• Ashleen Chappuis

The Latest on the Latest Ebola Outbreak

Updated: Oct 10, 2018

Overshadowed by US political news, the Democratic Republic of the Congo (DRC) is now fighting against its second Ebola outbreak of the summer and this one is much riskier.


The central African country's first outbreak of the summer started this May in rural villages in the west of the DRC. It quickly spread to the city of Mbandaka, which is home to over 1 million people. From there, it continued to the smaller cities of Bikoro and Iboko, which, like Mbandaka, are situated near the Congo River. Further down this major waterway is the nation's capital and largest city, Kinshasa, sparking international fears of a large-scale infection. [3]



In addition to being so close to a massive city, the outbreak was near the DRC's border with the Republic of the Congo and spread over multiple site, making logistics difficult. Healthcare workers were infected by the disease early, and cases were reported near forested areas, which only increased the risk of it spreading. [2] On top of that, this outbreak seemed to be more lethal than the infamous 2014 outbreak, which killed over 10,000 people. [2,3] By the time the outbreak was declared over in July, there were 54 confirmed cases of Ebola and 33 deaths related to the disease, resulting in a roughly 60% morality rate. [1,2] The mortality rate for 2014's outbreak was roughly 40%. [1] The cause of this difference has not been confirmed, however, and could range from changes in the virus to fewer people having access to healthcare to those infected having poorer nutrition due to the season. [2]


None the less, numerous international organizations sent aide to the infected areas, including the World Health Organization (WHO) who sent their newest technology, an experimental Ebola vaccine. [5]

Developed through a partnership between Merck and NewLink Genetics, this vaccine, rVsV-ZEBOV, is believed to be between 70% and 100% effective at protecting humans from Ebola. [4] By May 23rd, WHO had sent over 7,500 doses of this vaccine to the DRC to be deployed via ring vaccination. [5]


Ring vaccination is involves tracking down each case, confirming if it is indeed Ebola, and then vaccinating everyone the infected person came into contact with in the past 21 days. It requires painstaking digging for new cases and contacts, but is very effective. A similar vaccination program is used to eradicate smallpox. [2,5]


Since this vaccine is experimental, contacts needed to volunteer to be part of what is called a "compassionate use trial." This means that the vaccine was tested in lab animals and humans for safety and efficacy, and while it has not been approved yet, it has shown a much greater benefit than it does a risk. Those given rVsV-ZEBOV were part of one of Merck's three ongoing large scale trials on this experimental vaccine. [4,5]



The latest outbreak in the DRC is over 2,000 kilometers away from May's, in the norther province of Kivu. When the WHO’s Deputy Director-General of Emergency Preparedness and Response, Dr Peter Salama, spoke with the BBC Science Hour back in August, he said this outbreaks has all of the challenges of the first outbreak with an added layer of difficulty due to the conflicts in the area. He says since there are over 100 groups in the province, 20 of which are highly active, and 1 million of the 8 million people living in the region are displaces, ring vaccination is not an option. Instead, health care works are going to focus on mass vaccinations of everyone they can reach. He believes the UN peacekeeping will be essential to getting aide to this area, which is such a high security threat that health care workers need armed vehicle transports and personal protection devices on top of their typical hazmat suits. [2]


As of August 11th, this new outbreak had already claimed 36 lives and was suspected in 36 cases. [1] While western news has skipped over this story in the wake of white house scandals, it is still developing and this article will continue to be updated.


Sources:

[1] http://www.who.int/ebola/situation-reports/drc-2018/en/

[2] https://www.bbc.co.uk/programmes/w3cswqz4

[3] https://www.cnn.com/2018/07/24/health/ebola-outbreak-congo-ends-bn/index.html

[4] https://www.mrknewsroom.com/news-release/ebola-newsroom/phase-iii-trial-merck-and-newlink-genetics-investigational-ebola-vaccine

[5] http://www.who.int/ebola/drc-2018/faq-vaccine/en/





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