WHO to ship Ebola vaccine to Congo

KINSHASA, Congo -- Ebola vaccines will be shipped as quickly as possible to Congo as the number of suspected cases in the latest outbreak grows, the head of the World Health Organization said Friday as the agency prepared for a "worst-case scenario."

WHO Director-General Tedros Ghebreyesus in a Twitter post said the agreement was made in a phone call with Congo's health minister on Thursday. Tedros also confirmed on his Twitter account that the country agreed to authorize the emergency use of the vaccine.

The agency said in a statement that Tedros would visit the country this weekend to assess its needs.

Two cases of Ebola have been confirmed in the latest outbreak in a remote northwestern part of Congo. WHO said 34 Ebola cases have now been reported in the past five weeks, including the two confirmed cases, 18 probable cases, and 14 suspected cases, up from the 32 cases that the organization reported on Thursday.

There is no specific treatment for Ebola. A new experimental vaccine has been shown to be highly effective, though quantities are limited.

Challenges will include keeping the vaccine at low temperatures in Congo's heat and with the lack of infrastructure in a rural area, as well as getting the vaccine to those who have been exposed to the virus. Despite it occurring outside an urban area, this particular outbreak may be harder to contain because it has already spread across 37 miles. Some of those infected are health workers, which poses an additional risk of transmission to others. Those who help bury or clean the bodies of the infected are also at high risk.

Congo's health minister on Thursday announced the first death since the outbreak was declared early this week, though the hemorrhagic fever blamed for the death has not been confirmed as Ebola.

On Friday, the health ministry announced one new suspected case in Bikoro and a second in the Iboko health zone. It also said it knew of three sick people in Mbandaka, the capital of Equateur province, where it is sending experts to investigate.

Mobile laboratories are being deployed to Mbandaka and Bikoro today, the ministry said.

"The problem here is that we already have three separate locations that are reporting cases that cover as much as [37 miles] and maybe more," said Dr. Peter Salama, the WHO emergencies chief. "We have three health care workers infected and one who has been reported as of yesterday as having died."

While the risk of the latest outbreak spreading into other countries is low, nine nearby countries have been put on high alert, Salama said.

It is "absolutely a dire scene in terms of infrastructure" as medical teams try to contain the outbreak in a region with poor water and sanitation, few paved roads and little electricity, he said.

The vaccine was developed by Merck in 2016. In a trial of 11,800 people in Guinea in 2015, the vaccine had 100 percent efficacy, giving hope it could be a game-changer in preventing Ebola from spreading.

Researchers there used the same approach that was used to study smallpox, where they identify a "ring" of people who may have come into contact with an infected person, and then vaccinated all of those people after determining they may have been at risk. The side effects were mostly mild.

Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told The Washington Post that Ebola outbreaks are dangerous in an increasingly urbanizing Africa because once infections spread to a metropolitan area, they become much more difficult to control. Already, officials in Congo fear that the virus could spread to the provincial capital, Mbandaka, home to around 1 million people.

"All it would take is one or two of these infected individuals to go into a larger metropolitan area," Osterholm said.

Congo has suffered a number of Ebola outbreaks in recent years, but has largely managed to contain them. A 2014 outbreak killed 49 people. In this case, the vaccine's deployment is intended to assist health care workers in ending the outbreak long before it has the possibility of turning into an epidemic.

Information for this article was contributed by Saleh Mwanamilongo and Jamey Keaten of The Associated Press; by Siobhan O'Grady of The Washington Post; and by Katherine Tam of Bloomberg News.

A Section on 05/12/2018

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