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==Fatality rate==
==Fatality rate==
{{See also|Ebola virus disease#Prognosis}}
{{See also|Ebola virus disease#Prognosis}}
The infection and mortality data from Guinea, where new infections almost came to a standstill by 18 June, indicate a fatality rate of about 64%, which includes also cases of probable and suspected Ebola infections, as reported by the World Health Organization.<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|website=WHO|date=18 July 2014}}</ref> Guinea and WHO disagree on patient data, including mortality data.<ref>{{cite web|url=http://crofsblogs.typepad.com/h5n1/2014/06/guinea-government-disagrees-with-who-on-case-numbers.html |title=H5N1: Guinea: Government disagrees with WHO on Ebola case numbers |publisher=Crofsblogs.typepad.com |date=8 June 2014 |accessdate=27 July 2014}}</ref>
The infection and mortality data from Guinea, where new infections almost came to a standstill by 18 June, indicate a fatality rate of about 64%, which includes also cases of probable and suspected Ebola infections, as reported by the World Health Organization.<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|website=WHO|date=18 July 2014}}</ref> Guinea and WHO disagree on patient data, including mortality data.{{Citation needed}}


==Virology==
==Virology==

Revision as of 23:58, 9 August 2014

Western African Ebola epidemic
Situation map of the outbreak as of 7 August 2014
DateMarch 2014–present
LocationGuinea, Liberia, Nigeria, Sierra Leone
Casualties
961 deaths / 1779 cases (as of 6 August 2014)[1]

An epidemic of the Ebola virus disease (EVD) is ongoing in certain West African countries. The outbreak first began in Guinea in March 2014.[3] Since its initial outbreak, the virus has spread to Liberia, Sierra Leone, and Nigeria. The outbreak is the most severe Ebola virus outbreak recorded in regard to the number of human cases and fatalities.[4] On 8 August 2014, the World Health Organization (WHO) declared the outbreak a Public health emergency of international concern.[5] A total of 1779 suspected cases with 961 deaths have been reported by WHO as of 6 August 2014, of which 1134 cases and 622 deaths have been laboratory confirmed to be Ebola.[6] Various organisations, including the Economic Community of West African States (ECOWAS), U.S. Centers for Disease Control, and the European Commission have donated funds and mobilised personnel to help counter the outbreak; charities including Médecins Sans Frontières, the Red Cross,[7] and Samaritan's Purse are also working in the area.

Development of the outbreak

Initial outbreak in Guinea

The first known cases of a febrile disease, accompanied by diarrhea, vomiting, fatigue, and sometimes bleeding, began on 9 February; the disease was initially limited to Forested Guinea and Conakry, the capital city.[8] On March 19, Dr. Sakoba Keita, in charge of the Ministry of Health's disease prevention and emergency response division, acknowledged a local outbreak of an undetermined viral hemorrhagic fever; the outbreak, ongoing since February, had sickened at least 35 people and killed 23. Ebola was suspected, and samples had been sent to Senegal and France for disease identification.[9] On 25 March 2014, the World Health Organization (WHO) reported that the Ministry of Health of Guinea had reported an outbreak of Ebola virus disease (EVD) in four southeastern districts: Guekedou, Macenta, Nzerekore and Kissidougou with suspected cases in the neighboring countries of Liberia and Sierra Leone 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.[10] An initial report suggested that it was a new strain of ebolavirus,[11] but this was refuted by later studies which placed it within the lineage of the Zaire strain.[12][13] On 31 March, the U.S. Centers for Disease Control sent a five-person team "to assist Guinea Ministry of Health and World Health Organization lead an international response to the Ebola outbreak".[10] By 23 April, the total number of suspected and confirmed cases was 242, including 142 deaths at a fatality rate of 59%.[14] Around 23 May, the outbreak spread to Guinea's capital Conakry,[10] a city of about two million inhabitants. According to Ibrahima Touré, Country Director of Plan Guinea, an NGO: "The poor living conditions and lack of water and sanitation in most districts of Conakry pose a serious risk that the epidemic escalates into a crisis. People do not think to wash their hands when they do not have enough water to drink."[15]

Subsequent spread

In Liberia, the disease was reported in Lofa and Nimba counties in late March,[16] and by mid-April, the Ministry of Health and Social Welfare had recorded possible cases in Margibi and Montserrado counties.[17]

Sierra Leone, Mali and Ghana identified suspected cases of the disease by mid-April, but all clinical samples of suspected cases at the time tested negative for the Ebola virus.[18] The overall situation with the Ebola virus infection in Guinea improved in May. For several days no new alerts or cases of nosocomial transmission (hospital-acquired infections) were reported from Liberia and from five out of the six affected prefectures in Guinea. Gueckedou was the only location where community transmission and deaths were still being reported.

From 23 to 27 May 2014, three previously affected districts (Guéckédou, Macenta and Conakry), four new districts (Boffa, Télimélé, Boke and Dubréka) and one new country (Sierra Leone) reported several new EVD clinical cases.[19] In mid-June the first cases in Liberia's capital Monrovia were reported.[20]

Médecins Sans Frontières described the situation as being "totally out of control" in late June.[21] By early July, Liberia had reported 107 infections (52 laboratory-confirmed) and at least 65 deaths from Ebola,[22] and while only four deaths had been reported outside Lofa County by mid-April,[17] in mid-June, the MOHSW announced seven additional deaths in Montserrado County alone.[23]

The outbreak has progressed rapidly in Sierra Leone. The first cases were reported on 25 May in the Kailahun District, near the border with Guéckédou in Guinea.[24] By 20 June, there were 158 suspected cases, mainly in Kailahun and the adjacent district of Kenema, but also in the Kambia, Port Loko and Western districts in the north west of the country.[25] By 17 July, the total number of suspected cases in the country stood at 442, and had overtaken those in Guinea and Liberia.[26] By 20 July, cases of the pestilence had additionally been reported in the Bo District;[27] the first case in Freetown, Sierra Leone's capital, was reported in late July.[28][29]

The first case in Nigeria was reported by the WHO on 25 July:[30] Patrick Sawyer, a Liberian Ministry of Finance official, flew from Liberia to Nigeria after exposure to the virus and died at Lagos soon after arrival.[31] In response, the hospital where he was being treated was shut down and quarantined and the health officials who were treating him were isolated in an attempt to stop the spread of the virus.[32][33][34]

Response by country and organisation

Countries with active local transmission

Countries with active transmissions, as of August 9, 2014.

The national authorities of Guinea, Sierra Leone, and Liberia have activated their national emergency committees, prepared Ebola virus disease response plans and carried out needs assessments.[13]

WHO's Regional Director for Africa, Luis Sambo, visited the affected countries from 21 to 25 July, meeting with political leaders, ministers of health, NGOs and other agencies. He stressed the need to "promote behavioural change while respecting cultural practices."[30]

Guinea

The border between Guinea and Liberia remained open in April; Guinea's ambassador in Monrovia noted his government's belief that efforts to fight the disease directly would be more effective than closing the border.[35]

Liberia

On or before 23 July, the Liberian health ministry began to implement a strategic plan in line with the Accra meeting's conclusions to improve the country's response to the outbreak.[36]

On 27 July, Ellen Johnson Sirleaf, the Liberian president, announced that Liberia would close its borders, with the exception of a few crossing points such as the country's principal airport, where screening centres would be established, and the worst-affected areas in the country would be placed under quarantine.[37] Football events were banned, because large gatherings and the nature of the sport increase transmission risks.[38] Three days after the borders were closed, Sirleaf announced the closure of all schools nationwide, including the University of Liberia,[39] and a few communities were to be quarantined.[40] Sirleaf declared a state of emergency on 6 August, partly because the disease's weakening of the health care system had 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".[41] On the same day, the National Elections Commission announced that it would be unable to conduct the scheduled October 2014 senatorial election and requested postponement,[42] one week after the leaders of various opposition parties had publicly taken different sides on the question.[43]

Nigeria

There have been two confirmed and six other suspect cases in Nigeria as of 5 August 2014.[44] First was an imported case of a Liberian-American Patrick Sawyer, who traveled by air from Liberia, became violently ill on arriving in the city of Lagos. On 20 July, Sawyer flew into Nigeria via Lomé and Accra from Liberia, and he died five days later in Lagos. In response, the Nigerian government increased surveillance at all entry points to the country; health officials were placed at entry points to conduct tests on people arriving in the country. Initial reports noted that sixty-nine individuals previously in contact with Sawyer (including airport staff, fellow flight passengers and health workers at the hospital where Sawyer was hospitalised) were placed under close surveillance without symptoms.[45] On 4 August, it was confirmed that the doctor who treated the patient tested positive for the virus strain and is being treated.[46] The suspect cases include a Nigerian man who traveled to Guinea.[6] On 6 August, Nigerian authorities confirmed the Ebola death of a nurse who had treated Sawyer.[47]

Sierra Leone

Sierra Leone has instituted a temporary measure which includes reactivation of its "Active Surveillance Protocol" that will see all travelers into the country from either Guinea or Liberia subjected to strict screening to ascertain their state of health.[48] The government of Sierra Leone declared a state of emergency on 30 July and deployed troops to quarantine the hot spots of the epidemic.[49]

Awareness campaigns in Freetown, Sierra Leone's capital, were delivered in August 2014 on the radio or through car loudspeakers.[50]

Countries with suspected or non-transmissive cases

Benin

On August 7 Benin reported two possible Ebola cases at two different hospitals within the country. Both patients were Nigerians who had traveled to Benin on business. Samples were sent to Senegal for confirmation.[51]

Saudi Arabia

On 1 April, Saudi Arabia stopped issuing visas for the Muslim pilgrimage to Mecca to those from Guinea, Liberia, and Sierra Leone.[52] Despite this, however, it was reported that on 3 August a man suspected of being infected with Ebola returned home to Saudi Arabia from Sierra Leone and died within three days of arrival while being tested for the disease in the port city of Jeddah. Tissue samples were sent to an international reference lab on the advice of the World Health Organization to determine the cause of death.[53]

On 6 August, the Saudi Ministry of Health advised citizens and residents of Saudi Arabia to avoid travelling to Liberia, Sierra Leone, and Guinea until further notice.[54]

Spain

On 5 August 2014, the Brothers Hospitallers of St. John of God confirmed that the Spanish Brother Miguel Pajares was infected with the Ebola virus while volunteering in Liberia. The religious organisation also confirmed that it informed the Spanish Ministry of Foreign Affairs and Cooperation and the Ministry of Health, Social Services and Equality and requested his repatriation.[55] The repatriation, coordinated by the Spanish Ministry of Defense, occurred on 6 August 2014.[56] Spanish authorities confirmed that the patient would be treated in the 'Carlos III' hospital in Madrid, a decision that attracted some controversy.[57]

United States

On 31 July 2014, U.S. health officials from the Centers for Disease Control issued a travel advisory for Guinea, Liberia and Sierra Leone, warning against non-essential travel.[58]

American aid worker Dr. Kent Brantly, infected with the Ebola virus, was flown to the United States at the beginning of August for further treatment in Atlanta's Emory University Hospital, near the headquarters of the Centers for Disease Control.[59] Brantly had become infected while working in a Monrovia treatment center as medical director for the aid group Samaritan’s Purse; Nancy Writebol, one of Brantly's missionary coworkers, became infected at the same time and was flown to the same hospital.[60][61][62]

On 6 August 2014, the Centers for Disease Control moved its Ebola response to Level 1 (the highest on a scale from 1 to 6) to increase the agency's ability to respond to the outbreak.[63]

Other countries and economic regions

Economic Community of West African States

On 30 March 2014, during the 44th Summit of the heads of state and government of West Africa, Economic Community of West African States (ECOWAS) disbursed US$250,000 to deal with the outbreak.[64] At the event in July of that year, the Nigerian government donated US$500,000 to the Liberian government to aid the fight against the virus.[65]

In July, the WHO convened an emergency sub-regional meeting with health ministers from eleven countries in Accra, Ghana.[66] On 3 July 2014, the West African states announced collaboration on a new strategy, and the creation of a World Health Organization sub-regional centre in Guinea "to co-ordinate technical support";[67] the centre was inaugurated in Conakry on 24 July.[68]

On 31 July, the WHO and West Africa nations announced $100 million in aid to help contain the disease.[69]

European Union

In March, the European Commission (EC) gave €500,000 to help contain the spread of the virus in Guinea and its neighbouring countries. The EC has also sent a health expert to Guinea to help assess the situation and liaise with the local authorities. EU Commissioner for International Cooperation, Humanitarian Aid and Crisis Response Kristalina Georgieva said: "We are deeply concerned about the spread of this virulent disease and our support will help ensure immediate health assistance to those affected by it. It's vital that we act swiftly to prevent the outbreak from spreading, particularly to neighbouring countries."[70]

In April, a mobile laboratory, capable of performing the molecular diagnosis of viral pathogens of risk groups 3 and 4, was deployed in Guinea by the European Mobile Laboratory project (EMLab) as part of the WHO/GOARN outbreak response. Prior samples were analyzed at the Jean Mérieux BSL-4 Laboratory in Lyon.[71]

Germany's Foreign Office issued travel warnings for all affected countries at the end of July.[72] Spain did so on August 2.[73]

Hong Kong

On 30 July, Hong Kong's health authorities stepped up surveillance against the Ebola virus as a Hong Kong woman who fell ill after visiting Kenya tested negative for the disease. She was in stable condition in isolation.[74]

India

On 21 July, three Dwarka, Delhi residents on an inbound flight from Accra to New Delhi via Addis Ababa were placed under surveillance after WHO confirmation that one of the passengers on the flight had tested positive for Ebola; however, as of 8 August none of the three had shown any symptoms of the disease.[75] On 8 August, India placed all of its airports on high alert and stepped up surveillance of all travellers entering the country from Ebola-affected regions. The Union Health Minister, Dr. Harsh Vardhan, issued a statement, "There is no cause for panic. We have put in operation the most advanced surveillance and tracking systems." From 9 August, passengers coming from Ebola-affected countries will have to complete a form before landing; the form has a checklist for symptoms and asks travellers from West Africa for information about places visited, length of stay and other important information.

"The form is ready and will be officially released by Saturday. We will request all airlines to direct their staff to distribute the form in-flight, like immigration forms are given before arrival," said Dr Jagdish Prasad, director general of health services, Union Ministry of Health. In New Delhi, Ram Manohar Lohia Hospital in New Delhi has been designated as a treatment centre for Ebola Virus Disease (EVD) cases. A 24-hour emergency helpline will also be functional from Saturday. Its numbers are (011)-23061469, 3205 and 1302. The estimated 47,000 Indians in the affected countries are being contacted by area diplomatic missions and supplied with educational material about the disease.[76]

Morocco

Beginning in April, Morocco reinforced medical surveillance at the Casablanca airport, a regional hub for flights from and to West Africa.[77][78] In early August, Liberian interior minister Morris Dukuly announced the Ebola death of a Liberian man in the country.[79] However, the Moroccan Ministry of Health announced that the person died of a heart attack, rather than Ebola.[80][81]

Philippines

The Philippine Department of Foreign Affairs has raised Alert Level 2 in Guinea, Liberia and Sierra Leone and has temporarily halted the sending of Filipino workers to the affected countries since June 30. Filipino seafarers are also cautioned about potentially contracting Ebola when their ship docks in affected countries.[82] The Department of Health expressed its willingness to send medical workers to Ebola-affected countries to help contain the outbreak.[83]

Senegal

Senegal's Ministry of Interior has ordered all movements of people through the southern border with Guinea to be suspended indefinitely to prevent the spread of the disease, according to a statement published on 29 March by state agency APS.[84]

United Kingdom

Public Health Wales reported on 5 August 2014 that a British woman might have been exposed to the Ebola Virus while travelling in West Africa.[85] She volunteered to be house-bound in her home in Cardiff, Wales, even though she is showing no symptoms of the virus. The victim is being closely monitored by public health agencies.

Response by organisations

Airlines

Arik Air, Nigeria's main airline, has stopped flying to Liberia and Sierra Leone.[37]

On 5 August, British Airways suspended all flights to and from Liberia and Sierra Leone until the end of the month.[86]

US Centers for Disease Control

By the beginning of August, the U.S. Centers for Disease Control had placed staff in Guinea, Sierra Leone, Liberia, and Nigeria to assist the local Ministries of Health and WHO-led response to the outbreak.[87] On 6 August, the Centers for Disease Control moved its Ebola response to Level 1 (the highest on a scale from 1 to 6) to increase the agency's ability to respond to the outbreak.[63]

Tom Frieden, Director of the Centers for Disease Control, stated: "The bottom line with Ebola is we know how to stop it: traditional public health. Find patients, isolate and care for them; find their contacts; educate people; and strictly follow infection control in hospitals. Do those things with meticulous care and Ebola goes away."[88]

Médecins Sans Frontières

The humanitarian aid organisation Médecins Sans Frontières (Doctors Without Borders) has a team of 300 staff working in Guinea, Sierra Leone and Liberia, has set up specialist centers to give medical care to affected people, and has sent over 40 tonnes of equipment and supplies.[89] Samaritan's Purse is also providing direct patient care in multiple locations in Liberia.[90]

World Health Organization

WHO's Regional Director for Africa, Luis Sambo, visited the affected countries from 21 to 25 July, meeting with political leaders, ministers of health, NGOs and other agencies. He stressed the need to "promote behavioural change while respecting cultural practices."[30] On 24 July, WHO's Director General met with agencies and donors in Geneva to facilitate an increase in funding and manpower to respond to the outbreak.[30]

WHO declared the outbreak an international public health emergency on 8 August 2014, after a two-day teleconference of experts.[5]

OpenStreetMap

The OpenStreetMap community gathers on the internet thousands of contributors from around the world to produce a free map of the world and various OpenData extraction services. The Humanitarian OpenStreetMap Team, in coordination with MSF and the Red Cross, has partnered with the OpenstreetMap community. At the beginning of August, more than 700 contributors had produced detailed maps of the West Africa zones affected by the Ebola epidemic. These maps covered 24,000 square km (155 km x 155 km). Following the WHO declaration of an international public health emergency, new tasks were added to map new territories, starting with Monrovia, which has been severely affected by the epidemic. [91]

Complications in containment efforts

Difficulties faced in attempting to contain the outbreak include the outbreak's multiple locations across country borders,[21] inadequate equipment given to medical personnel,[92] funeral practices such as washing a body,[93] and reluctance among country people to follow preventive practices,[94] including "freeing" suspected Ebola patients from isolation,.[28][95]

Conspiracy theories

The extent and timing of the current Ebola outbreak has led to the rise of conspiracy theories that have complicated containment efforts.[96] There are reports of suspicion that the disease is caused by sorcery and that doctors are killing patients.[97] In late July, the former Liberian health minister Peter Coleman stated that "people don't seem to believe anything the government now says."[37]

Depletion of human resources

Several healthcare workers have been infected. Among the fatalities is Samuel Brisbane, a former advisor to the Liberian Ministry of Health and Social Welfare whom British newspaper The Guardian described as "one of Liberia's most high-profile doctors".[98] Two American aid workers at a treatment center in Monrovia run by Serving In Mission /Samaritan's Purse have also been infected.[98][99] On 2 August, Kent Brantly, one of the two workers, was flown into Atlanta's Emory University Hospital for treatment, making him the first patient infected with EVD in the United States.[100] On 29 July, leading Ebola doctor Sheik Umar Khan from Sierra Leone died in the outbreak.[101][102]

Hostility against health workers

There was also an attack on aid workers who were hurrying to retrieve "freed" patients and did not explain to villagers who they were,[103] and the Red Cross were forced to suspend operations in Guinea after staff were threatened by a group of men armed with knives.[104] Demonstrations outside the main hospital treating Ebola patients in Kenema, Sierra Leone, on 25 July were broken up by police.[105]

Fatality rate

See also: Ebola virus disease § Prognosis

The infection and mortality data from Guinea, where new infections almost came to a standstill by 18 June, indicate a fatality rate of about 64%, which includes also cases of probable and suspected Ebola infections, as reported by the World Health Organization.[1] Guinea and WHO disagree on patient data, including mortality data.[citation needed]

Virology

A researcher working with the Ebola virus while wearing a BSL-4 positive pressure suit to avoid infection
Main article: Ebola virus

The strain of virus affecting people in the current outbreak is a member of the Zaire lineage.[106]

Initial test results had suggested that the Zaire ebolavirus (EBOV) in Guinea was a different clade than the strains from outbreaks in the Democratic Republic of Congo and Gabon.[107] This result, however was contradicted by two subsequent reports.

The first of these reports reached the conclusion that the outbreak "is likely caused by a Zaire ebolavirus lineage that has spread from Central Africa into Guinea and West Africa in recent decades, and does not represent the emergence of a divergent and endemic virus".[108]

A second report published in June 2014 also supports the latter view, determining that it was "extremely unlikely that this virus falls outside the genetic diversity of the Zaïre lineage" and that their analysis "unambiguously supports Guinea 2014 EBOV as a member of the Zaïre lineage".[106]

Am article published in the New England Journal of Medicine on-line in August 2014[109] affirmed that while the current virus shares 97% of its genetic code with the Zaïre lineage, it constitutes a new strain indigenous to Guinea,[110] and was not imported from Central Africa to West Africa.[111]

Treatment

Researchers looking at slides of cultures of cells that make monoclonal antibodies. These are grown in a lab and the researchers are analyzing the products to select the most promising of them.
See also: Ebola virus disease § Research, and Ebola virus disease § Treatment

No ebola virus-specific treatment exists. Treatment is primarily supportive in nature and includes providing fluids, administration of anticoagulants and procoagulants, maintaining oxygen levels, pain management, and the use of medications to treat bacterial or fungal secondary infections.[112][113][114] Early treatment may increase the chance of survival.[115]

In July 2014 an experimental treatment was used for the first time in two humans. The treatment drug was referred to as ZMapp, an antibody response related therapy. The initial response appears positive. ZMapp was produced by MAPP Biopharmaceutical Inc. using a three-mouse monoclonal antibody, and transferred into tobacco plants (of the genus Nicotiana) for mass production.[116][117][118] In August 2014 the US Food and Drug Administration was reported to have allowed the use of another experimental drug, TKM-Ebola (which works uses RNA interference), to be used on Ebola patients.[119]

The current unavailability of the experimental treatment in the most affected regions has spurred some controversy. As a result, the World Health Organization has announced that it would convene an expert meeting of bioethicists to consider the implications of making the experimental treatment more widely available.[120]

Economic effects

In addition to the loss of life, the outbreak is having an economic effect. In early April, Conakry's Palm Camayenne Hotel, which is popular among businessmen and politicians, reported that it had less than a third of occupancy rate. At the same time, Brussels Airlines flights from Brussels to Conakry experienced reduced passenger traffic, while flights in the reverse direction experienced heavier traffic, and regional airline Gambia Bird delayed the start of a route to Conakry after Senegal closed its border with Guinea because of the outbreak.[121]

Non-essential employees of British firm London Mining in Sierra Leone were transported out of the country in June following an outbreak of the virus. At the time, at least 50 suspected cases of Ebola with five deaths had been reported.[122]

The ongoing outbreak in Sierra Leone caused the closure of schools, markets, Kailahun's lone bank and stores.[123]

Tekmira Pharmaceuticals, a Canadian company developing an experimental Ebola treatment, had their stock price rise due to the outbreak.

"Ebola in Town", a dance tune 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 in the first quarter of 2014.[124][125]

Timeline of the outbreak

Evolution of total cases and deaths.

A timeline of the outbreak follows, using data reported by the Centers for Disease Control and Prevention[10] and the World Health Organisation.[1] The table also includes suspected cases that are yet to be confirmed for the virus.

Date of report Total Guinea Liberia Sierra Leone Nigeria
cases deaths cases deaths cases deaths cases deaths cases deaths
6 Aug 2014 1779 961 495 367 554 294 717 298 13 2
4 Aug 2014 1711 932 495 363 516 282 691 286 9 1
1 Aug 2014 1603 887 485 358 468 255 646 273 4 1
30 Jul 2014 1440 826 472 346 391 227 574 252 3 1
27 Jul 2014 1323 729 460 339 329 156 533 233 1 1
23 Jul 2014 1201 672 427 319 249 129 525 224
20 Jul 2014 1093 660 415 314 224 127 454 219
18 Jul 2014 1048 632 410 310 196 116 442 206
15 Jul 2014 964 603 406 304 172 105 386 194
10 Jul 2014 888 539 409 309 142 88 337 142
8 Jul 2014 844 518 408 307 131 84 305 127
2 Jul 2014 759 467 413 303 107 65 239 99
24 Jun 2014 599 338 390 270 51 34 158 49
18 Jun 2014 528 337 398 264 33 24 97 34
10 Jun 2014 474 252 372 236 13 9 89 7
5 Jun 2014 438 231 344 215 13 9 81 7
2 Jun 2014 354 208 291 193 13 9 50 6
27 May 2014 309 200 281 186 12 9 16 5
23 May 2014 270 181 258 174 12 9
14 May 2014 245 164 233 157 12 9
5 May 2014 243 162 231 155 12 9
30 Apr 2014 233 153 221 146 12 9
23 Apr 2014 220 143 208 136 12 9
21 Apr 2014 215 136 203 129 12 9
17 Apr 2014 209 129 197 122 12 9
10 Apr 2014 169 108 157 101 12 9
7 Apr 2014 163 102 151 95 12 7
2 Apr 2014 135 88 127 83 8 5
1 Apr 2014 130 82 122 80 8 2
31 Mar 2014 114 70 112 70 2 0
27 Mar 2014 103 66 103 66
26 Mar 2014 86 60 86 60
25 Mar 2014 86 59 86 59

References

  1. ^ a b c "Disease Outbreak News". WHO. 18 July 2014.
  2. ^ "Ebola virus disease (EVD)". Global Alert and Response (GAR). World Health Organization. At: [1]. Retrieved 8 August 2014.
  3. ^ Roy-Macaulay, Clarence (31 July 2014). "Ebola Crisis Triggers Health Emergency". Drug Discov. Dev. Highlands Ranch, Colorado, United States: Cahners Business Information. Associated Press. Retrieved 3 August 2014.
  4. ^ "Chronology of Ebola Hemorrhagic Fever Outbreaks". Centers for Disease Control and Prevention. 24 June 2014. Retrieved 25 June 2014.
  5. ^ a b "WHO Statement on the Meeting of the International Health Regulations Emergency Committee Regarding the 2014 Ebola Outbreak in West Africa". World Health Organization. 8 August 2014. Retrieved 8 August 2014.
  6. ^ a b "Ebola virus disease, West Africa – update 6 August 2014 - WHO | Regional Office for Africa". Afro.who.int. Retrieved 8 August 2014.
  7. ^ Nossiter, Adam (28 July 2014). "Fear of Ebola Breeds a Terror of Physicians". The New York Times. Retrieved 29 July 2014.
  8. ^ Guinea Minister of Health (21 March 2014). "Épidémie de la fièvre virale hémorragique en Guinée: Déclaration du Ministre de la santé" (in French). L'Express Guinee. Retrieved 9 August 2014. {{cite web}}: Unknown parameter |trans_title= ignored (|trans-title= suggested) (help)
  9. ^ "Mystery hemorrhagic fever kills 23 in Guinea". Reuters. 19 March 2014. Retrieved 9 August 2014.
  10. ^ a b c d "Outbreak of Ebola in Guinea and Liberia". Centers for Disease Control and Prevention.
  11. ^ "Emergence of Zaire Ebola Virus Disease in Guinea — Preliminary Report". New England Journal of Medicine. 16 April 2014. Retrieved 3 May 2014.
  12. ^ "Guinea ebola outbreak sequences". Epidemic: Molecular Epidemiology and Evolution of Viral Pathogens. 17 April 2014. Retrieved 6 July 2014.
  13. ^ a b "Ebola Haemorrhagic Fever, Guinea (Situation)". WHO. 30 March 2014. Retrieved 31 March 2014.
  14. ^ "Ebola outbreak in Guinea 'unprecedented' – MSF". BBC News. 31 March 2014. Retrieved 31 March 2014.
  15. ^ Diallo, Boubacar (29 March 2014). "Ebora en Guinée : l'ONG Plan Guinée craint une aggravation de l'épidemie" (in French). Africa guinée. Retrieved 31 March 2014. {{cite web}}: Unknown parameter |trans_title= ignored (|trans-title= suggested) (help)
  16. ^ "2 of 5 Test Positive for Ebola in Liberia", Liberian Observer, 31 March 2014, retrieved 6 July 2014
  17. ^ a b Ebola Virus Disease Epidemic in Liberia: Situation Report 11 (PDF), LR: Ministry of Health and Social Welfare, 13 April 2014, retrieved 6 July 2014
  18. ^ "Ebola Haemorrhagic Fever, West Africa (Situation)". WHO. 16 April 2014. Retrieved 16 April 2014.
  19. ^ "Ebola Haemorrhagic Fever, West Africa (Situation)". WHO. 27 April 2014. Retrieved 27 April 2014.
  20. ^ "Seven die in Monrovia Ebola outbreak". BBC News. 17 June 2014. Retrieved 28 July 2014.
  21. ^ a b "Doctors Without Borders: West Africa's Ebola Outbreak is Totally Out of Control". CTVNews. 20 June 2014. Retrieved 21 June 2014.
  22. ^ "Outbreak of Ebola in Guinea, Liberia, and Sierra Leone". Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. Retrieved 3 July 2014.
  23. ^ "Seven die in Monrovia Ebola outbreak". BBC News. 17 June 2014. Retrieved 18 June 2014.
  24. ^ "Ebola virus disease, West Africa (Update of 26 May 2014)". WHO: Outbreak news. 26 May 2014. Retrieved 28 July 2014.
  25. ^ "Ebola virus disease, West Africa – update 23 June 2014". WHO: Outbreak news. 23 June 2014. Retrieved 28 July 2014.
  26. ^ "Ebola virus disease, West Africa – update 18 July 2014". WHO: Outbreak news. 18 July 2014. Retrieved 27 July 2014.
  27. ^ "Outbreak of Ebola in Guinea, Liberia, and Sierra Leone". Centers for Disease Control and Prevention. Retrieved 27 July 2014.
  28. ^ a b "Sierra Leone hunts Ebola patient kidnapped in Freetown". BBC News. 25 July 2014. Retrieved 27 July 2014.
  29. ^ "Ebola outbreak: Sierra Leone escaped patient dies". BBC News. 27 July 2014. Retrieved 27 July 2014.
  30. ^ a b c d "Ebola virus disease, West Africa – update 25 July 2014". WHO: Outbreak news. 25 July 2014. Retrieved 27 July 2014.
  31. ^ Wesee, Ben P. (4 August 2014). "I'm ok - Nigerian Ambassador Assures Public". The New Dawn, Monrovia. Retrieved 7 August 2014.
  32. ^ Cocks, Tim (28 July 2014). "Nigeria isolates Lagos hospital where Ebola victim died". Reuters. Retrieved 1 August 2014.
  33. ^ "Sierra Leone hunts Ebola patient kidnapped in Freetown". British Broadcasting Corporation. 25 July 2014.
  34. ^ "Ebola virus disease, West Africa – update 31 July 2014 - WHO | Regional Office for Africa". Afro.who.int. Retrieved 8 August 2014.
  35. ^ Kwanue, C.Y. (7 April 2014). "Guinean Gov't Provides Ebola Updates". Liberian Observer. Retrieved 7 April 2014.
  36. ^ "Ebola virus disease, West Africa – update 23 July 2014". WHO: Outbreak news. 23 July 2014. Retrieved 27 July 2014.
  37. ^ a b c "Ebola outbreak: Liberia shuts most border points". BBC News. 28 July 2014. Retrieved 28 July 2014.
  38. ^ "Ebola outbreak: Asky bans flights in West Africa". BBC News. 29 July 2014. Retrieved 29 July 2014.
  39. ^ Kwanue, C.Y. (1 August 2014). "In Compliance with Sirleaf's Mandate, UL Closed". Liberian Observer. Retrieved 2 August 2014.
  40. ^ "Liberia shuts schools, quarantines communities in bid to halt Ebola". Reuters. 30 July 2014. Retrieved 30 July 2014.
  41. ^ "Ellen Declares State of Emergency". Executive Mansion via Heritage. 6 August 2014. Retrieved 7 August 2014. {{cite web}}: Italic or bold markup not allowed in: |publisher= (help)
  42. ^ "NEC Recommends Postponement of Senatorial Election", Heritage, 7 August 2014. Accessed 7 August 2014.
  43. ^ Daygbor, E.J. Nathaniel (31 July 2014). "Senatorial Election Faces Postponement as Political Leaders Debate". The New Dawn. Retrieved 7 August 2014.
  44. ^ "Lagos has eight suspected Ebola cases, one confirmed: Nigerian health official | Reuters". In.reuters.com. Retrieved 8 August 2014.
  45. ^ "Nigeria 'on red alert' over Ebola death in Lagos". BBC News. 26 July 2014. Retrieved 27 July 2014.
  46. ^ Reuters (4 August 2014). "Lagos records second Ebola case in doctor who treated victim: Nigerian health minister". {{cite web}}: |author= has generic name (help)
  47. ^ Mark, Monica (6 August 2014). "Ebola Outbreak: Nurse who Treated First Victim in Nigeria Dies". The Guardian. Retrieved 7 August 2014.
  48. ^ Cham, Kemo (1 April 2014). "Sierra Leone restricts movement across borders over Ebola fears". Africa Review. Retrieved 1 April 2014.
  49. ^ "Sierra Leone declares state of emergency over Ebola". Reuters. 31 July 2014. Retrieved 31 July 2014.
  50. ^ Ofeibea Quist-Arcton (6 August 2014). "Skeptics In Sierra Leone Doubt Ebola Virus Exists". WVXU.
  51. ^ 4 hours ago. "Benin waiting for test results on two possible Ebola cases - Yahoo News". News.yahoo.com. Retrieved 8 August 2014.{{cite web}}: CS1 maint: numeric names: authors list (link)
  52. ^ "Visas refusés aux pèlerins de Guinée et du Libéria" (in French). 20min.ch. 1 April 2014. Retrieved 1 April 2014.
  53. ^ "Saudi being tested for Ebola dies in hospital". Associated Press. 6 August 2014. Retrieved 6 August 2014.
  54. ^ "(MOH) Advises Against Traveling To Parts Of West Africa Affected By Ebola Outbreak". Ministry of Health of Saudi Arabia. 6 August 2014. Retrieved 8 August 2014.
  55. ^ "Comunicado 5/8/2014 17:10". 5 August 2014. Retrieved 5 August 2014.
  56. ^ "Ebola patient's husband feels 'the comfort of God'". CNN.com. Retrieved 8 August 2014.
  57. ^ "Ebola: Spanish missionary infected with virus in Liberia flown to Spain". The Guardian. 7 August 2014. Retrieved 8 August 2014.
  58. ^ "The CDC Says You Shouldn't Fly To Countries Hardest Hit By Ebola Outbreak". TIME. 31 July 2014.
  59. ^ Steenhuysen, Julie. "Ebola patient coming to U.S. as aid workers' health worsens". MSN News. Retrieved 1 August 2014.
  60. ^ "Ebola outbreak: U.S. missionary Nancy Writebol leaves Liberia Tuesday". 4 August 2014. Retrieved 4 August 2014.
  61. ^ "Two Americans Stricken With Deadly Ebola Virus in Liberia". 28 July 2014. Retrieved 2 August 2014.
  62. ^ "Ebola drug likely saved American patients". CNN.com. Retrieved 8 August 2014.
  63. ^ a b August 6, 2014 6:26 PM (20 April 2011). "CDC issues emergency 'all-hands' call for Ebola response - Yahoo News". News.yahoo.com. Retrieved 8 August 2014.{{cite web}}: CS1 maint: numeric names: authors list (link)
  64. ^ "La CEDEAO décaisse 250 000 dollars pour faire face à la fièvre Ebola" (in French). abidjan.net. 30 March 2014. Retrieved 31 March 2014.
  65. ^ "Liberia: Nigerian President Donates 500k to Liberia's Ebola Fight". allAfrica.com. 11 July 2014. Retrieved 29 July 2014.
  66. ^ "WHO calls emergency sub-regional Ministerial meeting in Accra, Ghana to tackle the on-going Ebola virus in West Africa". 2 July 2014. Retrieved 2 July 2014.
  67. ^ "Ebola outbreak: West African states agree strategy". BBC News. 3 July 2014. Retrieved 4 July 2014.
  68. ^ "Sub-regional Ebola Coordination Centre officially opened by the Prime Minister of Guinea in the presence of the WHO Regional Director for Africa". WHO: Regional Office for Africa. 24 July 2014. Retrieved 27 July 2014.
  69. ^ "WHO, CDC See $100 Million Surge for Africa Ebola Battle". Bloomberg. 31 July 2014. Retrieved 4 August 2014.
  70. ^ "Ebola in West Africa: European Union joins effort to stop spread of disease and releases €500,000 in immediate funding". EU: Europa. 19 November 2013. Retrieved 31 March 2014.
  71. ^ "Inserm and the Institut Pasteur identify a new variant of Ebola virus in Guinea". INSERM.fr. 18 April 2014. Retrieved 24 April 2014.
  72. ^ "Reise- und Sicherheitshinweise" (in German). Federal Foreign Office. 1 August 2014.
  73. ^ de Benito, Emilio (2014). "España desaconseja viajar a Guinea, Sierra Leona o Liberia por el ébola". http://sociedad.elpais.com/sociedad/2014/08/02/actualidad/1406975715_416123.html (in Spanish). El País. {{cite web}}: |access-date= requires |url= (help); External link in |website= (help); Missing or empty |url= (help)
  74. ^ High alert for Ebola needed in Hong Kong, health minister says
  75. ^ "Ebola Scare: Indian in Delhi on Watch for Symptoms". International Business Times. 8 August 2014. Retrieved 8 August 2014.
  76. ^ "Airports in India put on Ebola Alert". Hindustan Times. 8 August 2014. Retrieved 8 August 2014.
  77. ^ "Fièvre Ebola : contrôle sanitaire renforcé au Maroc" (in French). Nouvelobs. 1 April 2014. Retrieved 1 April 2014. {{cite web}}: Unknown parameter |trans_title= ignored (|trans-title= suggested) (help)
  78. ^ Ndiaye Moctar, Pape (29 March 2014). "Le fleuve Sénégal infranchissable depuis mardi dernier" (in French). Sud Quotidien. Retrieved 31 March 2014. {{cite web}}: Unknown parameter |trans_title= ignored (|trans-title= suggested) (help)
  79. ^ "Liberian dies in Morocco of Ebola - Internal Affairs Minister discloses". Heritage. 1 August 2014. Retrieved 2 August 2014.
  80. ^ "Panique à Casablanca autour de l'Ebola" (in French). Le 360. 31 July 2014. Retrieved 6 August 2014. {{cite web}}: Unknown parameter |trans_title= ignored (|trans-title= suggested) (help)
  81. ^ "Une crise cardiaque et non la maladie d'Ebola à l'origine du décès du libérien à l'aéroport de Casablanca" (in French). MAP. 1 August 2014. Retrieved 6 August 2014. {{cite web}}: Unknown parameter |trans_title= ignored (|trans-title= suggested) (help)
  82. ^ "DFA warns sea-based OFWs when docking in Ebola-hit countries". Sun.Star. Retrieved 8 August 2014.
  83. ^ "Department of Health open to deploying experts in Ebola-hit countries". Sun.Star. Retrieved 8 August 2014.
  84. ^ "Ebola Death Toll in Guinea Rises to 70 as Senegal Closes Border". Bloomberg News. 29 March 2014. Retrieved 31 March 2014.
  85. ^ "Statement from Public Health Wales – Ebola in Wales". Public Health Wales. 5 August 2014.
  86. ^ "Ebola: BA suspends flights to Liberia and Sierra Leone". BBC. 5 August 2014. Retrieved 6 August 2014.
  87. ^ "Outbreak of Ebola in Guinea, Liberia, and Sierra Leone". Retrieved 3 August 2014.
  88. ^ "CDC's surge response to West African Ebola Outbreak". CDC. 6 August 2014.
  89. ^ "Ebola in West Africa: "The epidemic is out of control"". msf.org.uk. 25 June 2014. Retrieved 2 July 2014.
  90. ^ "Battling an Ebola Outbreak". SP.
  91. ^ "WHO declares Ebola outbreak an 'international public health emergency'". http://hot.openstreetmap.org. 8 August 2014. {{cite web}}: External link in |website= (help)
  92. ^ "Liberia: Unheralded Fear - Ebola Pose Risks for Liberia Health Workers". FrontPage Africa. 19 June 2014. Retrieved 21 June 2014 – via AllAfrica.com. {{cite web}}: Italic or bold markup not allowed in: |publisher= (help)
  93. ^ "Growing Ebola Outbreak Threatens to Overwhelm Volunteers". Today Health. 8 June 2014. Retrieved 21 June 2014.
  94. ^ "Ebola virus disease, West Africa – update 3 July 2014". World Health Organisation. 3 July 2014. Retrieved 4 July 2014.
  95. ^ "8 ebola suspects freed by relatives in Sierra Leone". Global Post. 28 May 2014. Retrieved 21 June 2014.
  96. ^ Mulchrone, Patrick (29 July 2014). "Ebola conspiracy theories spreading fast as outbreak travels round globe - was deadly virus created in laboratory? - Mirror Online". Mirror.co.uk. Retrieved 9 August 2014.
  97. ^ "Ebola, snakes and witchcraft: Stopping the deadly disease in its tracks in West Africa". International Federation of Red Cross and Red Crescent Societies. 24 June 2014. Retrieved 28 June 2014.
  98. ^ a b "Liberia: top doctor becomes latest Ebola victim". Guardian Online. 27 July 2014. Retrieved 28 July 2014.
  99. ^ "Samaritan's Purse Doctor Serving in Liberia Tests Positive for Ebola". Samaritan's Purse. 27 July 2014. Retrieved 28 July 2014.
  100. ^ "2 American Ebola patients head to USA".
  101. ^ "Top Ebola doctor dead in African outbreak; local airline suspends flights". New York Daily News. Associated Press. 29 July 2014. Retrieved 29 July 2014.
  102. ^ "Dr. Kent Brantly, one of two American Ebola patients, arrives safely at Emory University". Fox News. 2 August 2014.
  103. ^ "Villagers stone ebola trackers in Sierra Leone as cases rise". Chicago Tribune. 28 May 2014. Archived from the original on 2 July 2014. Retrieved 2 July 2014.[dead link]
  104. ^ "Red Cross suspends Ebola operations in southeast Guinea after threats". Reuters. 2 July 2014. Retrieved 4 July 2014.
  105. ^ "Ebola center in Sierra Leona under guard after protest march". Reuters news. 26 July 2014. Retrieved 27 July 2014.
  106. ^ a b "Clock Rooting Further Demonstrates that Guinea 2014 EBOV is a Member of the Zaïre Lineage". PLOS Current Outbreaks. 16 June 2014.
  107. ^ Baize, Sylvain; Pannetier, Delphine; Oestereich, Lisa; Rieger, Toni (16 April 2014). "Emergence of Zaire Ebola Virus Disease in Guinea — Preliminary Report". New England Journal of Medicine. doi:10.1056/NEJMoa1404505.
  108. ^ "Phylogenetic Analysis of Guinea 2014 EBOV Ebolavirus Outbreak". PLOS Current Outbreaks. 2 May 2014.
  109. ^ http://www.nejm.org/doi/full/10.1056/NEJMoa1404505?query=featured_home&#t=abstract
  110. ^ http://www.reuters.com/article/2014/04/17/us-guinea-ebola-idUSBREA3G11W20140417
  111. ^ http://www.zerohedge.com/news/2014-08-08/nigeria-declares-state-emergency-study-finds-west-african-ebola-virus-previously-und
  112. ^ Bausch DG, Feldmann H, Geisbert TW, Bray M, Sprecher AG, Boumandouki P, Rollin PE, Roth C (2007). "Outbreaks of Filovirus Hemorrhagic Fever: Time to Refocus on the Patient". The Journal of Infectious Diseases. 196: S136–S141. doi:10.1086/520542. PMID 17940941.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  113. ^ Jeffs B (2006). "A clinical guide to viral haemorrhagic fevers: Ebola, Marburg and Lassa". Tropical Doctor. 36 (1): 1–4. doi:10.1258/004947506775598914. PMID 16483416.
  114. ^ Nkoghé D, Formenty P, Nnégué S, Mvé MT, Hypolite I, Léonard P, Leroy E (2004). "Practical guidelines for the management of Ebola infected patients in the field". Medecine tropicale : revue du Corps de sante colonial. 64 (2): 199–204. PMID 15460155.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  115. ^ "Sierra Leone Is Epicenter of Ebola as Guinea Clinic Shut". 8 June 2014. Retrieved 30 July 2014.
  116. ^ "Experimental drug likely saved Ebola patients".
  117. ^ John Timmer (4 August 2014). "Antibodies from mice, made to look human, then produced in tobacco". arstechnica.
  118. ^ "Local Biotech Increasing Production of 'ZMapp' Ebola Drug".
  119. ^ Pollack, Andrew (7 August 2014) Second Drug Is Allowed for Treatment of Ebola The New York Times, Retrieved 8 August 2014
  120. ^ "WHO consults ethics experts on wider use of experimental Ebola drugs". Reuters. 6 August 2014.
  121. ^ Adama Diarra and Misha Hussain (4 April 2014). "Mali suspects first Ebola cases as regional death toll tops 90". Reuters. Retrieved 4 April 2014.
  122. ^ "UK employees leave Sierra Leone over Ebola threat". BBC News. 3 June 2014. Retrieved 4 June 2014.
  123. ^ "Ebola Wreaks Economic Woe In West Africa". NPR. 17 July 2014. Retrieved 19 July 2014.
  124. ^ Monica Mark (27 May 2014). "Ebola virus causes outbreak of infectious dance tune". The Guardian.
  125. ^ Mike Pflanz (28 May 2014). "Ebola rap warns West Africans of virus's dangers". Daily Telegraph.
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