Ebola 2014 World Map with event descriptions.
This map updates with new events. It covers 1976 to 2015.
The 2014 outbreak of the Ebola virus was identified initially on March 14th by a software tool at Boston, some 7,000 kilometers from the infection locations. Normal medical services were provided in rural areas of Guinea from close to the start of the epidemic. They didn't know that quarantine was needed. Not for weeks.
What has happened and is happening to contain Ebola is predicated on models that were built to predict outbreaks in rural areas. The transfer rate is estimated to be between 1 and 2. This is not realistic for cities. As you will see, urban environments and urban dysfunctions can produce catastrophic impacts on public health efforts.
Advanced economies are atypical.
In wealthy countries the samples from hemorrhagic disease incidents go straight to a lab for tests. The victim or victims are quarantined. Investigations proceed to determine prior human contacts with victims to anticipate additional infections.
Out in the Guinea bush last March, these procedures went off slowly or ineffectively or not at all. Matters have gotten steadily worse. Ebola spread out to three additional countries so far and the system at Monrovia, Liberia, has been compromised through a criminal break in at an Ebola clinic.
World Health Organization does what it can. These experts rely on straight-line, hierarchical report systems to identify outbreaks. Up till this outbreak that system had worked well enough. Diseases had been slow enough to be controlled. Raise the R-zero transmission rate and the system fails.
There's nothing here that a quick $1-billion wouldn't help. Think of it as though it was a war.
Estimates for the R-zero transmission rates for Ebola outbreaks ran to 1.83 for Congo/1995 and 1.34 for Uganda/2000. (R-zero is the number of new infections per identified victim outside of quarantine.) In this 2014 incident the disease presents a higher R-zero, likely in the 2 to 3 range for rural African societies, outrunning the WHO system with ease.
Software called HealthMap takes a different approach from WHO at early detection of outbreaks:
HealthMap... uses algorithms to scour tens of thousands of social media sites, local news, government websites, infectious-disease physicians’ social networks, and other sources to detect and track disease outbreaks.At the same time the computer simulation community is making efforts to analyze a wide range of more-or-less-likely Ebola outbreak patterns. Here the focus is on transmission. These models start by building on lists of critical factors and then roll the dice at transmission level to see how many people get hit:Sophisticated software filters irrelevant data, classifies the relevant information, identifies diseases and maps their locations with the help of experts. The site is run by a group of 45 researchers, epidemiologists, and software developers at [Boston College Hospital.]
-- from Public Health Watch,
-- Societal responses that affect containment: availability of quarantine beds, openness to medical personnel on the part of the infected, education generally and of women as healthcare providers in particular, withdrawal/retreat by doctors and nurses, (commonly religious) barriers to public health measures.Lethality ranges 50% to 90% for Ebola. There are five major identified strains.-- The specific R-zero for this strain of Ebola. Recognize that R-zero varies with population density.
-- Incubation period, which has run to 6 days on average in prior outbreaks with a range of 1 to 21 days.
-- Specifics of urban environments. This is for Lagos, Nigeria and 20,000,000 residents in the region. On Western terms this is a borderline failed city.
-- Commercial and seasonal population movements. For example: AIDS was spread initially along the truck routes. Truck stop prostitution was a prime vector.
There is an additional problem in Nigeria. The country is sharply divided between its Muslim north and its Christian south. The north does little to educate women. Going backward toward the 7th Century is more like it. The Salafi ideal. A path you also see with the Boko Harum, Gulf States Salafi and ISIS.
Memorizing the Koran does not intersect modern biology. That is going to hurt them.
The worst of it for Nigeria's Muslims is that the men try to get together five times a day for prayers. They are good Sunnis. It is a time for peace and friendship. Inject the Ebola virus into this system and you get a transmission environment that combines aerial dispersal with hand contact. And the risks fire off at five times a day.
Christians meet once a week or for some, once a day. The traditional African religions meet for festivals and celebrations. With Ebola in the mix: the less frequently people congregate, the better.
Considering the impacts of social structure, will it be possible to quarantine new Ebola cases faster than new cases are generated? What are the right estimates for R-zero for rural, trading town and urban environments?
Results from unofficial Monte Carlo runs are not good. Go for projections based on secondary information and we're in new territory. More below the orange muffin........