Journal Article > CommentaryFull Text
Nat Microbiol. 24 February 2016; Volume 1 (Issue 3); 16007.; DOI:10.1038/nmicrobiol.2016.7
Sprecher A, Feldman H, Hensley L, Kobinger GP, Nichol ST, et al.
Nat Microbiol. 24 February 2016; Volume 1 (Issue 3); 16007.; DOI:10.1038/nmicrobiol.2016.7
Concern over Ebola becoming endemic in West Africa has appeared in the medical and lay media. Routes of transmission, rates of viral evolution, suitability of humans as hosts and rarity of spillover events make this very unlikely. Without evidence that endemic Ebola is likely, ending epidemics should remain the focus.
Journal Article > Short ReportFull Text
Morbidity and Mortality Weekly Report. 14 November 2014; Volume 63 (Issue 46); 1082-6.
Nyenswah TG, Fahnbulleh M, Massaquoi M, Nagbe T, Bawo L, et al.
Morbidity and Mortality Weekly Report. 14 November 2014; Volume 63 (Issue 46); 1082-6.
On March 21, 2014, the Guinea Ministry of Health reported the outbreak of an illness characterized by fever, severe diarrhea, vomiting and a high fatality rate (59%), leading to the first known epidemic of Ebola virus disease (Ebola) in West Africa and the largest and longest Ebola epidemic in history. As of November 2, Liberia had reported the largest number of cases (6,525) and deaths (2,697) among the three affected countries of West Africa with ongoing transmission (Guinea, Liberia, and Sierra Leone). The response strategy in Liberia has included management of the epidemic through an incident management system (IMS) in which the activities of all partners are coordinated. Within the IMS, key strategies for epidemic control include surveillance, case investigation, laboratory confirmation, contact tracing, safe transportation of persons with suspected Ebola, isolation, infection control within the health care system, community engagement, and safe burial. This report provides a brief overview of the progression of the epidemic in Liberia and summarizes the interventions implemented.
Journal Article > ResearchFull Text
Cell. 18 June 2015; Volume 161 (Issue 7); DOI:10.1016/j.cell.2015.06.007
Park DJ, Dudas G, Wohl S, Goba A, Whitmer SL, et al.
Cell. 18 June 2015; Volume 161 (Issue 7); DOI:10.1016/j.cell.2015.06.007
The 2013-2015 Ebola virus disease (EVD) epidemic is caused by the Makona variant of Ebola virus (EBOV). Early in the epidemic, genome sequencing provided insights into virus evolution and transmission and offered important information for outbreak response. Here, we analyze sequences from 232 patients sampled over 7 months in Sierra Leone, along with 86 previously released genomes from earlier in the epidemic. We confirm sustained human-to-human transmission within Sierra Leone and find no evidence for import or export of EBOV across national borders after its initial introduction. Using high-depth replicate sequencing, we observe both host-to-host transmission and recurrent emergence of intrahost genetic variants. We trace the increasing impact of purifying selection in suppressing the accumulation of nonsynonymous mutations over time. Finally, we note changes in the mucin-like domain of EBOV glycoprotein that merit further investigation. These findings clarify the movement of EBOV within the region and describe viral evolution during prolonged human-to-human transmission.