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Observational study
The unprecedented scale of the West African Ebola virus disease outbreak is due to environmental and sociological factors, not special attributes of the currently circulating strain of the virus
  1. Derek Gatherer
  1. Division of Biomedical & Life Sciences, Faculty of Health & Medicine, Lancaster University, Lancaster, UK
  1. Correspondence to : Dr Derek Gatherer, Division of Biomedical & Life Sciences, Faculty of Health & Medicine, Lancaster University, Lancaster LA1 4YT, UK; d.gatherer{at}

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Commentary on: WHO Ebola Response Team. Ebola virus disease in West Africa—the first 9 months of the epidemic and forward projections. N Engl J Med 2014;371:1481–95.


An outbreak of Ebola virus disease (EVD), caused by Zaire ebolavirus, beginning in south-eastern Guinea in December 2013,1 but not formally identified until 23 March 2014, has spread to the neighbouring countries of Liberia, Sierra Leone and Mali, with limited transmission to Nigeria, USA, Spain and Senegal. The cumulative total of cases and deaths is 14 413 and 5177, respectively as of 11 November 2014, making this outbreak around 45 times larger than any previous one. No validated treatment is yet available, although numerous experimental therapies are being employed following the decision of the WHO Panel on Unregistered Interventions. Quarantine, contact tracing and symptomatic therapy remain the …

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  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.

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