An Ebola outbreak in Democratic Republic of Congo has worsened, with officials there reporting a total of 39 suspected cases between April 4 and May 13, including 19 deaths, the World Health Organization (WHO) stated Monday.
Three health care workers are among those who have been infected.
The outbreak is currently confined to the Bikoro, Iboko, and Wangata health zones, in Equateur province. WHO experts say the outbreak has not yet met the criteria “of a public heath event of international concern,” which would require an emergency WHO Committee meeting.
The regions affected by the outbreak, however, abut larger cities capable of spreading the virus much more quickly, including the port city of Mbandaka, which has a population of 1.2 million and sits directly along the Congo River, a major economic lifeline.
“The cases are being reported from remote locations that are difficult to access,” WHO officials said. “However, the proximity of the affected area to the Congo River, which links to the Republic of the Congo and the Central African Republic, increases the risk of cases occurring in neighboring countries.”
WHO officials noted that the outbreak is currently rated a “high” public health risk at the national level, “moderate” at the regional level, and “low” risk at the international level, with assessments ongoing.
We've updated this map. Turns out that the provincial capital of Equateur, Mbandaka, is home to roughly 1M people. It's less than 300 km or 175 miles from Bikoro and reachable by water. pic.twitter.com/3Q3PwAAdsh
— Helen Branswell (@HelenBranswell) May 11, 2018
This latest outbreak offers a reminder of the 2014 West Africa Ebola outbreak, which infected more than 28,000 people. That outbreak was later traced back to a single case in Meliandou, Guinea in late December 2013, where an 18-month-old boy died two days after developing flu-like symptoms. More than 11,000 of those infected by the virus died, and case fatality rates (CFR) ranged anywhere from 50 to 70 percent, depending on the study, although some health experts believe the percentage may have been slightly lower.
Health workers may have a new weapon in their arsenal to fight the current epidemic: the Merck-manufactured rVSV-ZEBOV vaccine. Also known as V920, the experimental vaccine showed astounding results following a first round of human trials in late 2016, after being fast-tracked due to the severity of the West Africa outbreak. According to researchers, the vaccine had an efficacy rate of 100 percent: Of the nearly 6,000 patients vaccinated, all were declared Ebola-“free” after 10 days.
“Had a vaccine been available earlier in the Ebola epidemic, thousands of lives might have been saved,” Jeremy Farrar, director of the British medical research institute Wellcome Trust, told the BBC in December 2016. “We have to get ahead of the curve and make promising diagnostics, drugs and vaccines for diseases we know could be a threat in the future.”
The WHO’s Africa director said Sunday that the organization has 4,000 doses of V920 prepared “for deployment” in the DRC; Merck has an additional 300,000 doses available for use if needed.
“We’re working on the deployment of these materials, especially readying the cold chain [storage equipment]. The start date of the vaccinations will depend on this deployment,” Matshidiso Moeti told Reuters reporters over the weekend.
As STAT News’ Helen Branswell notes, the WHO plans to employ a “ring vaccination” process, administering the vaccine to anyone who may have had contact with the infected individuals. So far, at least 382 contacts have been identified.
“That’s our plan. And so far things are going as planned,” Tedros Adhanom Ghebreyesus, director-general of the WHO, told Branswell on Sunday. “We have better weapons this time.”
Ebola is a viral hemorrhagic fever that predominantly affects humans and nonhuman primates, like monkeys, gorillas, and chimpanzees, according to the CDC. A person becomes infected after making contact with an infected animal, such as a fruit bat or primate. The virus is then passed between humans through blood or bodily fluids, like saliva, sweat, urine, semen, or breast milk. Humans may also become infected as a result of handling bushmeat. The virus is not spread through the air or by water.
Infected persons may exhibit symptoms such as fever, muscle pain, weakness, diarrhea, vomiting, and unexplained hemorrhaging or bruising. CFRs typically hover around 50 percent, although children under the age of 5 are much more likely to die as a result of exposure to the virus.