Ebola virus disease in West Africa—the first 9 months of the epidemic and forward projections
Open accessAbstract
BACKGROUND: On March 23, 2014, the World Health Organization (WHO) was notified of an outbreak of Ebola virus disease (EVD) in Guinea. On August 8, the WHO declared the epidemic to be a "public health emergency of international concern." METHODS: By September 14, 2014, a total of 4507 probable and confirmed cases, including 2296 deaths from EVD (Zaire species) had been reported from five countries in West Africa--Guinea, Liberia, Nigeria, Senegal, and Sierra Leone. We analyzed a detailed subset of data on 3343 confirmed and 667 probable Ebola cases collected in Guinea, Liberia, Nigeria, and Sierra Leone as of September 14. RESULTS: The majority of patients are 15 to 44 years of age (49.9% male), and we estimate that the case fatality rate is 70.8% (95% confidence interval [CI], 69 to 73) among persons with known clinical outcome of infection. The course of infection, including signs and symptoms, incubation period (11.4 days), and serial interval (15.3 days), is similar to that reported in previous outbreaks of EVD. On the basis of the initial periods of exponential growth, the estimated basic reproduction numbers (R0 ) are 1.71 (95% CI, 1.44 to 2.01) for Guinea, 1.83 (95% CI, 1.72 to 1.94) for Liberia, and 2.02 (95% CI, 1.79 to 2.26) for Sierra Leone. The estimated current reproduction numbers (R) are 1.81 (95% CI, 1.60 to 2.03) for Guinea, 1.51 (95% CI, 1.41 to 1.60) for Liberia, and 1.38 (95% CI, 1.27 to 1.51) for Sierra Leone; the corresponding doubling times are 15.7 days (95% CI, 12.9 to 20.3) for Guinea, 23.6 days (95% CI, 20.2 to 28.2) for Liberia, and 30.2 days (95% CI, 23.6 to 42.3) for Sierra Leone. Assuming no change in the control measures for this epidemic, by November 2, 2014, the cumulative reported numbers of confirmed and probable cases are predicted to be 5740 in Guinea, 9890 in Liberia, and 5000 in Sierra Leone, exceeding 20,000 in total. CONCLUSIONS: These data indicate that without drastic improvements in control measures, the numbers of cases of and deaths from EVD are expected to continue increasing from hundreds to thousands per week in the coming months.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
A New Framework and Software to Estimate Time-Varying Reproduction Numbers During Epidemics
Cori, A., Ferguson, N. M., Fraser, C., & Cauchemez, S. (2013) · American Journal of Epidemiology · doi:10.1093/aje/kwt133 · Cited by 1,530 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
The fluid dynamics of disease transmission
Bourouiba, L. (2021) · Annual Review of Fluid Mechanics · doi:10.1146/annurev-fluid-060220-113712 · Cited by 366 · see citing works
Community-centered responses to Ebola in urban Liberia: the view from below
Abramowitz, S. A., McLean, K. E., McKune, S. L., Bardosh, K. L., Fallah, M., Monger, J., Tehoungue, K., & Omidian, P. A. (2015) · PLOS Neglected Tropical Diseases · doi:10.1371/journal.pntd.0003706 · Cited by 298 · see citing works
The evolution of Ebola virus: Insights from the 2013-2016 epidemic
Holmes, E. C., Dudas, G., Rambaut, A., & Andersen, K. G. (2016) · Nature · doi:10.1038/nature19790 · Cited by 314 · see citing works
Ji, D., Ji, Y.-J., Duan, X.-Z., Li, W.-G., Sun, Z.-Q., Song, X.-A., Meng, Y.-H., Tang, H.-M., Chu, F., Niu, X.-X., et al. (2017) · Oncotarget · doi:10.18632/oncotarget.14498 · Cited by 257 · see citing works
IoMT amid COVID-19 pandemic: Application, architecture, technology, and security
Mohd Aman, A. H., Hassan, W. H., Sameen, S., Attarbashi, Z. S., Alizadeh, M., & Latiff, L. A. (2021) · Journal of Network and Computer Applications · doi:10.1016/j.jnca.2020.102886 · Cited by 237 · see citing works
When are pathogen genome sequences informative of transmission events?
Campbell, F., Strang, C., Ferguson, N., Cori, A., & Jombart, T. (2018) · PLOS Pathogens · doi:10.1371/journal.ppat.1006885 · Cited by 199 · see citing works
Tracing “Fearbola”: Psychological Predictors of Anxious Responding to the Threat of Ebola
Blakey, S. M., Reuman, L., Jacoby, R. J., & Abramowitz, J. S. (2015) · Cognitive Therapy and Research · doi:10.1007/s10608-015-9701-9 · Cited by 164 · see citing works
Barro, L., Drew, V. J., Poda, G. G., Tagny, C. T., El‐Ekiaby, M., Owusu‐Ofori, S., & Burnouf, T. (2018) · Vox Sanguinis · doi:10.1111/vox.12705 · Cited by 92 · see citing works
Nyakarahuka, L., Kankya, C., Krontveit, R., Mayer, B., Mwiine, F. N., Lutwama, J., & Skjerve, E. (2016) · BMC Infectious Diseases · doi:10.1186/s12879-016-2045-6 · Cited by 74 · see citing works
Hersi, M., Stevens, A., Quach, P., Hamel, C., Thavorn, K., Garritty, C., Skidmore, B., Vallenas, C., Norris, S. L., Egger, M., et al. (2015) · PLoS ONE · doi:10.1371/journal.pone.0140290 · Cited by 64 · see citing works
Marburg virus disease outbreaks, mathematical models, and disease parameters: a systematic review
Cuomo-Dannenburg, G., McCain, K., McCabe, R., Unwin, H. J. T., Doohan, P., Nash, R. K., Hicks, J. T., Charniga, K., Geismar, C., Lambert, B., et al. (2024) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(23)00515-7 · Cited by 59 · see citing works
Decosimo, C. A., Hanson, J., Quinn, M., Badu, P., & Smith, E. G. (2019) · Global Mental Health · doi:10.1017/gmh.2019.1 · Cited by 57 · see citing works
Ebola virus disease mathematical models and epidemiological parameters: a systematic review
Nash, R. K., Bhatia, S., Morgenstern, C., Doohan, P., Jorgensen, D., McCain, K., McCabe, R., Nikitin, D., Forna, A., Cuomo-Dannenburg, G., et al. (2024) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(24)00374-8 · Cited by 35 · see citing works
Garfin, D. R., Holman, E. A., Fischhoff, B., Wong-Parodi, G., & Silver, R. C. (2022) · International Journal of Disaster Risk Reduction · doi:10.1016/j.ijdrr.2022.103059 · Cited by 24 · see citing works
Ebola response in Sierra Leone: The impact on children
Fitzgerald, F., Awonuga, W., Shah, T., & Youkee, D. (2016) · Journal of Infection · doi:10.1016/j.jinf.2016.04.016 · Cited by 21 · see citing works
- Authors
- WHO Ebola Response Team
- Corresponding author
- WHO Ebola Response Team
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2014-10-16
- Volume
- 371
- Issue
- 16
- Pages
- 1481-1495
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC4235004
- OpenAlex
- W4210710163
- Cited by
- 1,674
- References
- 1
- Citations by year
- 2026: 55 · 2025: 46 · 2024: 57 · 2023: 46 · 2022: 76 · 2021: 91 · 2020: 117 · 2019: 102 · 2018: 117 · 2017: 166 · 2016: 254 · 2015: 384 · 2014: 141 · 2013: 4 · 2012: 2
- FWCI
- 221.45
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Bristol Research (University of Bristol) (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Sussex Research Online (University of Sussex) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
- Funders
- Wellcome Trust
- National Institute for Health and Care Research (NF-SI-0508-10252, HPRU-2012-10080, NF-SI-0513-10125)
- Medical Research Council (MR/K010174/1)
- National Institute of General Medical Sciences (U01GM110721)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Outbreaks Research
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Vectors
- Health Sciences › Medicine › Epidemiology › Virology and Viral Diseases
- Keywords
- Ebola virus disease, 2014 West Africa Ebola outbreak, basic reproduction number, case fatality rate, serial interval, incubation period, epidemic doubling time, forward projection, public health emergency of international concern, Zaire ebolavirus, Guinea, Liberia, Sierra Leone, Nigeria, Senegal, contact tracing
- MeSH terms
- Adolescent, Adult, Africa, Western, Child, Female, Humans, Male, Middle Aged, Mortality, Incidence, Hemorrhagic Fever, Ebola, Ebolavirus, Infectious Disease Incubation Period, Young Adult, Epidemics
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
