Feature

Breakdown + Breakdown runners-up

Science  19 Dec 2014:
Vol. 346, Issue 6216, pp. 1450-1451
DOI: 10.1126/science.346.6216.1450-b

Breakdown of the year: Ebola

This year, an Ebola outbreak that began in the remote Guinean village of Meliandou grew into a widespread epidemic that has alarmed the entire world. Outpacing efforts to contain it, the virus has ravaged Guinea and neighboring Liberia and Sierra Leone, creating a public health breakdown that Margaret Chan, director-general of the World Health Organization (WHO), described as “likely the greatest peacetime challenge that the United Nations and its agencies have ever faced.”

Ebola outbreaks have flared every few years since the virus was first identified in 1976. Yet until now, containment efforts derailed all outbreaks within a few months and kept them mostly remote and local, limiting the total number of cases to only 2500 or so. This time around, the virus spread across borders and through crowded cities, taking advantage of shaky health systems and a slow, uncoordinated international response to grow into an epidemic that has sickened more than 18,000 people and killed nearly 7000 so far, with isolated cases as far afield as Spain and the United States. “I wonder whether one person in the world could say that he or she predicted this outbreak,” says Bertrand Draguez, the medical director for Doctors Without Borders (MSF) in Brussels. Its future course is equally unpredictable.

After the first case in Meliandou in December 2013, it took 3 months for health officials to realize an Ebola outbreak was under way. MSF quickly sent in teams, and by late March, the virus had spread to four districts in Guinea, and Liberia and Sierra Leone had suspected cases. “We are facing an epidemic of a magnitude never before seen,” MSF warned on 31 March. But over the next month and a half, the outbreak waned and even Guinea's president declared the situation “well in hand.”

By mid-June, however, the number of cases in the three countries had skyrocketed to 504, surpassing the largest previous outbreak. MSF announced it no longer had enough staff to keep up with the spread. Wobbly health care systems in the three countries—which long had suffered from political instability, corruption, and staggering poverty—began to collapse. Overwhelmed clinics had no beds for the sick, who returned home and infected others.

Overwhelmed by Ebola in August, Monrovia converted this primary school classroom to an isolation ward. The health care worker is disinfecting a corpse.

PHOTO: JOHN MOORE/GETTY IMAGES

The problem still drew little international attention until two American missionary health care workers became infected in late July. On 8 August, WHO declared the epidemic a “public health emergency of international concern.” A month later, U.S. President Barack Obama announced that the country would send in 3000 military troops to help, millions of dollars of aid poured in, and an aggressive push emerged to develop Ebola drugs and vaccines.

Finger-pointing escalated in lockstep with the case counts. WHO and the international community took too long to act. No one effectively coordinated responses. Local governments played ostrich, fudged case reports, and imposed counterproductive quarantines. Frightened health care workers stayed away from work. Affected communities attacked aid workers and ostracized survivors. Sick people refused to go into isolation or divulge their contacts. Some cultures resisted changing dangerous burial practices.

Over and above those factors, the region's permeable borders and extensive transportation routes have complicated contact tracing and expanded the epidemic's reach. More vexing still, the sudden surges of patients in ever-changing locales have meant a constant shortage of trained doctors, nurses, janitors, ambulance drivers, and gravediggers.

Although Liberia has recently made progress in some places, Draguez, who recently visited 10 Ebola treatment units MSF runs in the three affected countries, says the end is nowhere in sight. “We have to keep on going with the same level of energy for 6 or 8 or even 12 months,” he warns. Already the Ebola epidemic of 2014 has made it starkly clear that we must move steadily and aggressively against this virus, or it will continue to teach us lessons we do not want to learn. –Jon Cohen

Breakdown runners-up

Unfortunately, there's always more than enough bad news to fill this category. A few of this year's notable flaps, stumbles, and reverses.

Stem cells made easy?

Rarely has so dazzling a claim gone down in flames so quickly. In January, researchers from Japan and the United States published what purported to be an easier, more powerful new method for turning adult cells into stem cells. But within 3 weeks, online commentators spotted questionable images in the two papers. Doubts multiplied as other labs around the world tried and failed to repeat the feat. Lead author Haruko Obokata was found guilty of misconduct, Nature retracted the papers, and in a tragedy that shook the field, one co-author took his own life. Officials in Japan radically reorganized the RIKEN institute where most of the work was done, cutting staff from more than 500 to 250.

Glimpse of creation?

In March, cosmologists working with a specialized telescope at the South Pole called BICEP2 claimed they had spotted in the afterglow of the big bang a sure signal that the newborn universe had undergone a bizarre growth spurt known as inflation. Others suggested the signal could have come from dust within our own galaxy, and in September, researchers with the European Space Agency's Planck spacecraft showed that most or all of it probably does. The two teams are working on a joint analysis, but the bold claim seems unlikely to hold up.

Lawmakers versus NSF

Is the science committee for the U.S. House of Representatives broken or simply doing its job as watchdog? The U.S. research community watched with dismay this year as the committee, led by Representative Lamar Smith (R–TX), pummeled the National Science Foundation and other federal science agencies at hearings, in press releases, and with subpoenas and legislation. Smith says he's making sure the government spends tax dollars wisely. His actions have captured headlines, but many scientists—remembering the bipartisan, big-picture policy discussions that used to be the panel's bread and butter—might prefer a return to quiet obscurity.

BREAKDOWN OF THE YEAR: EBOLA

The Ebola Epidemic,” Science Special Collection.

BREAKDOWN RUNNERS-UP

STAP cells

D. Normile, “Acid Treatment Could Provide Breakthrough Stem Cell Technique,” Science (29 January 2014).

D. Normile and G. Vogel, “Irreproducibility Dogs New Reprogramming Method,” Science 343, 6177 (21 March 2014).

D. Normile and G. Vogel, “STAP cells succumb to pressure,” Science 344, 6189 (13 June 2014).

G. Vogel and D. Normile, “EXCLUSIVE: Nature reviewers not persuaded by initial STAP stem cell papers,” Science (11 September 2014).

H. Obokata et al., “Bidirectional developmental potential in reprogrammed cells with acquired pluripotency,” Nature 505, 7485 (30 January 2014).

H. Obokata et al., “Stimulus-triggered fate conversion of somatic cells into pluripotency,” Nature 505, 7485 (30 January 2014).

Report on STAP Cell Research Paper Investigation,” RIKEN (1 April 2014).

BICEP

A. Cho, “Blockbuster claim could collapse in a cloud of dust,” Science 344, 6186 (23 May 2014).

A. Cho, “Evidence for cosmic inflation wanes,” Science 345, 6204 (26 September 2014).

A. Cho and Y. Bhattacharjee, “First Wrinkles in Spacetime Confirm Cosmic Inflation,” Science 343, 6177 (21 March 2014).

House Science Committee vs. NSF

J. Mervis, “Battle between NSF and House science committee escalates: How did it get this bad?Science (2 October 2014).

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