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Western African Ebola virus epidemic |
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This list of Ebola outbreaks records the known occurrences of Ebola virus disease, a highly infectious and acutely lethal viral disease that has afflicted humans and animals primarily in equatorial Africa. [1] The pathogens responsible for the disease are the five ebolaviruses recognized by the International Committee on Taxonomy of Viruses: Ebola virus (EBOV), Sudan virus (SUDV), Reston virus (RESTV), Taï Forest virus (TAFV), and Bundibugyo virus (BDBV). [2] [3] [4] [5] Four of the five variants have caused the disease in humans as well as other animals; RESTV has caused clinical symptoms only in non-human primates. [6] [7] RESTV has caused subclinical infections in humans, producing an antibody response but no visual symptoms or disease state manifestations. [8]
Transmission of the ebolaviruses between natural reservoirs and humans is rare, and outbreaks of Ebola virus disease are often traceable to a single case where an individual has handled the carcass of a gorilla, chimpanzee, bats, [9] or duiker. [10] The virus then spreads person-to-person, especially within families, in hospitals, and during some mortuary rituals where contact among individuals becomes more likely. [11]
Learning from failed responses, such as during the 2000 outbreak in Uganda, the World Health Organization (WHO) established its Global Outbreak Alert and Response Network, and other public health measures were instituted in areas at high risk. Field laboratories were established to confirm cases, instead of shipping samples to South Africa. [12] Outbreaks are also closely monitored by the United States Centers for Disease Control and Prevention (CDC) Special Pathogens Branch. [13]
Nigeria was the first country in western Africa to successfully curtail the virus, and its procedures have served as a model for other countries to follow. [14] [15] [16]
The information in the following tables comes from the World Health Organization (WHO). This data excludes all laboratory personnel cases, Reston virus cases (since they are all asymptomatic), and suspected cases. [17] For a complete overview, those cases are included below with footnotes and supporting sources.
Date | Country [lower-alpha 1] | Virus | Human cases | Human deaths | Case fatality rate | Description |
---|---|---|---|---|---|---|
Jun–Nov 1976 | Sudan | SUDV | 284 | 151 | 53% | Occurred in Nzara (the source town), Maridi, Tumbura, and Juba (cities in present-day South Sudan). The index cases were workers in a cotton factory. The disease was spread by close contact with an acute case, usually from patients to their nurses. Many medical care personnel were infected. [18] |
Aug 1976 | Zaire | EBOV | 318 | 280 | 88% | Yambuku and surrounding areas in what was then Zaire (present-day Democratic Republic of the Congo DRC). It spread through personal contact and by use of contaminated needles and syringes in hospitals and clinics. [19] | Occurred in
Aug–Sep 1979 | Sudan | SUDV | 34 | 22 | 65% | Occurred in Nzara and Maridi. This was a recurrent outbreak at the same site as the 1976 Sudan epidemic. [20] |
Dec 1994–Feb 1995 | Gabon | EBOV | 52 | 31 | 60% | Occurred in Makokou and gold-mining camps deep in the rainforest along the Ivindo River. Until 1995, the outbreak was incorrectly classified as yellow fever. [21] |
May–Jul 1995 | Zaire | EBOV | 315 | 254 | 81% | Occurred in Kikwit and surrounding areas. The outbreak was traced to a patient who worked in a forest adjoining the city. The epidemic spread through families and hospital admissions. [22] [23] |
Jan 1996–Mar 1997 | Gabon | EBOV | 91 | 66 | 72.53% | The first strain Occurred in the village of Mayibout 2 and neighboring areas. A chimpanzee found dead in the forest was eaten by villagers hunting for food. Nineteen people involved in the butchery of the animal became ill, and other cases occurred in their family members. [21] The last strain Occurred in the Booué area with transport of patients to Libreville. The index case-patient was a hunter who lived in a forest timber camp. The disease was spread by close contact with infected persons. A dead chimpanzee found in the forest at the time was determined to be infected. [21] |
Oct 2000–Jan 2001 | Uganda | SUDV | 425 | 224 | 53% | Occurred in the Gulu, Masindi, and Mbarara districts of Uganda. The three greatest risks associated with Sudan virus infection were attending funerals of case-patients, having contact with case-patients in one's family, and providing medical care to case-patients without using adequate personal protective measures. [24] Victims included Matthew Lukwiya. |
Oct 2001–Dec 2003 | Gabon ROC | EBOV | 302 | 254 | 84.11% | The first strain Occurred on both sides of the border between Gabon and the Republic of the Congo (RC). This outbreak included the first reported occurrence of Ebola virus disease in the RC. [25] The second strain Occurred in the districts of Mbomo and Kelle in the Cuvette-Ouest Department. [26] The third strain Occurred in Mbomo and Mbandza villages, located in Mbomo District in the Cuvette-Ouest Department. [27] |
Apr–Jun 2004 | Sudan | SUDV | 17 | 7 | 41% | Occurred in Yambio county in Western Equatoria of southern Sudan (present-day South Sudan). This outbreak was concurrent with an outbreak of measles in the same area, and several suspected EVD cases were reclassified later as measles cases. [28] |
Apr-May 2005 | ROC | EBOV | 12 | 10 | 83% | Occurred in the Etoumbi district of Cuvette Ouest Department of the Republic of the Congo [29] |
Aug–Nov 2007 | DRC | EBOV | 264 | 187 | 71% | |
Dec 2007–Jan 2008 | Uganda | BDBV | 149 | 37 | 25% | Occurred in the Bundibugyo District in western Uganda. This was the first identification of the Bundibugyo virus (BDBV). [3] [4] |
Dec 2008–Feb 2009 | DRC | EBOV | 32 | 14 | 45% | Occurred in the Mweka and Luebo health zones of the Kasaï-Occidental province. [30] |
Jun–Aug 2012 | Uganda | SUDV | 24 | 17 | 71% | Occurred in the Kibaale District. [31] |
Jun–Nov 2012 | DRC | BDBV | 57 | 29 | 51% | Occurred in the Orientale Province. [1] [32] |
Dec 2013–Jun 2016 | Widespread: Liberia Sierra Leone Guinea Limited and local: Nigeria Mali United States Senegal Spain United Kingdom Italy | EBOV | 28,616 | 11,310 | 70–71% (general) [33] [34] [35] [note 1] 57–59% (among hospitalized patients) [36] | Guéckédou, Guinea, in December 2013 and spread abroad. [37] [38] [33] Flare-ups of the disease continued into 2016, [39] and the outbreak was declared over on 9 June 2016. | This was the most severe Ebola outbreak in recorded history in regards to both the number of human cases and fatalities. It began in
Aug–Nov 2014 | DRC | EBOV | 66 [40] | 49 [40] | 74% | Équateur province. Outbreak detected 24 August and, as of 28 October 2014, the WHO said that twenty days had passed since the last reported case was discharged and no new contacts were being followed. [40] [41] Declared over on 15 November 2014. [42] | Occurred in
May–Jul 2018 | DRC | EBOV | 54 | 33 | 61% | On 8 May 2018, the government of the Democratic Republic of the Congo reported two confirmed cases of Ebola infection in the northwestern town of Bikoro. [43] On 17 May, a case was confirmed in the city of Mbandaka. [44] Health authorities were planning to ring vaccinate with rVSV-ZEBOV, a recently developed experimental Ebola vaccine, to contain the outbreak. [44] [45] The outbreak was ongoing as of 24 June 2018, in 2014 a different area of Equateur province was affected [46] [47] On 24 July 2018 the outbreak was declared over. [48] [49] [50] [51] |
Aug 2018–Jun 2020 | Widespread: DRC Limited and local: Uganda | EBOV | 3,470 [52] [53] | 2,280 [52] [53] | 66% | On 1 August 2018, the Democratic Republic of the Congo Ministry of Health declared an outbreak when 4 individuals tested positive for the Ebola virus. [54] [55] [56] [57] On 11 June 2019, the WHO confirmed that a five-year-old boy in Uganda died after being diagnosed with Ebola. [58] [59] On 25 June 2020, the second biggest EVD outbreak ever was declared over. [60] |
May 2020–Nov 2020 | DRC | EBOV | 130 | 55 | 42% | Eteni Longondo announced an additional Ebola outbreak, separate to the ongoing Kivu Ebola epidemic. The outbreak originated in Équateur province (which was also the location of the 2018 Équateur province Ebola outbreak). [61] [62] [63] By 17 October 2020, the case count was 128 with 53 fatalities. [64] By 18 November 2020, the World Health Organization and the Congolese government had not received reports of any cases of Ebola in Équateur province or all of the DRC for 42 days. [65] When the outbreak was declared over, there were 130 reported cases and 55 reported fatalities due to the virus. [66] | On 31 May 2020, the DRC Health Minister
Feb–May 2021 | DRC | EBOV | 12 | 6 | 50% | On 6 February 2021, an outbreak was declared in Butembo in the North Kivu province by the Ministry of Public Health of the Democratic Republic of the Congo. [67] By 3 May 2021, the outbreak was declared over. [68] |
Feb–Jun 2021 | Guinea | EBOV | 23 | 12 | 52% | First Ebola cases and deaths in the country since 2016. [67] [69] The first cases were confirmed on 14 February 2021, and by 9 April 2021, there were 23 reported cases of the virus, with 12 fatalities and 9 recoveries. [70] Scientists concluded that the likely source of the outbreak was a man who had survived the 2013-2016 West African epidemic but had unknowingly harbored the Ebola virus in his body, eventually transmitting it to somebody in his community, although the first known case of this current outbreak was a female nurse who had died on 28 January 2021. [71] The outbreak was declared over on 19 June 2021. [72] |
Oct–Dec 2021 | DRC | EBOV | 11 | 9 | 82% | On 8 October 2021, the Ministry of Public Health for the Democratic Republic of the Congo reported a new laboratory confirmed case of Ebola virus disease, ten more related cases were later confirmed. [73] On 16 December the outbreak was declared over. [74] |
Sept 2022–Jan 2023 | UGA | SUDV | 164 | 77 | 47% | Mubende District, Uganda. Seventy-seven people died, with a total of 164 cases detected. The outbreak was declared over in January 2023. [75] | On 20 September 2022 an outbreak was declared in
Date | Country [lower-alpha 1] | Virus | Human cases | Human deaths | Description |
---|---|---|---|---|---|
1976 | United Kingdom | SUDV or EBOV [note 2] | 1 | 0 | Laboratory infection by accidental stick of contaminated needle. [76] [77] |
1977 | Zaire | EBOV | 1 | 1 | Noted retroactively in the village of Tandala. [77] [78] [79] |
1989–1990 | Philippines | RESTV | 3 [lower-alpha 2] | 0 | The Reston virus (RESTV) was first identified when it caused high mortality in crab-eating macaques in a primate research facility responsible for exporting animals to the United States. [80] Three workers in the facility developed antibodies to the virus but did not get sick. [81] |
1989 | United States | RESTV | 0 | 0 | RESTV was introduced into quarantine facilities in Virginia and Pennsylvania by monkeys imported from the Philippines. No human cases were reported. [82] |
1990 | United States | RESTV | 4 [lower-alpha 2] | 0 | Monkeys imported from the Philippines introduced RESTV into quarantine facilities in Virginia and Texas. Four humans developed antibodies but did not get sick. [83] |
1992 | Italy | RESTV | 0 | 0 | RESTV was introduced into quarantine facilities in Siena by monkeys imported from the same facility in the Philippines that was the source of the 1989 and 1990 U.S. outbreaks. No human cases resulted. [84] |
1994 | Côte d'Ivoire [lower-alpha 3] | TAFV | 1 | 0 | This case was the first and thus far only recognition of Taï Forest virus (TAFV). Approximately one week after conducting necropsies on infected western chimpanzees in Taï National Park, a scientist contracted the virus and developed symptoms similar to those of dengue fever. She was discharged from a Swiss hospital two weeks later and fully recovered after six weeks. [85] |
1995 | Côte d'Ivoire | Unknown | 1 | 0 | One person, fleeing the civil war in neighboring Liberia, was identified as an Ebola case in Gozon. This is considered as a suspected case, excluding from the WHO outbreak counts. [86] [87] |
1996 | South Africa | EBOV | 1 | 1 | n/a |
1996 | United States | RESTV | 0 | 0 | RESTV was again introduced into a quarantine facility in Texas by monkeys imported from the same facility in the Philippines that was the source of the 1989 and 1990 U.S. outbreaks. No human cases resulted. [88] |
1996 | Philippines | RESTV | 0 | 0 | RESTV was identified at a monkey export facility in the Philippines. No human cases resulted. [89] |
1996 | Russia | EBOV | 1 | 1 | Laboratory contamination. [90] |
2004 | Russia | EBOV | 1 | 1 | Laboratory contamination. [91] |
2008 | Philippines | RESTV | 6 [lower-alpha 2] | 0 | First recognition of RESTV in pigs. Strain very similar to earlier strains. Occurred in November. Six workers from the pig farm and slaughterhouse developed antibodies but did not become sick. [92] [93] |
2011 | Uganda | SUDV | 1 | 1 | n/a[ citation needed ] |
2012 | Uganda | SUDV | 7 | 4 | n/a [ citation needed ] |
2015 | Philippines | RESTV | 0 | 0 | On 6 September 2015, the Philippine health secretary reported an outbreak of RESTV in a primate research and breeding facility. Twenty-five workers subsequently tested negative for the virus. [94] |
2017 | DRC | EBOV | 8 | 4 | On 11 May 2017, the Ministry of Public Health for the Democratic Republic of the Congo notified the WHO of an Ebola outbreak in the Likati health zone (LHZ) in Bas-Uele province, in the northern part of the country. Suspected infections were reported from Nambwa, Mouma, and Ngay. The LHZ borders the Central African Republic, which made this outbreak a moderate risk to the region. [95] [96] |
2018 | Hungary | N/A | 0 | 0 | On 20 April 2018, a laboratory accident led to a single worker being exposed to the Ebola virus, though he did not develop symptoms. [97] [98] |
2022 | DRC | EBOV | 5 | 5 | An outbreak in DRC began on April 23, and has killed 100% of those infected. [99] |
2022 | DRC | EBOV | 1 | 1 | A single case was confirmed in North Kivu. [100] |
Year | Country [lower-alpha 1] | Virus | Human cases | Human deaths | Case fatality rate | Comments |
---|---|---|---|---|---|---|
1967 | West Germany Yugoslavia | MARV | 31 | 7 | 23% | Marburg, Germany where the virus was first identified (historically) and the subsequent naming of the virus per the location [102] | In 1967 outbreaks in
1975 | Rhodesia South Africa | MARV | 3 | 1 | 33% | Individual had traveled to Zimbabwe [101] |
1980 | Kenya | MARV | 2 | 1 | 50% | Individual(s) traveled to Kitum Cave [101] |
1987 | Kenya | RAVV | 1 | 1 | 100% | Ravn virus (RAVV) one of two members of the species Marburg marburgvirus [103] |
1990 | Soviet Union | MARV | 1 | 1 | 100% | Laboratory incident [101] |
1998–2000 | DRC | MARV & RAVV | 154 | 128 | 83% | Occurred in Durba [101] |
2004–2005 | Angola | MARV | 252 | 227 | 90% | Largest Marburg virus outbreak ever occurred in Angola [104] |
2007 | Uganda | MARV & RAVV | 4 | 1 | 25% | Occurred in Kamwenge [101] |
2008 | Uganda Netherlands United States | MARV | 2 | 1 | 50% | - |
2012 | Uganda | MARV | 15 | 4 | 27% | Occurred in Kabale [101] |
2014 | Uganda | MARV | 1 | 1 | 100% | - |
2017 | Uganda | MARV | 3 | 3 | 100% | Uganda has had five outbreaks of the virus [105] |
2021 | Guinea | MARV | 1 | 1 | 100% | Guéckédou prefecture was declared over, a case of the Marburg virus disease was confirmed by health authorities through laboratory analysis. [106] This is the first-ever case of the Marburg virus disease in West Africa. [107] On August 2, the patient succumbed to the illness. [108] | In August 2021, two months after the re-emergent Ebola epidemic in the
2022 | Ghana | MARV | 3 | 3 | 100% | First time Ghana has had cases of Marburg virus disease [109] [110] |
2023 | Equatorial Guinea | MARV | 17 | 12 | 70% | First time Marburg virus disease was detected in the country. |
2023 | Tanzania | MARV | 9 | 6 | 67% | First time Marburg virus disease was detected in the country. [111] [112] |
2024 | Rwanda | MARV | 26 | 6 | 23% | First time Marburg virus disease was detected in the country |
Marburg virus disease (MVD), formerly Marburg hemorrhagic fever (MHF) is a viral hemorrhagic fever in human and non-human primates caused by either of the two Marburgviruses: Marburg virus (MARV) and Ravn virus (RAVV). Its clinical symptoms are very similar to those of Ebola virus disease (EVD).
The genus Ebolavirus is a virological taxon included in the family Filoviridae, order Mononegavirales. The members of this genus are called ebolaviruses, and encode their genome in the form of single-stranded negative-sense RNA. The six known virus species are named for the region where each was originally identified: Bundibugyo ebolavirus, Reston ebolavirus, Sudan ebolavirus, Taï Forest ebolavirus, Zaire ebolavirus, and Bombali ebolavirus. The last is the most recent species to be named and was isolated from Angolan free-tailed bats in Sierra Leone. Each species of the genus Ebolavirus has one member virus, and four of these cause Ebola virus disease (EVD) in humans, a type of hemorrhagic fever having a very high case fatality rate. The Reston virus has caused EVD in other primates. Zaire ebolavirus has the highest mortality rate of the ebolaviruses and is responsible for the largest number of outbreaks of the six known species of the genus, including the 1976 Zaire outbreak and the outbreak with the most deaths (2014).
Viral hemorrhagic fevers (VHFs) are a diverse group of animal and human illnesses. VHFs may be caused by five distinct families of RNA viruses: the families Filoviridae, Flaviviridae, Rhabdoviridae, and several member families of the Bunyavirales order such as Arenaviridae, and Hantaviridae. All types of VHF are characterized by fever and bleeding disorders and all can progress to high fever, shock and death in many cases. Some of the VHF agents cause relatively mild illnesses, such as the Scandinavian nephropathia epidemica, while others, such as Ebola virus, can cause severe, life-threatening disease.
Crimean–Congo hemorrhagic fever (CCHF) is a viral disease. Symptoms of CCHF may include fever, muscle pains, headache, vomiting, diarrhea, and bleeding into the skin. Onset of symptoms is less than two weeks following exposure. Complications may include liver failure. Survivors generally recover around two weeks after onset.
The species Bundibugyo ebolavirus is the taxonomic home of one virus, Bundibugyo virus (BDBV), that forms filamentous virions and is closely related to the infamous Ebola virus (EBOV). The virus causes severe disease in humans in the form of viral hemorrhagic fever and is a Select agent, World Health Organization Risk Group 4 Pathogen, National Institutes of Health/National Institute of Allergy and Infectious Diseases Category A Priority Pathogen, Centers for Disease Control and Prevention Category A Bioterrorism Agent, and is listed as a Biological Agent for Export Control by the Australia Group.
The species Sudan ebolavirus is a virological taxon included in the genus Ebolavirus, family Filoviridae, order Mononegavirales. The species has a single virus member, Sudan virus (SUDV). The members of the species are called Sudan ebolaviruses. It was discovered in 1977 and causes Ebola clinically indistinguishable from the ebola Zaire strain, but is less transmissible than it. Unlike with ebola Zaire there is no vaccine available.
Marburg virus (MARV) is a hemorrhagic fever virus of the Filoviridae family of viruses and a member of the species Marburg marburgvirus, genus Marburgvirus. It causes Marburg virus disease in primates, a form of viral hemorrhagic fever. The World Health Organization (WHO) rates it as a Risk Group 4 Pathogen. In the United States, the National Institute of Allergy and Infectious Diseases ranks it as a Category A Priority Pathogen and the Centers for Disease Control and Prevention lists it as a Category A Bioterrorism Agent. It is also listed as a biological agent for export control by the Australia Group.
Ravn virus is a close relative of Marburg virus (MARV). RAVV causes Marburg virus disease in humans and nonhuman primates, a form of viral hemorrhagic fever. RAVV is a Select agent, World Health Organization Risk Group 4 Pathogen, National Institutes of Health/National Institute of Allergy and Infectious Diseases Category A Priority Pathogen, Centers for Disease Control and Prevention Category A Bioterrorism Agent, and listed as a Biological Agent for Export Control by the Australia Group.
Ebola, also known as Ebola virus disease (EVD) and Ebola hemorrhagic fever (EHF), is a viral hemorrhagic fever in humans and other primates, caused by ebolaviruses. Symptoms typically start anywhere between two days and three weeks after infection. The first symptoms are usually fever, sore throat, muscle pain, and headaches. These are usually followed by vomiting, diarrhoea, rash and decreased liver and kidney function, at which point some people begin to bleed both internally and externally. It kills between 25% and 90% of those infected – about 50% on average. Death is often due to shock from fluid loss, and typically occurs between six and 16 days after the first symptoms appear. Early treatment of symptoms increases the survival rate considerably compared to late start. An Ebola vaccine was approved by the US FDA in December 2019.
In 2014, an outbreak of Ebola virus disease in the Democratic Republic of the Congo (DRC) occurred. Genome sequencing has shown that this outbreak was not related to the 2014–15 West Africa Ebola virus epidemic, but was of the same EBOV species. It began in August 2014 and was declared over in November of that year, after 42 days without any new cases. This is the 7th outbreak there, three of which occurred during the period of Zaire.
Oyewale Tomori is a Nigerian professor of virology, educational administrator, and former vice chancellor of Redeemer's University. In 2024, he became the chair of West Africa National Academy of Scientists.
On 11 May 2017, the Democratic Republic of the Congo (DRC) was identified by the World Health Organization (WHO) as having one Ebola-related death.
The 2017 Uganda Marburg virus outbreak was confirmed by the World Health Organization (WHO) on 20 October 2017 after there had been an initial fatality due to the virus.
The 2018 Équateur province Ebola outbreak occurred in the north-west of the Democratic Republic of the Congo (DRC) from May to July 2018. It was contained entirely within Équateur province, and was the first time that vaccination with the rVSV-ZEBOV Ebola vaccine had been attempted in the early stages of an Ebola outbreak, with a total of 3,481 people vaccinated. It was the ninth recorded Ebola outbreak in the DRC.
Jean-Paul Joseph Gonzalez is a French virologist. He graduated from the Medical School of Bordeaux University France.
The Kivu Ebola epidemic was an outbreak of Ebola virus disease (EVD) mainly in eastern Democratic Republic of the Congo (DRC), and in other parts of Central Africa, from 2018 to 2020. Between 1 August 2018 and 25 June 2020 it resulted in 3,470 reported cases. The Kivu outbreak also affected Ituri Province, whose first case was confirmed on 13 August 2018. In November 2018, the outbreak became the biggest Ebola outbreak in the DRC's history, and had become the second-largest Ebola outbreak in recorded history worldwide, behind only the 2013–2016 Western Africa epidemic. In June 2019, the virus reached Uganda, having infected a 5-year-old Congolese boy who entered Uganda with his family, but was contained.
Jean-Jacques Muyembe is a Congolese microbiologist. He is the general director of the Democratic Republic of the Congo Institut National pour la Recherche Biomedicale (INRB). He was part of team at the Yambuku Catholic Mission Hospital that investigated the first Ebola outbreak, and was part of the effort that discovered Ebola as a new disease, although his exact role is still subject to controversy. In 2016, he led the research that designed, along with other researchers at the INRB and the National Institute of Health Vaccine Research Center in the US, one of the most promising treatment for Ebola, mAb114. The treatment was successfully experimented during recent outbreaks in the DRC, on the express decision of the then DRC Minister of Health, Dr Oly Ilunga, despite a prior negative advice from the World Health Organization.
In August–November 1976, an outbreak of Ebola virus disease occurred in Zaire. The first recorded case was from Yambuku, a small village in Mongala District, 1,098 kilometres (682 mi) northeast of the capital city of Kinshasa.
On 7 February 2021, the Congolese health ministry announced that a new case of Ebola near Butembo, North Kivu had been detected the previous day. The case was a 42-year-old woman who had symptoms of Ebola in Biena on 1 February 2021. A few days after, she died in a hospital in Butembo. The WHO said that more than 70 people who had contact with the woman had been tracked.
Rwanda is currently experiencing its first-ever outbreak of Marburg virus disease (MVD).The outbreak was first reported to the World Health Organization on September 28, 2024. The U.S. embassy in Rwanda has issued an alert on the matter.
The reported case fatality rate in the three intensetransmission countries among all cases for whom a definitive outcome is known is 71 percent.
... [I]s between 57% and 59% in the 3 intense-transmission countries, with no detectable improvement since the onset of the epidemic.