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 ===== Epidemiology: Ebola Outbreak (2013-2016) =====
-Ebola first emerged in 1976 in southern Sudan and Democratic Republic of Congo. Previous to the West Africa outbreak in 2014, there was only around 100-200 cases, while the 2014 outbreak alone had greater than 25000 cases. The West Africa outbreak involved transmission between both rural and urban areas, and across borders. The densest areas include Liberia, Guinea and Sierra Leone (Kramer et al. 2016). Differences in the magnitude of outbreaks between the 2014 outbreak and previous ones are due to external factors and not the virulence of the Ebola virus. These external factors included late diagnosis and recognition that symptoms were associated with Ebola. Another factor was the lack of experience and preparation of an Ebola outbreak in West Africa. These factors lead to the significant differences in cases.
+Ebola first emerged in 1976 in southern Sudan and Democratic Republic of Congo. Previous to the West Africa outbreak in 2014, there was only around 100-200 cases, while the 2014 outbreak alone had greater than 25000 cases. The West Africa outbreak involved transmission between both rural and urban areas, and across borders. The densest areas include Liberia, Guinea and Sierra Leone (Kramer et al. 2016). Differences in the magnitude of outbreaks between the 2014 outbreak and previous ones are due to external factors and not the virulence of the Ebola virus. These external factors included late diagnosis and recognition that symptoms were associated with Ebola. Another factor was the lack of experience and preparation of an Ebola outbreak in West Africa. These factors lead to the significant differences in cases (Mack et al. 2016).
 {{ :ebola_map.png |}}
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 **ZMapp**
-Developed by Mapp Biopharmaceutical, Inc., based in San Diego, is composed of three different laboratory-made proteins called monoclonal antibodies. The treatment is designed to prevent the progression of EVD within the body by targeting the main surface glycoprotein of the Ebola virus that is essential in facilitating viral endocytosis of the host cell. The monoclonal antibodies work to bind complementarily to the viral glycoprotein epitope and inhibit binding to host cell receptors, thus preventing endocytosis and viral infection of the host cell. Earlier studies in nonhuman primates demonstrated that ZMapp had strong antiviral activity and prevented death when administered as late as five days after experimental infection with Zaire ebolavirus. It is tested on animals and results indicate it helps alleviate the fever, viraemia and abnormalities of blood count. It also reverses elevated liver enzymes and mucosal haemorrhages. ELISA and neutralizing antibody assays indicate that ZMapp is cross-reactive with the Guinean variant of Ebola.
+Developed by Mapp Biopharmaceutical, Inc., based in San Diego, is composed of three different laboratory-made proteins called monoclonal antibodies. The treatment is designed to prevent the progression of EVD within the body by targeting the main surface glycoprotein of the Ebola virus that is essential in facilitating viral endocytosis of the host cell. The monoclonal antibodies work to bind complementarily to the viral glycoprotein epitope and inhibit binding to host cell receptors, thus preventing endocytosis and viral infection of the host cell. Earlier studies in nonhuman primates demonstrated that ZMapp had strong antiviral activity and prevented death when administered as late as five days after experimental infection with Zaire ebolavirus. It is tested on animals and results indicate it helps alleviate the fever, viraemia and abnormalities of blood count. It also reverses elevated liver enzymes and mucosal haemorrhages (Marcinkiewicz et al., 2014).
 **rVSV-ZEBOV**
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 Falasca, L., Agrati, C., Petrosillo, N., Di Caro, A., Capobianchi, M. R., Ippolito, G., & Piacentini, M. (2015). Molecular mechanisms of Ebola virus pathogenesis: focus on cell death. Cell Death and Differentiation, 22(8), 1250–1259. http://doi.org/10.1038/cdd.2015.67
+Gates, B. The next epidemic—lessons from Ebola. N Engl J Med. 2015; 372: 1381–1384
 Hayman, D. T. S., Yu, M., Crameri, G., Wang, L.-F., Suu-Ire, R., Wood, J. L. N., & Cunningham, A. A. (2012). Ebola Virus Antibodies in Fruit Bats, Ghana, West Africa. Emerging Infectious Diseases, 18(7), 1207–1209. http://doi.org/10.3201/eid1807.111654
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 Kai KupferschmidtJun. 1, 2017 , 1:00 PM, 20 2017 JKN, 20 2017 KKN, 20 2017 ESN, Marc Heller, E&E NewsNov. 20, 2017, 17 2017 MWN, 20 2017 N, 17 2017 N, 16 2017 N. Hunting for Ebola among the bats of the Congo. Science | AAAS. 2017 Jul 26 [accessed 2017 Nov 24]. http://www.sciencemag.org/news/2017/06/hunting-ebola-among-bats-congo
+Kaushik, A., Tiwari, S., Jayant, R. D., Marty, A., & Nair, M. (2016). Towards Detection and Diagnosis of Ebola Virus Disease at Point-of-Care. Biosensors & Bioelectronics, 75, 254–272. http://doi.org/10.1016/j.bios.2015.08.040
 Marcinkiewicz, J., Bryniarski, K., & Katarzyna, N. (2014). Ebola Haemorrhagic Fever Virus: Pathogenesis, Immune Responses, Potential Prevention. Folia Medica Cracoviensia, 3, 39-48. Retrieved from http://www.fmc.cm-uj.krakow.pl/pdf/54_3_39.pdf
+Kramer, A. M., Pulliam, J. T., Alexander, L. W., Park, A. W., Rohani, P., & Drake, J. M. (2016). Spatial spread of the West Africa Ebola epidemic. Royal Society Open Science, 3(8), 160294. http://doi.org/10.1098/rsos.160294
+Mack, A., Snair, M. R., & Mundaca-Shah, C. (2016). The ebola epidemic in West Africa: proceedings of a workshop. Washington, DC: The National Academies Press.
 Muhlberger, E. (2007). Filovirus replication and transcription. Retrieved from https://www.futuremedicine.com/doi/abs/10.2217/17460794.2.2.205.
-Regules, J., Beigel, J., Paolino, M., Voel, J., Castellano, A., Hu, Z.,…Thomas, J. (2017). A Recombinant Vesicular Stomatitis Virus Ebola Vaccine. The New England Journal of Medicine, 376, 330-341.  Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMoa1414216?af=R&rss=currentIssue#t=article
+Regules, J., Beigel, J., Paolino, M., Voel, J., Castellano, A., Hu, Z.,…Thomas, J. (2017). A Recombinant Vesicular Stomatitis Virus Ebola Vaccine. The New England Journal of Medicine, 376, 330-341.  Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMoa1414216af=R&rss=currentIssue#t=article
+Varkey, J. B., Shantha, J. G., Crozier, I., Kraft, C. S., Lyon, G. M., Mehta, A. K., ... & Ströher, U. (2015). Persistence of Ebola virus in ocular fluid during convalescence. New England Journal of Medicine, 372(25), 2423-2427. Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMoa1500306#t=article.
 World Health Organization (WHO). (2014). Laboratory diagnosis of Ebola virus disease. [accessed 2017 Nov 18]. http://www.who.int/csr/resources/publications/ebola/laboratory-guidance/en/

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