Outbreak<unk>  outbreak worldwide It is generally believed that a one or two-year-old boy, later identified as Emile Ouamouno, who died in December 2013 in the village of Méliandou, Guéckédou Prefecture, Guinea, was the index case of the<unk><unk><unk> . Scientists have deduced that bats are involved in the spread of the<unk> , and, incidentally, the boy's home was in the vicinity of a large colony of Angolan free-tailed bats, according to media reports. His mother, sister, and grandmother, per media reports later became ill with similar symptoms and also died; people infected by these initial cases spread the disease to other villages. There was knowledge of Tai Forest<unk>  in Côte d'Ivoire, which had resulted in one human transmission in 1994. Thus, these early cases were diagnosed as other conditions more common to the area and the disease had several months to spread before it became recognised as<unk> . Monthly aggregate<unk>  cases in the<unk> <unk><unk>  2014–15 Monthly aggregate<unk>  deaths in the<unk> <unk><unk>  2014–15 On 25 March 2014, the WHO indicated that Guinea's Ministry of Health had reported an outbreak of<unk><unk>  disease in four southeastern districts, and that suspected cases in the neighbouring countries of Liberia and Sierra Leone were being investigated. In Guinea, a total of 86 suspected cases, including 59 deaths, had been reported as of 24 March. By late May, the outbreak had spread to Conakry, Guinea's capital—a city of about two million people. On 28 May, the total number of reported cases had reached 281, with 186 deaths. In Liberia, the disease was reported in four counties by mid-April 2014 and cases in Liberia's capital Monrovia were reported in mid-June. The outbreak then spread to Sierra Leone and progressed rapidly. By 17 July, the total number of suspected cases in the country stood at 442, surpassing those in Guinea and Liberia. By 20 July, additional cases of the disease had been reported by the media in the Bo District, while the first case in Freetown, Sierra Leone's capital, was reported in late July. As the<unk>  progressed, a small outbreak occurred in Nigeria that resulted in 20 cases and another in Mali with 7 cases. Four other countries (Senegal, Spain, the United Kingdom and the United States of America) also reported cases imported from<unk> <unk>  with widespread and intense transmission. On 31 March 2015, one year after the first report of the outbreak, the total number of cases was in excess of 25,000—with over 10,000 deaths. As the<unk>  waned, following international control efforts, the edition of 8 April 2015 of the WHO's<unk>  Situation Reports stated that a total of 30 cases were reported and on 29 July 2015, the WHO weekly update reported only 7 cases—the lowest in more than a year. In October 2015, the WHO recorded its first week without any new cases, and while the large-scale<unk>  appeared to have ended by late 2015, sporadic new cases continued to be reported. On 14 January 2016, after all the previously infected countries had been declared<unk> -free, the WHO reported that "all known chains of transmission have been stopped in<unk> <unk> , but cautioned that further small outbreaks of the disease could occur in the future. The following day, Sierra Leone confirmed its first new case since September 2015. Countries that experienced widespread transmission Outbreak distribution map affected part of<unk> <unk> (17 December 2014) Guinea On 25 March 2014, the WHO reported an outbreak of<unk><unk>  disease in four southeastern districts of Guinea with a total of 86 suspected cases, including 59 deaths, and MSF assisted the Ministry of Health by establishing<unk>  treatment centres in the epicentre of the outbreak. On 31 March, the U.S. Centers for Disease Control and Prevention (CDC) sent a five-person team to assist in the response to the outbreak. Thinking that spread of the<unk>  had been contained, MSF closed its treatment centres in May, leaving only a skeleton staff to handle the Macenta region. However, in late August, according to media reports, large numbers of new cases reappeared in the region. In February 2015, media reported that Guinea recorded a rise in cases for the second week in a row, health authorities stated that this was related to the fact that they "were only now gaining access to faraway villages", where violence had previously prevented them from entering. On 14 February, violence erupted and an<unk>  treatment centre near the centre of the country was destroyed. Guinean Red Cross teams said they had suffered an average of 10 attacks a month over the previous year; MSF reported that acceptance of<unk>  education remained low and that further violence against their workers might force them to leave. Resistance to interventions by health officials among the Guinean population remained greater than in Sierra Leone and Liberia, per media reports, raising concerns over its impact on ongoing efforts to halt the<unk> ; in mid-March, there were 95 new cases and on 28 March, and a 45-day "health emergency" was declared in 5 regions of the country. On 22 May, the WHO reported another rise in cases, per media reports, which was believed to have been due to funeral transmissions; on 25 May, six persons were placed in prison isolation after they were found travelling with the corpse of an individual who had died of the disease, on 1 June, it was reported that violent protests in a north Guinean town at the border with Guinea-Bissau had caused the Red Cross to withdraw its workers. In late June 2015, the WHO reported that "weekly case incidence has stalled at between 20 and 27 cases since the end of May, whilst cases continue to arise from unknown sources of infection, and to be detected only after post-mortem testing of community deaths". On 29 July, a sharp decline in cases was reported, with only a single case, per media reports left by the end of the week, the number of cases eventually plateaued at 1 or 2 cases per week after the beginning of August. On 28 October, an additional 3 cases were reported in the Forécariah Prefecture by the WHO. On 6 November, a media report indicated Tana village to be the last known place with<unk>  in the country, and on 11 November, WHO indicated that no<unk>  cases were reported in Guinea; this was the first time since the<unk>  began, that no cases had been reported in any country. On 15 November, the last quarantined individuals were released, per media reports and on 17 November, the last<unk>  patient in Guinea—a 3-week-old baby—had recovered; the 42-day countdown toward the country being declared<unk> -free started on 17 November, the day after the patient yielded a second consecutive negative blood test. The patient was discharged from the hospital on 28 November, per media reports on 29 December 2015, upon expiration of the 42-day waiting period, the WHO declared Guinea<unk> -free. On 17 March 2016, the government of Guinea reported, per the media, that 2 people had again tested positive for<unk><unk>  in Korokpara, it was also reported that they were from the village where members of one family had recently died from vomiting (and diarrhea). On 19 March, it was also reported by the media that another individual had died due to the<unk>  at the treatment centre in Nzerekore, consequently, the country's government quarantined an area around the home where the cases took place. On 22 March, the media reported that medical authorities in Guinea had quarantined 816 suspected contacts of the prior cases (more than 100 individuals were considered high-risk); the same day, Liberia ordered its border with Guinea closed. Macenta Prefecture, from Korokpara, registered Guinea's fifth fatality due to<unk><unk>  disease within the same period. On 29 March, it was reported that about 1,000 contacts had been identified (142 of them high-risk), and on 30 March 3 more confirmed cases were reported from the sub-prefecture of Koropara. On 1 April, it was reported by the media, that possible contacts, which numbered in the hundreds, had been vaccinated with an experimental vaccine using a ring vaccination approach. On 5 April 2016, it was reported via the media, that there had been 9 new cases of<unk>  since the<unk>  resurfaced, out of which 8 were fatal; on 1 June, after the stipulated waiting period, the WHO again declared Guinea<unk> -free, after which the country entered a 90-day period of heightened surveillance that was concluded on 30 August 2016. In September 2016, findings were published suggesting that the resurgence in Guinea was caused by an<unk>  survivor who, after eight months of abstinence, had sexual relations with several partners, including the first victim in the new outbreak. The disease was also spread to Liberia by a woman who went there after her husband had died of<unk> . Sierra Leone Kenema Hospital, Sierra Leone The first person reported infected in Sierra Leone, according to media reports,
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