Ebola can be contained, but the effort is just “ramping up”
On May 15, tests confirmed deaths in central Africa from a species of Ebola virus for which there are no vaccines or therapeutics.
The outbreak of a rare strain of Ebola virus, for which there is currently no vaccine, will cause more suffering and deaths in central Africa, Northeastern University public health experts said. But it can ultimately be contained with the appropriate international response, they said.
“This is something that is very controllable,” said Samuel Scarpino, the director of AI + life sciences at Northeastern University and a professor of the practice in health and computer sciences. Scarpino is developing a dashboard to help international healthcare organizations respond to the outbreak.
The current outbreak has been progressing very rapidly. On May 15, lab tests confirmed deaths from the Bundibugyo strain of the Ebola virus in Ituri Province of the Democratic Republic of the Congo (DRC) and in Kampala, Uganda. At that point, the World Health Organization declared an outbreak of the virus, but just two days later, the international agency declared the outbreak a public health emergency of international concern. By May 19, the WHO had reported 33 confirmed cases, 500 suspected cases and 130 suspected deaths.
“These numbers will change as field operations are scaling up, including strengthening surveillance, contact tracing and laboratory testing,” Tedros Adhanom Ghebreyesus, WHO’s the director-general said in an address to Member States at the 79th World Health Assembly.
Given the scale at which the outbreak has grown, experts are also concerned about the virus spreading undetected.
“It’s not unprecedented, but definitely concerning and worrying and atypical that it has clearly been a while since the transmission started,” Scarpino said. “We don’t yet know what that means quantitatively – whether a while is a month or whether it’s three months – but it is later than we normally detect an Ebola outbreak.”
The delay in detection underscores some challenges facing epidemiologists and healthcare workers working to contain the outbreak, experts said.
Early Ebola symptoms are similar to symptoms of other diseases in the area including malaria, dengue and influenza, Scarpino said, and the region of the DRC where the outbreak originated also lacked the necessary tests to detect the rare strain of the virus.
“The tests were coming back negative for basically everything,” Scarpino said.
“This will get worse before it gets better,” he added. ”But the risk of spreading outside of that region of countries is very low.”
While experts like Scarpino largely agree that this outbreak is likely to be contained, the response will not be without its challenges, others said.
The outbreak occurred in a region that has experienced armed conflict displacing roughly 100,000 people, according to the WHO, and among a population with a “high level of transience,” due to work in mining, according to Neil Maniar, director of the Master of Public Health Program and professor of practice in public health and health sciences at Northeastern.
The region also has limited healthcare infrastructure due to instability both locally and abroad, Maniar noted.
“It is a concern, to be perfectly honest, that our ability to contain this is somewhat diminished as a result of the disruption to public health infrastructure, both here in the United States and around the world,” Maniar said.
He said the Trump administration has dismantled the United States Agency for International Development (USAID), the lead international humanitarian and development arm of the U.S. government, and moved that agency’s responsibilities to the State Department. The administration has also withdrawn from the World Health Organization (WHO), saying the organization mishandled the COVID-19 pandemic and other global health crises.
Maniar cited both actions on the part of the current administration as “definitely playing a role,” in responding to the outbreak.
“We have lost key staff who have the historical knowledge of previous outbreaks,” Maniar said. “We have a diminished infrastructure, which certainly impacts the ability to respond to an outbreak like this that can very rapidly evolve.”
These circumstances are further complicated by the fact that treating those infected with the virus is challenging, as the virus is predominantly transmitted through superspreader events — such as funerals or even overwhelmed healthcare facilities — involving infected, symptomatic individuals (infectiousness increases as the symptoms increase) and even the deceased, Scarpino said.
So, a large amount of personal protective equipment, testing equipment and bleach and a new protocol in burial and mourning practices are required, he said.
However, there is hope.
“The WHO and other organizations have a lot of experience responding to these kinds of outbreaks,” Scarpino said. “We have a proven playbook for test, trace, isolate; safe and respectful burials; and protecting health care workers and preventing health care transmission.”
