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Vaccinations to begin as Ebola spreads in Congo
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For the first time, doses of an investigational vaccine will be administered to help stop an outbreak of Ebola virus that continues to spread in the Democratic Republic of the Congo, raising fears of a larger outbreak.
The unlicensed vaccine, V920 (Merck), will be given on a voluntary basis to health care workers in already-affected areas or places at risk for spread and anyone else who has had contact with confirmed Ebola cases or their contacts, WHO announced. Because V920 remains unlicensed, vaccinations will be conducted as part of a trial, with participants followed for an unspecified period of time.
The approach, known as ring vaccination, is similar to a trial conducted during the height of the Ebola epidemic in West Africa that showed the vaccine was highly protective against the Zaire strain of the virus, which WHO has confirmed is causing the current outbreak.
WHO said it would work with the Ministry of Public Health of the Democratic Republic of the Congo (DRC) and Doctors Without Borders (MSF) to administer the vaccine. Seth Berkley, MD, CEO of Gavi, the Vaccine Alliance — which stockpiles V920 for emergency use under an agreement with Merck — said doses were on the way, along with $1 million to fund the vaccination drive. WHO spokesman Tarik Jasarevic told Infectious Disease News that an initial 4,000 doses were en route to the outbreak zone but did not say when vaccinations would begin. The DRC was also prepared to use the Merck vaccine during an outbreak last year but ultimately deemed it unnecessary.
According to WHO, 39 confirmed, probable or suspected cases have been reported in the DRC since April 4, including 19 deaths. The agency said it has identified and is following up with 393 contacts. It is the ninth Ebola outbreak in the DRC since the virus was discovered there in 1976.
The current outbreak is centered in Bikoro, a remote area in northwestern DRC where 29 of the 39 cases have been reported, including the only two confirmed cases. The area’s remoteness complicates delivery of the vaccine, which needs to be kept at very low temperatures, but WHO said the logistics were being worked out.
Ten additional cases have been reported from two other areas, including two probable cases in Wangata, an area adjacent to Mbandaka, a large port city on the Congo River with a population of 1.2 million. Officials have said that the current outbreak’s proximity to the Congo River raises the risk for regional spread. The river links the DRC to two other countries, the Republic of the Congo and the Central Africa Republic, and flows past several large population centers, including the capital cities of Kinshasa and Brazzaville.
WHO Director-General Tedros Adhanom Ghebreyesus, PhD, MSc, visited the Ebola-affected areas over the weekend and said he was “impressed by the strong leadership” of the DRC government.”
“In Bikoro I saw first-hand the efforts the national health authorities and all our partners are investing in rapidly establishing the key elements of Ebola containment,” Tedros said in a press release. – by Gerard Gallagher
Disclosures: Berkley is the CEO of Gavi. Jasarevic and Tedros work for WHO.