Ebola’s reign of terror: since outbreak a year ago virus has killed over 7,500 Lucy Lamble It is now a year since the outbreak of Ebola in Guinea, after a toddler in the rural south-east came into contact with a fruit bat. By March, the virus had spread across the border to Liberia and it reached Sierra Leone in May. More people have died in this outbreak – 7,588 as of 24 December, according to the World Health Organisation – than in all known occurrences combined. Medical professionals were particularly affected due to the nature of their work, further weakening already fragile healthcare in these countries. The social and economic impact of the outbreak is hard to overestimate. In September Unicef assessed that at least 3,700 children in Guinea, Liberia and Sierra Leone had lost one or both parents to Ebola. The outbreak was reported in March when hospital staff alerted Guinea’s Ministry of Health to a mysterious disease with a high death rate and symptoms including fever, diarrhoea and vomiting. By June, Médecins sans Frontières (MSF), who were at the forefront of efforts to tackle Ebola, described the outbreak as “out of control”. A civil servant Patrick Sawyer, travelled by air from Monrovia to Lagos on 20 July, triggering a series of cases in southern Nigeria. He died in hospital five days later. Nineteen people were infected: seven died. At one point about 200 were under surveillance. Senegal successfully contained its sole case, reported in August. As frustration grew over the slow response, calls for funding and especially medical staff increased. In September, Barack Obama called the epidemic “a potential threat to global security” and WHO’s emergency chief, Bruce Aylward, said the outbreak was “unparalleled in modern times”. In Europe, France, Italy, Germany, Spain, Norway and Switzerland have treated patients who contracted the virus in west Africa. In August a nurse, Will Pooley, the first Briton confirmed to have Ebola, recovered after treatment in London. He returned to work in Sierra Leone in October. Two priests with Ebola were repatriated to Spain and treated in Madrid. Both died. On 6 October, Spanish authorities said that a nurse, Teresa Romero Ramos, part of the team treating the Spanish missionaries, had tested positive for the disease. Ramos, the first known person to become infected outside west Africa, was confirmed free of Ebola on 21 October. In Dallas, Texas, on 30 September the first case diagnosed in the US was Thomas Duncan, who had travelled from Monrovia. A Liberian national, he was treated at the Texas Presbyterian hospital after initially being sent home, but died on 8 October. Nurses Nina Pham and Amber Joy Vinson, who had cared for Duncan, tested positive. Both recovered and were discharged from centres in Maryland and Georgia in late October. That same month, a Nebraska hospital treated the US national Ashoka Mukpo, a cameraman who had been working for NBC in Liberia when he contracted the disease. In New York a doctor, Craig Spencer, who had returned from Guinea, where he had been working for MSF, was revealed to have contracted Ebola. He, too, recovered and was discharged on 11 November. The “inappropriate” quarantine imposed on Kaci Hickox, an American nurse, despite her testing negative for Ebola on returning to the US after working in Sierra Leone, was eventually lifted as the governors of New York and New Jersey scaled back plans to forcibly isolate medics who had come into contact with the virus. A two-year-old girl died from Ebola on 24 October in Kayes, in the west of Mali, after travelling from Guinea. This case was contained but in November, in an unrelated case cluster in Mali’s capital, Bamako, a nurse and a doctor died. Both had treated an Islamic preacher from Guinea who was initially diagnosed with a kidney problem and later died. According to the US Centers for Disease Control and Prevention, six Malians have now died from Ebola. The WHO set a 60-day goal for tackling Ebola – to isolate and treat 70% of those infected, and bury safely 70% of those who died, by 1 December. This target was met in Liberia and Guinea, but Sierra Leone did not reach the treatment figure, as cases are still rising in the west of the country. At the start of this month, a Cuban doctor, Felix Baez, who contracted Ebola in Sierra Leone, returned home after successful treatment in Switzerland, telling reporters in Havana: “I will return there to finish what I started.” .