Ebola virus disease (EVD), commonly referred to solely as Ebola, is a rare and serious illness caused by one of several virus species within the genus
Ebolavirus. Four species cause EVD in humans:
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Bundibuygo ebolavirus
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Sudan ebolavirus
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Tai Forest ebolavirus
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Zaire ebolavirus
Zaire ebolavirus is the most common and deadliest strain, responsible for the most outbreaks. EVD is a viral hemorrhagic fever and while case fatality rates have varied significantly, the average fatality rate is approximately 50%. However, when EVD is caused by
Zaire ebolavirus, the fatality rate is estimated to be 70–90%. Ebola is transmitted through contact with infected bodily fluids, such as blood, feces, urine and saliva.
Ebola was first identified in 1976 during two simultaneous outbreaks in what are now the Democratic Republic of Congo (formerly Zaire) and South Sudan (formerly Sudan). More than 30 outbreaks of varying sizes have occurred since the virus was identified, with the vast majority of cases in West and sub-Saharan Africa. The most recent outbreak was in Uganda in 2022–2023 and was unique as outbreaks caused by
Sudan ebolavirus are relatively rare.
APHL works both domestically and internationally to strengthen national laboratory systems to prepare for and respond to Ebola as well as other highly infectious disease threats. Many public health laboratories in the US can conduct testing for the Ebola virus using tests deployed through the
Laboratory Response Network and/or using commercially available assays. APHL also collaborates with CDC and the
African Society for Laboratory Medicine (ASLM) to develop guidance, implement training and provide necessary support for laboratories outside the US to ensure they are able to perform safe, high quality and efficient testing.
Previous APHL Ebola Response Efforts
2018 Strengthening Laboratory Response in Sierra Leone
In Sierra Leone, APHL worked through 2018 to strengthen laboratory capacity and renovate the central laboratory. APHL-ASLM consultants developed laboratory SOPs, supported implementation of a specimen referral system and implemented quality assurance practices at mobile testing centers run by donor nations. In addition, a unified laboratory implementation plan was developed to enable international aid workers to quickly identify how to support a single, integrated strategy for delivery of laboratory services.
APHL also assisted ASLM and the African Public Health Laboratory Network to improve surveillance, communications, coordination and information sharing to enable quick response to emerging disease threats as well as implemeted data repositories for capacity and capability mapping of member laboratories. This also included ensuring access to specialized testing capacity made available across the network, coordinating action on new global and regional policy prioritie and collaboration for research initiatives and sharing relevant data. APHL also facilitated cross-training and assessments to raise all laboratories to standardized levels of capacity and readiness.
2014–2015 APHL Ebola Response
During the height of the Ebola response in 2014–2015, APHL provided situational updates and technical assistance to public health laboratories. The association developed a
template to assist laboratories in conducting risk assessments of their facilities and other laboratory guidance documents for clinical and public health laboratories. In addition, APHL worked with state and local public health laboratories to prepare them to conduct Ebola testing and to respond to questions from clinical laboratories in their jurisdictions.
Outside the US, APHL worked with CDC and ASLM to stand up the African Public Health Laboratory Network and explore ways to build laboratory capacity on the continent. APHL facilitated a training on testing for the Zaire ebolavirus at the ASLM meeting in Cape Town in 2014 and collaborated with ASLM to develop a webpage and African Public Health Laboratories Network Listserv to share information related to the Ebola outbreak.