New Ebola Outbreak in Democratic Republic of the Congo: Global Health Concerns

Strategic Insights -

The Democratic Republic of the Congo (DRC) has declared a new Ebola outbreak in Kasai Province, caused by the most severe strain: Zaire Ebola virus. The outbreak began with a 34-year-old pregnant woman who was admitted to hospital on August 20 and died five days later. Two health workers who treated her also became infected and died. By September 15, there were 81 confirmed cases and 28 deaths, including four health workers.

Key Takeaways:

  • The outbreak is the 16th Ebola epidemic in the DRC, with the largest in 2019 and the most recent in 2022.
  • Genetic analysis suggests the outbreak likely began after a spillover from an animal to a human, rather than a continuation of earlier outbreaks.
  • Ebola virus disease was first identified in 1976 in a village near the Ebola River in Zaire and Sudan, and fruit bats are the natural host of the virus.
  • Humans can become infected after contact with animals such as bats, chimpanzees, antelope, or porcupines, and Ebola mainly spreads through direct contact with blood or other body fluids.
  • Symptoms can appear between two to 21 days, including fever, fatigue, muscle pain, headaches, and sore throat, progressing to vomiting, diarrhoea, abdominal pain, rash, bleeding, and shock.
  • Without early treatment, the death rate can reach 50-90%, depending on the availability of high-quality health care.
  • Ebola can spread rapidly within families, health-care facilities, and during funerals, where many people gather and the bodies are washed or touched.
  • Survivors can carry the virus in certain parts of the body for months or years, and in rare instances, Ebola can "reactivate" in a survivor and trigger new transmission chains.
  • Health authorities are worried about the sensitivity of the DRC due to its current management of multiple outbreaks, ongoing armed conflict, and limited access to certain communities.
  • A vaccine, Ervebo (rVSV-ZEBOV), has been approved and is being used to combat the outbreak, showing 100% effectiveness in a clinical trial against Zaire Ebola when given immediately after exposure.
  • Early isolation of suspected cases, tracing contacts, quarantining them, and setting up field hospitals to increase capacity are critical to controlling the outbreak.

Statistics:

  • 81 confirmed cases reported as of September 15
  • 28 deaths, including four health workers, reported as of September 15
  • Death rate without early treatment: 50-90%
  • Effective timeline for symptoms to appear: 2-21 days
  • Duration of symptoms: can progress from sudden fever and fatigue to severe symptoms including vomiting, diarrhoea, abdominal pain, rash, bleeding, and shock
  • Number of health workers infected during the largest recorded epidemic in 2014: over 800
  • Number of health workers who died during the largest recorded epidemic in 2014: two-thirds
  • Vaccine effectiveness: 100% when given immediately after exposure, 95% when given 12 or more days after exposure, 84% in real-world scenarios
  • Total doses of vaccine sent by the World Health Organization: 400

Sources:

  • "Ebola virus disease: what you need to know" by C Raina Macintyre, Ashley Quigley, Mohana Priya Kunasekaran, and Noor Jahan Begum Bari (The Conversation Africa)
  • World Health Organization (WHO) information on Ebola virus disease
  • EPIWATCH, AI-driven platform for outbreak detection