OUTBREAK OF VIRUS
DRC to use trial vaccine in bid to contain Ebola
The remoteness of Bikoro, at the epicentre of the latest outbreak, ‘bodes well for containment’
Kinshasa — A pioneering vaccine and rapid response could bring the Democratic Republic of the Congo’s (DRC’s) latest Ebola outbreak under control, minimising the chances of it spreading to more populous areas, officials said.
Two cases of the Zaire strain of the Ebola virus were confirmed by Congolese authorities on May 8 around Bikoro in the northwestern province of Equateur. The World Health Organisation (WHO) said on Friday the cases were among 34 people with suspected Ebola infections in the area in the past five weeks, 18 of whom died and were considered carriers.
It is the ninth recorded outbreak in a country that last battled the disease in 2017. In this case, the remoteness of Bikoro — some 240km by dilapidated road southwest of the provincial capital of Mbandaka, a city of about a million people — may both aid and complicate containment efforts.
"We have the advantage of having this epidemic in a very remote area where travelling isn’t easy," said Jean-Jacques Muyembe-Tamfum, director-general of the National Institute for Biomedical Research, based in the capital, Kinshasa.
"We think that if all the control teams are at the epidemic site we can control this epidemic in two to three months."
The viral disease, which has no known cure although a vaccine has been successfully trialled, was first reported in 1976 in the Congo. It struck northern Equateur in 2014, killing 49 people in cases unrelated to the epidemic in West Africa that year in which more than 11,000 people died.
With road travel between Bikoro and Mbandaka taking about 15 hours, establishing an "air bridge" is "the only way to mount a serious response", WHO deputy director-general for emergency response Peter Salama said.
Bikoro’s airstrip cannot yet accommodate even small aircraft, so the initial response will rely on UN helicopters.
The WHO was widely criticised for reacting too slowly to the 2014-16 epidemic in West Africa. The latest response is "very different", Salama said, pointing to the money, material and personnel already mobilised since May 8. "We are planning for all scenarios, including the worst scenario."
The WHO and Doctors Without Borders already have teams in Bikoro and as many as 40 experts will soon arrive, Salama said on Friday. While outbreaks in remote areas usually mean the disease can be contained, on this occasion suspected cases have been reported in three locations spread over 60km.
"We must situate the index case in each site to see if the cases are linked or if they are separate epidemics," said Muyembe, who was in the team that researched the first recorded Ebola outbreak.
Three health professionals have already been infected with suspected Ebola, one of whom has died.
Before the weekend, only five samples had been taken and sent to Kinshasa, two of which tested positive for Ebola. Mobile laboratories arrived in Bikoro on May 12 and have started testing suspected carriers.
The government has authorised the WHO to use the VSV vaccine, which was trialled successfully in Guinea in 2015. The vaccine could arrive in Kinshasa on Tuesday, WHO spokesman Eugene Kabambi said.
"This is an experimental vaccine, not a licensed product, and there are a lot of complications," including ensuring it is stored at the correct temperature, Salama said. "It’s a highly complex operation in one of the most difficult terrains in the world."
This outbreak’s proximity to the Congo River, which links the area to Mbandaka, Kinshasa and Brazzaville, the capital of the Republic of Congo, fuels worries the virus could reach a city.
The WHO has put Congo’s nine neighbouring countries on high alert, especially the Republic of Congo and the Central African Republic because of their connected river systems.