The average time required to detect an Ebola virus disease (EVD) outbreak following spillover of Ebola virus (EBOV) to a primary human case has remained essentially unchanged for over 40 years, with some of the longest delays in detection occurring in recent decades. In this review, our aim was to examine the relationship between delays in detection of EVD and the duration and size of outbreaks, and we report that longer delays are associated with longer and larger EVD outbreaks. Historically, EVD outbreaks have typically been comprised of less than 100 cases (median = 60) and have lasted less than 4 months (median = 118 days). The ongoing outbreak in Democratic Republic of the Congo, together with the 2013-2016 west Africa outbreak, are stark outliers amidst these trends and had two of the longest delays in detection on record. While significant progress has been made in the development of EVD countermeasures, implementation during EVD outbreaks is problematic. Thus, EVD surveillance must be improved by the broad deployment of modern diagnostic tools, as prompt recognition of EVD has the potential to stem early transmission and ultimately limit the duration and size of outbreaks.

中文翻译：

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埃博拉病毒病的延迟识别与更长或更长时间的爆发有关。

在埃博拉病毒（EBOV）传染给人类原发性病例后，检测埃博拉病毒病（EVD）爆发所需的平均时间在40多年来基本上没有变化，最近几十年出现了一些最长的检测延迟。在这篇综述中，我们的目的是研究检测EVD的延迟与暴发的持续时间和规模之间的关系，并且我们报告更长的延迟与更长和更大的EVD暴发有关。从历史上看，EVD爆发通常少于100例（中位数= 60），持续时间少于4个月（中位数= 118天）。在这些趋势中，刚果民主共和国持续爆发的疫情以及2013-2016年西非疫情与众不同，是有记录以来拖延时间最长的两次。尽管在EVD对策的开发方面已取得了重大进展，但在EVD爆发期间的实施还是有问题的。因此，必须通过广泛部署现代诊断工具来改进EVD监视，因为迅速识别EVD有可能阻止早期传播，并最终限制爆发的持续时间和规模。