The Ebola crisis: perspectives from European Public Health.

Abstract

As of 26 November 2014, 15 935 cases of Ebola had been reported to the World Health Organization (WHO), of whom 5689 have died.1 It is widely believed that these figures are underreported and the actual number of cases and deaths is higher.2 Six cases and one death were reported outside West Africa.3 This unprecedented outbreak took professionals and policy makers by surprise as it occurred where it was not expected and developed on a scale that could not have been predicted. Or at least, that has been the accepted view. A consideration of the population affected and the weak health infrastructure of the countries most affected should have led to a recognition that, once a contagious disease such as Ebola developed in this setting, the scope for rapid spread was great, given the high population density and degree of connectivity among the people of the region.4 Unlike previous outbreaks that occurred in remote rural areas of central Africa,5 this developed in a densely populated area and, very quickly, outbreaks occurred in the capitals of the main affected countries (Guinea, Sierra Leone and Liberia). Rapid initial spread was facilitated by lack …