Table 1.
Laboratory-Confirmed Outbreaks of Ebola and Marburg Virus Disease Since Discovery Through June 2015a
| Year of Onset | Virus | Country | Epicenter(s) | Cases, No. (CFR, %) | Source of Primary Infection | Factors Contributing to Secondary Spread | Underlying Civil Unrest in Country or Region? | Country UNDP HDI Rankingb |
|---|---|---|---|---|---|---|---|---|
| 1967 | Marburg | Germany and Yugoslavia | Marburg and Cologne, Germany; Belgrade, Yugoslavia | 32 (22) | Imported monkeys from Uganda | Dissection of monkeys to harvest organs, Nosocomial transmission | No | Germany, 5; Yugoslavia, 64 |
| 1975 | Marburg | Rhodesia (present-day Zimbabwe) and South Africa | Travelers; exact site of infection unknown | 3 (33) | Unknown | Nosocomial transmission | No | Rhodesia, 172; South Africa, 121 |
| 1976 | Ebola | Zaire (present-day DRC) | Yambuku | 318 (88) | Unknown | Nosocomial transmission | Aftermath of DRC independence crisis (1960–1965); Mobutu “kleptocracy” and failed state (1965–1997) | 186 |
| 1976 | Ebola | Sudan | Maridi and Nzara | 284 (53) | Unknown | Nosocomial transmission | First Sudan civil war (1955–1972) | 171 |
| 1979 | Ebola | Sudan | Maridi and Nzara | 34 (65) | Unknown | Nosocomial transmission | First Sudan civil war (1955–1972) | 171 |
| 1980 | Marburg | Kenya | Kisumu | 2 (50) | Cave entry | Nosocomial transmission | No | 145 |
| 1994 | Ebola | Gabon | Mékouka, Ogooué-Ivindo Province | 52 (60) | Infection in gold mining camps | Traditional healing practices; nosocomial and community-based transmission | No | 106 |
| 1995 | Ebola | DRC | Kikwit | 315 (81) | Unknown | Nosocomial and community-based transmission | Mobutu kleptocracy and failed state (1965–1997) | 186 |
| 1996 | Ebola | Gabon | Mayibout, Ogooué-Ivindo Province | 21 (57) | Consumption of dead chimpanzee | Community-based transmission | No | 106 |
| 1996 | Ebola | Gabon | Booué, Ogooué-Ivindo Province | 45 (74) | Consumption of chimpanzee? | Nosocomial and community-based transmission | No | 106 |
| 1996 | Ebola | South Africa | Johannesburg | 2 (50) | Imported from Gabon by infected physician | Nosocomial transmission | No | 121 |
| 1998 | Marburg | DRC | Durba | 154 (83) | Repeated primary introductions from exposure in gold mine | Community-based transmission | Second DRC civil war (1996–1997); Mobutu kleptocracy and failed state (1965–1997) | 186 |
| 2000 | Ebola | Uganda | Gulu | 425 (53) | Unknown | Nosocomial and community-based transmission | Lord's Resistance Army insurgency, 1987 to present | 161 |
| 2001 | Ebola | Gabon and ROC | Ogooué-Ivindo Province, Gabon; Cuvette Ouest Region, ROC | 65 (82) | Hunting and consumption of nonhuman primates | Nosocomial transmission and community-based transmission; traditional healing practices | ROC civil war (1997–1999) | Gabon, 106; ROC, 142 |
| 2001 | Ebola | Gabon and ROC | Ogooué-Ivindo Province; Cuvette Ouest Region | 57 (75) | Unknown | Community-based transmission | ROC civil war (1997–1999) | Gabon, 106; ROC, 142 |
| 2002 | Ebola | ROC | Mbomo and Kéllé, Cuvette Ouest Region | 143 (89) | Hunting and consumption of nonhuman primates | Nosocomial and community-based transmission, Traditional healing practices | ROC civil war (1997–1999) | 142 |
| 2003 | Ebola | ROC | Mbomo and Mbandza, Cuvette Ouest Region | 35 (83) | Hunting and consumption of nonhuman primates | Traditional healing practices | ROC civil war (1997–1999) | 142 |
| 2004 | Marburg | Angola | Uíge | 252 (90) | Unknown | Nosocomial transmission and community-based transmission | War of independence (1961–1974) and civil war (1975–2002) | 148 |
| 2004 | Ebola | South Sudan | Yambio | 17 (41) | Exposure to baboon meat? | Nosocomial transmission and community-based transmission | Second Sudan civil war (1983–2005) | 171 |
| 2007 | Marburg | Uganda | Ibanda, Kamwenge | 4 (25) | Bat exposure in gold mine | Community-based transmission | No | 161 |
| 2007 | Ebola | DRC | Kasai Occidental Province | 264 (71) | Exposure to local wildlife, including bats | Nosocomial and community-based transmission | Ongoing armed conflict | 186 |
| 2007 | Ebola | Uganda | Bundibugyo | 149 (25) | Unknown | Nocosomial transmission and community-based transmission | No | 161 |
| 2007 | Ebola | DRC | Mweka and Luebo | 32 (47) | Exposure to fruit bats through hunting? | Unknown | Ongoing armed conflict | 186 |
| 2012 | Marburg | Uganda | Kimbale, Ibanda, Kamwange | 41 (58) | Unknown | Community-based transmission | No | 161 |
| 2012 | Ebola | Uganda | Kibaale | 11 (36) | Unknown | Community-based transmission | No | 161 |
| 2012 | Ebola | DRC | Province Orientale | 36 (36) | Hunted bushmeat? | Community-based transmission | Ongoing armed conflict | 186 |
| 2012 | Ebola | Uganda | Luwero | 6 (50) | Unknown | Unknown | No | 161 |
| 2013 | Ebola | Republic of Guinea, Liberia, and Sierra Leone | Southeast forest region of Guinea | Ongoing; >27 500 cases at this writing | Unknown | Nosocomial and community-based transmission | Guinea: long-standing civil unrest and tribal conflict, coup d’état (2009); Liberia: civil wars (1989–1996 and 1999–2003); Sierra Leone: civil war (1991–2002) | Guinea, 178; Liberia, 174; Sierra Leone, 177 |
| 2014 | Ebola | DRC | Province Equateur | 66 (74) | Hunted bushmeat? | Community-based transmission | Ongoing armed conflict | 186 |
Abbreviations: CFR, case fatality rate; DRC, Democratic Republic of the Congo; ROC, Republic of the Congo; UNDP HDI, United Nations Development Programme Human Development Index.
a Single cases and cases related to laboratory infections are not shown.
b Of 187 ranked countries, 2013 rankings [14]. The median ranking for countries with a recognized Ebola or Marburg virus outbreak is 154.5.