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*For 15 years, no outbreaks of Ebola virus were recorded, until Ebola re-emerged in 1994 when a Swiss ethnologist was infected during a chimpanzee autopsy in Tai National Park in Ivory Coast.<ref name="pmid7746057">{{cite journal| author=Le Guenno B, Formenty P, Formentry P, Wyers M, Gounon P, Walker F et al.| title=Isolation and partial characterisation of a new strain of Ebola virus. | journal=Lancet | year= 1995 | volume= 345 | issue= 8960 | pages= 1271-4 | pmid=7746057 | doi= | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7746057  }} </ref><ref name="pmid9988164">{{cite journal| author=Formenty P, Hatz C, Le Guenno B, Stoll A, Rogenmoser P, Widmer A|title=Human infection due to Ebola virus, subtype Côte d'Ivoire: clinical and biologic presentation. | journal=J Infect Dis | year= 1999 | volume= 179 Suppl 1 | issue=  | pages= S48-53 | pmid=9988164 | doi=10.1086/514285 | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9988164  }} </ref> During the same period, 3 other outbreaks occurred in Mekouka, Mayibout, and Booue in Gabon between 1994 and 1997.<ref name="pmid9988168">{{cite journal| author=Khan AS, Tshioko FK, Heymann DL, Le Guenno B, Nabeth P, Kerstiëns B et al.| title=The reemergence of Ebola hemorrhagic fever, Democratic Republic of the Congo, 1995. Commission de Lutte contre les Epidémies à Kikwit. | journal=J Infect Dis | year= 1999 | volume= 179 Suppl 1 | issue=  | pages= S76-86 | pmid=9988168 | doi=10.1086/514306 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9988168  }} </ref><ref name="pmid9988167">{{cite journal| author=Georges AJ, Leroy EM, Renaut AA, Benissan CT, Nabias RJ, Ngoc MT et al.| title=Ebola hemorrhagic fever outbreaks in Gabon, 1994-1997: epidemiologic and health control issues. | journal=J Infect Dis | year= 1999 | volume= 179 Suppl 1 | issue=  | pages= S65-75 | pmid=9988167 | doi=10.1086/514290 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9988167  }} </ref><ref name="pmid9111553">{{cite journal| author=Amblard J, Obiang P, Edzang S, Prehaud C, Bouloy M, Guenno BL| title=Identification of the Ebola virus in Gabon in 1994. |journal=Lancet | year= 1997 | volume= 349 | issue= 9046 | pages= 181-2 | pmid=9111553 | doi=10.1016/S0140-6736(05)60984-1 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9111553  }} </ref>
*For 15 years, no outbreaks of Ebola virus were recorded, until Ebola re-emerged in 1994 when a Swiss ethnologist was infected during a chimpanzee autopsy in Tai National Park in Ivory Coast.<ref name="pmid7746057">{{cite journal| author=Le Guenno B, Formenty P, Formentry P, Wyers M, Gounon P, Walker F et al.| title=Isolation and partial characterisation of a new strain of Ebola virus. | journal=Lancet | year= 1995 | volume= 345 | issue= 8960 | pages= 1271-4 | pmid=7746057 | doi= | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7746057  }} </ref><ref name="pmid9988164">{{cite journal| author=Formenty P, Hatz C, Le Guenno B, Stoll A, Rogenmoser P, Widmer A|title=Human infection due to Ebola virus, subtype Côte d'Ivoire: clinical and biologic presentation. | journal=J Infect Dis | year= 1999 | volume= 179 Suppl 1 | issue=  | pages= S48-53 | pmid=9988164 | doi=10.1086/514285 | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9988164  }} </ref> During the same period, 3 other outbreaks occurred in Mekouka, Mayibout, and Booue in Gabon between 1994 and 1997.<ref name="pmid9988168">{{cite journal| author=Khan AS, Tshioko FK, Heymann DL, Le Guenno B, Nabeth P, Kerstiëns B et al.| title=The reemergence of Ebola hemorrhagic fever, Democratic Republic of the Congo, 1995. Commission de Lutte contre les Epidémies à Kikwit. | journal=J Infect Dis | year= 1999 | volume= 179 Suppl 1 | issue=  | pages= S76-86 | pmid=9988168 | doi=10.1086/514306 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9988168  }} </ref><ref name="pmid9988167">{{cite journal| author=Georges AJ, Leroy EM, Renaut AA, Benissan CT, Nabias RJ, Ngoc MT et al.| title=Ebola hemorrhagic fever outbreaks in Gabon, 1994-1997: epidemiologic and health control issues. | journal=J Infect Dis | year= 1999 | volume= 179 Suppl 1 | issue=  | pages= S65-75 | pmid=9988167 | doi=10.1086/514290 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9988167  }} </ref><ref name="pmid9111553">{{cite journal| author=Amblard J, Obiang P, Edzang S, Prehaud C, Bouloy M, Guenno BL| title=Identification of the Ebola virus in Gabon in 1994. |journal=Lancet | year= 1997 | volume= 349 | issue= 9046 | pages= 181-2 | pmid=9111553 | doi=10.1016/S0140-6736(05)60984-1 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9111553  }} </ref>
*The period between 2000 and 2004 was remarkable for the emergence of multiple outbreaks among humans as well as among animals (gorillas and chimpanzees) in Gabon, the Republic of Congo, and Uganda.<ref name="pmid16002313">{{cite journal| author=Pourrut X, Kumulungui B, Wittmann T, Moussavou G, Délicat A, Yaba P et al.| title=The natural history of Ebola virus in Africa. | journal=Microbes Infect | year= 2005 | volume= 7 | issue= 7-8 | pages= 1005-14 | pmid=16002313 | doi=10.1016/j.micinf.2005.04.006 | pmc=| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16002313  }} </ref> At least 20 outbreaks were reported between the years 1976 (time of discovery) and 2013.
*The period between 2000 and 2004 was remarkable for the emergence of multiple outbreaks among humans as well as among animals (gorillas and chimpanzees) in Gabon, the Republic of Congo, and Uganda.<ref name="pmid16002313">{{cite journal| author=Pourrut X, Kumulungui B, Wittmann T, Moussavou G, Délicat A, Yaba P et al.| title=The natural history of Ebola virus in Africa. | journal=Microbes Infect | year= 2005 | volume= 7 | issue= 7-8 | pages= 1005-14 | pmid=16002313 | doi=10.1016/j.micinf.2005.04.006 | pmc=| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16002313  }} </ref> At least 20 outbreaks were reported between the years 1976 (time of discovery) and 2013.
*In December 2013, the largest Ebola outbreak occurred in Guinea. The index case was thought to be a 2-year-old boy. The 2013-2014 outbreak then involved Liberia, Sierra Leone, Senegal, and Nigeria before the virus was spread to Europe, Asia, and America, making Ebola virus a worldwide threat. On August 8 2014, the World Health Organization (WHO) declared the Ebola epidemic to be a Public Health Emergency of International Concern (PHEIC).<ref name="pmid25140855">{{cite journal| author=Briand S, Bertherat E, Cox P, Formenty P, Kieny MP, Myhre JK et al.| title=The international Ebola emergency. | journal=N Engl J Med | year= 2014 | volume= 371 | issue= 13 | pages= 1180-3 | pmid=25140855 | doi=10.1056/NEJMp1409858 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25140855  }} </ref>
*In March 23 2014, the Ministry of Health of Guinea notified the [[World Health Organization]] (WHO) of an emerging outbreak. The outbreak rapidly evolved to become the largest Ebola outbreak since its discovery in 1976. The first case of the Ebola outbreak was reported in Guinea in December 2013. The index case was thought to be a 2-year-old boy. The 2014 outbreak then involved Liberia, Sierra Leone, Senegal, and Nigeria before the virus was spread to Europe, Asia, and America, making Ebola virus a worldwide threat. On August 8 2014, the WHO declared the Ebola epidemic to be a Public Health Emergency of International Concern (PHEIC).<ref name="pmid25140855">{{cite journal| author=Briand S, Bertherat E, Cox P, Formenty P, Kieny MP, Myhre JK et al.| title=The international Ebola emergency. | journal=N Engl J Med | year= 2014 | volume= 371 | issue= 13 | pages= 1180-3 | pmid=25140855 | doi=10.1056/NEJMp1409858 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25140855  }} </ref>


==References==
==References==

Revision as of 14:05, 31 October 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Michael Maddaleni, B.S.; Guillermo Rodriguez Nava, M.D. [2]; Yazan Daaboul, M.D.

Overview

Ebola virus was first discovered in 1976 when two simultaneous outbreaks occurred in Zaire and Sudan. The first description of Ebola virus was made by Ngoy Mushola in Yambuku, Zaire during the 1976 outbreak. During the outbreak, Peter Piot analyzed blood samples of an infected Belgian nun in Zaire and was the first to describe the virus morphology using electron microscopy. The Ebola virus was named after the Ebola River Valley in the Democratic Republic of the Congo (formerly Zaire).[1] Approximately 14 outbreaks of Ebola virus have been described since its discovery. The 2013-2014 outbreak marks the largest Ebola outbreak, involving Africa, Asia, Europe, and America and making the virus a worldwide disease.

Historical Perspective

Discovery

  • The Ebola virus was first discovered in 1976 following two simultaneous outbreaks of Ebola hemorrhagic fever between June and November in Zaire and between August and November in Sudan.[2][3]
  • Nurse Mayinga N'Seka, a nurse in Zaire, is thought to be the index case in the first recognized Ebola epidemic in 1976. She was believed to be the only patient infected via airborne transmission of the Ebola virus.
  • The fist description of Ebola virus infection was made by Ngoy Mushola, who recorded the first case in Yambuku town in Zaire. In Dr. Mushola's daily log, he stated
The illness is characterized by a high temperature of about 39 °C,hematemesis, bloody diarrhea, retrosternal abdominal pain, prostration with "heavy" articulations, and rapid evolution death after a mean of three days...
  • During the outbreak, blood samples of infected Belgian nuns in Zaire were refrigerated in non-secure thermos and sent to Europe for analysis. Peter Piot was the first to analyze and describe Ebola virus morphology using electron microscopy. He noted the presence of long, worm-like agents that resemble the Marburg virus that was associated with the death of laboratory workers in Germany.
  • The virus was then named after the Ebola river located in the town Yambuku, Democratic Republic of the Congo (formerly Zaire), which is the site of the first recognized Ebola outbreak.
  • The first outbreaks occurred almost simultaneously in Sudan on June - November 1976 due to the so-called Sudan ebolavirus and in the Democratic Republic of Congo (formerly Zaire) on August - November 1976 due the so-called Ebola Zaire.
  • Ever since the initial discovery, 5 strains of Ebola virus have been identified.

Spread

  • The first two recorded outbreaks of Ebola virus occurred in 1976, followed by a third outbreak in 1979.[4]
  • For 15 years, no outbreaks of Ebola virus were recorded, until Ebola re-emerged in 1994 when a Swiss ethnologist was infected during a chimpanzee autopsy in Tai National Park in Ivory Coast.[5][6] During the same period, 3 other outbreaks occurred in Mekouka, Mayibout, and Booue in Gabon between 1994 and 1997.[7][8][9]
  • The period between 2000 and 2004 was remarkable for the emergence of multiple outbreaks among humans as well as among animals (gorillas and chimpanzees) in Gabon, the Republic of Congo, and Uganda.[10] At least 20 outbreaks were reported between the years 1976 (time of discovery) and 2013.
  • In March 23 2014, the Ministry of Health of Guinea notified the World Health Organization (WHO) of an emerging outbreak. The outbreak rapidly evolved to become the largest Ebola outbreak since its discovery in 1976. The first case of the Ebola outbreak was reported in Guinea in December 2013. The index case was thought to be a 2-year-old boy. The 2014 outbreak then involved Liberia, Sierra Leone, Senegal, and Nigeria before the virus was spread to Europe, Asia, and America, making Ebola virus a worldwide threat. On August 8 2014, the WHO declared the Ebola epidemic to be a Public Health Emergency of International Concern (PHEIC).[11]

References

  1. Bardi, Jason Socrates (2002). "Death Called a River". Scribbs Research Institute. 2 (1). Retrieved 2006-12-08.
  2. "Ebola haemorrhagic fever in Zaire, 1976". Bull World Health Organ. 56 (2): 271–93. 1978. PMC 2395567. PMID 307456.
  3. "Ebola haemorrhagic fever in Sudan, 1976. Report of a WHO/International Study Team". Bull World Health Organ. 56 (2): 247–70. 1978. PMC 2395561. PMID 307455.
  4. Baron RC, McCormick JB, Zubeir OA (1983). "Ebola virus disease in southern Sudan: hospital dissemination and intrafamilial spread". Bull World Health Organ. 61 (6): 997–1003. PMC 2536233. PMID 6370486.
  5. Le Guenno B, Formenty P, Formentry P, Wyers M, Gounon P, Walker F; et al. (1995). "Isolation and partial characterisation of a new strain of Ebola virus". Lancet. 345 (8960): 1271–4. PMID 7746057.
  6. Formenty P, Hatz C, Le Guenno B, Stoll A, Rogenmoser P, Widmer A (1999). "Human infection due to Ebola virus, subtype Côte d'Ivoire: clinical and biologic presentation". J Infect Dis. 179 Suppl 1: S48–53. doi:10.1086/514285. PMID 9988164.
  7. Khan AS, Tshioko FK, Heymann DL, Le Guenno B, Nabeth P, Kerstiëns B; et al. (1999). "The reemergence of Ebola hemorrhagic fever, Democratic Republic of the Congo, 1995. Commission de Lutte contre les Epidémies à Kikwit". J Infect Dis. 179 Suppl 1: S76–86. doi:10.1086/514306. PMID 9988168.
  8. Georges AJ, Leroy EM, Renaut AA, Benissan CT, Nabias RJ, Ngoc MT; et al. (1999). "Ebola hemorrhagic fever outbreaks in Gabon, 1994-1997: epidemiologic and health control issues". J Infect Dis. 179 Suppl 1: S65–75. doi:10.1086/514290. PMID 9988167.
  9. Amblard J, Obiang P, Edzang S, Prehaud C, Bouloy M, Guenno BL (1997). "Identification of the Ebola virus in Gabon in 1994". Lancet. 349 (9046): 181–2. doi:10.1016/S0140-6736(05)60984-1. PMID 9111553.
  10. Pourrut X, Kumulungui B, Wittmann T, Moussavou G, Délicat A, Yaba P; et al. (2005). "The natural history of Ebola virus in Africa". Microbes Infect. 7 (7–8): 1005–14. doi:10.1016/j.micinf.2005.04.006. PMID 16002313.
  11. Briand S, Bertherat E, Cox P, Formenty P, Kieny MP, Myhre JK; et al. (2014). "The international Ebola emergency". N Engl J Med. 371 (13): 1180–3. doi:10.1056/NEJMp1409858. PMID 25140855.