n South African Medical Journal - Ebola virus disease in West Africa - South African perspectives : editorial




The outbreak of Ebola virus disease (EVD) in West Africa has been raging for nearly a year at the time of writing. The likely index case of the outbreak was a 2-year-old child who died on 6 December 2013, having acquired the infection late in November 2013, although the outbreak was only formally announced in March 2014. On 13 October 2014, a total of 8 400 suspected and confirmed cases of EVD, culminating in more than 4 000 deaths, has been reported. This case count is nearly three times the total number of cases of EVD reported in 20 earlier outbreaks from 1976 to 2013. Although it may seem logical to believe that the present virus has mutated to become more lethal and transmissible since previous outbreaks, this epidemic is widely recognised to be fuelled by socioeconomic and public health-related issues that have complicated conventional containment efforts. Full genome characterisation of Ebola virus isolates from Guinea and Sierra Leone has revealed that they are . This strain has been associated with haemorrhagic fever outbreaks in central African countries since 1976, with case fatality rates of up to 90%. The current fatality rate is estimated to be between 60% and 70%; describing it as 'the most lethal outbreak of EVD to date' therefore relates more to the scale of the epidemic than the actual death rate.


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