There is reason to be cautiously optimistic about the trajectory of the current Ebola outbreak in the Democratic Republic of the Congo, the director-general of the World Health Organization said Wednesday.
In a news conference in Geneva, Tedros Adhanom Ghebreyesus said disease transmission rates are declining in most of the affected provinces, though he warned there are months of work remaining to get the outbreak under control.
“The epidemic continues to grow and continues to kill,” Tedros said. He noted that while there has been a reduction in cases in Ituri province — the epicenter of the epidemic — that decline is based on a high level of cases to begin with.
The outbreak, caused by the Bundibugyo species of Ebola, is the second-largest on record. As of Sunday, there had been 7,258 confirmed cases and 3,510 deaths occurring across seven provinces in northeastern DRC.
That’s a quarter of the size of the West African Ebola outbreak, but that earlier outbreak ran for about two years. In this case, the outbreak was only discovered to be underway in mid-May, though investigations suggest it may have started early this year.
Complicating efforts to contain the spread of the deadly virus is the fact that this part of the DRC has been wracked by violence for decades, leaving huge numbers of people displaced and struggling to feed their families.
Early in the outbreak, Tedros talked about having visited the outbreak zone and being struck by the fact that many people seemed to view Ebola as a lesser of evils. In their view, he said, more people in the region die from malaria or hunger, or in political violence.
He said people he spoke to suggested that outsiders only turn up to help in response to Ebola outbreaks they fear could spread to their own countries.
The rise in Ebola deaths as the outbreak has grown has moderated that view to a degree, Tedros noted.
“There is improvement. There is better cooperation. They’ve started to realize that this thing is serious,” he said.
In related news, the WHO said it expects a Phase 3 randomized clinical trial of Ebola vaccines to begin in the next couple of weeks, with the first vaccine to be put into the field being Merck’s Ervebo, which targets the Zaire Ebola virus. There is some evidence it may also provide cross-protection against Bundibugyo. When vaccines that specifically target Bundibugyo complete Phase 1 safety and dosing trials, they will be added to that trial, said Meg Doherty, director of the agency’s department of science for health.
Independent of that trial, frontline workers in hot spots are going to be offered the vaccine as part of an observational trial that should start later this week or early next week, she said. That study, being conducted by DRC and Doctors Without Borders, will give participants a shot of Ervebo, followed a month later by a shot of an experimental vaccine designed to protect against the Sudan version of the Ebola virus. The approach will compare cases among people who were vaccinated versus people who were not.