PLOS Neglected Tropical Diseases, Thursday 4 June 2015 What factors might have led to the emergence of Ebola in West Africa? June 4, 2015 DOI: 10.1371/journal.pntd.0003652 Abstract “An Ebola outbreak of unprecedented scope emerged in West Africa in December 2013 and presently continues unabated in the countries of Guinea, Sierra Leone, and Liberia. Ebola is not new to Africa, and outbreaks have been confirmed as far back as 1976. The current West African Ebola outbreak is the largest ever recorded and differs dramatically from prior outbreaks in its duration, number of people affected, and geographic extent. The emergence of this deadly disease in West Africa invites many questions, foremost among these: why now, and why in West Africa? Here, we review the sociological, ecological, and environmental drivers that might have influenced the emergence of Ebola in this region of Africa and its spread throughout the region. Containment of the West African Ebola outbreak is the most pressing, immediate need. A comprehensive assessment of the drivers of Ebola emergence and sustained human-to-human transmission is also needed in order to prepare other countries for importation or emergence of this disease. Such assessment includes identification of country-level protocols and interagency policies for outbreak detection and rapid response, increased understanding of cultural and traditional risk factors within and between nations, delivery of culturally embedded public health education, and regional coordination and collaboration, particularly with governments and health ministries throughout Africa. Public health education is also urgently needed in countries outside of Africa in order to ensure that risk is properly understood and public concerns do not escalate unnecessarily. To prevent future outbreaks, coordinated, multiscale, early warning systems should be developed that make full use of these integrated assessments, partner with local communities in high-risk areas, and provide clearly defined response recommendations specific to the needs of each community. ...” Key Learning Points · Significant political, social, and environmental changes have occurred in West Africa, likely contributing to the emergence of the most deadly Ebola outbreak in history. · Similarity in outbreak characteristics (including R0, symptoms, incubation time, and serial time) between West Africa and previous Ebola outbreaks suggests that there has not been any significant change in the virus affecting transmissibility. · Information collection and communication remain a challenge in resource-poor settings and specific strategies and tools will need to be developed to allow rapid identification and response within the context and constraints identified in the local environment. · Integrated approaches involving both human and animal health [“One Health”] must be developed that engage the research, law enforcement, and policy environments within these local settings. Please read complete article: http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003652 Note: Co-authors of this piece, Kathleen A. Alexander, DVM, PhD is listed on the One Health Initiative Supporters list http://www.onehealthinitiative.com/supporters.php and Viriginia M. Dato, MD, MPH is a member of the One Health Initiative team’s Honorary Advisory Board http://www.onehealthinitiative.com/advBoard.php.