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Outbreaks Chronology: Ebola Virus Disease

Known Cases and Outbreaks of Ebola Virus Disease, in Reverse Chronological Order:

Year(s) Country Ebola subtype Reported number of human cases Reported number (%) of deaths among cases Situation
May – July 2017 Democratic Republic of the Congo Ebola virus 8 4 (50%) Outbreak occurred in the Likati health zone of the province of Bas Uélé. The response faced challenging logistical obstacles, including the remoteness of the area and limited services. Mobile diagnostic laboratories provided testing of samples in the affected areas.
August-November 2014 Democratic Republic of the Congo Ebola virus 66 49 (74%) Outbreak occurred in multiple villages in the Democratic Republic of the Congo. The outbreak was unrelated to the outbreak of Ebola in West Africa.34
March 2014-2016 Multiple countries Ebola virus 28,616 11,310 Outbreak primarily in Guinea, Liberia and Sierra Leone. Thirty-six confirmed cases were reported from Italy, Mali, Nigeria, Senegal, Spain, the United Kingdom, and the United States 32. A further 24 Ebola-confirmed patients were transported to France, Germany, Italy, the Netherlands, the United Kingdom, the United States, Norway, Spain, and Switzerland 33
November 2012-January 2013 Uganda Sudan virus 6* 3* (50%) Outbreak occurred in the Luwero District. CDC assisted the Ministry of Health in the epidemiologic and diagnostic aspects of the outbreak. Testing of samples by CDC’s Viral Special Pathogens Branch occurred at UVRI in Entebbe. 31
June-November 2012 Democratic Republic of the Congo Bundibugyo virus 36* 13* (36.1%) Outbreak occurred in DRC’s Province Orientale. Laboratory support was provided through CDC and the Public Health Agency of Canada (PHAC)’s field laboratory in Isiro, as well as through the CDC/UVRI lab in Uganda. The outbreak in DRC had no epidemiologic link to the near contemporaneous Ebola outbreak in the Kibaale district of Uganda. 31
June-October 2012 Uganda Sudan virus 11* 4* (36.4%) Outbreak occurred in the Kibaale District of Uganda. Laboratory tests of blood samples were conducted by the UVRI and the CDC. 31
May 2011 Uganda Sudan virus 1 1 (100%) The Uganda Ministry of Health informed the public a patient with suspected Ebola Hemorrhagic fever died on May 6, 2011 in the Luwero district, Uganda. The quick diagnosis from a blood sample of Ebola virus was provided by the new CDC Viral Hemorrhagic Fever laboratory installed at the Uganda Viral Research Institute (UVRI). 30
December 2008-February 2009 Democratic Republic of the Congo Zaire virus 32 15 (47%) Outbreak occurred in the Mweka and Luebo health zones of the Province of Kasai Occidental. 29
November 2008 Philippines Reston virus 6 (asymptomatic) 0 First known occurrence of Ebola-Reston in pigs. Strain closely similar to earlier strains. Six workers from the pig farm and slaughterhouse developed antibodies but did not become sick. 27 28
December 2007-January 2008 Uganda Bundibugyo virus 149 37 (25%) Outbreak occurred in Bundibugyo District in western Uganda. First reported occurrence of a new strain. 26
2007 Democratic Republic of the Congo Zaire virus 264 187 (71%) Outbreak occurred in Kasai Occidental Province. The outbreak was declared over November 20. Last confirmed case on October 4 and last death on October 10. 24 25
2004 Russia Zaire virus 1 1 (100%) Laboratory contamination. 23
2004 Sudan (South Sudan) Sudan virus 17 7 (41%) Outbreak occurred in Yambio county of southern Sudan. This outbreak was concurrent with an outbreak of measles in the same area, and several suspected EHF cases were later reclassified as measles cases. 22
November-December 2003 Republic of the Congo Zaire virus 35 29 (83%) Outbreak occurred in Mbomo and Mbandza villages located in Mbomo distric, Cuvette Ouest Département. 21
December 2002-April 2003 Republic of the Congo Zaire virus 143 128 (89%) Outbreak occurred in the districts of Mbomo and Kéllé in Cuvette Ouest Département. 20
October 2001-March 2002 Republic of the Congo Zaire virus 57 43 (75%) Outbreak occurred over the border of Gabon and the Republic of the Congo. This was the first time that Ebola hemorrhagic fever was reported in the Republic of the Congo. 19
October 2001-March 2002 Gabon Zaire virus 65 53 (82%) Outbreak occurred over the border of Gabon and the Republic of the Congo. 19
2000-2001 Uganda Sudan virus 425 224 (53%) Occurred in Gulu, Masindi, and Mbarara districts of Uganda. The three most important risks associated with Ebola virus infection were attending funerals of Ebola hemorrhagic fever case-patients, having contact with case-patients in one’s family, and providing medical care to Ebola case-patients without using adequate personal protective measures. 18
1996 Russia Zaire virus 1 1 (100%) Laboratory contamination 17
1996 Philippines Reston virus 0 0 Ebola-Reston virus was identified in a monkey export facility in the Philippines. No human infections were identified. 16
1996 USA Reston virus 0 0 Ebola-Reston virus was introduced into a quarantine facility in Texas by monkeys imported from the Philippines. No human infections were identified. 15
1996 South Africa Zaire virus 2 1 (50%) A medical professional traveled from Gabon to Johannesburg, South Africa, after having treated Ebola-infected patients and having been exposed to the virus. He was hospitalized, and a nurse who took care of him became infected and died. 14
1996-1997 (July-January) Gabon Zaire virus 60 45 (74%) Occurred in Booué area with transport of patients to Libreville. Index case-patient was a hunter who lived in a forest camp. Disease was spread by close contact with infected persons. A dead chimpanzee found in the forest at the time was determined to be infected. 11
1996 (January-April) Gabon Zaire virus 37 21 (57%) Occurred in Mayibout area. A chimpanzee found dead in the forest was eaten by people hunting for food. Nineteen people who were involved in the butchery of the animal became ill; other cases occurred in family members. 11
1995 Democratic Republic of the Congo (formerly Zaire) Zaire virus 315 250 (81%) Occurred in Kikwit and surrounding area. Traced to index case-patient who worked in the forest adjoining the city. The epidemic spread through families and hospitals. 13
1994 Côte d’Ivoire (Ivory Coast) Taï Forest virus 1 0 Scientist became ill after conducting an autopsy on a wild chimpanzee in the Tai Forest. The patient was treated in Switzerland. 12
1994 Gabon Zaire virus 52 31 (60%) Occurred in Mékouka and other gold-mining camps deep in the rain forest. Initially thought to be yellow fever; identified as Ebola hemorrhagic fever in 1995. 11
1992 Italy Reston virus 0 0 Ebola-Reston virus was introduced into quarantine facilities in Sienna by monkeys imported from the same export facility in the Philippines that was involved in the episodes in the United States. No humans were infected. 10
1989-1990 Philippines Reston virus 3 (asymptomatic) 0 High mortality among cynomolgus macaques in a primate facility responsible for exporting animals in the United States. 8
Three workers in the animal facility developed antibodies but did not get sick. 9
1990 USA Reston virus 4 (asymptomatic) 0 Ebola-Reston virus was introduced once again into quarantine facilities in Virginia, and Texas by monkeys imported from the Philippines. Four people developed antibodies but did not get sick. 7
1989 USA Reston virus 0 0 Ebola-Reston virus was introduced into quarantine facilities in Virginia and Pennsylvania by monkeys imported from the Philippines. 6
1979 Sudan (South Sudan) Sudan virus 34 22 (65%) Occurred in Nzara, Maridi. Recurrent outbreak at the same site as the 1976 Sudan epidemic. 5
1977 Zaire Zaire virus 1 1 (100%) Noted retrospectively in the village of Tandala. 4
1976 England Sudan virus 1 0 Laboratory infection by accidental stick of contaminated needle. 3
1976 Sudan (South Sudan) Sudan virus 284 151 (53%) Occurred in Nzara, Maridi and the surrounding area. Disease was spread mainly through close personal contact within hospitals. Many medical care personnel were infected. 2
1976 Zaire (Democratic Republic of the Congo – DRC) Zaire virus 318 280 (88%) Occurred in Yambuku and surrounding area. Disease was spread by close personal contact and by use of contaminated needles and syringes in hospitals/clinics. This outbreak was the first recognition of the disease. 1

*Numbers reflect laboratory confirmed cases only.

References

  1. World Health Organization. Ebola haemorrhagic fever in Zaire, 1976 [958 KB, 24 pages]. Report of an International Convention. Bulletin of the World Health Organization. 1978;56(2):271-293.
  2. World Health Organization. Ebola haemorrhagic fever in Sudan, 1976. Report of a WHO/International Study Team [1.4 MB, 24 pages]. Bulletin of the World Health Organization. 1978;56(2):247-270.
  3. Emond RT, Evans B, Bowen ET, et al. A case of Ebola virus infection. British Medical Journal. 1977;2(6086):541-544.
  4. Heymann DL, Weisfeld JS, Webb PA, et al. Ebola hemorrhagic fever: Tandala, Zaire, 1977-1978. Journal of Infectious Diseases. 1980;142(3):372-376.
  5. Baron RC, McCormick JB, and Zubeir OA. Ebola virus disease in southern Sudan: hospital dissemination and intrafamilial spread. Bulletin of the World Health Organization. 1983;61(6):997-1003.
  6. Jahrling PB, Geisbert TW, Dalgard DW, et al. Preliminary report: isolation of Ebola virus from monkeys imported to USA. Lancet. 1990;335(8688):502-505.
  7. Centers for Disease Control. Update: Filovirus infection in animal handlers. Morbidity Mortality Weekly Report. 1990;39(13):221.
  8. Hayes CG, Burans JP, Ksiazek TG, et al. Outbreak of fatal illness among captive macaques in the Philippines caused by an Ebola-related filovirus. American Journal of Tropical Medicine and Hygiene. 1992;46(6):664-671.
  9. Miranda ME, White ME, Dayrit MM, Hayes CG, Ksiazek TG, and Burans JP. Seroepidemiological study of filovirus related to Ebola in the Philippines. Lancet. 1991;337:425-426.
  10. World Health Organization. Viral haemorrhagic fever in imported monkeys [1.2 MB, 8 pages]. Weekly Epidemiological Record. 1992;67(24):183.
  11. Georges AJ, Leroy EM, Renaud AA, et al. Ebola hemorrhagic fever outbreaks in Gabon, 1994-1997: epidemiologic and health control issues. Journal of Infectious Diseases. 1999;179:S65-75.
  12. Le Guenno B, Formenty P, Wyers M, et al. Isolation and partial characterisation of a new strain of Ebola virus. Lancet. 1995;345:1271-1274.
  13. Khan AS, Tshioko FK, Heymann DL, et al. The Reemergence of Ebola Hemorrhagic Fever, Democratic Republic of the Congo, 1995. Journal of Infectious Diseases. 1999;179:S76-S86.
  14. World Health Organization. Ebola haemorrhagic fever – South Africa [469 KB, 8 pages]. Weekly Epidemiological Record. 1996;71(47):359.
  15. Rollin PE, Williams J, Bressler D, et al. Isolated cases of Ebola (subtype Reston) virus among quarantined non-human primates recently imported from the Philippines to the United States. Journal of Infectious Diseases. 1999;179 (suppl 1):S108-S114.
  16. Miranda ME, Ksiazek TG, Retuya TJ, et al. Epidemiology of Ebola (subtype Reston) virus in the Philippines, 1996. Journal of Infectious Diseases. 1999;179 (suppl 1):S115-S119.
  17. Borisevich IV, Markin VA, Firsova IV, et al. Hemorrhagic (Marburg, Ebola, Lassa, and Bolivian) fevers: epidemiology, clinical pictures, and treatment. Voprosy Virusologii – Problems of Virology (Moscow). 2006;51(5):8–16 [Russian].
  18. Okware SI, Omaswa FG, Zaramba S, et al. An outbreak of Ebola in Uganda. Tropical Medicine and International Health. 2002;7(12):1068-1075.
  19. World Health Organization. Outbreak(s) of Ebola haemorrhagic fever, Congo and Gabon, October 2001- July 2002 [518 KB, 12 pages]. Weekly Epidemiological Report. 2003;78(26):223-225.
  20. Formenty P, Libama F, Epelboin A, et al. Outbreak of Ebola hemorrhagic fever in the Republic of the Congo, 2003: a new strategy? Medecine Tropicale (Marseille). 2003;63(3):291-295.
  21. World Health Organization. Ebola haemorrhagic fever in the Republic of the Congo – Update 6. Weekly Epidemiological Record. 6 January 2004.
  22. World Health Organization. Outbreak of Ebola haemorrhagic fever in Yambio, south Sudan, April-June 2004 [159 KB, 8 pages]. Weekly Epidemiological Record. 2005;80(43):370-375.
  23. Akinfeyeva LA, Aksyonova OI, Vasilyevich IV, et al. A case of Ebola hemorrhagic fever. Infektsionnye Bolezni (Moscow). 2005;3(1):85–88 [Russian].
  24. Declaration de son Excellence Monsieur le Ministre de la Santé Publique annonçant la fin de l’épidémie de FHV à virus Ebola dans les zones de santé de Mweka, Luebo et Bulape dans la Province du KasaiOccidental [579 KB, 3 pages] . Mardi, le 20 novembre 2007. Dr Victor Makwenge Kaput, Ministre de la Santé Publique.
  25. World Health Organization. Ebola virus haemorrhagic fever, Democratic Republic of the Congo – Update. [159 KB, 8 pages]. Weekly Epidemiological Record. 2007;82(40):345-346.
  26. MacNeil A, Farnon EC, Morgan OW, et al. Filovirus Outbreak Detection and Surveillance: Lessons from Bundibugyo [203 KB, 7 pages] . Journal of Infectious Diseases. 2011;204:S761-S767.
  27. World Health Organization. Ebola Reston in pigs and humans, Philippines [240 KB, 8 pages]. Weekly Epidemiological Record. 2009;84(7):49-50.
  28. Barrette RW, Metwally SA, Rowland JM, et al. Discovery of Swine as a Host for the Reston ebolavirus. Science. 2009;325;204-206.
  29. World Health Organization. End of the Ebola Outbreak in the Democratic Republic of the Congo. Global Alert and Response. 17 Febuary 2009.
  30. Shoemaker T, MacNeil A, Balinandi S, et al. Reemerging Sudan Ebola Virus Disease in Uganda, 2011. Emerging Infectious Diseases. 2012;18(9):1480-1483.
  31. Albarino CG, Shoemaker T, Khristova ML, et al. Genomic analysis of filoviruses associated with four viral hemorrhagic fever outbreaks in Uganda and the Democratic Republic of the Congo in 2012. Virology. 2013;442(2):97-100.
  32. WHO Ebola Response team. After Ebola in West Africa — Unpredictable Risks, Preventable Epidemics. New England Journal of Medicine. 2017;375(6):587-596
  33. Uyeki TM, Mehta AK, Davey Jr RT. Clinical Management of Ebola Virus Disease in the United States and Europe. New England Journal of Medicine. 374(7):636-646.
  34. Maganga GD, Kapetshi J, Berthet N., et al. Ebola Virus Disease in the Democratic Republic of Congo. New England Journal of Medicine. 371(22):2083-2091.

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illustration of colorful DNA strand behind the text - CDC laboratories produce first genomic sequence of Liberian Ebola

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