Outbreak_total_lr_17_Sept /> Updated with Sierra Leone per Gov (OCHA report states 18 September but totals are as per SL gov on 17 September) <ref name=Ebola_Outbreak_total_sl_17_Sept /> Nigeria and Senegal stat.}}<ref name="Ebola_Outbreak_total_17_Sept"></ref><ref name="Ebola_Outbreak_total_lr_17_Sept"></ref><ref name="Ebola_Outbreak_total_sl_17_Sept"></ref> | |||
| |- | |||
| | 14 Sep 2014 || 5,339 || 2,586 || 942 || 601 || 2,720 || 1,461 || 1,655 || 516 || 21 || 8 || 1 || 0 || || || ✓{{efn|group=note|14 September Guinea as per WHO report.<ref name=Ebola_Outbreak_total_18_Sept /> Updated with Liberia numbers as per Gov.<ref name=Ebola_Outbreak_total_lr_14_Sept /> Updated with Sierra Leone death toll as per Gov<ref name=Ebola_Outbreak_total_sl_14_Sept />}}<ref name="Ebola_Outbreak_total_18_Sept">{{cite web|url= http://apps.who.int/iris/bitstream/10665/133833/1/roadmapsitrep4_eng.pdf?ua=1|title= Ebola Response Situation Report 4, 18 September 2014 |publisher = WHO|date=19 September 2014| accessdate=20 September 2014}}</ref><ref name="Ebola_Outbreak_total_lr_14_Sept"></ref><ref name="Ebola_Outbreak_total_sl_14_Sept"></ref> | |||
| |- | |||
| | 10 Sep 2014 || 4,846|| 2,375 || 899 || 568 || 2,415 || 1,307|| 1,509 || 493 ||22 || 8 || 3 || 0 || || || ✓{{efn|group=note|10 Sept From Primary Source OCHA<ref name=Ebola_Outbreak_total_10_Sept /> and Liberia government.<ref name=Ebola_LB_10_Sept /> Nigeria and Senegal stat}}<ref name="Ebola_Outbreak_total_10_Sept"></ref><ref name="Ebola_LB_10_Sept"></ref> | |||
| |- | |||
| | 7 Sep 2014 || 4,366|| 2,177 || 861 || 557 || 2,081 || 1,137|| 1,424 || 476 ||22 || 7 || 3 || 0 || || || ✓ {{efn|group=note|7 Sept WHO<ref name=Ebola_Outbreak_total_7_Sept /> report Sierra Leone death rate suspected added up double in report.<ref name=SL_7Sep />}}<ref name="Ebola_Outbreak_total_7_Sept"></ref><ref name="SL_7Sep"></ref> | |||
| |- | |||
| | 3 Sep 2014 || 4,001|| 2,089 || 823 || 522 || 1,863 || 1,078|| 1,292 || 452 ||22 || 7 || 1 || 0 || || || ✓<ref>, OCHA</ref> | |||
| |- | |||
| | 31 Aug 2014 || 3,707|| 1,808 || 771 || 494 || 1,698 || 871|| 1,216 || 436 ||21 || 7 || 1 || 0 || || || ✓{{efn|group=note|31 Aug WHO<ref name=WHO_31Aug /> SL death toll wrong.<ref name=SL_31Aug />}} <ref name="WHO_31Aug">{{cite web|url=http://who.int/csr/don/2014_09_04_ebola/en/|title=WHO: Ebola Response Roadmap Situation Report 2, 5 September 2014|publisher=WHO|accessdate=18 September 2014}}</ref><ref name="SL_31Aug"></ref> | |||
| |- | |||
| | 25 Aug 2014 || 3,071|| 1,553 || 648 || 430 || 1,378 || 694 || 1,026 || 422|| 19 || 7 || || || || || ✓<ref>, WHO</ref> | |||
| |- | |||
| | 20 Aug 2014 || 2,615|| 1,427 || 607 || 406 || 1,082 || 624 || 910 || 392 || 16 || 5 || || || || || ✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4260-ebola-virus-disease-west-africa-22-august-2014.html|title=Ebola virus disease, West Africa – update 22 August 2014|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 18 Aug 2014 || 2,473|| 1,350 || 579 || 396 || 972 || 576 || 907 || 374 || 15 || 4 || || || || || ✓<ref>{{cite web|url=http://who.int/csr/don/2014_08_20_ebola/en/|title=Ebola virus disease, West Africa – update 20 August 2014|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 16 Aug 2014 || 2,240|| 1,229 || 543 || 394 || 834 || 466 || 848 || 365 || 15 || 4 || || || || || ✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4258-ebola-virus-disease-west-africa-19-august-2014.html|title=Ebola virus disease, West Africa – update 19 August 2014|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 13 Aug 2014 || 2,127|| 1,145 || 519 || 380 || 786 || 413 || 810 || 348 || 12 || 4 || || || || || ✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4256-ebola-virus-disease-west-africa-15-august-2014.html|title=Ebola virus disease, West Africa – update 15 August 2014|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 11 Aug 2014 || 1,975|| 1,069 || 510 || 377 || 670 || 355 || 783 || 334 || 12 || 3 || || || || || ✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4254-ebola-virus-disease-west-africa-13-august-2014.html|title=Ebola virus disease, West Africa – update 13 August 2014|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 9 Aug 2014 || 1,848|| 1,013 || 506 || 373 || 599 || 323 || 730 || 315 || 13 || 2 || || || || || ✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4242-ebola-virus-disease-west-africa-11-august-2014.html|title=Ebola virus disease, West Africa – update 11 August 2014|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 6 Aug 2014 || 1,779 || 961 || 495 || 367 || 554 || 294 || 717 || 298 || 13 || 2 || || || || || ✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4241-ebola-virus-disease-west-africa-8-august-2014.html|title=Ebola virus disease, West Africa – update 8 August 2014|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 4 Aug 2014 || 1,711 || 932 || 495 || 363 || 516 || 282 || 691 || 286 || 9 || 1 || || || || || ✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4240-ebola-virus-disease-west-africa-6-august-2014.html|title=Ebola virus disease, West Africa – update 6 August 2014|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 1 Aug 2014 || 1,603 || 887 || 485 || 358 || 468 || 255 || 646 || 273 || 4 || 1 || || || || || ✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4239-ebola-virus-disease-west-africa-4-august-2014.html|title=Ebola virus disease, West Africa – update 4 August 2014|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |} | |||
| {|class="wikitable collapsible collapsed" style="text-align: right;" width=950px | |||
| |+Archived Ebola cases and deaths by country – 22 March to 30 July | |||
| |- | |||
| ! rowspan=2 |Date ||colspan=2 | Total || colspan=2 | Guinea || colspan=2 | Liberia || colspan=2 | Sierra Leone || colspan=2 | Nigeria || colspan=2 | Senegal || rowspan=2 |Refs | |||
| |- | |||
| ! style="color: red;" | Cases || Deaths || style="color: red;" | Cases || Deaths || style="color: red;" | Cases || Deaths || style="color: red;" | Cases || Deaths || style="color: red;" | Cases || Deaths || style="color: red;" | Cases || Deaths | |||
| |- | |||
| | 30 Jul 2014 || 1,440 || 826 || 472 || 346 || 391 || 227 || 574 || 252 || 3 || 1 || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4238-ebola-virus-disease-west-africa-31-july-2014.html|title=Ebola virus disease, West Africa – update 31 July 2014|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 27 Jul 2014 || 1,323 || 729 || 460 || 339 || 329 || 156 || 533 || 233 || 1 || 1 || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4236-ebola-virus-disease-west-africa-29-july-2014.html|title=Ebola virus disease, West Africa – update 29 July 2014|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 23 Jul 2014 || 1,201 || 672 || 427 || 319 || 249 || 129 || 525 || 224 || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4233-ebola-virus-disease-west-africa-25-july-2014.html|title=Ebola virus disease, West Africa – update 25 July 2014|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 20 Jul 2014 || 1,093 || 660 || 415 || 314 || 224 || 127 || 454 || 219 || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4230-ebola-virus-disease-west-africa-23-july-2014.html|title=Ebola virus disease, West Africa – update 23 July 2014|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 17 Jul 2014 || 1,048 || 632 || 410 || 310 || 196 || 116 || 442 || 206 || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4225-ebola-virus-disease-west-africa-18-july-2014.html|title=Ebola virus disease, West Africa – update 18 July 2014|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 14 Jul 2014 || 982 || 613 || 411 || 310 || 174 || 106 || 397 || 197 || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4224-ebola-virus-disease-west-africa-17-july-2014.html|title=Ebola virus disease, West Africa – update 17 July 2014|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 12 Jul 2014 || 964 || 603 || 406 || 304 || 172 || 105 || 386 || 194 || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4222-ebola-virus-disease-west-africa-14-july-2014.html|title=Ebola virus disease, West Africa – update 14 July 2014|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 8 Jul 2014 || 888 || 539 || 409 || 309 || 142 || 88 || 337 || 142 || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4220-ebola-virus-disease-west-africa-10-july-2014.html|title=Ebola virus disease, West Africa – update 10 July 2014|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 6 Jul 2014 || 844 || 518 || 408 || 307 || 131 || 84 || 305 || 127 || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4217-ebola-virus-disease-west-africa-7-july-2014.html|title=Ebola virus disease, West Africa – update 7 July 2014|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 2 Jul 2014 || 779 || 481 || 412 || 305 || 115 || 75 || 252 || 101 || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4216-ebola-virus-disease-west-africa-3-july-2014.html|title=Ebola virus disease, West Africa – update 3 July 2014 |publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 30 Jun 2014 || 759<br />(6/25)+22 || 467<br />+14 || 413<br />+3 || 303<br />+5 || 107<br />+8 || 65<br />+7 || 239<br />+11 || 99<br />+2 || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4214-ebola-virus-disease-west-africa-1-july-2014.html|title=Ebola virus disease, West Africa – update 1 July 2014|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 22 Jun 2014 || 599 || 338 || — || — || 51 || 34 || — || — || || || || ||✓<ref name="DON 23JUN14">{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4172-ebola-virus-disease-west-africa-23-june-2014.html|title=Ebola virus disease, West Africa – update 23 June 2014|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 20 Jun 2014 || 581 || 328 || 390<br />+0 || 270<br />+3 || — || — || 158<br />+0 || 34<br />+4 || || || || ||✓<ref name="DON 23JUN14" /> | |||
| |- | |||
| | 17 Jun 2014 || 528 || 337 || — || — || — || — || 97<br />(6/15)+31 || 49<br />+4 || || || || ||✓<ref name="DON 17JUN14">{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4166-ebola-virus-disease-west-africa-17-june-2014.html|title=Ebola virus disease, West Africa (Situation as of 17 June 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 16 Jun 2014 || 526 || 334 || 398 || 264 || 33<br />(6/11)+9 || 24<br />+5 || — || — || || || || ||✓<ref name="DON 17JUN14" /> | |||
| |- | |||
| | 15 Jun 2014 || 522 || 333 || 394 || 263 || 33 || 24 || 95 || 46 || || || || ||✓<ref>, WHO</ref> | |||
| |- | |||
| | 10 Jun 2014 || 474 || 252 || 372 || 236 || — || — || — || — || || || || || CDC<ref name=Previous_Updates_2014_West_Africa_Outbreak /> | |||
| |- | |||
| | 6 Jun 2014 || 453 || 245 || — || — || — || — || 89<br />+8 || 7<br />+1 || || || || ||✓<ref name="DON 07JUN14">{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4162-ebola-virus-disease-west-africa-7-june-2014.html|title=Ebola virus disease, West Africa (Situation as of 7 June 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 5 Jun 2014 || 445 || 244 || 351<br />+7 || 226<br />+6 || — || — || 81<br />+9 || 6 || || || || ||✓<ref name="DON 07JUN14" /><ref name="DON 05JUN14">{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4158-ebola-virus-disease-west-africa-5-june-2014.html|title=Ebola virus disease, West Africa (Situation as of 5 June 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 3 Jun 2014 || 436 || 233 || 344<br />+11 || 215<br />+3 || — || — || — || — || || || || ||✓<ref name="DON 05JUN14" /> | |||
| |- | |||
| | 1 Jun 2014 || 383 || 211 || 328 || 208<br />+21 || — || — || 79<br />+13 || 6 || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4157-ebola-virus-disease-west-africa-1-june-2014.html|title=Ebola virus disease, West Africa (Situation as of 01 June 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 29 May 2014 || 354 || 211 || — || — || —<br />+1 || —<br />+1 || 50<br />+34 || 6<br />+1 || || || || ||✓<ref name="DON 30MAY14">{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4154-ebola-virus-disease-west-africa-30-may-2014.html|title=Ebola virus disease, West Africa (Situation as of 30 May 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 28 May 2014 || 319 || 209 || 291 || 193 || — || — || — || — || || || || ||✓<ref name="DON 30MAY14" /> | |||
| |- | |||
| | 27 May 2014 || 309 || 202 || 281 || 186 || — || — || 16 || 5 || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4150-ebola-virus-disease-west-africa-27-may-2014.html|title=Ebola virus disease, West Africa (Situation as of 27 May 2014)|publisher=WHO|accessdate=18 September 2014}}</ref><ref>, WHO</ref> | |||
| |- | |||
| | 23 May 2014 || 270 || 185 || 258 || 174 || — || — || — || — || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4141-ebola-virus-disease-west-africa-situation-as-of-23-may-2014.html|title=Ebola virus disease, West Africa (Situation as of 23 May 2014)|publisher=|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 18 May 2014 || 265 || 187 || 253 || 176 || — || — || — || — || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4140-ebola-virus-disease-west-africa-situation-as-of-18-may-2014.html|title=Ebola virus disease, West Africa (Situation as of 18 May 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 12 May 2014 || 260 || 182 || 248 || 171 || — || — || — || — || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4136-ebola-virus-disease-west-africa-situation-as-of-15-may-2014.html|title=Ebola virus disease, West Africa (Situation as of 15 May 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 10 May 2014 || 245 || 168 || 233 || 157 || 12 || 11 || — || — || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4135-ebola-virus-disease-west-africa-situation-as-of-10-may-2014.html|title=Ebola virus disease, West Africa (Situation as of 10 May 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 7 May 2014 || 249 || 169 || 236 || 158 || — || — || — || — || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4134-ebola-virus-disease-west-africa-situation-as-of-9-may-2014.html|title=Ebola virus disease, West Africa (Situation as of 9 May 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 3 May 2014 || 244 || 166 || 231 || 155 || — || — || 0 || 0 || || || || ||✓<ref name="DON 05MAY14">{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4131-ebola-virus-disease-west-africa-5-may-2014.html|title=Ebola virus disease, West Africa (Situation as of 5 May 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 2 May 2014 || 239 || 160 || — || — || 13 || 11 || || || || || || ||✓<ref name="DON 02MAY14">{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4130-ebola-virus-disease-west-africa-2-may-2014.html|title=Ebola virus disease, West Africa (Situation as of 2 May 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 1 May 2014 || 237 || 158 || 226 || 149 || — || — || || || || || || ||✓<ref name="DON 02MAY14" /> | |||
| |- | |||
| | 30 Apr 2014 || 233 || 155 || 221 || 146 || — || — || || || || || || ||CDC<ref name=Previous_Updates_2014_West_Africa_Outbreak /> | |||
| |- | |||
| | 24 Apr 2014 || 253 || 152 || — || — || 35 || — || || || || || || ||✓<ref name="DON 25APR14">{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4121-ebola-virus-disease-west-africa-25-april-2014.html|title=Ebola virus disease, West Africa (Situation as of 25 April 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 23 Apr 2014 || 252 || 152 || 218 || 141 || — || — || || || || || || ||✓<ref name="DON 25APR14" /> | |||
| |- | |||
| | 21 Apr 2014 || 242 || 147 || — || — || 34<br />↓26? || 11<br />-2 || || || || || || ||✓<ref name="DON 22APR14">{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4106-ebola-virus-disease-west-africa-22-april-2014.html|title=Ebola virus disease, West Africa (Situation as of 22 April 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 20 Apr 2014 || 235 || 149 || 208 || 136 || — || — || || || || || || ||✓<ref name="DON 22APR14" /> | |||
| |- | |||
| | 17 Apr 2014 || 230 || 142 || 203 || 129 || 27 || 13 || || || || || || ||GU<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4104-ebola-virus-disease-west-africa-19-april-2014.html|title=Ebola virus disease, West Africa (Situation as of 19 April 2014)|publisher=|accessdate=18 September 2014}}</ref><br />LI✓<ref>, WHO</ref> | |||
| |- | |||
| | 16 Apr 2014 || 224 || 135 || 197 || 122 || 27 || 13 || (1) || || || || || ||<!-- LI 1 recent case Lassa Fever but never in this table-->✓<ref name="DON 16APR14">{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4100-ebola-virus-disease-west-africa-16-april-2014.html|title=Ebola virus disease, West Africa (Situation as of 16 April 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 14 Apr 2014 || 194 || 121 || 168 || 108 || — || — || || || || || || ||✓<ref name="DON 14APR14">{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4095-ebola-virus-disease-west-africa-14-april-2014.html|title=''Ebola virus disease, West Africa (Situation as of 14 April 2014)''|publisher=|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 11 Apr 2014 || 184 || 114 || — || — || 26 || 13 || || || || || || ||✓<ref name="DON 14APR14" /> | |||
| |- | |||
| | 10 Apr 2014 || 183 || 113 || — || — || 25 || 12 || — || — || || || || ||✓<ref name="DON 10APR14">{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4093-ebola-virus-disease-west-africa-10-april-2014.html|title=Ebola virus disease, West Africa (Situation as of 10 April 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 9 Apr 2014 || 179 || 111 || 158 || 101 || — || — || — || — || || || || ||✓<ref name="DON 10APR14" /> | |||
| |- | |||
| | 7 Apr 2014 || 172 || 105 || 151 || 95 || 21 || 10 || —<br />(−2) || — || || || || ||✓<ref name="DON 07APR14">{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4087-ebola-virus-disease-west-africa-7-april-2014.html|title=Ebola virus disease, West Africa (Situation as of 7 April 2014)|publisher=WHO|accessdate=18 September 2014}}</ref><ref name="DASH 07APR14">{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4089-dashboard-ebola-virus-disease-in-west-africa-07-april-2014.html|title=Dashboard – Ebola Virus Disease in West Africa (07 April 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 1 Apr 2014 || 135 || 88 || 127 || 83 || 8<br />+0 || 5<br />+1 || || || || || || ||<!--LI may be 2 Apr-->✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4074-ebola-virus-disease-west-africa-2-april-2014.html|title=Ebola virus disease, West Africa (Situation as of 2 April 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 31 Mar 2014 || 130 || 82 || 122 || 80 || 8 || 2 || — || — || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4073-ebola-virus-disease-west-africa-1-april-2014.html|title=Ebola virus disease, West Africa (Situation as of 1 April 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 29 Mar 2014 || 114 || 71 || — || — || 2<br />↓5 || 1<br />↓1 || — || — || || || || ||?<ref name="30MAR14LI">{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4072-ebola-virus-disease-liberia.html|title=Ebola virus disease, Liberia (Situation as of 30 March 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 28 Mar 2014 || 120 || 76 || 112 || 70 || — || — || (2) || (2) || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4071-ebola-virus-disease-guinea-30-march-2014.html|title=Ebola virus disease, Guinea (Situation as of 30 March 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 27 Mar 2014 || 111 || 72 || 103 || 66 || 8 || 6 || (6) || (5) || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4069-ebola-virus-disease-guinea-27-march-2014.html|title=Ebola virus disease, Guinea (Situation as of 27 March 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 26 Mar 2014 || 86 || 62 || 86 || 62 || || || || || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4067-ebola-virus-disease-in-guinea-26-march-2014.html|title=Ebola virus disease in Guinea (Situation as of 26 March 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 25 Mar 2014 || 86 || 60 || 86 || 60 || || || || || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4065-ebola-virus-disease-in-guinea-25-march-2014.html|title=Ebola virus disease in Guinea (Situation as of 25 March 2014)|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |- | |||
| | 24 Mar 2014 || 86 || 59 || 86 || 59 || || || || || || || || ||✓<ref>{{citation |author=WHO |title=Ebola Hemorrhagic Fever in Guinea |journal=Outbreak Bulletin |volume=4 |issue=1 |date=24 March 2014 |url=http://www.afro.who.int/index.php?option=com_docman&task=doc_download&gid=9154&Itemid=2593}}</ref> | |||
| |- | |||
| | 22 Mar 2014 || 49 || 29 || 49 || 29 || || || || || || || || ||✓<ref>{{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4063-ebola-virus-disease-in-guinea.html|title=Ebola virus disease in Guinea|publisher=WHO|accessdate=18 September 2014}}</ref> | |||
| |} | |||
| :<small>'''Notes:''' | |||
| :: ''Date'' is the "as of" date from the reference. A single source may report statistics for multiple "as of" dates. | |||
| :: Total cases and deaths before 1 July 2014 are calculated. | |||
| :: Numbers with ± are deltas from a previous report. The deltas may not be consistent. | |||
| :: Numbers with a ↓ indicate cases that were eliminated. | |||
| :: Liberia: | |||
| ::: 29 Mar: LI data is confused. Earlier, there were 8 suspected cases and 6 deaths (no confirmed cases). Seven suspected cases were tested by 29 Mar, and five were not Ebola. That should take suspected cases to 3, but a total was not stated; it also implies deaths should be at most 3. The report states only 2 suspected deaths were tested, and one was not Ebola.<ref name="30MAR14LI" /> | |||
| ::: 21 Apr: reduced deaths by 2: one in Guinea total and one case discarded. 26 samples negative for Ebola.<ref name="DON 22APR14" /> | |||
| ::: 24 Apr: stated it was reviewing its 27 suspected cases and may toss all of them;<ref name="DON 25APR14" /> | |||
| ::: 2 May: reclassification complete.<ref name="DON 02MAY14" /> | |||
| :: Sierra Leone: cases were reported, but by 3 May there were no cases.<ref name="DON 05MAY14" /> Early reports are marked with parens "()". | |||
| ::: 7 Apr: 2 suspected cases of EVD were confirmed as Lassa Fever.<ref name="DON 07APR14" /> | |||
| ::: 15 Apr: Of 12 suspected cases, 11 were tested for Ebola but came up negative.<ref name="DON 16APR14" /> | |||
| :: Mali: 4 possible cases were reported on 7 April,<ref name="DON 07APR14" /><ref name="DASH 07APR14" /> but they were not EVD.<ref name="DON 16APR14" /> | |||
| </small> | |||
| {{reflist|group=note}} | |||
| {{clear right}} | |||
| ==References== | |||
| {{Reflist |30em}} | |||
| ==External links== | |||
| {{Commons category|2014 West Africa Ebola outbreak}} | |||
| * {{cite web|url=http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news.html|publisher=World Health Organization (WHO)|title=Outbreak Updates}}. | |||
| * {{cite web|url=http://www.cdc.gov/vhf/ebola/|publisher=US Centers for Disease Control and Prevention (CDC)|title=Outbreak Updates}}. | |||
| * Healthmap.org | |||
| * (Graphic) | |||
| {{Ebola}} | |||
| {{Navboxes | |||
| |title = Topics of affected countries | |||
| |titlestyle = | |||
| |state =autocollapse | |||
| |list = | |||
| {{Guinea topics}} | |||
| {{Liberia topics}} | |||
| {{Nigeria topics}} | |||
| {{Sierra Leone topics}} | |||
| }} | |||
| {{Portal bar|Africa|Current events|Medicine|Viruses}} | |||
| {{Use DMY dates|date=August 2014}} | |||
| ] | |||
| ] | |||
| ] | |||
| ] | |||
| ] | |||
| ] | |||
| ] | |||
Revision as of 17:24, 6 October 2014
The government's of the world have done this! Beware!