Containing the Ebola outbreak

Containing the Ebola outbreak

You might’ve heard in the news that medical workers in parts of Africa are struggling to bring an outbreak of Ebola under control… The World Health Organisation has declared the epidemic a public health emergency of international concern rather than a pandemic, but there’s still no vaccine available yet. So in this Squiz Shortcut, we’ll get you across:

• What Ebola is

• The challenges involved in containing this outbreak

• And what’s next in the public health response…

🙋🏻‍♀️ This newsletter was written by Larissa Huntington and Sophie Felice

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What’s the latest with the Ebola outbreak?
The number of confirmed cases is rising daily, but the latest reports put them at 598 in the Democratic Republic of the Congo (the DRC) and 19 in Uganda - and at least 115 people have died from it. But medical experts say the true number of cases could be much higher because the outbreak is in a war zone, so there are big challenges in finding and treating people.

Let’s take a step back… What is Ebola?
One important thing to know is that it isn’t just one virus. It’s actually a group of related viruses - but the one at the centre of this current outbreak is called the Bundibugyo strain. 

Tell me about that strain…
It was first identified in Uganda back in 2007 - and it’s a rarer form of the virus, so there isn’t as much known about it as other forms that have caused previous outbreaks. Another thing to know is that, unlike COVID-19, this isn’t a virus that’s spread through the air. You can’t catch it simply by being near someone infected in a crowd or on public transport, for example. 

How is it spread?
It spreads through direct contact with the bodily fluids of someone who’s sick with it or who has died from it. That means family members and healthcare workers are among those most at risk. The thing about this virus is that, while it mightn’t spread easily, when people get sick with it, it can be severe… 

What are the symptoms?
It often starts with a fever, headaches, body aches and weakness. And as it gets worse, patients can start to develop vomiting and diarrhoea. With no cure, medical workers are relying on replacing fluids and electrolytes in patients, and managing fevers with medicines. That’s if it’s picked up early. Without treatment, it can be fatal, but as we mentioned, finding and treating the people who’ve fallen sick has been a major challenge with this outbreak. And it’s had a head start… 

What do you mean by that?
Initial tests on the first cluster of sick people were carried out for another strain of the virus - a more commonly known one called the Zaire strain - and they showed false negatives. Two weeks passed before the virus was confirmed to be the Bundibugyo strain, but by then, it was out in the community and health workers have struggled to catch-up… 

When was Ebola first detected in Africa?
It was first discovered in the northwest of what is now the DRC back in 1976, but the biggest outbreak was between 2014 and 2016 in West Africa. It infected almost 29,000 people across the countries of Guinea, Liberia and Sierra Leone and became known as the West African Ebola epidemic. 

What was the toll?
That strain killed more than 11,000 people, and it changed the way the world approaches these viruses, leading to the development of vaccines for the most common strain, the Zaire one. But because the Bundibugyo variety is rare, no approved vaccine exists for it yet. For now, healthcare workers are concentrating on contact tracing to contain the outbreak, but it’s proving difficult. 

What are they up against?
Parts of the DRC have extremely challenging terrain - we’re talking about dense jungle, steep mountains and dirt roads - and the region’s currently in the middle of an armed conflict. So medical workers are travelling through those conditions in motorbike convoys or on foot in areas where violence and gunfire exchanges are pretty commonplace. All of which makes tracing people a lot harder.

Remind me about contact tracing…
When someone develops Ebola, authorities need to quickly identify who they’ve been in close contact with and isolate and monitor them for any symptoms. In some areas, reports say those workers are only managing to trace around half of the contacts, but health experts say that figure needs to be closer to 90% to bring an outbreak under control. Adding to that, millions of people have already been displaced by the war, making it even harder to keep track of where they are. So the pressure’s really on to develop a vaccine… 

Speaking of, where is that up to?
At least 3 vaccines are currently in development. Oxford University has researchers working on one of them, another is at the International Aids Vaccine Initiative, a global, non-profit scientific research organisation, and the third one is being worked on by American pharmaceutical and biotech company Moderna. A key financial backer is the Coalition for Epidemic Preparedness Innovations (CEPI)… And something people mightn’t know is that there’s an Australian playing a major role in that.

Go on…
The Chair of CEPI is former Australian Health Department secretary Jane Halton. She was in Geneva when the WHO declared the outbreak an international emergency. CEPI has committed US$61.8 million in emergency funding to support several vaccine candidates, taking what Halton calls a “many shots on goal” approach. And they’ve made it clear that the vaccine won’t necessarily immunise people, it’s more to save lives by reducing the severity of the symptoms.

Got it… What other concerns are there around this outbreak?
Adding to the international pressure are concerns over large crowds at the FIFA men’s World Cup which kicks off this week, with millions of fans travelling between countries. There have been reports about this, but infectious disease experts say Ebola itself isn’t the biggest worry because the risk of transmission is considered low. It’s illnesses like measles, influenza and COVID that are actually considered more of a risk because they’re easier to spread.

Righto… So, what’s being done to contain the Ebola outbreak?
There’s a huge effort underway to stop it from spreading further in Africa - measures include expanding treatment centres and ramping up lab testing, and nearby countries are also preparing in case cases cross any other borders.

Have any borders been closed?
Not at this stage, but in some countries like the US and Canada, travellers from the affected countries are being screened and then monitored for symptoms. But the biggest risk still remains inside the DRC and Uganda - until a vaccine arrives, authorities are relying on contact tracing in really difficult conditions to reach people before it spreads further. We’ll keep the updates coming in the Squiz Today newsletter and podcast so stay tuned…

Onto our Recommendations

Reading: This story from the BBC which explains why contact tracing has become such a challenge with this outbreak.

Listening: This episode of The Conversation Weekly podcast with Oxford University researchers who are working on a vaccine.

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