By Marie Rosenthal, MS
Almost 2,700 cases of Ebola virus have been reported in the Democratic Republic of the Congo since the outbreak began a year ago. The international community said it will continue its “robust effort” to fight this killer, which threatens not only the DRC but also its neighbors.
The DRC Ministry of Health declared an outbreak of Ebola last August. One year later, the outbreak continues in North Kivu and Ituri provinces, where there are armed conflicts that complicate the public health response, increasing the risk for disease spread both within the DRC and to neighboring countries.
As of July 30, 2019, a total of 2,713 cases, including 148 in health care workers, and 1,813 deaths have been reported, said Henry Walke, MD, MPH, the director of the CDC’s Division of Preparedness and Emerging Infections and incident manager of the 2018 CDC Ebola Response, during a press briefing on Aug. 1.
On July 17, the International Health Regulations Emergency Committee of the World Health Organization declared the outbreak a “public health emergency of international concern” (PHEIC) after travel-associated cases were reported in neighboring Uganda.
Despite the continuing challenges, the DRC and international partners including the U.S. government continue to mount a robust response to end the outbreak, the CDC said.
“Ebola has been identified by the Department of Homeland Security as a national security threat and [the United States] has been focused on the support of development of new medical countermeasures, initially to address the West Africa outbreak,” said Anthony Fauci, MD, the director of the National Institute of Allergy and Infectious Diseases.
During the outbreak in West Africa that occurred in 2014, the United States and private and public partners began to develop vaccines, medications—including a monoclonal antibody that was developed from the blood of an Ebola survivor—and tests for Ebola virus. The ones that seemed most promising after clinical trials are being used in a real-life clinical trial in the DRC, Dr. Fauci explained.
“Several of the candidates that were tested in the clinic trial have relevance now, both the vaccine that’s been distributed in the DRC, as well as for some of the therapeutic agents that are being tested in a randomized controlled trial,” he said. “In Liberia, there was a ZMF trial, which was a combination of three monoclonal antibodies that was tested in West Africa, against the placebo control, the placebo being a standard of care treatment, that was shown to be a signal suggestive of being effective. And the reason I bring that up, is because it is now used as the control in the trial that is taking place in the DRC,” Dr. Fauci said.
“Hopefully, by the end of this endeavor that’s going on right now, we will be able to make some sort of determination about which one or more of these interventions are actually effective,” he said.
More than 171,000 people have been vaccinated using an investigational Ebola vaccine, including front-line health care workers and other people who are at risk for Ebola, such as contacts of known Ebola cases.
Border health officials have screened an estimated 79 million people at regional airports and at busy land borders between the DRC and neighboring countries. Aside from the isolated cluster of three travel-related cases in Uganda with no further transmission in that country, and one travel-related incident with a fish trader who crossed into Uganda and then returned to the DRC, no additional cases have been reported outside of the DRC, and the risk for global spread of Ebola remains low.
On June 13, 2019, the CDC activated its Emergency Operations Center to support the U.S. response to the outbreak. The CDC has sent more than 200 experts in epidemiology, case management, infection prevention and control, laboratory science, border health measures, risk communication, community engagement, information technology, emergency management and logistics to the DRC, countries bordering the outbreak area, and WHO headquarters. These experts are working with the Department of Health and Human Services partners, the U.S. Agency for International Development Disaster Assistance Response Team on the ground in the DRC, and the American Embassy in Kinshasa, the DRC, to support the Congolese and international response. Two hundred ninety-four additional CDC staff have supported the response from the agency’s Atlanta headquarters and CDC country offices in the DRC and neighboring countries.
“As the WHO PHEIC declaration makes clear, this Ebola outbreak continues to be a complex and serious public health threat,” said CDC Director Robert R. Redfield Jr., MD. “CDC remains prepared for the prolonged journey ahead and remains committed to working with our U.S. government and international partners to support the response and end this outbreak.”
One year into the fight against Ebola, the CDC and the U.S. government remain committed to working with and empowering the ministries of health of the DRC and neighboring countries, collaborating with other international partners, to ensure the outbreak response is well coordinated. The CDC is committed to strengthening the health care system in the DRC to reduce the risk for future outbreaks, not only of Ebola but other diseases, such as HIV, measles, tuberculosis and malaria. The CDC’s commitment to global health goes hand in hand with the its commitment to the safety and security of the American public, the public officials said.