Mass vaccinations and lockdowns in DRC as Ebola cases surge
WHO dispatches Ervebo doses and monoclonal therapy to Kasai province after cases more than double; movement restrictions and checkpoints imposed
Health officials in the Democratic Republic of the Congo have begun targeted mass vaccinations and imposed local lockdowns in parts of Kasai province as health authorities respond to a rapidly escalating Ebola outbreak that has more than doubled in size in the past week.
The World Health Organization said vaccination is being offered to people exposed to the Ebola virus and front-line health workers in the Kasai region, where cases rose from 28 to 68 in seven days. The outbreak, declared earlier this month, has left at least 16 people dead, including four health workers.
An initial shipment of 400 doses of the Ervebo vaccine, an FDA-approved vaccine used during outbreaks, was sent to Bulape, a current hotspot, and additional supplies are due to arrive in the coming days, the WHO said. The agency’s International Coordinating Group on Vaccine Provision has approved an additional 45,000 vaccine doses, increasing the country’s emergency stockpile from about 2,000 doses. Treatment courses of the monoclonal antibody therapy Mab114, also known by the brand name Ebanga, have been dispatched to treatment centers in Bulape. Inmazeb, another monoclonal antibody treatment, and Ebanga are the two therapies approved by the U.S. Food and Drug Administration for treating Ebola.
The WHO said the Ervebo vaccine is safe and protects against the Zaire ebolavirus species, which has been identified as the cause of the ongoing outbreak. Vaccines are generally reserved for use during active outbreaks and are offered to contacts of confirmed cases and health personnel at elevated risk.
The first laboratory-confirmed case in the current cluster was a pregnant woman who sought care at Bulape General Reference Hospital on Aug. 20 with high fever, bloody stool, excessive bleeding and weakness. She died on Aug. 25 from organ failure. Testing on Sept. 4 confirmed Ebola, the WHO said.
Ebola virus disease spreads through direct contact with the blood or body fluids of a symptomatic infected person, contact with contaminated objects and contact with infected animals such as bats or nonhuman primates. Symptoms usually begin with fever, headache and muscle pain, and can progress to severe diarrhea, vomiting, abdominal pain and unexplained bleeding or bruising. Without treatment, Ebola can cause severe disease and high mortality; the Zaire ebolavirus species has been associated with fatality rates ranging from roughly 36 percent to as high as 90 percent in past outbreaks.
Local authorities in affected areas have instituted confinement measures for some communities and set up multiple checkpoints along territorial borders to limit movement and reduce the risk of further spread. Francois Mingambengele, the administrator of Mweka territory, which includes Bulape, told Reuters earlier this month that the situation is a crisis and that cases were multiplying.
Ebola has a long history in the DRC, where the virus was first identified in 1976. The current event marks the country’s 16th known outbreak and the seventh in Kasai province. Previous outbreaks in eastern Congo in 2018 and 2020 each killed more than 1,000 people. The largest recorded Ebola epidemic occurred in West Africa from 2014 to 2016, when more than 28,600 cases were reported.
Earlier this year, a separate Ebola event in Uganda was caused by the Sudan virus, a different ebolavirus species. That outbreak involved 12 confirmed cases and two probable cases with four deaths and was declared over in April. In February, two patients in New York City who had recently traveled from Uganda were evaluated for suspected Ebola and transported from an urgent care center to a hospital; testing later showed they did not have Ebola. The first confirmed Ebola case in the United States was reported in 2014 in a traveler from Liberia who died a week after diagnosis.
Health authorities said they are continuing to scale up vaccination, case finding, testing and treatment, and to maintain movement restrictions where necessary to limit transmission. Additional vaccine shipments and therapeutic courses are expected to arrive in the coming days as response teams work to contain the outbreak.