Since the first known Ebola outbreak in 1976, the virus' attack on West Africa this year has been the worst ever.
But what does that actually look like? The current issue of the New England Journal of Medicine has several pieces dedicated to Ebola, including this one in which the authors chart the outbreak's exponential growth:
In the issue, the head of the Centers for Disease Control Tom Frieden also leads an article on what it will take to prevent future Ebola outbreaks, and isolates these three measures:
The first is meticulous infection control in health care settings. The greatest risk of transmission is not from patients with diagnosed infection but from delayed detection and isolation. Since the early symptoms of Ebola virus disease (EVD) - fever, nausea, vomiting, diarrhea, and weakness - are nonspecific and common, patients may expose family caregivers, health care workers, and other patients before the infection is diagnosed.
Second, educating and supporting the community to modify long-standing local funeral practices to prevent contact with body fluids of people who have died from EVD, at least temporarily until the outbreak is controlled, will close the second major route of propagation of the virus. This is a culturally sensitive issue that requires culturally appropriate outreach and education.
And third, avoiding handling of bush meat (wild animals hunted for sustenance) and contact with bats (which may be the primary reservoir of Ebola virus) can reduce the risk of initial introduction of Ebola virus into humans. Bush meat consumption could be reduced through socioeconomic development that increases access to affordable protein sources. Where bush meat consumption continues, safer slaughter and handling can be encouraged. The potential effect of deforestation and other environmental changes on increasing human-bat contacts needs to be further studied and addressed.