West African Ebola epidemic

From late 2013 to mid-2016 an epidemic of Ebola virus disease swept through West Africa, above all Guinea, Liberia and Sierra Leone. It was the largest Ebola outbreak ever recorded and the first to reach epidemic scale. By the end, according to the World Health Organization (WHO), about 28,600 people had been infected and more than 11,300 had died, figures the WHO itself believed understated the true toll. The crisis overwhelmed weak health systems, shook the region's economies and exposed failings in the international response.

The first known case is generally believed to have been a small boy in the village of Méliandou, in south-eastern Guinea, who died in December 2013. Bats are strongly suspected as the natural reservoir of the virus, and researchers think the boy may have caught it from an insect-eating bat colony near the village. Members of his family then fell ill, and the disease spread to nearby villages. Because Ebola had never been seen in the region, early cases were mistaken for more familiar illnesses, and the virus spread for months before it was identified.

Guinea's health ministry reported the outbreak in March 2014, by which time cases were suspected in Liberia and Sierra Leone. The disease reached Guinea's capital, Conakry, by late May, Liberia's capital, Monrovia, by mid-June and Freetown by late July. Extreme poverty, fragile health services, distrust of governments after years of conflict such as the Sierra Leone Civil War, and traditional burial practices that involved washing the body all helped the virus spread. In the hardest-hit areas there had long been only one or two doctors for every 100,000 people. Smaller outbreaks in Nigeria and Mali were contained, and a few cases were carried to Senegal, Spain, the United Kingdom, Italy and the United States.

On 8 August 2014 the WHO declared a public health emergency of international concern, and in September the UN Security Council called the epidemic a threat to international peace and security. The aid group Médecins Sans Frontières, the largest organisation working on the ground, warned that the world was losing the battle. Governments closed borders and schools and imposed quarantines, which sometimes caused food shortages, and health workers in Guinea faced repeated attacks from frightened communities. An international plan aimed to isolate every case and safely bury every victim. Case numbers reached their peak in October 2014 and then slowly fell, although Sierra Leone continued to see sharp increases into December.

By early 2015 new cases were falling steeply. Liberia was first declared free of Ebola in May 2015, Sierra Leone in November and Guinea in December, but flare-ups kept recurring, some traced to survivors in whom the virus had lingered and been passed on through sexual contact. The WHO declared the epidemic finally over on 9 June 2016. A two-year trial showed that the rVSV-ZEBOV vaccine offered protection; it was approved by regulators in 2019.

The epidemic left about 17,000 survivors, many suffering lasting health problems, and the UN reported that 22,000 children had been left without a mother, a father or both. Trade, investment, farming and tourism collapsed in the worst-hit countries; the World Bank later put the losses at about 12 per cent of their combined economic output. The WHO was widely criticised for reacting too slowly, and in April 2015 it acknowledged serious failings in coordination and communication.

Our 2010 map shows Guinea, Liberia and Sierra Leone a few years before the epidemic began.