The current outbreak of Ebola in the Democratic Republic of Congo (DRC) has infected 1,720 and killed 1,136, giving the viral disease a whopping 66 percent fatality rate. And the situation is making public health experts on the ground increasingly nervous.
It’s the second worst Ebola outbreak in history, and while more than 110 cases were identified in the past week alone, the World Health Organization warns that “these numbers are likely to continue to increase” as health workers address a backlog created by a major disruption of health care services by armed militia groups.
The worst Ebola outbreak in history was in West Africa from 2014 to 2016, and infected almost 30,000 people, killing more than 11,000. And even though the current outbreak hasn’t touched nearly as many people, health officials on the ground are sounding the alarm to get more international attention.
“Whether it gets to the absolute scale of West Africa or not, none of us know, but this is massive in comparison with any other outbreak in the history of Ebola and it is still expanding,” Jeremy Farrar, the head of the Wellcome Trust, told the Guardian.
Thankfully the outbreak has so far been relatively confined geographically, but there are concerns that an infected person could make their way from DRC to nearby Uganda and turn this into an international crisis. The World Health Organization declined to declare the current Ebola outbreak a global health emergency on April 12, largely because the viral disease had not spread outside of the DRC. At that point, 1,206 people had been infected and 764 people had been killed.
“It’s remarkable it hasn’t spread more geographically but the numbers are frightening and the fact that they are going up is terrifying,” Farrar said.
Aside from its 66 percent fatality rate, the latest outbreak is scary in some unique ways. Children, for instance, are being especially hard hit, with almost a third of cases hitting children under the age of 18.
The good news is that health officials on the ground are now armed with an experimental vaccine created by Merck called V920 that has been tremendously effective. But the number of vaccine doses are relatively limited, and it takes a while after getting the jab for it to work.
The latest figures indicate that over 114,553 people in the region have gotten an Ebola vaccination, including over 28,000 health care workers. But one of the new Ebola cases diagnosed this week was a health care worker who had been vaccinated roughly 10 days earlier, which was sadly not enough time for the vaccine to start working. The vaccine is typically effective after 10 days, a representative at Merck told Gizmodo via email.
There are a lot of other things working against health workers on the ground right now—including widespread violence in the DRC and the rapid spread of misinformation, even among some health care workers who believe that they shouldn’t be vaccinated. Some people believe that Ebola isn’t a real public health hazard, while others think that Ebola was brought into the area to simply make money from the local population. Roughly 36 percent of people in the DRC believe that Ebola doesn’t even exist.
Dr. Richard Valery Mouzoko Kiboung, an epidemiologist from Cameroon who traveled to DRC to treat Ebola patients, was killed last month in one of several violent attacks that regularly take place against Ebola health care workers. But it’s not just violence directed at workers that helps Ebola spread. Local militias are fighting against the government and that violence, even if it’s not directed at Ebola doctors and nurses, can cause treatments to be suspended for days at a time, giving windows of pause that allow the disease to spread while people go untreated.
The militia attacks also cause large groups of people to flee, potentially helping diseases like Ebola spread quickly. The fighting in North Kivu and Ituri provinces, for example, has displaced thousands of people recently, with roughly 100,000 people in North Kivu displaced last month alone.
The Center For Infectious Disease Research and Policy at the University of Minnesota notes that an ISIS-aligned militia group Allied Democratic Forces (ADF) has stepped up attacks significantly in recent months. The group wants to turn DRC into what it calls the Central Africa Province of the Caliphate and has taken credit for attacks on Ebola treatment centers.
“The ongoing violent attacks sow fear, perpetuate mistrust, and further compound the multitude of challenges already faced by frontline health care workers,” the WHO said in a statement late last week. “Without a commitment from all groups to cease these attacks, it is unlikely that this [Ebola] outbreak can remain successfully contained in North Kivu and Ituri provinces.”
The government of South Korea announced yesterday that it would be sending $500,000 for Ebola response efforts in the DRC but public health leaders are very concerned that they’re not getting the money they need to effectively combat Ebola.
“We are entering a phase where we will need major shifts in the response,” WHO Director-General Tedros Adhanom Ghebreyesus recently said on a trip to the DRC. “WHO and partners cannot tackle these challenges without the international community stepping in to fill the sizeable funding gap.”
The long and the short of it? The vaccine has been amazing and it’s a great tool in the fight against Ebola. But if the fighting continues, more people are going to be infected. And it becomes much more likely that this outbreak spirals out of control.