As it prepares to deploy an experimental Canadian-developed vaccine to battle the world’s latest Ebola outbreak, the World Health Organization says it is deeply concerned by the spread of the virus into a Congolese city of 1.2 million people.
Thousands of doses of the vaccine arrived in the Democratic Republic of the Congo this week. This is the first time the experimental vaccine, developed in Winnipeg’s microbiology laboratory, will be used to fight a new Ebola outbreak, although it was shown to be effective during the final days of the previous major outbreak in 2015.
The WHO is convening a meeting of its emergency committee on Friday. Border-screening measures have already been boosted in 13 countries near Congo.
So far, there have been 44 suspected, probable or confirmed Ebola cases, including 23 deaths, in the outbreak that began in a remote region of Congo. But the disclosure of a confirmed case in the city of Mbandaka, the provincial capital of Équateur, is a dangerous new development that will greatly complicate the fight against the virus.
“The challenge just got much, much tougher,” said Peter Salama, the WHO deputy director-general for emergency preparedness and response, in a tweet on Thursday.
“Confirmation of urban Ebola in the Democratic Republic of the Congo is a game-changer in this outbreak,” he said.
Mbandaka is a port city on the Congo River, a major transport route that flows downstream to Congo’s capital, Kinshasa. Riverboats travel regularly between the two cities and the city of Brazzaville, capital of the Republic of Congo.
In a statement on Thursday, the WHO said the urban Ebola case is “very concerning.”
Until now, the Ebola cases had been confined to forest villages in the isolated rural area of Bikoro, about 150 kilometres from the provincial capital. The area is so remote that the WHO had to use helicopters to fly its experts into the main sites after the outbreak was confirmed on May 8.
The outbreak will be a major test for the experimental vaccine, which was developed by scientists at the National Microbiology Laboratory in Winnipeg over a 15-year period. The vaccine has been licensed to Merck and Co., although regulators have not yet given approval for it to be marketed.
The vaccine was shown to be highly effective in 2015, when it was given to about 5,800 people who had contact with Ebola patients in the West African country of Guinea during the waning days of the previous major Ebola outbreak, which killed about 11,300 people in three countries. But this will be the first time the vaccine has been used to tackle a new outbreak.
The first batch of more than 4,000 doses arrived on Wednesday in Kinshasa and vaccinations are expected to begin early next week.
The vaccine is designed to “ring-fence” the Ebola outbreak by protecting health-care workers and family members who are in contact with those who have the virus.
But the vaccine can be difficult to deploy, since it must be stored at a temperature of between minus-60 C and minus-80 C. This is a major challenge in remote regions with unreliable electricity supplies.
So far, health workers have identified about 430 people who may have been in contact with suspected Ebola cases and they were trying to trace thousands of others. But that was before the new urban case, which makes the task much more difficult.
The WHO is deploying about 30 experts to conduct surveillance in Mbandaka, while more than 110 Red Cross volunteers in Bikoro and Mbandaka are alerting communities and disinfecting houses where Ebola cases have been suspected.
Another agency, Médecins sans frontières (Doctors Without Borders), has set up isolation zones in the main hospitals of Mbandaka and Bikoro. It is also setting up two Ebola treatment centres in the city and the rural region. Several tonnes of medical supplies will arrive in the next few days.
Congolese Health Minister Oly Ilunga Kalenga said the spread of the virus to Mbandaka is a “new phase” for the outbreak. He said the authorities will intensify their tracing of all air, river and road routes out of the city.
Last week, U.S. President Donald Trump asked Congress to cut US$252-million in government funds that had been set aside to deal with Ebola outbreaks, but health experts criticized the suggestion.