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

Accepted version
Peer-reviewed

Type

Article

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Authors

Dudas, Gytis 
Carvalho, Luiz Max 
Bedford, Trevor 
Tatem, Andrew J 
Baele, Guy 

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.

Description

Keywords

Climate, Disease Outbreaks, Ebolavirus, Genome, Viral, Geography, Hemorrhagic Fever, Ebola, Humans, Internationality, Linear Models, Molecular Epidemiology, Phylogeny, Travel

Journal Title

Nature

Conference Name

Journal ISSN

0028-0836
1476-4687

Volume Title

544

Publisher

Springer Science and Business Media LLC
Sponsorship
Wellcome Trust (097997/Z/11/Z)
Biotechnology and Biological Sciences Research Council (BB/N001176/1)
European Commission Horizon 2020 (H2020) Societal Challenges (643476)
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