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Ebola outbreak in west Africa is officially over

BMJ 2016; 352 doi: (Published 14 January 2016) Cite this as: BMJ 2016;352:i243
  1. Anne Gulland
  1. 1London

The World Health Organization has declared the outbreak of Ebola virus disease in west Africa officially over, more than two years after it began.

Liberia is the last of the three west African countries worst affected by the virus to mark 42 days since the last patient tested negative for the disease. Liberia was first declared free of the virus in May 2015 but has had two flare ups of the virus since then. Sierra Leone was declared free of transmission on 7 November last year, and Guinea was declared free of it on 29 December.1 2

The world was first alerted to a possible epidemic of Ebola virus disease in the region in March 2014, when the first cases were declared in Guinea, but it is thought that the outbreak actually began in December 2013 in remote forested regions of the country. As at 3 January this year there have been 28 637 cases of the disease worldwide and 11 315 deaths, although this is likely to be an underestimate.

Sierra Leone was the worst affected country, with 14 122 cases of the disease, including 3955 deaths. Liberia has had 10 675 cases with 4809 deaths and Guinea 3804 cases with 2536 deaths.

Rick Brennan, director of WHO’s department of emergency risk management and humanitarian response, said on Thursday 14 January, “This is the end of Ebola virus disease transmission in west Africa, but the job is not yet done. We still have an ongoing residual risk to manage.”

There have been 10 flare ups of the disease that were not part of the original outbreak and were most likely caused by the virus remaining in survivors after recovery. The virus can persist in semen and other body fluids, and new guidance from WHO recommends that male survivors practise safe sex until they have at least two negative tests of their semen, a week apart. If they have no access to testing, men should practise safe sex for at least 12 months after recovery, said Brennan.

Peter Graaff, director for the Ebola response at WHO, said that the three worst affected countries were in a much better position now to deal with any new outbreaks than they were two years ago.

“Right now it is our collective responsibility to ensure countries continue to detect and prevent cases and respond swiftly,” he said.

Graaff said that populations were experiencing a new “normal” and that there was a tension between returning to old healthcare practices and remaining vigilant. “The tension is that the traditional practices are important from a cultural point of view. We need to find a balance between continued safety and being able to live a life one wants,” he said.


Cite this as: BMJ 2016;352:i243


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