The 2014 Ebola Outbreak: Preparedness in West African Countries and its Impact on the Size of the Outbreak

The recent Ebola virus outbreak in West Africa was the first that reached epidemic size resulting in more than 28,000 suspected and confirmed cases and more than 11,000 deaths. Here, we performed a meta-analysis to determine the role of preparedness in the course of the epidemic. Relevant research articles were identified using the search terms "Ebola 2014 preparedness", "Ebola 2014 treatment and diagnosis", "Ebola 2014 isolation", "Ebola 2014 culture", and "Ebola 2014 Health Care Workers" in PubMed. 21 relevant original articles in English were identified and analysed. Results revealed that a lack of preparedness substantially contributed to the scale of the Ebola epidemic in West Africa. Studies consistently reported on shortcomings in the availability and use of personal protective equipment, transportation and communication systems, surveillance, patient isolation and treatment, training of healthcare workers, and public awareness and perception in the affected West African countries. Effective surveillance and patient isolation enabled outbreak control. In conclusion, effective health care systems and procedures for early detection and containment of outbreaks, in combination with education of the population will be needed to better control future Ebola outbreaks and outbreaks of other (novel) pathogens for which no effective treatment is available.