the first-identified viral outbreak site in zaire. reports conflict about who initially coined the name: either karl johnson of the american cdc team or belgian researchers. subsequently, a number of other cases were reported, almost all centred on the yambuku mission hospital or close contacts of another case. in all, 318 cases and 280 deaths (an 88% fatality rate) occurred in zaire. although the two outbreaks were at first believed connected, scientists later realised that they were caused by two distinct ebolaviruses, sudv and ebov. 1995–2014 cases of ebola fever in africa since 1976 the second major outbreak occurred in zaire (now the democratic republic of the congo, drc), in 1995, affecting 315 and killing 254. in 2000, uganda had an outbreak infecting 425 and killing 224; in this case, the sudan virus was found to be the ebola species responsible for the outbreak. in 2003, an outbreak in the drc infected 143 and killed 128, a 90% death rate, the highest of a genus ebolavirus outbreak to date. in 2004, a russian scientist died from ebola after sticking herself with an infected needle. between april and august 2007, a fever epidemic in a four-village region of the drc was confirmed in september to have been cases of ebola. many people who attended the recent funeral of a local village chief died. the 2007 outbreak eventually infected 264 individuals and killed 187. on 30 november 2007, the uganda ministry of health confirmed an outbreak of ebola in the bundibugyo district in western uganda. after confirming samples tested by the united states national reference laboratories and the centers for disease control, the world health organization (who) confirmed the presence of a new species of genus ebolavirus, which was tentatively named bundibugyo. the who reported 149 cases of this new strain and 37 of those led to deaths. the who confirmed two small outbreaks in uganda in 2012, both caused by the sudan variant. the first outbreak affected seven people, killing four, and the second affected 24, killing 17. on 17 august 2012, the ministry of health of the drc reported an outbreak of the ebola-bundibugyo variant in the eastern region. other than its discovery in 2007, this was the only time that this variant has been identified as responsible for an outbreak. the who revealed that the virus had sickened 57 people and killed 29. the probable cause of the outbreak was tainted bush meat hunted by local villagers around the towns of isiro and viadana. in 2014, an outbreak occurred in the drc. genome-sequencing showed that this outbreak was not related to the 2014–15 west africa ebola virus outbreak, but was the same ebov species, the zaire species. it began in august 2014, and was declared over in november with 66 cases and 49 deaths. this was the 7th outbreak in the drc, three of which occurred during the period when the country was known as zaire. 2013–2016 west africa main article: west african ebola virus epidemic cases and deaths from april 2014 to july 2015 during the 2013–2015 outbreak in march 2014, the world health organization (who) reported a major ebola outbreak in guinea, a west african nation. researchers traced the outbreak to a one-year-old child who died in december 2013. the disease rapidly spread to the neighbouring countries of liberia and sierra leone. it was the largest ebola outbreak ever documented, and the first recorded in the region. on 8 august 2014, the who declared the epidemic an international public health emergency. urging the world to offer aid to the affected regions, its director-general said, "countries affected to date simply do not have the capacity to manage an outbreak of this size and complexity on their own. i urge the international community to provide this support on the most urgent basis possible." by mid-august 2014, doctors without borders reported the situation in liberia's capital, monrovia, was "catastrophic" and "deteriorating daily". they reported that fears of ebola among staff members and patients had shut down much of the city's health system, leaving many people without medical treatment for other conditions. in a 26 september statement, who said, "the ebola epidemic ravaging parts of west africa is the most severe acute public health emergency seen in modern times. never before in recorded history has a biosafety level four pathogen infected so many people so quickly, over such a broad geographical area, for so long." intense contact tracing and strict isolation largely prevented further spread of the disease in the countries that had imported cases. it caused significant mortality, with a considerable case fatality rate. by the end of the epidemic, 28,616 people had been infected; of these, 11,310 had died, for a case-fatality rate of 40%. as of 8 may 2016, 28,646 suspected cases and 11,323 deaths were reported; however, the who said that these numbers may be underestimated. because they work closely with the body fluids of infected patients, healthcare workers were especially vulnerable to infection; in august 2014, the who reported that 10% of the dead were healthcare workers. 2014 ebola virus epidemic in west africa in september 2014, it was estimated that the countries' capacity for treating ebola patients was insufficient by the equivalent of 2,122 beds; by december there were a sufficient number of beds to treat and isolate all reported ebola cases, although the uneven distribution of cases was causing serious shortfalls in some areas. on 28 january 2015, the who reported that for the first time since the week ending 29 june 2014, there had been fewer than 100 new confirmed cases reported in a week in the three most-affected countries. the response to the epidemic then moved to a second phase, as the focus shifted from slowing transmission to ending the epidemic. on 8 april 2015, the who reported only 30 confirmed cases, the lowest weekly total since the third week of may 2014. on 29 december 2015, 42 days after the last person tested negative for a second time, guinea was declared free of ebola transmission. at that time, a 90-day period of heightened surveillance was announced by that agency. "this is the first time that all three countries – guinea, liberia and sierra leone – have stopped the original chains of transmission ...", the organisation stated in a news release. a new case was detected in sierra leone on 14 january 2016. however, the outbreak was declared no longer an emergency on 29 march 2016. 2014 spread outside west africa main articles: ebola virus cases in the united states, ebola virus disease in spain, and ebola virus disease in the united kingdom on 19 september, eric duncan flew from his native liberia to texas; five days later he began showing symptoms and visited a hospital but was sent home. his condition worsened and he returned to the hospital on 28 september, where he died on 8 october. health officials confirmed a diagnosis of ebola on 30 september – the first case in the united states. in early october, teresa romero, a 44-year-old spanish nurse, contracted ebola after caring for a priest who had been repatriated from west africa. this was the first transmission of the virus to occur outside africa. romero tested negative for the disease on 20 october, suggesting that she may have recovered from ebola infection. on 12 october, the centers for disease control and prevention (cdc) confirmed that a nurse in texas, nina pham, who had treated duncan tested positive for the ebola virus, the first known case of transmission in the united states. on 15 october, a second texas health-care worker who had treated duncan was confirmed to have the virus. both of these people recovered. an unrelated case involved a doctor in new york city, who returned to the united states from guinea after working with médecins sans frontières and tested positive for ebola on 23 october. the person recovered and was discharged from bellevue hospital on 11 november. on 24 december 2014, a laboratory in atlanta, georgia reported that a technician had been exposed to ebola. on 29 december 2014, pauline cafferkey, a british nurse who had just returned to glasgow from sierra leone, was diagnosed with ebola at glasgow's gartnavel general hospital. after initial treatment in glasgow, she was transferred by air to raf northolt, then to the specialist high-level isolation unit at the royal free hospital in london for longer-term treatment. 2017 democratic republic of the congo main article: 2017 democratic republic of the congo ebola virus outbreak on 11 may 2017, the drc ministry of public health notified the who about an outbreak of ebola. four people died, and four people survived; five of these eight cases were laboratory-confirmed. a total of 583 contacts were monitored. on 2 july 2017, the who declared the end of the outbreak. 2018 équateur province main article: 2018 équateur province ebola outbreak on 14 may 2018, the world health organization reported that "the democratic republic of congo reported 39 suspected, probable or confirmed cases of ebola between 4 april and 13 may, including 19 deaths." some 393 people identified as contacts of ebola patients were being followed up. the outbreak centred on the bikoro, iboko, and wangata areas in equateur province, including in the large city of mbandaka. the drc ministry of public health approved the use of an experimental vaccine. on 13 may 2018, who director-general tedros adhanom ghebreyesus visited bikoro. reports emerged that maps of the area were inaccurate, not so much hampering medical providers as epidemiologists and officials trying to assess the outbreak and containment efforts. the 2018 outbreak in the drc was declared over on 24 july 2018. 2018–2020 kivu main article: kivu ebola epidemic on 1 august 2018, the world's 10th ebola outbreak was declared in north kivu province of the democratic republic of the congo. it was the first ebola outbreak in a military conflict zone, with thousands of refugees in the area. by november 2018, nearly 200 congolese had died of ebola, about half of them from the city of beni, where armed groups are fighting over the region's mineral wealth, impeding medical relief efforts. by march 2019, this became the second largest ebola outbreak ever recorded, with more than 1,000 cases and insecurity continuing to be the major resistance to providing an adequate response. as of 4 june 2019, the who reported 2025 confirmed and probable cases with 1357 deaths. in june 2019, two people died of ebola in neighbouring uganda. in july 2019, an infected man travelled to goma, home to more than two million people. one week later, on 17 july 2019, the who declared the ebola outbreak a global health emergency, the fifth time such a declaration has been made by the organisation. a government spokesman said that half of the ebola cases are unidentified, and he added that the current outbreak could last up to three years. on 25 june 2020, the second biggest evd outbreak ever was declared over. 2020 équateur province on 1 june 2020, the congolese health ministry announced a new drc outbreak of ebola in mbandaka, équateur province, a region along the congo river. genome sequencing suggests that this outbreak, the 11th outbreak since the virus was first discovered in the country in 1976, is unrelated to the one in north kivu province or the previous outbreak in the same area in 2018. it was reported that six cases had been identified; four of the people had died. it is expected that more people will be identified as surveillance activities increase. by 15 june the case count had increased to 17 with 11 deaths, with more than 2,500 people having been vaccinated. the 11th evd outbreak was officially declared over on 19 november 2020. by the time the équateur outbreak ended, it had 130 confirmed cases with 75 recoveries and 55 deaths. north kivu on 7 february 2021, the congolese health ministry announced a new case of ebola near butembo, north kivu detected a day before. the case was a 42-year-old woman who had symptoms of ebola in biena on 1 february 2021. a few days after, she died in a hospital in butembo. the who said that more than 70 people with contact with the woman had been tracked. on 11 february 2021, another woman who had