Ebola Virus Disease in West Africa — The First 9 Months of the Epidemic and Forward Projections – WHO Ebola Response Team – September 23, 2014. DOI: 10.1056/NEJMoa1411100

“As of September 14, 2014, a total of 4507 confirmed and probable cases of Ebola virus disease (EVD), as well as 2296 deaths from the virus, had been reported from five countries in West Africa — Guinea, Liberia, Nigeria, Senegal, and Sierra Leone. In terms of reported morbidity and mortality, the current epidemic of EVD is far larger than all previous epidemics combined. The true numbers of cases and deaths are certainly higher. There are numerous reports of symptomatic persons evading diagnosis and treatment, of laboratory diagnoses that have not been included in national databases, and of persons with suspected EVD who were buried without a diagnosis having been made. The epidemic began in Guinea during December 2013, and the World Health Organization (WHO) was officially notified of the rapidly evolving EVD outbreak on March 23, 2014. On August 8, the WHO declared the epidemic to be a “public health emergency of international concern.” By mid-September, 9 months after the first case occurred, the numbers of reported cases and deaths were still growing from week to week despite multinational and multisectoral efforts to control the spread of infection.1 The epidemic has now become so large that the three most-affected countries — Guinea, Liberia, and Sierra Leone — face enormous challenges in implementing control measures at the scale required to stop transmission and to provide clinical care for all persons with EVD…These data indicate that without drastic improvements in control measures, the numbers of cases of and deaths from EVD are expected to continue increasing from hundreds to thousands per week in the coming months.”