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What factors might have led to the emergence of Ebola in West Africa?
K.A. Alexander¹, C.E. Sanderson¹, M. Marathe2,3, B.L. Lewis³, C.M. Rivers³, J. Shaman4, J.M. Drake5, E. Lofgren³, V.M. Dato6, M.C. Eisenberg7, and S. Eubank³
1 Department of Fisheries and Wildlife Conservation, Virginia Tech, Blacksburg, Virginia
2 Department of Computer Science, Virginia Tech, Blacksburg, Virginia.
3 Network Dynamics and Simulation Science Laboratory, Virginia Bioinformatics Institute, Virginia Tech, Blacksburg, Virginia.
4 Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York
5 Odum School of Ecology, University of Georgia, Athens, Georgia
6 Department of Biomedical Informatics, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
7 Departments of Epidemiology and Mathematics, University of Michigan, Ann Arbor, Michigan
An Ebola outbreak of unprecedented scope emerged in West Africa in December 2013 and presently continues unabated in the countries of Guinea, Sierra Leone, and Liberia. Ebola is not new to Africa and outbreaks have been confirmed as far back as 1976. The current West African Ebola outbreak is the largest ever recorded and differs dramatically from prior outbreaks in its duration, number of people affected, and geographic extent. The emergence of this deadly disease in West Africa invites many questions, foremost among these: Why now and why in West Africa? Here, we review the sociological, ecological, and environmental drivers that might have influenced the emergence of Ebola in this region of Africa and its spread throughout the region. Containment of the West African Ebola outbreak is the most pressing, immediate need. A comprehensive assessment of the drivers of Ebola emergence and sustained human-to-human transmission is also needed in order to prepare other countries for importation or emergence of this disease. Such assessment includes identification of country-level protocols and interagency policies for outbreak detection and rapid response, increased understanding of cultural and traditional risk factors within and between nations, delivery of culturally embedded public health education, and regional coordination and collaboration, particularly with governments and health ministries throughout Africa. Public health education is also urgently needed in countries outside of Africa in order to ensure that risk is properly understood and public concerns do not escalate unnecessarily. To prevent future outbreaks, coordinated, multiscale, early warning systems should be developed that make full use of these integrated assessments, partner with local communities in high-risk areas, and provide clearly defined response recommendations specific to the needs of each community.
Competing Interests: The authors have declared that no competing interests exist.
Funding: The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.This work has been partially supported by DTRA CNIMS Contract HDTRA1-11-D-0016-0001. Research reported in this publication was partially supported by the National Institute of General Medical Sciences of the National Institutes of Health under award number 5U01GM070694-11 and U01 GM110748 as well as the RAPIDD program of the Science and Technology Directorate, US Department of Homeland Security and the NLM Pittsburgh Biomedical Informatics Training Grant 5T15 LM007059-28.
Copyright: © 2014 Alexander et al. This is an open-access manuscript distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.