The outbreak of Ebola virus disease (EVD) in west Africa in 2014–15 received global media attention. Such outbreaks typically lead to widespread fear and panic, and stigmatisation and social exclusion of patients with the disease, survivors, and relations.1 The psychosocial eff ects include adjustment disorders, symptoms of anxiety, and depression.2,3 For example, in the Nigerian response, a patient experienced severe distress, needing specialist psychiatrist consultation on the isolation ward.2 Other responses to stress included contacts either over-reporting or under-reporting core symptoms of interest to the contact tracing team— both of which might distort eff orts to identify cases. Additionally, delirium is common at the end-stage of the disease, presenting a serious and dangerous management challenge in which strict infection control must be maintained.
