Congo remains on high alert in Ebola outbreak’s shadow
MBANDAKA, Congo — The two brothers of Adalbert Wanza made a 170-mile round trip on foot, and by boat and motorcycle through Congo’s dense rain forest to tell him the grave news.
A visitor had died while in their home village, Ikoko-Impenge. A local priest buried him with ritual honors, including giving the corpse its last food and drink. Days later, the priest and most of his family were dead. When he heard the story, Wanza, the Catholic bishop of Mbandaka, knew it could be Ebola. Lab tests proved him right.
Over the next three weeks, the most serious outbreak of the virus since an epidemic in West Africa between 2014 and 2016 spread from deep within the rain forest to bigger towns and finally to Mbandaka, a regional hub of nearly 1.2 million people at the confluence of the Congo and Ruki rivers.
As of Friday, 37 cases of Ebola had been confirmed, four of them in Mbandaka. Twelve confirmed cases resulted in death, as have an additional 13 suspected or probable cases.
The outbreak has triggered a widespread effort to contain it, led by the Congolese government and the World Health Organization, and aided by numerous aid groups.
The WHO, aid groups and West African governments underestimated the last big outbreak, which started in Guinea in 2014. More than 11,000 died in that epidemic, and cases spread as far as Nigeria’s capital, Abuja, and Dallas in the United States.
A sense of foreboding hangs over conversations among these groups. The last confirmed case in Mbandaka was reported May 22.
“We must make sure we leave not even one stone unturned,” said Pierre Rollin, an Ebola expert for the U.S. Centers for Disease Control and Prevention who is now in Congo. “Signs point to a diminishing number of cases, but there are no guarantees until we have gone weeks without any.”
The aid community has gone into overdrive since the Wanza brothers’ revelation in early May, which helped alert the national government to the outbreak. Medical organizations are using every strategy available, including an experimental vaccine cleared by the WHO for “compassionate use.” It was administered in the waning days of the West African epidemic, but this is its first deployment in the early stages of an outbreak. Hundreds have received the vaccine, and there are supplies for thousands more.
The virus is not one of the most contagious — it is transmittable through direct contact such as touching bodily fluids — but symptoms can take more than a week to show up, meaning infected individuals can travel long distances and encounter many people before there’s any inkling they are ill.
Contact tracing is the process through which everyone who has interacted with someone suspected of having Ebola is identified and monitored. To succeed, it requires the near-instantaneous creation of a network of informants who surveil movements of people in and out of areas where the virus is suspected.
Because the vaccine is asyet unlicensed, everyone who receives it must sign a consent form. Aid workers say that sometimes involves considerable persuasion.
“The lesson from West Africa is this: The concept of a vaccine is not something that someone in rural Guinea or Congo will understand in just two minutes,” said Fatoumata Battouly Diallo, 31, the team leader of the Guinean vaccinators.