Joel G Breman1, David L Heymann2, Graham Lloyd3, Joseph B McCormick4, Malonga Miatudila5, Frederick A Murphy6, Jean-Jacques Muyembé-Tamfun7, Peter Piot8, Jean-François Ruppol9, Pierre Sureau10, Guido van der Groen11, Karl M Johnson12. 1. Fogarty International Center, National Institutes of Health, Bethesda, Maryland. 2. Chatham House Centre on Global Health Security London School of Hygiene and Tropical Medicine. 3. Office of the Director, Medical Research Establishment, Porton Down, United Kingdom. 4. Brownsville Campus of the University of Texas School of Public Health, Houston. 5. Health, Population, and Nutrition, World Bank, Washington D.C. 6. Department of Pathology, University of Texas, Galveston. 7. Institut National de Recherche Médical. 8. London School of Hygiene and Tropical Medicine. 9. Fonds Médical Tropical, Kinshasa, Democratic Republic of the Congo. 10. Institute Pasteur, Paris, France. 11. Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium. 12. Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.
Abstract
BACKGROUND: In 1976, the first cases of Ebola virus disease in northern Democratic Republic of the Congo (then referred to as Zaire) were reported. This article addresses who was responsible for recognizing the disease; recovering, identifying, and naming the virus; and describing the epidemic. Key scientific approaches used in 1976 and their relevance to the 3-country (Guinea, Sierra Leone, and Liberia) West African epidemic during 2013-2016 are presented. METHODS: Field and laboratory investigations started soon after notification, in mid-September 1976, and included virus cell culture, electron microscopy (EM), immunofluorescence antibody (IFA) testing of sera, case tracing, containment, and epidemiological surveys. In 2013-2016, medical care and public health work were delayed for months until the Ebola virus disease epidemic was officially declared an emergency by World Health Organization, but research in pathogenesis, clinical presentation, including sequelae, treatment, and prevention, has increased more recently. RESULTS: Filoviruses were cultured and observed by EM in Antwerp, Belgium (Institute of Tropical Medicine); Porton Down, United Kingdom (Microbiological Research Establishment); and Atlanta, Georgia (Centers for Disease Control and Prevention). In Atlanta, serological testing identified a new virus. The 1976 outbreak (280 deaths among 318 cases) stopped in <11 weeks, and basic clinical and epidemiological features were defined. The recent massive epidemic during 2013-2016 (11 310 deaths among 28 616 cases) has virtually stopped after >2 years. Transmission indices (R0) are higher in all 3 countries than in 1976. CONCLUSIONS: An international commission working harmoniously in laboratories and with local communities was essential for rapid success in 1976. Control and understanding of the recent West African outbreak were delayed because of late recognition and because authorities were overwhelmed by many patients and poor community involvement. Despite obstacles, research was a priority in 1976 and recently. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.
BACKGROUND: In 1976, the first cases of Ebola virus disease in northern Democratic Republic of the Congo (then referred to as Zaire) were reported. This article addresses who was responsible for recognizing the disease; recovering, identifying, and naming the virus; and describing the epidemic. Key scientific approaches used in 1976 and their relevance to the 3-country (Guinea, Sierra Leone, and Liberia) West African epidemic during 2013-2016 are presented. METHODS: Field and laboratory investigations started soon after notification, in mid-September 1976, and included virus cell culture, electron microscopy (EM), immunofluorescence antibody (IFA) testing of sera, case tracing, containment, and epidemiological surveys. In 2013-2016, medical care and public health work were delayed for months until the Ebola virus disease epidemic was officially declared an emergency by World Health Organization, but research in pathogenesis, clinical presentation, including sequelae, treatment, and prevention, has increased more recently. RESULTS: Filoviruses were cultured and observed by EM in Antwerp, Belgium (Institute of Tropical Medicine); Porton Down, United Kingdom (Microbiological Research Establishment); and Atlanta, Georgia (Centers for Disease Control and Prevention). In Atlanta, serological testing identified a new virus. The 1976 outbreak (280 deaths among 318 cases) stopped in <11 weeks, and basic clinical and epidemiological features were defined. The recent massive epidemic during 2013-2016 (11 310 deaths among 28 616 cases) has virtually stopped after >2 years. Transmission indices (R0) are higher in all 3 countries than in 1976. CONCLUSIONS: An international commission working harmoniously in laboratories and with local communities was essential for rapid success in 1976. Control and understanding of the recent West African outbreak were delayed because of late recognition and because authorities were overwhelmed by many patients and poor community involvement. Despite obstacles, research was a priority in 1976 and recently. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Entities:
Keywords:
Discovery of Ebola Zaire virus; Ebola in 1976 and 2013–2016; Ebola virus disease
Authors: Maria D Van Kerkhove; Ana I Bento; Harriet L Mills; Neil M Ferguson; Christl A Donnelly Journal: Sci Data Date: 2015-05-26 Impact factor: 6.444
Authors: Daniel J Park; Gytis Dudas; Shirlee Wohl; Augustine Goba; Shannon L M Whitmer; Kristian G Andersen; Rachel S Sealfon; Jason T Ladner; Jeffrey R Kugelman; Christian B Matranga; Sarah M Winnicki; James Qu; Stephen K Gire; Adrianne Gladden-Young; Simbirie Jalloh; Dolo Nosamiefan; Nathan L Yozwiak; Lina M Moses; Pan-Pan Jiang; Aaron E Lin; Stephen F Schaffner; Brian Bird; Jonathan Towner; Mambu Mamoh; Michael Gbakie; Lansana Kanneh; David Kargbo; James L B Massally; Fatima K Kamara; Edwin Konuwa; Josephine Sellu; Abdul A Jalloh; Ibrahim Mustapha; Momoh Foday; Mohamed Yillah; Bobbie R Erickson; Tara Sealy; Dianna Blau; Christopher Paddock; Aaron Brault; Brian Amman; Jane Basile; Scott Bearden; Jessica Belser; Eric Bergeron; Shelley Campbell; Ayan Chakrabarti; Kimberly Dodd; Mike Flint; Aridth Gibbons; Christin Goodman; John Klena; Laura McMullan; Laura Morgan; Brandy Russell; Johanna Salzer; Angela Sanchez; David Wang; Irwin Jungreis; Christopher Tomkins-Tinch; Andrey Kislyuk; Michael F Lin; Sinead Chapman; Bronwyn MacInnis; Ashley Matthews; James Bochicchio; Lisa E Hensley; Jens H Kuhn; Chad Nusbaum; John S Schieffelin; Bruce W Birren; Marc Forget; Stuart T Nichol; Gustavo F Palacios; Daouda Ndiaye; Christian Happi; Sahr M Gevao; Mohamed A Vandi; Brima Kargbo; Edward C Holmes; Trevor Bedford; Andreas Gnirke; Ute Ströher; Andrew Rambaut; Robert F Garry; Pardis C Sabeti Journal: Cell Date: 2015-06-18 Impact factor: 41.582
Authors: Suerie Moon; Devi Sridhar; Muhammad A Pate; Ashish K Jha; Chelsea Clinton; Sophie Delaunay; Valnora Edwin; Mosoka Fallah; David P Fidler; Laurie Garrett; Eric Goosby; Lawrence O Gostin; David L Heymann; Kelley Lee; Gabriel M Leung; J Stephen Morrison; Jorge Saavedra; Marcel Tanner; Jennifer A Leigh; Benjamin Hawkins; Liana R Woskie; Peter Piot Journal: Lancet Date: 2015-11-23 Impact factor: 79.321
Authors: Cordelia E M Coltart; Benjamin Lindsey; Isaac Ghinai; Anne M Johnson; David L Heymann Journal: Philos Trans R Soc Lond B Biol Sci Date: 2017-05-26 Impact factor: 6.237
Authors: Anne W Rimoin; Kai Lu; Matthew S Bramble; Imke Steffen; Reena H Doshi; Nicole A Hoff; Patrick Mukadi; Bradly P Nicholson; Vivian H Alfonso; Gerrard Olinger; Cyrus Sinai; Lauren K Yamamoto; Christina M Ramirez; Emile Okitolonda Wemakoy; Benoit Kebela Illunga; James Pettitt; James Logue; Richard S Bennett; Peter Jahrling; David L Heymann; Peter Piot; Jean Jacques Muyembe-Tamfum; Lisa E Hensley; Graham Simmons Journal: J Infect Dis Date: 2018-01-04 Impact factor: 5.226
Authors: Carlos Polanco; José Lino Samaniego Mendoza; Thomas Buhse; Vladimir N Uversky; Ingrid Paola Bañuelos Chao; Marcela Angola Bañuelos Cedano; Fernando Michel Tavera; Daniel Michel Tavera; Manuel Falconi; Abelardo Vela Ponce de León Journal: Cell Biochem Biophys Date: 2018-03-06 Impact factor: 2.194
Authors: Matthew S Bramble; Nicole Hoff; Pavlo Gilchuk; Patrick Mukadi; Kai Lu; Reena H Doshi; Imke Steffen; Bradly P Nicholson; Allen Lipson; Neerja Vashist; Cyrus Sinai; D'andre Spencer; Garrard Olinger; Emile Okitolonda Wemakoy; Benoit Kebela Illunga; James Pettitt; James Logue; Jonathan Marchand; Justin Varughese; Richard S Bennett; Peter Jahrling; Guy Cavet; Tito Serafini; Erica Ollmann Saphire; Eric Vilain; Jean Jacques Muyembe-Tamfum; Lisa E Hensely; Graham Simmons; James E Crowe; Anne W Rimoin Journal: J Infect Dis Date: 2018-11-05 Impact factor: 5.226
Authors: Lee Worden; Rae Wannier; Nicole A Hoff; Kamy Musene; Bernice Selo; Mathias Mossoko; Emile Okitolonda-Wemakoy; Jean Jacques Muyembe Tamfum; George W Rutherford; Thomas M Lietman; Anne W Rimoin; Travis C Porco; J Daniel Kelly Journal: PLoS Negl Trop Dis Date: 2019-08-05