Ebola

===1976===
====Sudan====
[[File:Cotton Factory in Nzara, South Sudan.jpg|thumb|Cotton factory in Nzara, South Sudan, where the first outbreak occurred]]

The first known outbreak of EVD was identified only after the fact. It occurred between June and November 1976, in [[Nzara, South Sudan]]<ref name="Hoenen2012">{{Cite journal |vauthors=Hoenen T, Groseth A, Feldmann H |date=July 2012 |title=Current Ebola vaccines |journal=Expert Opin Biol Ther |volume=12 |issue=7 |pages=859–872 |doi=10.1517/14712598.2012.685152 |pmc=3422127 |pmid=22559078}}</ref><ref name="Peterson AT, Bauer JT, Mills JN 2004 40–47">{{Cite journal |vauthors=Peterson AT, Bauer JT, Mills JN |year=2004 |title=Ecologic and Geographic Distribution of Filovirus Disease |journal=Emerg. Infect. Dis. |volume=10 |issue=1 |pages=40–47 |doi=10.3201/eid1001.030125 |pmc=3322747 |pmid=15078595}}</ref> (then part of [[Sudan]]), and was caused by [[Sudan virus]] (SUDV). The Sudan outbreak infected 284 people and killed 151. The first identifiable case in Sudan occurred on 27 June in a storekeeper in a cotton factory in [[Nzara]], who was hospitalised on 30 June and died on 6 July.<ref name="Feldmann2011" /><ref name="who's first encounter">{{Cite web |title=Ebola haemorrhagic fever in Sudan, 1976 |url=http://whqlibdoc.who.int/bulletin/1978/Vol56-No2/bulletin_1978_56(2)_247-270.pdf |url-status=dead |archive-url=https://web.archive.org/web/20141013194802/http://whqlibdoc.who.int/bulletin/1978/Vol56-No2/bulletin_1978_56(2)_247-270.pdf |archive-date=13 October 2014 |access-date=8 October 2014}}</ref> Although the WHO medical staff involved in the Sudan outbreak knew that they were dealing with a heretofore unknown disease, the actual "positive identification" process and the naming of the virus did not occur until some months later in [[Zaire]].<ref name="who's first encounter" />

====Zaire====
{{main|1976 Zaire Ebola virus outbreak}}
[[File:CDC worker incinerates med-waste from Ebola patients in Zaire.jpg|thumb|upright|A CDC worker incinerates medical waste from Ebola patients in Zaire in 1976.]]

On 26 August 1976, the second outbreak of EVD began in [[Yambuku]], a small rural village in [[Mongala District]] in northern [[Zaire]] (now known as the [[Democratic Republic of the Congo]]).<ref>{{Cite book | vauthors = Hewlett B, Hewlett B |url=https://books.google.com/books?id=aboFAAAAQBAJ&pg=PA103 |title=Ebola, Culture and Politics: The Anthropology of an Emerging Disease |date=2007 |publisher=Cengage Learning |isbn=978-1111797317 |page=103 |access-date=31 July 2014}}</ref><ref name="Feldmann2003">{{Cite journal |vauthors=Feldmann H, Jones S, Klenk HD, Schnittler HJ |date=August 2003 |title=Ebola virus: from discovery to vaccine |journal=Nature Reviews Immunology |volume=3 |issue=8 |pages=677–685 |doi=10.1038/nri1154 |pmid=12974482 |s2cid=27486878|doi-access=free }}</ref> This outbreak was caused by EBOV, formerly designated ''Zaire ebolavirus'', a different member of the [[genus]] ''Ebolavirus'' than in the first Sudan outbreak. The [[index case|first person infected with the disease]] was the village school's headmaster [[Mabalo Lokela]], who began displaying symptoms on 26 August 1976.<ref name="whqlibdoc.who.int">{{Cite journal |last=Report of an International Commission |year=1978 |title=Ebola haemorrhagic fever in Zaire, 1976 |url=http://whqlibdoc.who.int/bulletin/1978/Vol56-No2/bulletin_1978_56(2)_271-293.pdf |url-status=dead |journal=Bull. World Health Organ. |volume=56 |issue=2 |pages=271–293 |pmc=2395567 |pmid=307456 |archive-url=https://web.archive.org/web/20140808213715/http://whqlibdoc.who.int/bulletin/1978/Vol56-No2/bulletin_1978_56%282%29_271-293.pdf |archive-date=8 August 2014 |access-date=14 August 2014 }}</ref> Lokela had returned from a trip to Northern Zaire near the border of the [[Central African Republic]], after visiting the [[Ebola River]] between 12 and 22 August. He was originally believed to have [[malaria]] and was given [[quinine]]. However, his symptoms continued to worsen, and he was admitted to Yambuku Mission Hospital on 5 September. Lokela died on 8 September 14 days after he began displaying symptoms.<ref name="urlOutbreak of Ebola Viral Hemorrhagic Fever – Zaire, 1995">{{Cite journal |last=Centers for Disease Control Prevention (CDC) |year=1995 |title=Outbreak of Ebola Viral Hemorrhagic Fever – Zaire, 1995 |url=https://www.cdc.gov/mmwr/preview/mmwrhtml/00037078.htm |url-status=live |journal=Morbidity and Mortality Weekly Report |volume=44 |issue=19 |pages=381–382 |pmid=7739512 |archive-url=https://web.archive.org/web/20170625191457/https://www.cdc.gov/mmwr/preview/mmwrhtml/00037078.htm |archive-date=25 June 2017 }}</ref><ref name="urlMabalo Lokela Archives – Political Moll">{{Cite web | vauthors = Elezra M |title=Ebola: The Truth Behind The Outbreak (Video) l |url=http://politicalmoll.com/tag/mabalo-lokela/ |url-status=dead |archive-url=https://web.archive.org/web/20150712140500/http://politicalmoll.com/tag/mabalo-lokela/ |archive-date=12 July 2015 |access-date=18 October 2014 |website=Mabalo Lokela Archives – Political Mol}}</ref>

Soon after Lokela's death, others who had been in contact with him also died, and people in Yambuku began to panic. The country's Minister of Health and Zaire President [[Mobutu Sese Seko]] declared the entire region, including Yambuku and the country's capital, [[Kinshasa]], a quarantine zone. No-one was permitted to enter or leave the area, and roads, waterways, and airfields were placed under [[martial law]]. Schools, businesses and social organisations were closed.<ref name="Stimola">{{Cite book | vauthors = Stimola A |url=https://archive.org/details/ebola0000stim/page/31 |title=Ebola |publisher=Rosen Pub. |year=2011 |isbn=978-1435894334 |edition=1st |location=New York |pages=[https://archive.org/details/ebola0000stim/page/31 31, 52] |url-access=registration}}</ref> The initial response was led by Congolese doctors, including [[Jean-Jacques Muyembe-Tamfum]], one of the discoverers of Ebola. Muyembe took a blood sample from a Belgian nun; this sample would eventually be used by [[Peter Piot]] to identify the previously unknown Ebola virus.<ref>{{Cite news |title=This Congolese Doctor Discovered Ebola But Never Got Credit For It – Until Now |work=NPR.org |url=https://www.npr.org/sections/goatsandsoda/2019/11/04/774863495/this-congolese-doctor-discovered-ebola-but-never-got-credit-for-it-until-now |access-date=5 November 2019}}</ref> Muyembe was also the first scientist to come into direct contact with the disease and survive.<ref>{{Cite web | vauthors = McNeish H |date=24 March 2017 |title=He Treated The Very First Ebola Cases 40 Years Ago. Then He Watched The World Forget. |url=https://www.huffpost.com/entry/ebola-neglected-tropical-diseases_n_58d2ac02e4b0f838c62e9e0d |access-date=5 November 2019 |website=HuffPost}}</ref> Researchers from the [[Centers for Disease Control and Prevention]] (CDC), including Piot, co-discoverer of Ebola, later arrived to assess the effects of the outbreak, observing that "the whole region was in panic."<ref name="Piot_2012">{{Cite book |title=No time to lose: a life in pursuit of deadly viruses |vauthors=Piot P, Marshall R |publisher=W.W. Norton & Co. |year=2012 |isbn=978-0393063165 |edition=1st |location=New York |pages=30, 90}}</ref><ref name="Piot-one">{{Cite news | vauthors = Piot P |date=11 August 2014 |title=Part one: A virologist's tale of Africa's first encounter with Ebola |work=ScienceInsider |url=https://www.science.org/content/article/part-one-virologists-tale-africas-first-encounter-ebola |url-status=live |archive-url=https://web.archive.org/web/20141009050901/http://news.sciencemag.org/africa/2014/08/part-one-virologists-tale-africas-first-encounter-ebola |archive-date=9 October 2014 }}</ref><ref name="Piot-two">{{Cite news | vauthors = Piot P |date=13 August 2014 |title=Part two: A virologist's tale of Africa's first encounter with Ebola |work=ScienceInsider |url=https://www.science.org/content/article/part-two-virologists-tale-africas-first-encounter-ebola |url-status=live |archive-url=https://web.archive.org/web/20141116233325/http://news.sciencemag.org/africa/2014/08/part-two-virologists-tale-africas-first-encounter-ebola |archive-date=16 November 2014 }}</ref>

Piot concluded that Belgian nuns had inadvertently started the epidemic by giving unnecessary vitamin injections to pregnant women without sterilizing the syringes and needles. The outbreak lasted 26 days and the quarantine lasted two weeks. Researchers speculated that the disease disappeared due to the precautions taken by locals, the quarantine of the area, and discontinuing of the injections.<ref name=Stimola/>

During this outbreak, Ngoy Mushola recorded the first clinical description of EVD in [[Yambuku]], where he wrote the following in his daily log: "The illness is characterised with a high temperature of about {{convert|39|°C|0}}, [[haematemesis]], diarrhoea with blood, retrosternal abdominal pain, prostration with 'heavy' articulations, and rapid evolution death after a mean of three days."<ref>{{Cite web | vauthors = Bardi JS |title=Death Called a River |url=http://www.scripps.edu/newsandviews/e_20020114/ebola1.html |url-status=live |archive-url=https://web.archive.org/web/20140802170848/http://www.scripps.edu/newsandviews/e_20020114/ebola1.html |archive-date=2 August 2014 |access-date=9 October 2014 |website=The Scripps Research Institute}}</ref>

The virus responsible for the initial outbreak, first thought to be the [[Marburg virus]], was later identified as a new type of virus related to the genus ''[[Marburgvirus]]''. Virus strain samples isolated from both outbreaks were named "Ebola virus" after the [[Ebola River]], near the first-identified viral outbreak site in Zaire.<ref name=Feldmann2011/> Reports conflict about who initially coined the name: either Karl Johnson of the American CDC team<ref name="hz">{{Cite book | vauthors = Preston R |title=The Hot Zone |title-link=The Hot Zone |date=20 July 1995 |publisher=Anchor Books ([[Random House]]) |page=[https://archive.org/details/hotzone1995pres/page/n144 117] |quote=Karl Johnson named it Ebola |author-link=Richard Preston}}</ref> or Belgian researchers.<ref name="observer">{{Cite web | vauthors = von Bredow R, Hackenbroch V |date=4 October 2014 |title=In 1976 I Discovered Ebola&nbsp;– Now I Fear an Unimaginable Tragedy |url=https://www.theguardian.com/world/2014/oct/04/ebola-zaire-peter-piot-outbreak |url-status=live |archive-url=https://web.archive.org/web/20170103105318/https://www.theguardian.com/world/2014/oct/04/ebola-zaire-peter-piot-outbreak |archive-date=3 January 2017 |website=[[The Guardian]]}}</ref> Subsequently, a number of other cases were reported, almost all centred on the Yambuku mission hospital or close contacts of another case.<ref name="whqlibdoc.who.int" /> In all, 318 cases and 280 deaths (an 88% fatality rate) occurred in Zaire.<ref name="emedicine.com">{{Cite web | vauthors = King JW |date=2 April 2008 |title=Ebola Virus |url=http://www.emedicine.com/MED/topic626.htm |url-status=live |archive-url=https://web.archive.org/web/20080928063653/http://www.emedicine.com/med/TOPIC626.HTM |archive-date=28 September 2008 |access-date=6 October 2008 |website=eMedicine |publisher=WebMD }}</ref> Although the two outbreaks were at first believed connected, scientists later realised that they were caused by two distinct ebolaviruses, SUDV and EBOV.<ref name=Feldmann2003/>