The West African Ebola epidemic was the most widespread outbreak of the disease to date. Beginning in Meliandou in southern Guinea in December 2013, it spread to adjacent Liberia and Sierra Leone, affecting the cities of Conakry and Monrovia, with minor outbreaks in Mali and Nigeria. Cases reached a peak in October 2014 and the epidemic was under control by late 2015, although occasional cases continued to occur into April 2016. Ring vaccination with the then-experimental vaccine rVSV-ZEBOV was trialled in Guinea.
More than 28,000 suspected cases were reported with more than 11,000 deaths; the case fatality rate was around 40% overall and around 58% in hospitalised patients. Early in the epidemic nearly 10% of the dead were healthcare workers. The outbreak left about 17,000 survivors, many of whom reported long-lasting post-recovery symptoms. Extreme poverty, dysfunctional healthcare systems, distrust of government after years of armed conflict, local burial customs of washing the body, the unprecedented spread of Ebola to densely populated cities, and the delay in response of several months all contributed to the failure to control the epidemic.