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Taxi driver is second person to die in DRC Ebola outbreak
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An experimental vaccine is available to help contain an outbreak of Ebola virus that has killed at least two people in a remote area of the Democratic Republic of the Congo since April 22, but government officials have not yet asked to use it.
WHO announced on Friday that Congo was experiencing an outbreak of Ebola in the Bas-Uele province more than 800 miles from the capital city of Kinshasa. The case count has climbed from nine suspected patients to 20, with three suspected deaths, according to WHO spokesman Christian Lindmeier.
Lindmeier told Infectious Disease News that two of the deaths have been confirmed by laboratory testing. The first — and possible index case — was a man aged 39 years who died upon arriving at a health care facility. The second death was a taxi driver who drove the initial patient to the health care facility, according to Lindmeier.
No cause of the outbreak has been identified yet, but WHO said a field investigation and contact tracing of the suspected patients was underway as of Friday.
It is Congo’s eighth Ebola outbreak since the virus was discovered near the country’s Ebola river in 1976. Congo’s last outbreak killed 49 people and occurred from August to November 2014, but was unrelated to the West African Ebola epidemic that killed more than 11,300 people.
There are indications that the current outbreak can be contained: Congo hasexperience fighting Ebola, and this is the first outbreak anywhere for which there is an available vaccine that can be deployed to help stop the spread of the virus.
Gavi CEO Seth Berkley, MD, said the vaccine alliance has 300,000 doses of the experimental vaccine rVSV-ZEBOV stockpiled and ready to use under an agreement signed last year with the drug’s developer, Merck.
But deploying the vaccine would require a written request from the Congo government to Gavi, Lindmeier noted. Gavi spokesman James Fulker told Infectious Disease News that a request has not yet been made and that the cost of using the vaccine in Congo would be decided only if that happens.
The vaccine, which was developed in Canada, was 100% effective at preventing the disease during a 2015 ring vaccination trial in Guinea, where the West African epidemic started. It targets the Zaire strain of the virus, which WHO said is causing the current outbreak in Congo.
“The fact that this is a country that has experience dealing with Ebola should give us hope that we won’t see a pandemic on the scale of the 2014 outbreak that hit West Africa,” Berkley said in a statement. – by Gerard Gallagher
Disclosures: Berkley and Fulker work for Gavi. Lindmeier is a spokesman for WHO.
Perspective
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Daniel R. Lucey, MD, MPH
Since April 22 an Ebola-Zaire virus outbreak has been associated with 20 suspected cases, two confirmed deaths, and at least 125 possible contacts in a remote area in northern Democratic Republic of Congo (DRC) near the Central African Republic. A much better-coordinated international response has begun in DRC than occurred in 2014 during the West African Ebola epidemic.
An imminent decision point, likely to occur this week, is whether to offer the Ebola vaccine rVSV-ZEBOV that was used in a phase 3 efficacy ring vaccination trial in Guinea. This vaccine trial, itself a product of admirable international coordination, was reported to offer protection to contacts and contacts of contacts of persons recently diagnosed with Ebola virus infection. Of note, this vaccine was not given to persons before exposure to Ebola virus, and immunity after the single dose is of unknown duration. The DRC has not formally requested the vaccine so far.
The WHO Strategic Advisory Group of Experts on Immunization met in Geneva from April 25 to 27, before this outbreak was known. It advised that if an outbreak of Ebola-Zaire occurs before a licensed vaccine is available, then this vaccine should be offered to “(i) contacts and contacts of contacts; (ii) local and international health care and front line workers in the affected areas and (iii) health care and frontline workers in areas at risk of expansion of the outbreak.”
In the West African Ebola epidemic, WHO reported that more than 510 West African health workers died due to the virus.
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