A deadly Ebola outbreak in the Democratic Republic of Congo has spread to the port city of Mbandaka, a populous region with around 1.2 million people, officials reported this week.
Officials from the World Health Organization said Thursday that DRC authorities had reported an additional five new Ebola cases, including “one laboratory-confirmed case,” since its last official update on May 14. The most recent announcement brings the number of Ebola virus cases in DRC to 44, including 23 deaths, since April 4.
The latest update is especially alarming because of the location of the newly discovered cases. Originally confined to the Bikoro, Iboko, and Wangata health zones in Equateur province, officials were concerned that the outbreak might spill over into the crowded Mbandaka region, which serves as a major hub of activity and sits directly along the Congo River, a crucial economic lifeline. Health officials now confront a growing epidemic that may spread more quickly and easily through the densely-populated region.
“The confirmed case in Mbandaka, a large urban centre located on major national and international river, road and domestic air routes increases the risk of spread within the Democratic Republic of the Congo and to neighbouring countries,” WHO spokespersons stated, saying they had raised the public health risk level to “very high” at the national level and “high” on the regional scale. Currently, the global threat level remains low.
“This is a major development in the outbreak,” Peter Salama, deputy director general of emergency preparedness and response at the WHO, told the Washington Post on Thursday. “We have urban Ebola, which is a very different animal from rural Ebola. The potential for an explosive increase in cases is now there.”
Officials said Thursday that the group Médecins Sans Frontières, or Doctors Without Borders, had established an Ebola treatment center in Bikoro to handle the cases. The DRC Ministry of Health (MoH) also installed a mobile laboratory in the region, with plans to install a second one in Mbandaka in the coming days.
Surveillance points have been established at various ports of entry “along the Congo River and at the airport and bus stations in Mbandaka,” officials said.
The newly revised threat forced WHO Director-General Tedros Adhanom to convene an Emergency Committee meeting Friday, during which health officials determined that the outbreak did not meet the conditions of a Public Health Emergency for the international community. Nearby nations would instead be given support and resources to prevent further spread.
“Nine neighbouring countries of #DRC, including Congo-Brazzaville and Central African Republic, have been advised that they are at high risk of spread of #Ebola and have been supported with equipment and personnel,” WHO officials tweeted.
The organization also advised against restricting trade or travel to DRC.
Nine neighbouring countries of #DRC, including Congo-Brazzaville and Central African Republic, have been advised that they are at high risk of spread of #Ebola and have been supported with equipment and personnel.
— World Health Organization (WHO) (@WHO) May 18, 2018
Health workers are currently armed with at least 7,540 doses of the experimental Merck-manufactured rVSV-ZEBOV Ebola vaccine, also called V920. Developed in the wake of the deadly 2014 West Africa Ebola outbreak, which infected more than 28,000 and killed more than 11,000 of those infected, V920 began human trials in late 2016, yielding promising results: of the nearly 6,000 patients vaccinated, all were declared Ebola-“free” after 10 days, according to researchers — an astounding 100 percent efficacy rate.
In addition to the 7,540 doses of V920 — officials say 4,300 doses have arrived in Kinshasa already and Merck has an additional 300,000 doses available for distribution if necessary.
Health workers are using a “ring” method to inoculate residents who may have had contact with the infected individuals, in order to prevent the disease from spreading further. Director-General Tedros said Sunday that authorities had so far identified at least 382 contacts eligible for vaccination, although with Thursday’s updated totals, the number may rise.
The WHO on Thursday noted that the 7,540 doses of V920 would be “enough for 50 rings of 150 people.”
Ebola, a viral hemorrhagic fever, is found mostly in nonhuman primates and fruit bats, and can be transferred to humans after contact with an infected animal, according to the US Centers for Disease Control and Prevention. The virus is passed between humans through blood or bodily fluids like saliva, sweat, urine, semen, or breast milk. Humans may also become infected after handling tainted bushmeat. The disease is not air- or water-borne.
Infected persons typically exhibit flu-like symptoms such as fever, muscle pain, weakness, diarrhea, and vomiting. Some experience sudden hemorrhaging or bruising. The disease has a fatality rate of around 50 percent, although young children are more likely to die as a result of exposure.