Congolese officials approve new Ebola vaccine for use in outbreak

In case you haven’t heard, the Democratic Republic of the Congo (DRC) is experiencing an outbreak of Ebola virus disease (Zaire strain). Now, before anyone jumps to any conclusions about this Ebola outbreak turning into a repeat of the 2014 outbreak in West Africa, there are a few key points to understand. One is that Congo is, unfortunately, very familiar with Ebola as they’ve had eight outbreaks since 1976. The second is that many of the Ebola outbreaks that occur in Congo, this one included, occur in less populated and remote areas of the country. The West Africa outbreak occurred in an area with dense population and easy transportation between towns and countries, which facilitated Ebola’s spread. This is not that. But this is still an Ebola outbreak and, as such, must be taken very seriously.

Map of cases in Congo 2017 outbreak. Courtesy WHO.

On the bright side, it appears that this outbreak is turning out to be smaller than the WHO (World Health Organization) originally thought. So far, as of 28 May, there have been two confirmed cases, three probable cases, 14 suspected cases, and four deaths. Almost 600 contacts have been identified for follow-up and only around 100 are still undergoing follow-up. The rest have completed their surveillance period.

The Congolese people are benefiting from the lessons and technological advances that came about from the 2014 West African Ebola outbreak. Laboratory testing is crucial to diagnose Ebola as many of the early symptoms can mimic other diseases. And since Ebola is so contagious, early testing and diagnosis ensures Ebola-carrying people are identified and quarantined to prevent them from spreading Ebola to their contacts. Since the 2014 outbreak, much effort has been put into developing rapid initial Ebola tests. Congo is using these tests, and others, to help stop the outbreak. Once the first case of Ebola was confirmed the Ministry of Health, WHO and others, sent a mobile lab into the field to the affected area. The mobile lab performs testing immediately which results in early detection of cases. Without the mobile lab, the samples would have to be sent to the National Institute of Biomedical Research (INBR) in Kinshasa for testing. And with Ebola, time is a key factor in stopping the spread.

A GeneXpert diagnostic testing set-up in the INRB lab in Kinshasa. This diagnostic tool was adapted during the outbreak of Ebola in West Africa to rapidly test for the disease. Results are ready in one hour. WHO/A. Clements-Hunt

Laboratory testing advances aren’t the only benefit Congo is receiving from the 2014 West Africa outbreak. As you may remember, there were a couple vaccine trials that started towards the end of the 2014 outbreak. Some were not finished due to the outbreak ending. One trial, using rVSV-ZEBOV, demonstrated 100% effectiveness in Guinea. This vaccine was developed by Merck and has not been licensed for use yet, but the Democratic Republic of Congo’s health ministry gave the ok to use the vaccine to help stop the outbreak. Now there is a MSF (Medecins Sans Frontieres) team who is arriving to help validate the vaccination protocol with the technical teams. The vaccination campaign could be challenging given the remote area of the current outbreak, but I’m confident MSF and Congo teams can overcome those challenges.

The current Ebola virus disease outbreak in the Congo is not entirely unusual for the country. What is unusual is the implementation of new testing and prevention methods that came into existence because of the 2014 West Africa outbreak. Congo has had eight “small” outbreaks since 1976 but it took the 2014 West African outbreak, and the thousands who died, for these new Ebola resources to be developed.┬áMaybe one day the world won’t have to see a massive, multi-country outbreak of a known deadly disease before time, money and energy are spent at developing tools to address the disease.

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