Thirty-eight years of Ebola in Central Africa
Data from all Ebola outbreaks in the Democratic Republic of the Congo since 1976 shows that early hospitalisation can save lives.
Ebola virus disease commonly causes symptoms such as high fever, vomiting, and diarrhoea. It may also cause muscle pain, headaches, and bleeding, and often leads to death.
There have been seven outbreaks of Ebola virus disease in the Democratic Republic of the Congo (DRC) since 1976. The DRC is the country that has had the most outbreaks of this disease in the world. The most recent outbreak in the DRC was in 2014; this was separate from the outbreak that started in West Africa in the same year. Alicia Rosello, Mathias Mossoko and colleagues have now compiled the data from all seven of the outbreaks in the DRC into a single dataset, which covers almost 1000 patients.
Analysing this data revealed that people between 25 and 64 years of age were most likely to be infected by the Ebola virus, possibly because most healthcare workers fall into this category. Age also affected how likely a patient was to die, with those aged under 5 and over 15 more likely to die than those aged between 5 and 15. Delaying going to hospital once symptoms had started, even by one day, also increased the likelihood of death.
Rosello, Mossoko and colleagues also examined the Ebola virus effective reproduction number, which indicates how many people, on average, an infected person passes the virus on to. Outbreaks that initially featured viruses with a reproduction number larger than three tended to be stemmed quickly. However, when the reproduction number was lower, national and international organisations were slower to respond to the signs of the outbreak, leading to outbreaks that lasted longer.
Further research is needed to understand why the likelihood of death is different for different age groups and to investigate the effect of the different routes of transmission of the virus on interventions such as vaccination.
To find out more
Read the eLife research paper on which this eLife digest is based: “Ebola virus disease in the Democratic Republic of the Congo, 1976–2014” (November 3, 2015).
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