Vaccine now offers a shot at beating Ebola
As Congo faces virus, experimental drug is key hope of stopping new epidemic
JOHANNESBURG — Hopes of containing a growing outbreak of the Ebola virus in Congo are pinned on an experimental vaccine that was tested in 2015 during a major outbreak of the disease.
The World Health Organization plans to vaccinate up to 10,000 people in the first phase of its response and has so far imported 4,000 doses of the vaccine, manufactured by the pharmaceutical giant Merck, whichappears to be highly effective in preventing infection.
The outbreak was first detected this month in a rural area known as Bikoro. The threat grew with the discovery of four cases in Mbandaka, a city of 1.2 million that lies on the Congo River.
The river is a major trade route linking Mbandaka to the capital, Kinshasa, as well as to Brazzaville, the capital of neighboring Republic of Congo.
An emergency WHO meeting Friday decided that the first doses of the vaccine will go to people who had contact with confirmed cases in Mbandaka, and the next will go to contacts of contacts.
Vaccinations are expected to begin Sunday or Monday. The organization stopped short of declaring the outbreak an international health emergency.
But Dr. Robert Steffen, chairman of the WHO emergency committee, said nine countries in the region had been advised to prepare themselves for Ebola cases.
Twenty-five people have died of suspected Ebola in the current outbreak. At least 45 have been infected, including three medical staff.
In their effort to contain the spread, health workers have tracked down more than 500 people who had contact with people who were infected.
All of the four cases in Mbandaka have been confirmed by laboratory testing.
The WHO was notified of the outbreak in Mbandaka on May 8.
Fighting Ebola in a crowded urban setting is complicated.
Though the new vaccine proved effective in clinical trials in Guinea in 2015, it is difficult to trace people who had contact with the virus in a major city.
In the biggest outbreak of Ebola — which infected 28,000 people and killed 11,300 in the West African countries of Liberia, Sierra Leone and Guinea from 2013 to 2016 — the virus spread swiftly to cities from a rural trade hub near the borders of the three nations.
A recent outbreak of bubonic plague in Madagascar underscored the difficulty of trying to contain epidemics in cities.
Normally limited to a remote mountainous area of the country, the bacterial disease spread to the capital, Antananarivo, and other cities after one man contracted it in the hinterlands and took a commuter minibus through the capital to the coast.
What might have been a few dozen cases became 2,348, causing 202 deaths.
In the case of the Ebola infection confirmed in Mbandaka, Steffen said it was not clear how it was contracted.
Until that case was found, the outbreak had been concentrated in remote villages near Bikoro, a market town on the shores of Lake Tumba.
Steffen said authorities face the complex task of monitoring dozens of small ports along the Congo River for possible cases.
Thirty WHO staffers were deployed to the region along with members of the health organization Doctors Without Borders, which played a major role in fighting the 2013-16 outbreak.
At the outset of that epidemic, the available treatment was limited to rehydration. Victims were crowded into isolation wards to stop the spread of the virus, but in many cases intravenous fluids were not provided because using needles was seen as too risky for medical staff.
Dying patients were given bottled water, but many were too sick to drink it.
Westerners who were evacuated to hospitals in Europe and the U.S. fared better than the West Africans. Locals often hoped their symptoms were from malaria or typhoid and put off checking into Ebola treatment units, from which few survivors emerged. By the time they went for treatment, it was difficult to save them.
WHO experts are optimistic that those who suspect they may have the illness this time will report to treatment facilities early, knowing the vaccine could save their lives.
The WHO has sought $26 million from donors over three months to cover the vaccination campaign.