Health teams are working to contain a fast-growing outbreak of the Bundibugyo strain with limited tools
The Democratic Republic of Congo has spent years building world-class infrastructure to fight Ebola. He accumulated Ervebo vaccine stocks and therapeutic treatments, ready to quell outbreaks of the relatively common Zairian strain of the deadly virus.
But what happens when the enemy changes armor?
The rare Bundibugyo strain, for which there is no vaccine or specific treatment, is now forcing Congo’s public health officials to scramble to contain a fast-growing outbreak with limited tools. On May 17, the World Health Organization declared the outbreak constitutes a public health emergency of international concern. As of May 22, at least 82 cases – including seven deaths – have been confirmed, most in northern Congo, but also two people in Uganda who traveled from Congo and an American doctor who was flown to Germany for treatment.
“THE the scale of the epidemic… is much greater“, however, WHO Director-General Tedros Adhanom Ghebreyesus said during a press briefing on May 20. As of May 22, there were also nearly 750 suspected cases and 177 suspected deaths.
The Bundibugyo strain has just fueled two relatively small outbreaks before – one in 2007, when it was first discovered, and one in 2012. About 30% of people who contracted the virus died. By comparison, the Zaire strain is far deadlier: up to 90 percent of patients who do not receive treatment die. And it is responsible for the majority of epidemics in Africa, including the two largest. from 2014 and 2018. This is why epidemic preparation focused on the Zaire strain and not the Bundibugyo strain.
Even with this preparation, sharp reductions in international aid and ongoing conflict in the region have hampered efforts to control the disease. “This hastened the collapse of [Congo’s] fragile health system, leaving millions of people defenseless against preventable diseases like Ebola,” says Fatuma Noor, communications manager for Oxfam International based in Kenya.
Such shortcomings can be the cause of delay of almost a month between the first known death in this outbreak on April 24 and confirmation of the outbreak on May 15, Reuters reported.
As a result of these gaps, frontline responders are catching up and must now rely on more traditional, low-tech public health interventions to combat the Bundibugyo outbreak. For example, three Ebola treatment centers were opened in the region to isolate patients and provide care as crucial as rehydration. Efforts are underway to identify people who may have been exposed and monitor them for 21 days, the incubation period of the virus. Public officials also recommend safe burial practices to avoid exposure to bodily fluids that transmit the virus.
Oxfam deploys teams on the ground to help set up local “community protection committees” made up of tribal leaders, women and youth, Noor says. Their job is to quickly identify people at risk and encourage them to get to health centers quickly. In addition, the humanitarian group distributes soap and hand-washing devices, while ensuring access to clean water and sanitation facilities to communities that do not have running water or private toilets, she said.
Other international aid is also stepping up. Among these efforts, U.S. officials say they have activated $23 million to help with disease surveillancelaboratory capacity and funding for up to 50 treatment clinics. And the WHO announced that it had provided more than 11 tons of medical suppliesincluding isolation tents and water disinfection kits.
With no vaccine available to counter the Bundibugyo strain, early supportive care significantly improves survival, says Luke Nyakarahuka, an epidemiologist at the Uganda Virus Research Institute in Entebbe.
It will be necessary at least six to nine months to make available a vaccine targeting the Bundibugyo strain, said WHO senior adviser Vasee Moorthy. An international coalition of public health leaders, including those from the WHO and the Africa Centers for Disease Control and Prevention, held an emergency meeting on May 22 to identify priorities for developing “medical countermeasures”» for the Bundibugyo strain.
“We need a single-dose vaccine if we want to intervene and try to clearly influence the course of the epidemic,” Moorthy said at the meeting. “What will really be most effective is a single-dose vaccine specific to Bundibugyo.”
Helen Rees, a vaccine researcher at the University of the Witwatersrand in Johannesburg, stressed: “Time will tell, but I hope we are on the right track. »
Editor Erin Garcia of Jesus contributed to this story.