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The Ebola outbreak in West Africa is the largest Ebola outbreak in history. It can be traced back to a boy who died of Ebola inDecember; he lived in Guéckédou in southeastern Guinea, which is surrounded bySierra Leone and Liberia. Easy movement in and out of these countries, combined with poor facilities and delayed identification, have contributed to Ebola’s rapid spread, creating a public health disaster. As of this writing approximately 3,000 people have died from Ebola since December and over 6,000people have been infected. This particular strain of Ebola (i.e., Zaire Strain)is thought to be spread through animals, perhaps by bats. Prior Ebola out breaks were easily contained because they occurred in sparsely populated regions.

CBHD’s news blog—bioethics.com—documents disasters through the lens of news headlines and journal articles. The timeline of news events since March when the outbreak made international news, highlights theout break’s rapid progression as well as bioethics questions that are specific to epidemics: the slow response of international aid groups, the use of Ebola drugs that were untested on humans, hastening clinical trials of Ebola remedies and vaccines, medical workers being flown back to their home country while infected West African medical workers must stay, appropriate allocation of resources from foreign countries, and containment practices that may violate human dignity. For a more complete timeline of headlines see the full resource onbioethics.com at www.bioethics.com/ebola-timeline.

“4 Health CareWorkers among 66 Dead in Ebola Outbreak”

by Sydney Lupkin, ABCNews, March 27, 2014.

The ongoing outbreak has sickened 103 people in Guineain all, and this Ebola strain has a 64 percent fatality rate, WHO officials said. The number of people reported sickened by Ebola in Guinea has more than doubled in the past five days. (http://tinyurl.com/m8j533u)

“Ebola Virus ClaimsLives of More than 200 People in Guinea”

by AFP, The Guardian, June 4, 2014.

More than 200 people have died from the highly contagious Ebola virus in Guinea, amounting to one of the worst ever out breaks of the disease, the World Health Organisation said on Wednesday. The UN's health agency said it had so far registered 328 confirmed or suspected cases ofEbola in Guinea, including 208 deaths. (http://tinyurl.com/lbevfyl)  

“Ebola Challenges West African Countries as WHO Ramps Up Response”

by The World Health Organization,June 26, 2014.

Since March 2014, more than 600 cases of Ebola and over 390 deaths have been reported in Guinea, Liberia and Sierra Leone. . . . [T]he outbreak is causing concern among health authorities because the deadly disease is being transmitted in communities and in health-care settings, and it has appeared in cities as well as rural and border areas. (http://tinyurl.com/q7yepbu)

“Ebola’s DeadlySpread in Africa Driven by Public Health Failures, Cultural Beliefs”

by Dick Thompson, National Geographic, July 2, 2014.

[H]ealth authorities from 11 West African countries and international agencies began a two-day crisis meeting today in Accra,Ghana, on how to combat the crisis. The World Health Organization (WHO) says “drasticaction” is needed to stem the outbreak, which since March has grown to 759confirmed cases in Guinea, Sierra Leone, and Liberia, including 467 deaths. (http://tinyurl.com/l4rg7js)

“Sierra Leone’s Top Ebola Doctor Is Dead from Ebola”

by Abby Ohlheiser, Washington Post,July 29, 2014.

A Sierra Leone doctor who treated more than 100 Ebola patients has died from the virus, the country's chief medical officer Brima Kargbo confirmed to the media on Tuesday. Sheik Umar Khan has been hailed as a “national hero” for his work treating Ebola. (http://tinyurl.com/kgtv2z6)

“Emergency Efforts in Africa to Contain Ebola as Toll Rises”

by Adam Nossiter and Denise Grady, NewYork Times, July 31, 2014.

West African leaders quickened the pace of emergency efforts on Thursday, deploying soldiers and authorizing house-to-house searches for infected people in an effort to combat the disease. . . . The viral illness has exacted a terrible toll, killing 729 people, including top physicians inLiberia and Sierra Leone. (http://tinyurl.com/o5dts3k)

“Ebola Crisis:Infected Doctor Kent Brantly Lands in US”

by BBC, August 2, 2014.

A US doctor infected with the deadly Ebola virus inLiberia has arrived in the US for treatment at a specialised unit in Atlanta,Georgia. . . . Fellow infected US aid worker Nancy Writebol is expected to follow shortly. . . . The current mortality rate is about 55%. (http://tinyurl.com/pl7khpn)

“Ebola Crisis: WorldBank Announces $200m Emergency Fund”

by BBC, August 4, 2014.

The World Bank has announced that it is allocating$200m (£120m) in emergency assistance for West African countries battling to contain the Ebola outbreak. (http://tinyurl.com/mvvc523)  

“Two Americans WhoContracted Ebola in Africa Received an Experimental Serum”

by Brady Dennis and LennyBernstein, Washington Post, August 4,2014.

This so-called experimental serum is a cocktail of antibodies that have the capability of blocking the virus,” Fauci said, adding:“The physicians in charge of the patients’ care made a risk-benefit decision.The risk was less than the potential benefit.” (http://tinyurl.com/kv8ounz)

“WHO to Convene Panelon Use of Experimental Ebola Drugs”

by Brady Dennis and Lenny Bernstein, WashingtonPost, August 6, 2014.

The World Health Organization said Wednesday that it would convene a group of medical ethicists early next week to wrestle with questions about the use of experimental treatments in the deepening Ebola outbreak in West Africa. (http://tinyurl.com/m3emfge)  

“Ebola Declared a Public-HealthEmergency”

by Erika Check Hayden, Nature, August 8,2014.

The WHO has formally declared the outbreak to be a“public health emergency of international concern,” . . . By 6 August, 932 people had died in the current outbreak, most in Sierra Leone, Guinea andLiberia. (http://tinyurl.com/nsa8dbd)

“Tracing Ebola’sOutbreak to an African 2-Year-Old”

by Denise Grady and Sheri Fink, New YorkTimes, August 9, 2014.

Patient Zero in the Ebola outbreak, researchers suspect, was a 2-year-old boy who died on Dec. 6, just a few days after falling ill . . . . A week later, it killed the boy’s mother, then his 3-year-old sister, then his grandmother. All had fever, vomiting and diarrhea, but no one knew what had sickened them. (http://tinyurl.com/pet3vnt)

“WHO Says It IsEthical to Use Experimental Drugs to Fight Ebola Virus”

by Monte Morin, Los Angeles Times, August 12, 2014.

A World Health Organization panel advised Tuesday thatit was ethical to use experimental, nonapproved drugs to combat the ongoing Ebola virus epidemic in West Africa. . . . To date, 1,013 have died in the outbreak. (http://tinyurl.com/psnbtlh)

“EthicalConsiderations for Use of Unregistered Interventions for Ebola Virus Disease(EVD)”

by WorldHealth Organization, August 12, 2014.

Ethical criteria must guide the provision of such interventions. These include transparency about all aspects of care, informed consent, freedom of choice, confidentiality, respect for the person, preservation of dignity and involvement of the community. (http://tinyurl.com/kleowcf)

“WHO: Toll of EbolaOutbreak Has Been ‘Vastly’ Underestimated”

by Abby Phillip, WashingtonPost, August 15, 2014.

There have been 1,069 deaths attributed to Ebola so far, but the true toll of the virus could be far greater. (http://tinyurl.com/nb4j5sx)

“Ebola Patient Revelsin ‘Miraculous Day’ as He and Another Exit Hospital”

by Alan Blinder and Donald G.McNeil, Jr. New York Times, August 21, 2014.

Emory said on Thursday that Dr. Brantly . . . andNancy Writebol, a missionary from Charlotte, N.C., who also contracted Ebola while in Africa this summer, had been released from its specialized isolation unit this week. (http://tinyurl.com/omjtbnq)  

“Anecdotal Evidence about Experimental Ebola Therapies”

by World Health Organization, August 21, 2014.

Clinicians working in Liberia have informed WHO that 2doctors and 1 nurse have now received the experimental Ebola therapy, ZMapp. The nurse and one of the doctors show a marked improvement. . . . According to the manufacturer, the very limited supplies of this experimental medicine are now exhausted. (http://tinyurl.com/ntlwt5f)

“Ebola Drug TrialsSet to Begin amid Crisis”

by Declan Butler, Nature, September2, 2014.

The first phase of clinical trials, to test for a product’s safety, is usually carried out in healthy volunteers in facilities with sophisticated clinical-trials infrastructure. But an unusual combination of factors — the difficulty of implementing public-health measures to control the disease’s spread in the affected countries, the huge social and economic disruption that it is causing and the fact that the current outbreak kills about 53% of the people it infects — makes this crisis an exception. (http://tinyurl.com/ooy82gv)

“Ebola VaccinesRacing Forward at Record Pace”

by Jon Cohen, Science, September 9,2014.

In as little as 2 months, this [Ebola] vaccine may go into the arms of thousands of health care workers and other first-line responders to the Ebola epidemic now wreaking havoc in West Africa. No experimental vaccine has ever been on a faster track toward widespread use. (http://tinyurl.com/ml4jetd)

“U.S. to Commit Up to3,000 Troops to Fight Ebola in Africa”

by Helene Cooper, Michael D. Shear, and Denise Grady, New York Times, September 15, 2014.

Mr. Obama will offer help to President Ellen Johnson Sirleaf of Liberia in the construction of as many as 17 Ebola treatment centers in the region, with about 1,700 treatment beds. (http://tinyurl.com/q79s6dy)

“Eight Bodies Found after Attack on Guinea Ebola Education Team”

by Conakry, Reuters,September 18, 2014.

Eight bodies, including those of three journalists, were found after an attack on a team trying to educate locals on the risks of the Ebola virus in a remote area of southeastern Guinea, a government spokesman said on Thursday… Since then the virus has killed some 2,630 people and infected at least 5,357 people, according to World Health Organization (WHO). (http://tinyurl.com/orh9guv)

“Sierra Leone toStart 3-Day Nationwide Lockdown to Stop Ebola”

by Sydney Lupkin, ABC News, September 18, 2014.

Sierra Leone is set to begin a three-day lockdown tonight at midnight to curb the spread of Ebola . . . . Government authorities have ordered the country's 6 million people to stay in their homes from Sept.19 through Sept. 21, while volunteers go door-to-door to screen for Ebola. (http://tinyurl.com/n9gat6t)

“Ebola Death TollNears 3,000 in West Africa, Says WHO”

by Andrew Morse, The Wall Street Journal,September 25, 2014.

2,917 people had likely died from the disease as ofSept. 21, 2014. A total of 6,263 people had confirmed, suspected or probable cases of the disease. (http://tinyurl.com/kz28pc5)

“CDC: Ebola Confirmed in Dallas Patient”

by Janet St. James and Josh Davis,WFAA, September 30, 2014.

A patient in a Dallas hospital was confirmed Tuesday to have the deadly Ebola virus . . . . Within hours, a team of CDC investigators arrived in North Texas to begin working on the first-ever case of this strain of the Ebola virus confirmed in the U.S. The Dallas patient remains in “strict isolation” at Texas Health Presbyterian Hospital Dallas. (http://tinyurl.com/n5wdm3o)