20/02/2015
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• First discovered in 1976; two simultaneous human outbreaks
– South Sudan
– Northern Zaire
(now Democratic Republic of the Congo)
– Latter in village near Ebola river, from which disease takes its name
• 1976-2012: Several outbreaks in African regions

www.nytimes.com
How does EVD outbreak 2014 compare with past outbreaks?

EVD Outbreak 2014 – Key events
06-Dec: Death of index case
2 year old, Meliandou village,
Guéckédou, Guinea.
Followed by deaths of his mother, sister, grandmother
All retrospectively identified
18 Mar: Guinea announces outbreak
20 Mar: Lab tests confirm Ebola
23 Mar: WHO notified of outbreak in Guinea
25 Mar: First WHO report released
31 Mar: Liberia reports confirmed case
01 Apr:
MSF warns outbreak unprecedented
Dec 2013 Jan 2014 Feb 2014 Mar 2014 Apr 2014

EVD Outbreak 2014 – Key events
12 May: EVD cases in
Guinean capital, Conakry
17 Jun: EVD cases now in
Liberian capital, Monrovia
25 Jul: Nigeria reports first
EVD case
08 Aug: WHO declares PHEIC
12 Aug: Deaths >1,000
(WHO)
21 Aug: Two medically evacuated cases in US, successfully treated with experimental therapy ZMapp
29 Aug: Senegal reports first
EVD case
May 2014 Jun 2014 Jul 2014 Aug 2014

EVD Outbreak 2014 – Key events
06 Oct: First EVD case in Europe (nurse in
Spain)
08 Oct: Death of first US EVD case
12 Oct: Nurse tests positive in US
(2 o case)
15 Oct: 2 nd nurse tests positive in US
17 Oct: Outbreak declared over in Senegal
20 Oct: Outbreak declared over in Nigeria
23 Oct: First EVD case in Mali
02 Dec: Outbreak declared over in Spain
29 Dec: First EVD case diagnosed in UK
(Scottish nurse)
28 Sept: First
EVD case in US
12 Nov: Three more cases in Mali; no links to first case
18 Jan : Outbreak declared over Mali
Sept 2014 Oct 2014 Nov 2014 Dec 2014 Jan 2015

Source: http://www.telegraph.co.uk/

Ebola Outbreak 2014 in West Africa
Affected countries
• Widespread transmission
– Sierra Leone
– Liberia
– Guinea
• Outbreak declared over
– Nigeria
– Senegal
– Mali

Number of EVD cases and deaths, 2014/2015
WHO update 18 February 2015
Guinea
Liberia
Sierra Leone
Mali
Nigeria*
Senegal*
Spain
UK
USA
Total
1
0
1
0
8
6
20
8
1
0
4
1
3108
2057
3900
3408
9007
11103
Widespread and intense transmission
23253
9380
*Outbreaks declared over, Senegal (17 Oct) and Nigeria (20 Oct)
Cases
Deaths

Cases of EVD by country, 2014/2015
WHO Update 18 February 2015
Country
Guinea
Liberia
Sierra Leone
Mali
Nigeria
Senegal
Spain
United Kingdom
United States
Total
Cases*
3108
9007
11103
8
20
1
1
1
4
23253
*Confirmed, probable or suspected but not repatriations
Deaths*
2057
3900
3408
0
0
6
8
0
1
9380

Geographical distribution of new cases and total cases in
Guinea, Liberia, and Sierra Leone
WHO Update 18 February 2015

FIGURE 3. Number of new cases of Ebola virus disease reported —
Guinea, Liberia, and Sierra Leone, November 9 –30, 2014

Clinically compatible cases Guinea, Liberia and
Sierra Leone as of 20 Feb 2015
Source: Public Health England, 20 February 2015

Cases in Guinea, Liberia and Sierra Leone,
2014/2015
WHO update 18 February 2015
9000
8000
7000
6000
5000
4000
3000
2000
1000
0
2727
374
7
Guinea
3149
1876
3982
Liberia
8212
287
2604
Sierra Leone
Confirmed
Probable
Suspected

Number of new confirmed cases per report week,
23 November 2014 – 15 February 2015
Graphs from Public Health England EVD Epidemiological Update 20 February 2015

WHO (10 Dec 2014):
• Case fatality rate 71%
Sierra Leone*:
• 74% CFR overall
• 57% CFR < 21 years
• 94% CFR >45 years
• Positive correlation between viral load and risk of death
*Clinical illness and outcomes in patients with Ebola in Sierra Leone,
Schieffelin et al, NEJM, 29 Oct 2014

Clinical illness in first 106 patients with EVD,
Sierra Leone, May-June 2014 (n=106)
Schieffelin et al, NEJM, 29 Oct 2014

WHO Update 18 February 2015
Deaths Country
Guinea
Liberia
Sierra Leone
Mali
Nigeria
Spain
United Kingdom*
United States†
Total
*Case infected in Sierra Leone
†Two cases infected in US, one in Guinea
Cases
167
372
294
2
11
3
851
1
1
488

Non-repatriated cases of EVD outside of
West Africa, as of 19 February 2015 (n=6)
Date of diagnosis
Country of diagnosis
30 Sep 2014 USA
06 Oct 2014 Spain
11 Oct 2014
15 Oct 2014
23 Oct 2014
29 Dec 2014
USA
USA
USA
UK
Country of infection
Type
Liberia
Spain
USA
USA
Imported
Local transmission
Local transmission
Local transmission
Guinea Imported
Sierra Leone Imported
HCW Status
No
Yes
Yes
Yes
Yes
Yes
Died
EVD free
EVD free
EVD free
EVD free
EVD free

Medical evacuations and repatriations from West Africa, as of 19 Feb 2015
•
• 36 individuals evacuated or repatriated (includes confirmed cases or those with an Ebola exposure)
• 26 evacuated to Europe
– 12 confirmed EVD cases
–
Germany 3 ; Spain 2
France 2; UK 1
Norway 1; Netherlands 1
Italy 1; Switzerland 1
14 tested negative
10 evacuated to US

Countries involved in the management of
EVD cases www.wikipedia.com

Ongoing updates on the EVD situation available at: http://www.who.int/csr/disease/ebola/situati on-reports/en/