Virus genomes reveal factors that spread and sustained the Ebola epidemic.

Journal: Nature
Published:
Abstract

The 2013-2016 West African epidemic caused by the Ebola virus was of unprecedented magnitude, duration and impact. Here we reconstruct the dispersal, proliferation and decline of Ebola virus throughout the region by analysing 1,610 Ebola virus genomes, which represent over 5% of the known cases. We test the association of geography, climate and demography with viral movement among administrative regions, inferring a classic 'gravity' model, with intense dispersal between larger and closer populations. Despite attenuation of international dispersal after border closures, cross-border transmission had already sown the seeds for an international epidemic, rendering these measures ineffective at curbing the epidemic. We address why the epidemic did not spread into neighbouring countries, showing that these countries were susceptible to substantial outbreaks but at lower risk of introductions. Finally, we reveal that this large epidemic was a heterogeneous and spatially dissociated collection of transmission clusters of varying size, duration and connectivity. These insights will help to inform interventions in future epidemics.

Authors
Gytis Dudas, Luiz Carvalho, Trevor Bedford, Andrew Tatem, Guy Baele, Nuno Faria, Daniel Park, Jason Ladner, Armando Arias, Danny Asogun, Filip Bielejec, Sarah Caddy, Matthew Cotten, Jonathan D'ambrozio, Simon Dellicour, Antonino Di Caro, Joseph Diclaro, Sophie Duraffour, Michael Elmore, Lawrence Fakoli, Ousmane Faye, Merle Gilbert, Sahr Gevao, Stephen Gire, Adrianne Gladden Young, Andreas Gnirke, Augustine Goba, Donald Grant, Bart Haagmans, Julian Hiscox, Umaru Jah, Jeffrey Kugelman, Di Liu, Jia Lu, Christine Malboeuf, Suzanne Mate, David Matthews, Christian Matranga, Luke Meredith, James Qu, Joshua Quick, Suzan Pas, My Phan, Georgios Pollakis, Chantal Reusken, Mariano Sanchez Lockhart, Stephen Schaffner, John Schieffelin, Rachel Sealfon, Etienne Simon Loriere, Saskia Smits, Kilian Stoecker, Lucy Thorne, Ekaete Tobin, Mohamed Vandi, Simon Watson, Kendra West, Shannon Whitmer, Michael Wiley, Sarah Winnicki, Shirlee Wohl, Roman Wölfel, Nathan Yozwiak, Kristian Andersen, Sylvia Blyden, Fatorma Bolay, Miles Carroll, Bernice Dahn, Boubacar Diallo, Pierre Formenty, Christophe Fraser, George Gao, Robert Garry, Ian Goodfellow, Stephan Günther, Christian Happi, Edward Holmes, Brima Kargbo, Sakoba Keïta, Paul Kellam, Marion P Koopmans, Jens Kuhn, Nicholas Loman, N'faly Magassouba, Dhamari Naidoo, Stuart Nichol, Tolbert Nyenswah, Gustavo Palacios, Oliver Pybus, Pardis Sabeti, Amadou Sall, Ute Ströher, Isatta Wurie, Marc Suchard, Philippe Lemey, Andrew Rambaut