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Almost 400 people have died in an Ebola outbreak in Guinea, Sierra Leone, and Liberia this year, a greater toll than the 280 killed in 1976 when the virus first appeared. The death toll led the World Health Organization to declare Thursday, “This is no longer a country-specific outbreak but a sub-regional crisis that requires firm action by governments and partners.” The outbreak is expected last three or four more months, particularly on the border where the countries meet. A variety of factors are contributing to the spread. Hospitals are allowing patients to leave, there are unsafe burial practices in the region, and there is a significant amount of cross-border movement.