2014 Ebola

Outbreak
BY BACHVIET NGUYEN, KASSIE KIRLIK
AND BREIANA HARKINSON
MAY 8, 2017
BLOCK A
Table of Contents
Section Slide Number
Summary #3 - 11

Math Questions #12 - 23

Conclusion #24

Bibliography #25
Below: A selection of bushmeat, whose consumption is
believed to be the root of the outbreak.

The Nature of Ebola

◦ Ebola is a viral hemorrhagic fever that affects humans and
primates, but is also found in bats, who are asymptomatic
carriers of the virus (no symptoms). The defining symptoms of
this deadly disease consist of fever, diarrhea, and vomiting,
which progress to malfunction of the liver and kidneys with
internal/external bleeding. The disease was believed to have
undergone interspecies transmission through the practice of
humans eating raw or undercooked bush meat taken from
infected animals. The Ebola virus is transmitted through
exposure to bodily fluids like blood or saliva. The mortality rate
in the 2014 West Africa Ebola Outbreak was 70%. Survivors of
Ebola will experience Post-Ebola Virus Syndrome, which has the
symptoms of eye problems (possibly blindness), chronic joint
pain and severe headaches. Before 2016, no vaccine was
available, and the only available cure was through expensive
serums containing antibodies.
2014: Rapid Rise of an Epidemic
In March of 2014, the first cases of the deadly disease Ebola were reported in West Africa,
primarily concentrated in the nations of Liberia, Guinea, and Sierra Leone. Throughout 2014, the
virus was out of control, spreading from rural areas to densely populated cities like Monrovia
and Freetown. As health care facilities in West Africa were already inadequate and primitive
before the epidemic, the number of infected individuals increased exponentially, with thousands
of new cases reported per month. In fact, there are so many deaths that infectious bodies are
rotting on the streets in Sierra Leone. Thus, the WHO declares Ebola to be a Public Health
Emergency of International Concern. By August 2014, there are not enough hospital beds to
treat patients. Consequently, the World Health Organization, Medecins Sans Frontières and
western governments intervene. Isolated outbreaks spring up in Europe and North America due
to travellers returning from affected regions, causing several doctors and nurses to be infected
and quarantined. At the end of 2014, there were 20,000 confirmed cases and 7,800 deaths due
to Ebola.
Infection
Graph for
West
Africa
2015: The Decline of Ebola
By January 8, 2015, it was reported that the number of cases had reached 21,000, and that the
number of deaths had reached 8,000. Despite the high figures, the rates of infection in West
Africa were dropping rapidly due to upgraded medical facilities, increased foreign aid in the form
of medical teams and hundreds of millions of dollars, and finally the education of the population
on preventive measures against infection. In addition, disposal of infected corpses was now
done in a sterile manner like cremation, and the sale of bush meat is banned. Thus, on January
18, the WHO declares Mali Ebola-free. By May 1, there are no new infections in Liberia, and only
10 new infections in Sierra Leone. The WHO declares Liberia Ebola-free on May 9, and all of
West Africa is sterilized of Ebola by January 14, 2016. The Ebola outbreak ultimately resulted in
28,616 cases and 11,310 deaths.
Preliminary
Symptoms
A volunteer participating in a Phase 2 trial of
rVSV-ZEBOV.

2016: Aftermath of the

Outbreak
In December of 2016, the WHO announced that a viable
vaccine for West African Ebola was approved for clinical
trials, with a success rate of 70% - 100%. The vaccine, known
as rVSV-ZEBOV, was developed by scientists from the Public
Health Agency of Canada. So far, 300 000 units of the vaccine
have been stockpiled in case of future outbreaks. The
vaccine first saw official frontline use when 800 people in
Guinea were vaccinated during another Ebola outbreak in
March 2016.
Factors for the Spread of Ebola
•People preparing cadavers for burial often had extensive contact with the bodies. As a result,
cadavers contaminated with Ebola would also infect many people at a funeral.
•The widespread practice of eating bush meat in West Africa was an impetus for the 2014 Ebola
epidemic. Bats, a popular snack of many Africans, are also an infamous carrier of the Ebola virus.
Patient Zero is believed to have been infected by Ebola from eating a grilled bat.
•It is a common practice for West Africans to nurse sick family members at home instead of
taking them to the hospital. Many West Africans are superstitious and believe that medical
workers are trying to poison them, which cripples the health care system.1
•Health services in West Africa are severely lacking. For example, Sierra Leone only had 136
doctors for a population of 6 million people.2
A soldier in quarantine gear.

Factors for the Decline of

Ebola
•Donations and aid eventually resulted in more Ebola treatments
centers being built. Ebola patient care procedures are
standardized.
•An experimental vaccine rVSV-ZEBOV began to be used on
patients with a 70% - 100% clinical success rate.
•Education of the local population resulted in sterile disposal of
cadavers, which prevented infections at funerals. Sick patients
were immediately removed from family homes, preventing other
family members from being infected.
•Extensive military quarantines and travel bans were put in place
to prevent the disease from spreading to more African nations.
.
 The Logistic Equation
Due to the conditions under which the 2014 Ebola outbreak progressed, it experienced logistic growth (when the
epidemic initially experienced exponential growth, but the growth rate decreased as population approached
carrying capacity). Carrying capacity K is the maximum number of individuals infected as time t approaches
infinity (𝑡 → ∞).
We can model the approximate logistic growth of the Ebola epidemic using the equation

𝑃0 𝐾
𝑃 𝑡 =
𝑃0 + (𝐾 − 𝑃0 )𝑒 −𝑟𝑡
Let K represent the carrying capacity of the population.
Let r represent the intrinsic infection rate (per capita rate of increase)
Let 𝑃0 represent the initial number of infected individuals, when 𝑡 = 0 days starting from December 2, 2013.
Let P(t) represent the population of infected individuals at time t.
Let t represent the time passed since December 2, 2013, in days. {𝑡 ≥ 0}
The Logistic Model of Ebola
On December 2, 2013, Patient Zero, who was a boy named Emile Ouamouno, died of Ebola in the
nation of Guinea.1 We can therefore conclude that 𝑷𝟎 = 𝟏.
When the WHO declared the official end of the Ebola outbreak on April 13, 2016, an overall total of
28616 people had been infected.2 As a result, the carrying capacity is 𝑲 = 𝟐𝟖𝟔𝟏𝟔.
The intrinsic infection (growth) rate of the 2014 Ebola epidemic is 𝒓 = 𝟎. 𝟎𝟑𝟒𝟓. A statistical research
paper by Hiroshi Nishiura & Gerardo Chowell found that 𝒓 = 𝟎. 𝟎𝟑𝟖 per day,3 while research by G. F.
Webb & C. J. Browne for the Journal of Biological Dynamics indicated that 𝒓 = 𝟎. 𝟎𝟑𝟏 per day.4 For
0.038+0.031
the purposes of this project, we took the average of the two r values to get 𝑟 = = 0.0345.
2
𝑃0 𝐾 (1)(28616)
𝑃 𝑡 = 𝑃 𝑡 =
𝑃0 + 𝐾−𝑃0 𝑒 −𝑟𝑡 1+(28616−1)𝑒 −0.0345𝑡

The approximate logistic 𝟐𝟖𝟔𝟏𝟔
growth of the 2014 Ebola 𝑷 𝒕 = {𝒕 ≥ 𝟎}
epidemic is 𝟏+𝟐𝟖𝟔𝟏𝟓𝒆−𝟎.𝟎𝟑𝟒𝟓𝒕
 𝟐𝟖𝟔𝟏𝟔
𝑷 𝒕 = {t ≥ 0}
𝟏+𝟐𝟖𝟔𝟏𝟓𝒆−𝟎.𝟎𝟑𝟒𝟓𝒕

𝐥𝐢𝐦 𝑷 𝒕 = 𝟐𝟖𝟔𝟏𝟔
𝒕→∞
Logistic Infection Rate of Ebola
The growth rate of a logistic function P(t) is given by the differential equation
𝑑𝑃 𝑃
= 𝑟𝑃(1 − )
𝑑𝑡 𝐾
For the 2014 Ebola outbreak, we have the disease dynamic parameters of 𝑟 = 0.0345 and 𝐾 =
𝑑𝑃
28616. represents the logistic infection rate of Ebola, in number of individuals per day. P
𝑑𝑡
represents the infected population after t days.
𝑑𝑃 𝑃 𝒅𝑷 𝑷
= 𝑟𝑃 1 − = 𝟎. 𝟎𝟑𝟒𝟓𝑷(𝟏 − )
𝑑𝑡 𝐾 𝒅𝒕 𝟐𝟖𝟔𝟏𝟔
Mathematical Questions:
•Question 1: How many individuals will be infected by the Ebola virus by May 31, 2014, if the
𝑑𝑃
outbreak started on December 2, 2013? What will be the logistic infection rate of the
𝑑𝑡
epidemic at this time? Use the original parameters given in slide #13.
•Question 2: How many days will it take for 20,000 people to be infected with Ebola? On which
approximate date will this occur? Use the original parameters given in slide #13.
•Question 3: If 20 people were initially infected with Ebola because they all shared a bus, what is
the doubling time for the infected population, in days? Assume equation parameters r and K
remain the same, with 𝑟 = 0.0345, and 𝐾 = 28616.
•Question 4: If the population of infected individuals is 121 people after 119 days have passed
since December 2, 2013, then what is the intrinsic growth rate r? Assume parameters 𝐾 =
28616 and 𝑃0 = 1.
 t = # of days between Dec.2,2013 and May.31,2014 = 180 days
K = 28616
r = 0.0345

Question 1
How many individuals will be infected by the Ebola virus by May 31, 2014, if the outbreak started on December 2,
𝑑𝑃
2013? What will be the logistic growth rate 𝑑𝑡 of the epidemic at this time? Use the parameters given in slide #14.
28616 𝑑𝑃 𝑃
𝑃 𝑡 = {𝑡 ≥ 0} = 0.0345𝑃(1 − )
1+28615𝑒 −0.0345𝑡 𝑑𝑇 28616
28616
𝑃 180 = 𝑑𝑃 489.21
1+28615𝑒 −0.0345(180)
= 0.0345(489.21)(1 − )
28616 𝑑𝑇 28616
𝑃 180 =
1+28615𝑒 −6.21
𝑑𝑃
28616 = 16.589 ≈ 𝟏𝟔. 𝟔 individuals infected per day
𝑃 180 = 𝑑𝑇
1+28615𝑒 −6.21 when the infected population is 489.
𝑃 180 = 489.21 ≈ 𝟒𝟖𝟗 infected individuals after 180 days.
Question 1 (Graphical Solution)
Question 2 (Algebraic Solution)
How many days will it take for 20,000 people to be infected with Ebola? On which approximate date will
this occur? Use the parameters given in slide #14.
𝒕 = 𝟑𝟐𝟏. 𝟖𝟓
28616 Dec.2,2013 plus 321 days equals
𝑃 𝑡 = {𝑡 ≥ 0} days
1+28615𝑒 −0.0345𝑡 October 19, 2014, which is the
28616 approximate date where 20000
20000 = people have been infected.
1+28615𝑒 −0.0345𝑡

20000 1 + 28615𝑒 −0.0345𝑡 = 28616

K = 28616
20000 + 572300000𝑒 −0.0345𝑡 = 28616 r = 0.0345
572300000𝑒 −0.0345𝑡 = 8616 P(t) = 20000
8616
𝑒 −0.0345𝑡 =
572300000
8616
ln = −0.0345𝑡
572300000
Question
2
(Graphical
Solution)
 K = 28616
r = 0.0345
P(t) = 2𝑷𝟎 = 𝟒𝟎
Question 3 𝑷𝟎 = 𝟐𝟎

If 20 people were initially infected with Ebola because they all shared a bus, what is the doubling time for
the infected population, in days? Assume equation parameters r and K remain the same, with 𝑟 = 0.0345,
and 𝐾 = 28616.
−0.0345𝑡
𝑃0 𝐾
800 + 1143840𝑒 = 572320
𝑃 𝑡 = −𝑟𝑡 1143840𝑒 −0.0345𝑡
=571520
𝑃0 +(𝐾−𝑃0 )𝑒
−0.0345𝑡
571520
(20)(28616) 𝑒 =
𝑃 𝑡 = −0.0345𝑡
1143840
20+(28616−20)𝑒
572320 571520
𝑃 𝑡 = ln = −0.0345𝑡
20+28596𝑒 −0.0345𝑡 1143840
572320
40 = 𝒕 = 𝟐𝟎. 𝟏 days is the doubling time.
20+28596𝑒 −0.0345𝑡

40 20 + 28596𝑒 −0.0345𝑡 = 572320

Question 3 (Graphical Solution)
 K = 28616
r = 0.0345
𝑷𝟎 = 𝟏

Question 4 P(t) = 121

t = 119

If the population of infected individuals is 121 people after 119 days have passed since December 2, 2013,
then what is the intrinsic growth rate r? Assume parameters 𝐾 = 28616 and 𝑃0 = 1.
𝑃0 𝐾 28495
𝑃 𝑡 = ln = −119𝑟
𝑃0 +(𝐾−𝑃0 )𝑒 −𝑟𝑡 3462415
(1)(28616)
𝑃 𝑡 = 𝒓 = 𝟎. 𝟎𝟒
1+(28616−1)𝑒 −𝑟𝑡
28616
121 = The intrinsic infection rate or rate of
1+28615𝑒 −𝑟(119)
infection per capita is 0.04.
121(1 + 28615)𝑒 −119𝑟 ) = 28616
121 + 3462415𝑒 −119𝑟 = 28616
3462415𝑒 −119𝑟 = 28495
28495
𝑒 −119𝑟 =
3462415
Conclusion
During our research, we found that while Ebola is a deadly, nasty disease, it can be properly contained with adequate
medical resources and skillful management. The fact that Ebola can only be transmitted through bodily fluids and not the air
means it has a limited potency compared to airborne diseases like SARS. Due to the impoverished conditions in West Africa,
Ebola was able to achieve an exponential infection rate from December 2013 to April 2016. However, after proper medical
𝑑𝑃
facilities were constructed and treatment procedures for Ebola were standardized, the infection rate decreased rapidly to
𝑑𝑡
0 after April 2016. To minimize the rate of infection, it is necessary to dispose of bodies through cremation and to move sick
patients from family homes to treatment centers as soon as possible. Educating the civilian population about the symptoms
of Ebola will encourage individuals to seek medical help and to be conscientious about infecting other people. The
installation of military quarantines and travel bans in affected countries also restricted the value of the carrying capacity K, as
the maximum possible infected population was limited to the population of West African nations instead of the rest of the
continent or the world. Epidemiologists and crisis managers will benefit the most from our research, as the optimal
procedures to limit the spread of Ebola have now been stated. We also developed a logistic curve that approximately models
the spread of the disease, allowing medical personnel to determine when the infection rate is highest and the amount of
time before the infection reaches carrying capacity with a low infection rate. As a result, medical officials will know when to
optimize the number of reserve medical supplies (beds, vaccines, IVs, etc…) and workers to send out to hospitals at a certain
date. With the development of the highly effective Canadian rVSV-ZEBOV vaccine, it is very likely that future Ebola outbreaks
will not achieve exponential growth, simply dying out. Experiences learned from the 2014 epidemic have led to standardized
care plans that also limit the contagiousness of the disease. Without a doubt, the international community is highly prepared
to combat Ebola at the moment. The only concern is the overarching possibility that the Ebola virus could mutate in the
future, increasing its lethality or worse, its contagiousness.
 Bibliography
1. "Ebola Patient Zero: Emile Ouamouno Of Guinea First To Contract Disease". International Business Times. 28 October 2014. Retrieved 29
October 2014.
2. "2014 Ebola Outbreak in West Africa - Case Counts." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Division of High-Consequence Pathogens and Pathology (DHCPP) Viral
Special Pathogens Branch (VSPB), 14 Apr. 2016. Web. 08 May 2017.
https://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/case-counts.html
3. Nishiura and Chowell: Theoretical perspectives on the infectiousness of Ebola virus disease. Theoretical Biology and Medical Modelling 2015 12:1.
https://tbiomed.biomedcentral.com/articles/10.1186/1742-4682-12-1
4. G. F. Webb & C. J. Browne (2016) A model of the Ebola epidemics in West Africa incorporating age of infection, Journal of Biological Dynamics,
10:1, 18-30, DOI: 10.1080/17513758.2015.1090632
http://dx.doi.org/10.1080/17513758.2015.1090632
5. http://www.bbc.com/news/world-africa-29324595
6. https://www.theguardian.com/global-development/poverty-matters/2014/aug/13/ebola-epidemic-poor-facilities-distrust-healthcare
7. World Health Organization: http://www.who.int/mediacentre/factsheets/fs103/en/
8. Centers for Disease Control: https://www.cdc.gov/vhf/ebola/
9. Wikipedia: https://en.wikipedia.org/wiki/West_African_Ebola_virus_epidemic_timeline