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Therefore, as in humans, apes likely become infected either by<br />

direct contact with the EBOV reservoir (presumed to include<br />

different bat species)(Leroy et al., 2004; Caillaud et al., 2006),<br />

via the touching of infectious other animals (Caillaud et al.,<br />

2006; Walsh et al., 2007) or via contact with bodily fluids of<br />

an infected cohort (Rouquet et al., 2005; Caillaud et al., 2006;<br />

Walsh et al., 2007).<br />

Determining total great ape morbidity and mortality due to<br />

EHF is difficult. Great ape population surveys revealed declines<br />

in great ape signs ranging from 95–98 % in Minkebé<br />

National Park (Gabon), Lossi Sanctuary and Lokoué Bai (Republic<br />

of Congo) between 1994 and 2004. Additionally, Walsh<br />

et al., 2003) compared ape nest counts and concluded that Gabon’s<br />

ape population had decreased by almost 50% (Walsh et<br />

al., 2003) over 2 decades. Considering the density of ape populations<br />

in these regions, and presuming that some epidemics<br />

go unnoticed, it would not be unrealistic to consider that tens<br />

of thousands of great apes may have been lost in recent years.<br />

Based on the calculations, it seems likely, that EBOV is the major<br />

driver of these losses (Huijbregts et al., 2003; Walsh et al.,<br />

2003; Bermejo et al., 2006; Devos et al., 2008). However, the<br />

diagnostic data available for such calculations are scarce and assumptions<br />

are mainly based on the fact that great ape declines<br />

could be spatially or temporally linked with the few confirmed<br />

EBOV outbreaks in wildlife and/or humans (Huijbregts et al.,<br />

2003; Walsh et al., 2003; Bermejo et al., 2006; Wittmann et<br />

al., 2007; Devos et al., 2008). The World Conservation Union<br />

(IUCN) upgraded the western lowland gorilla (Gorilla gorilla gorilla)<br />

to a “critically endangered” status as a result of this alarming<br />

trend (IUCN, 2008), and lists infectious disease as one of<br />

the top threats to the species. Indeed, while it is reasonable to<br />

imagine EBOV is implicated in observed massive great ape declines,<br />

it is obvious that baseline data on background mortality<br />

caused by other pathogens are missing.<br />

EBOV has been confirmed in carcasses of only 16 wild great<br />

apes thus far (Wittmann et al., 2007); a small number given the<br />

thousands of animals presumed to have died from EHF. Producing<br />

solid biological evidence of EBOV as the cause of great<br />

ape population decreases is extremely challenging. Diagnostic<br />

samples are difficult to acquire, due to the vastness and remoteness<br />

of the regions in question and the rapid decomposition of<br />

carcasses. Samples that are collected from carcasses are often<br />

of poor quality, making analyses prone to false-negative results<br />

(Rouquet et al., 2005).<br />

Early detection of wildlife mortality events combined with<br />

rapid sampling and diagnostic testing is key for understanding<br />

threats to wildlife and needs to be enforced (Gillespie et al.,<br />

2008; Gillespies and Chapman, 2008). Strengthening wildlife<br />

disease surveillance systems in great ape range states, with the<br />

involvement of local communities, represents an important<br />

step towards obtaining more data. In addition, improving laboratory<br />

capacity and employing field diagnostic techniques also<br />

holds promise for identifying causes of mortality. Future EB-<br />

OV-related research should strive to better understand EBOV<br />

natural ecology and geographical distribution. This information,<br />

combined with knowledge of infection risk factors and<br />

length of immunity for great apes, may shed clues on which<br />

ape populations are most at risk for future infections and be<br />

used to develop timely, safe and ethically reviewed prophylactic<br />

strategies and treatments for the mitigation of ape health<br />

threats. For example, vaccination strategies are recommended<br />

to reduce the infection rates of ape populations when considered<br />

critical for their survival. Several EBOV vaccines have been<br />

developed for human use but identifying the ideal candidates<br />

for wild great apes is challenging. Highly effective oral vaccines<br />

may pose dangers for non-target species and injectable vaccines<br />

pose major logistical challenges when considering the need to<br />

dart vast numbers of elusive great apes. We must ensure that<br />

the initiative is applied in a safe way consistent with the goals<br />

and principles conservation.<br />

Great ape health research must take a broad epidemiological<br />

approach. Recent health studies have identified other pathogens<br />

as threats to the health of increasingly vulnerable great<br />

ape populations (Leendertz et al., 2006; Köndgen et al., 2008),<br />

reminding us to be careful to avoid missing die offs due to a<br />

“new” pathogen while we are hot on the trail of the one we<br />

know best. The future of great ape health must be proactive<br />

rather than reactive.<br />

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