The outbreak started late in December 2013. Ebola was not suspected at the time, since it had never been seen in that area before and no one thought to look for it. It was believed to be Lassa, another viral hemorrhagic fever that is endemic to the region. I’m not sure how/why Ebola was finally tested for, but one story has it that a doctor (perhaps an MSF doctor) noticed hiccuping, a symptom that he had only seen manifest in Ebola patients. The Guinean ministry of health announced on 19 March that there was a viral disease that had sickened 35 and killed 23; by a week later, the disease was identified as Ebola.
This occurred in an area where public health is almost non-existent and people are highly mobile through porous borders. Guinea had, at one point eliminated the virus and was well into the 42 day wait period, when more Ebola victims came across the border from Liberia or Sierra Leone where they had apparently been hiding.
A crucial event in this outbreak was the funeral of a shaman in Sierra Leone, who had become ill while using traditional remedies to treat people. Because she was well-known, many women from different villages helped to prepare her body for the funeral, a process that involves ritual washing. This spread Ebola to several neighboring villages.
This practice of washing bodies, and of hands-on funeral rites, is responsible for a large number of cases. These people have superstitious beliefs and are mostly illiterate, so many are predisposed not to believe or understand public health messages.
I would love to address the molecular biology aspects of this that you brought up, but I need to get ready for work so I will have to address that in a later post.
Before I go, though, let me post a couple of links.
This is a documentary on a 1995 outbreak in Kikwit, DRC:
https://www.youtube.com/watch?v=miJ57LpN2Lg (47 min)
I first saw this documentary in a class I took several years ago. I think the insight it provides on various factors that promote the spread of Ebola, and measures that had to be used to control it is quite interesting. (The convalescent serum treatment they tried is not proven, and has had mixed results in actual use.)
Here is the Wikipedia entry on the current outbreak:
http://en.wikipedia.org/wiki/Ebola_virus_epidemic_in_West_Africa
It provides not only a good sequence of events, but discusses many of the challenges of trying to contain the disease. These countries until very recently were the locales of very brutal civil wars that went on for decades. They have almost no infrastructure. Their healthcare systems are grossly inadequate, even more so now that they have lost so many healthcare workers to Ebola. The people mistrust foreigners and are highly superstitious—getting them to understand basics of infectious disease transmission is incredibly challenging. They are upset and prone to rioting over the fact that people come and remove dead bodies without allowing them to give a proper burial (which involves giving an enema and washing the body). And so on.
Yes, The UN (UNICEF, anyway) knew what was going on even then.
I am well aware of the cultural differences between (most of) the US and Africa.
It hasn't been so long since a wake was standard issue in this country either, at least in some parts of the population.
But, just as African Culture has its quirks, so do we.
Those weaknesses in our cultural framework that cannot or will not be anticipated will be exposed if this disease gets a solid foothold, just as the vulnerabilities inherent in African Culture have been exposed.
I got into a bit of a wrangle with someone who could/would not understand that hygiene, like safety, begins with the individual, regardless of circumstance.
Technology is nice, and sometimes even essential, but poor or slovenly habits can thwart even the most laudable of available technologies, and much of America is slovenly. I believe we were more germ conscious before we had antibiotics to look toward for salvation, even if for many their surroundings were a little less convenient than the more modern fixtures of today.
Speak with anyone who has been a fireman, worked EMS, or been a policeman who gets an unanticipated glimpse into people's lives, and they will be able to describe an America that is far from gleaming stainless steel and spotless glass. Yes, some are fastidious and I laud them, but many are not.
Despite our smugness, the fastidious share a world with those who are not, and that can be anyone's undoing. Recall the scene in the video you linked where the fellow took off his gloves in the middle of the village and dropped them on the ground--another disposed of them properly. There was another where, riding in the back of the truck with the corpse, one person pulled down their mask...
Even those who should know better will have lapses.
More later.