Exploring the human-animal interface of Ebola virus disease outbreaks.

Whereas the prevention and treatment of Ebola virus disease (EVD) have been well studied after the 2013-16 outbreak in West Africa, the emergence of human outbreaks and their mechanisms have yet to be explored in detail. In particular, it has yet to be clarified whether the emergence records offer any theoretical insight into the changing interface between humans and animal reservoirs. Here we explore the epidemiological record of emergence, investigating predominant causes of the introduction to the human population, their characteristics, and frequencies. We retrieved data of every outbreak that can be traced back to a single zoonotic spillover. Through statistical analysis, we have shown that (i) the leading cause of emergence was eating and hunting habits, (ii) primates act as the main source of zoonotic spillover, and (iii) Zaire ebolavirus is the most virulent type. Moreover, the trend of emergence was demonstrated not to be a Poisson process, indicating that some unknown, underlying, non-random mechanisms are likely to govern the spillover event. In the Democratic Republic of Congo, an increasing emergence trend was favored compared with a purely random emergence model. Outbreak event data and their causative viruses should be explored biologically and epidemiologically to possibly predict future outbreak events.