This year marks the 10-year anniversary of the 2014-2016 Ebola epidemic in West Africa. While the outbreak was officially declared on March 23, 2014, the first cases were traced to a small village Guéckédou, Guinea from back in December 2013. The cases spread from Guinea on to Liberia and Sierra Leone, to Nigeria and Senegal, and even to Europe and the United States. The first countries impacted; Guinea, Liberia, and Sierra Leone were also the hardest hit. By the time the WHO declared the epidemic over on March 29, 2016, more than 28,000 cases of Ebola Virus Disease (EVD) and over 11,000 deaths were reported.
The epidemic highlighted how vulnerable everyone is to infectious disease in a world that is getting ever smaller and interconnected. In a grim foreshadowing of the 2020 COVID pandemic, the Ebola epidemic demonstrated that a deadly, zoonotic disease affecting people in a village on the other side of the world truly is everyone’s concern. One of the biggest takeaways from the Ebola epidemic was the realization that global and local public health institutions had to take stock of their weaknesses and address them before the next emergency.
Some of the improvements implemented included the creation of the Africa Centres for Disease Control and Prevention to help to increase the public health infrastructure as well as coordinate information and resources among nations on the continent. New goals for surveillance and reporting were set up such as the 7-1-7 target by the WHO Regional Office for Africa (AFRO) where the time from outbreak to response commencement would be kept to two weeks or less (≤7 days to detect, ≤1 to notify, and ≤7 to response).
Here, in the US, there was also a recognition that work needed to be done in terms of preparation especially after an individual traveling from Monrovia, Liberia to Dallas, Texas became the first person to be diagnosed with Ebola in the United States and two of the healthcare workers treating him also tested positive. The Regional Ebola Treatment Network (RETN) was established in 2014 and formed the foundation for future infrastructure such as the National Emerging Special Pathogens Training and Education Center (NETEC) and the National Special Pathogen System (NSPS).
In addition to all the preparation and surveillance infrastructure that have been put in place, some of the greatest advances since 2014 has been in the areas of research and development of vaccines and therapeutics. The decisions made by the WHO and other institutions in 2014 to allow experimental drugs to be used to treat patients provided valuable clinical data to researchers. Today there is one FDA approved vaccine for use against Ebola, Ervebo (rVSV-EBOV), and two FDA approved therapeutics, atoltivimab-maftivimab-odesivimab (Inmazeb) and ansuvimab (Ebanga). While there is still much work yet to be done to prevent a repeat of 2014-2016, there has also been a great deal accomplished in just 10 years.
Shannon is a Research Associate II for the SPECTRE Program.
References:
El Ayoubi, L. W., Mahmoud, O., Zakhour, J., & Kanj, S. S. (2024). Recent advances in the treatment of ebola disease: A brief overview. PLOS Pathogens, 20(3). https://doi.org/10.1371/journal.ppat.1012038
Guardian News and Media. (2014, October 15). Ebola epidemic 2014: Timeline. The Guardian. https://www.theguardian.com/world/2014/oct/15/ebola-epidemic-2014-timeline
Keita, M., Boland, S. T., Okeibunor, J., Chamla, D., Gueye, A. S., & Moeti, M. (2024). 10 years after the 2014–16 ebola epidemic in West Africa: Advances and challenges in African epidemic preparedness. The Lancet. https://doi.org/10.1016/s0140-6736(24)00583-x
World Health Organization. (n.d.-a). Ebola outbreak 2014-2016 - West Africa. World Health Organization. https://www.who.int/emergencies/situations/ebola-outbreak-2014-2016-West-Africa
Image: https://pixabay.com/photos/ebola-isolation-infection-virus-549471/