HURDLES:
The affected area’s remoteness complicates medical response, while crowded mining settlements and constant movement of workers risk accelerating transmission
Bloomberg
A rare strain of Ebola with no approved vaccine or treatment might have circulated undetected for weeks in northeastern Democratic Republic of the Congo (DR Congo) before killing dozens of people.Laboratory testing by the National Institute for Biomedical Research in Kinshasa confirmed the outbreak is caused by the Bundibugyo strain, the WHO said on Friday. The virus has caused only two previous known outbreaks, in Uganda in 2007 and eastern Congo in 2012.About 246 suspected cases and 65 deaths have been reported mainly in Mongbwalu and Rwampara health zones in Ituri Province, near the Ugandan border, with additional suspected infections in Bunia, the provincial capital, the Africa Centers for Disease Control and Prevention said. Four deaths have been confirmed among laboratory-positive cases.
Ebola is among the world’s deadliest infectious diseases, killing between roughly a quarter and almost 90 percent of infected people depending on the virus species and the medical care available. The Zaire strain caused the devastating West African epidemic a decade ago and has received the most research funding, leading to licensed vaccines and treatments.“Ebola Zaire is the one that got all the attention, for very good reasons,” University of Texas Medical Branch biocontainment care unit director Susan McLellan said. The development of medical countermeasures, including monoclonal antibodies and vaccines, is less advanced for Bundibugyo, she said, but added that clinicians would likely still consider Gilead Sciences Inc’s remdesivir for Bundibugyo infections. Laboratory research has suggested the strain might be more susceptible to the antiviral than Zaire.Uganda has also confirmed a Bundibugyo case in a Congolese patient who died at a hospital in Kampala after traveling across the border for treatment.The WHO said it is deploying additional epidemiologists, laboratory specialists and infection-control experts to Ituri while airlifting 5 metric tonnes of emergency supplies including testing equipment, protective gear and treatment materials.The outbreak is unfolding in remote Mongbwalu, where insecurity, poor roads, mining-related population movement and frequent cross-border travel complicate the response. The region is also affected by armed groups and weak infrastructure, complicating efforts to deliver medical supplies and do disease surveillance and contact tracing.“To access Mongbwalu isn’t easy,” Resource Matters Congo director Jimmy Munguriek said.The area has only one major hospital, he said, adding that overcrowded mining settlements and constant movement of workers could accelerate transmission.“These zones are full of people who come from everywhere to work in artisanal mining,” Munguriek said. Armed groups active in the area and distrust of health authorities could also hamper containment efforts, he added. The scale of the outbreak suggests the virus might have circulated undetected for weeks before being identified. The WHO said it first received signals of a suspected outbreak on Tuesday last week and deployed a team to support investigations. Initial tests for the Zaire strain were negative, with additional testing later confirming Bundibugyo on Thursday.Patients have presented with fever, weakness, vomiting and, in some cases, bleeding, the WHO said, adding that several people rapidly deteriorated and died.
