Ebola is one of the most harmful viral diseases that can affect humans. It was first found in 1976 shortly after episodes of a deadly type of hemorrhagic fever occurred in various areas of Central Africa, first in the Democratic Republic of the Congo in a village near the Ebola River, and then another outbreak in Sudan about five hundred miles from the first. In fact, both outbreaks were thought to be the same virus carried by a traveler, but genetic testing later showed that they were caused by different strains of the Ebola virus. Subsequent research into the virus as well as epidemiological records show that the Ebola virus was with us long before both of these first-ever documented infections occurred. The virus likely spread as a result of human population expansion, the encroachment of civilization into forested habitats, and strong interactions with wild animals. Since this first detection in 1976, we have seen several cases and episodes of Ebola virus disease in Africa, with the 2014–2016 Ebola outbreak in West Africa, which began in rural Guinea, being even worse. Ebola soon spread to cities and across borders within weeks. Within months, the epidemic was truly an international crisis. With this episode, health workers accounted for 3.9% in Sierra Leone, Liberia and Guinea, in contrast to the earlier episode in K i k wit in 1995, when health workers accounted for 25% of all infections at that time. In 2014-2015, the vast majority of transmission events occurred between close relatives, mostly through direct contact with the bodies of those who died of Ebola. Public health interventions to modify bereavement and burial behaviors and the introduction of safe burials have been significant in managing this epidemic.
At the time of the first Ebola outbreak in 1976, much effort was devoted to identifying the host as well as the mechanism of disease transmission so that the information could be used to address the episodes. Researchers have examined the vast array of wildlife, insects and plants looking for the source and reservoir, and locating the source has proven to be extremely difficult because the host in the reservoir of the Ebola virus is unlikely to have any symptomatic disease, so it will be contained in the ecosystem simply by distribution from the host to the host and also through intermediate hosts or vectors until it finally manifests as an acute disease in humans. African bats have actually been identified as almost certainly involved in the spread of the Ebola virus and may even be the source animal, but this has not yet been fully proven. During the early episodes, the use of dirty needles as well as syringes almost certainly allowed the spread of the Ebola virus. There are reports that during this initial outbreak in the Democratic Republic of the Congo in 1976, nurses at a missionary hospital used only five syringes for 300 to 600 patients a day. Any close exposure to contaminated blood, as well as this recycling of contaminated needles, as well as inappropriate nursing approaches, may have been the source of much human-to-human transmission during earlier Ebola outbreaks. As much more is known about the transmission of the virus and the dangers associated with numerous health strategies, this risk is much less and any outbreaks are usually brought under control immediately.
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