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The Journal Gazette

Tuesday, June 05, 2018 1:00 am

Lessons of last battle

New Ebola outbreak chance to implement what's been learned since 2015 scare

Christer Watson

Ebola is back.

I've read short news stories here and there, but this has not yet gotten the full attention of the international media. The last time this virus made the news, it was in 2015. There was a widespread outbreak in west Africa. About 11,000 people died. In the United States, there were misguided calls for travel bans and quarantines. Hopefully this outbreak won't be big news, but that will require a better medical response than last time.

The latest outbreak is also in Africa, but this time in the sub-Saharan Democratic Republic of Congo. In early May, a couple of cases were announced by the government. Since that announcement, news agencies have reported about 30 deaths. The outbreak appears to be in the early stages, but it could get very bad very quickly.

The outbreak is along the Congo River. Some cases are quite close to large cities. If Ebola were to spread to those cities, this outbreak could be similar to the 2015 one, with a similar death toll.

The good news is that scientists have been working on a vaccine. Actually, vaccine work had been done in the mid-2000s by a lab in Canada. That lab had tested the vaccine in animals, but not people. At the end of the 2015 outbreak, another group did a small test in humans. Of about 6,000 people given the vaccine, none developed Ebola. The vaccine initially appears to work very well.

However, the vaccine requires more testing. Does it work against all four types of Ebola? Does the vaccine work regardless of a person's exposure history? The 6,000 people were all in Guinea, where the outbreak was but which had never had an outbreak previously. The Republic of Congo, where the current outbreak is, has had nine previous outbreaks. As a result, people in the Republic of Congo probably have different immune histories.

Despite that uncertainty, the vaccine has been approved for emergency use. Since 2015, agencies and companies have been preparing for this situation. The main actors appear to be the World Health Organization, Doctors Without Borders and Merck. Several thousand doses of the vaccine have already been shipped to the Republic of Congo.

That quick response represents a significant success. Unfortunately, getting the vaccine to all the outbreak areas is difficult. The vaccine has to be kept very cold, -110 degrees F. The outbreak is in some remote areas without consistent access to electricity for refrigerators.

Early action is important because it can limit the spread significantly. Despite the impressions and the fear generated by the last outbreak, Ebola does not spread very easily. For example, it does not spread through the air. It spreads through contact with the bodily fluids of an infected person.

The fear is mostly inspired by the very gruesome symptoms once a person is infected. Also, it is very deadly. About 70 percent of those infected in west Africa died.

The vaccine will be used to stop the disease from spreading. People infected with Ebola and people in contact with the infected will get the vaccine. Additionally, those infected will be quarantined and the bodies of the dead will be disposed of safely.

This last issue can be quite difficult. When people with Ebola die, their bodies are still a source of the disease. Standard funeral practices, however, include washing the body and laying hands on the body. Both these practices can spread the disease.

Changing that behavior can be hard. It requires strong trust between medical workers and the family of the dead.

If these quick actions work, the outbreak will end shortly. Few people will die and, hopefully, it will not become a major news story. I think we should all imagine what could happen over the next couple months in the Republic of Congo. If it doesn't happen, that means the vaccine research and public health workers have been successful.

 

Christer Watson, of Fort Wayne, is a professor of physics at Manchester University. Opinions expressed are his own. He wrote this for The Journal Gazette, where his columns appear the first and third Tuesday of each month.