2014’s Ebola outbreak: four decades in the making

This year’s Ebola outbreak has surprised the world, spreading further than anyone expected and prompting many to ask whether governments and pharmaceutical companies have reacted fast enough. Here, Lancaster University’s Dr Derek Gatherer explains where this epidemic has come from and what it’s taught us.

When people look back on 2014, it may be best remembered as the year of Ebola. This extremely virulent virus had previously notched up just over 1,000 victims since its discovery in 1976, east of the Ebola River in what was then Zaire (now the Democratic Republic of Congo). But this year, it has exploded across West Africa, killing over 6,000 people by the second week of December.

Our assumptions about Ebola were wrong

Two comforting assumptions about Ebola had previously been made – that it was confined to remote regions of central Africa, and that the notorious virulence of the disease acted as a kind of self-limiting factor, with epidemics always burning themselves out after their initial flare-up.

But these assumptions have been shattered. Ebola had been little more than a curious exhibit in virology’s chamber of horrors; now the virus has well and truly arrived as a serious player in the global disease-threat league tables.

A slow reaction to Ebola?

As the 2014 West African rainy season unfolded, and while the Western World watched apprehensively, media reports tended to give the impression that the scientific and medical establishment had no suitable drugs, no vaccine and, some would have it, no clue.

The truth, however, is a little more complicated. The previous most westerly appearance of the Zaire variant of Ebola was nearly 5,000 kilometres away in Gabon. The similar but considerably less lethal Lassa fever, is one of the endemic viruses popping up in Guinea virtually every year. Together, these facts contributed to the three-month lag between the first cases of Ebola and the official recognition of the outbreak.

By this time, the virus had slipped the net that was about to be thrown around its forest epicentre and was already claiming its first victims in the teeming shanty towns of Guinea’s capital, Conakry.

Nearly 40 years of Ebola research

Virologists have not been neglecting Ebola – in the 37 years since the virus was first identified, a large chest of potential treatments and vaccines have been developed. These were in various stages of progress when this year’s outbreak took hold.

The fact that none of them had yet reached the stage of approval required for full commercial release, was not deliberate callousness on the part of pharmaceutical researchers and companies. It was more a consequence of the relatively small number of Ebola victims in a world where other viruses – HIV, hepatitis C and influenza, to name the worst culprits – were killing millions.

A task of unprecedented proportions

Public health officials were not exactly fumbling around in the dark either. Nearly four decades of dealing with smaller Ebola emergencies had produced a cadre of well-drilled outbreak response workers, who knew exactly what steps to take to bring the virus under control.

The only problem was that these methods had previously been proven in outbreaks numbering dozens or, at worst, hundreds of cases, generally in well-defined locations. Scaling these methods up to an outbreak area encompassing three countries was a task of unprecedented proportions.

Is Ebola under control?

Perhaps, after nearly nine months of struggle, the outbreak is finally coming under control – and governments and pharmaceutical companies should be much more prepared if there’s another epidemic in the future.

The story is not yet over, however. If you want to follow what has happened so far, learn about the virus and its potential treatments, and also think about what the future might hold, join our free online course, “Ebola: Symptoms, History and Origins.”

“Ebola: Symptoms, History and Origins” from Lancaster University starts on 2 February 2015. You can join the course now or join the conversation using #FLebolaBasics.