The World Health Organization has confirmed a new Ebola outbreak in some areas of the Democratic Republic of Congo. This is the first outbreak in the country since 2014. Officials have confirmed three deaths related to the outbreak, while nine people are suspected of being infected.

Ebola killed more than 11,000 people in the last outbreak, and health officials are concerned that a similar outcome will occur if the disease isn’t eradicated. WHO released a statement informing they received reports of a cluster of undiagnosed illness and deaths that included hemorrhagic symptoms in Likati Health Zone, Baes Uele Province in the north of the Democratic Republic of Congo.

Ebola Outbreak at Congo
A new Ebola outbreak has caused the death of three people in the Democratic Republic of Congo. Image credit: Reuters.

The outbreak has already left three deaths

On May 11, the Ministry of Health of the Democratic Republic of Congo informed WHO that they had conducted tests on some individuals. Out of five samples, one tested positive for Ebola virus at the Institut National de Recherche Biomédicale (INRB) in Kinshasa.

Ebola Outbreak at El Congo
A group of Ebola Responders. Image credit: Baz Ratner/Reuters.

“An investigation team led by the Ministry of Health and supported by WHO and partners has deployed and is expected to reach the affected area in the coming days,” said Dr. Peter Salama, WHO Executive Director for Emergencies, in a statement published Friday.

The outbreak started on April 22 in the Likati Health Zone of the Bas Uele Province. The Washington Post reported that the first victim had to travel by motorbike across the large province to reach a hospital in Likati. Once he was tested, it took ten days for his blood sample to reach Kinshasa. In Congo, there aren’t roads that span the country, and long-distance travel is mostly restricted to private airplanes and river boats.

Marie-Paule Kieney, an assistant director at WHO who played a key role during the West African epidemic, said that Merck -the company that makes the vaccine which appeared to work in a trial held in Guinea in 2015,- is ready to provide the product if necessary.

“Discussions are ongoing with the government on whether vaccination should be undertaken or not,” said Kieney, according to Science Magazine. “The outbreak is very small so that it may be stopped through containment only.”

Traditional containment includes confirming and isolating cases, providing protective gear for health care workers, using safe burial methods, as well as educating the public about how to reduce their risks of contracting the disease.

According to Science Magazine, a person helping with the response who asked not to be identified, said there are 52 suspected cases, which is causing frustration as a decision has yet to be made about whether to use the vaccine. The person stated that if it were up to them, they’d be using it already.

Regulatory bodies have to decide whether to use Ebola vaccine

Doctors Without Borders (MSF), which led the initial health care response to the West African epidemic, announced today that it plans to send 14 people to Likati, including doctors, nurses, logisticians, sanitation and water experts, health promoters, and an epidemiologist.

A statement from the organization noted that they would be joined by ten people from the DRC’s Ministry of Health along with 15 tons of medical and logistical supplies sent by cargo plane from Kinshasa.

Ebola Outbreak at Congo
An Ebola responder in RP Congo. Image credit: Reuters.

An MSF spokesperson was not aware whether the organization had requested the vaccine for its team.

Doses of the Merck vaccine exist, but because of its experimental status, they require what’s known as an “Expanded Access” study protocol to be approved by regulatory bodies. If the vaccine isn’t approved, it cannot be shipped to the DRC. WHO has over 10,000 doses in Geneva, Switzerland, which are leftovers from the West Africa outbreak, according to Science Magazine. Merck is believed to also have around 700,000 doses conserved on ice in the United States.

In a meeting on April 25 held by WHO’s Strategic Advisory Group of Experts on Immunization (SAGE), the members recommended that the Merck vaccine “be promptly deployed” if the strain Ebola Zaire -which is the virus in the DRC- emerges.

SAGE also suggested that Expanded Acess study should be implemented immediately after the confirmation of a case and that the vaccine should be used in the same “ring vaccination” strategy that worked in Guinea two years ago. At that time, the vaccine was also given to people who were in close contact with each confirmed case, including health care workers.

The DRC was not among the leading three African countries affected by the 2014 epidemic, but the death toll on the country was significant. WHO confirmed 66 cases and 49 deaths in the country. More than 28,600 people were infected worldwide and over 11,300 died. Guinea, Sierra Leone, and Liberia, the most affected countries, have all been Ebola-free since June 2017.

A recent review of the world’s pandemic response published in the New England Journal of Medicine last year said that an investment of over $4.5 billion is needed every year for improving detection and intervention tools. The paper predicted that at least one pandemic event will almost certainly occur within the next 100 years and that there is a 20 percent chance of four or more.

Source: Science Magazine