File photo taken on March 21, 2021 shows a medical worker vaccinating a local resident against the Ebola virus in North Kivu province, northeastern Democratic Republic of the Congo DRC. DRC declared the 14th outbreak of Ebola virus after one confirmed case was reported in Mbandaka, a city in the DRC’s northwestern Equateur Province, confirmed Saturday the World Health Organization in a statement. (Photo by Alain Uaykani/Xinhua via Getty Images)
Xinhua News Agency via Getty Images
A new Ebola outbreak has occurred in the Democratic Republic of Congo’s province Ituri, claiming 87 lives already with at least 336 suspected cases. The outbreak was first confirmed Friday, according to the World Health Organization.
Although the DRC may appear geographically distant to many Americans, it represents a serious global public health concern. There are several issues that make this outbreak of particular concern for global health.
Infectious Diseases Ignore Borders
Infectious diseases do not respect international borders, and a single infection in one place on the globe can easily spread to different parts of the world. This was readily apparent with the COVID-19 pandemic as well as more recently with global cases of Hantavirus on a cruise ship, a rare infection that has spread among people of different nations. Modern aviation connects even remote regions to major global hubs within hours.
Although Ebola does not spread as effectively as respiratory viruses, it still poses a threat to spread across countries. The Ebola virus is usually spread when individuals come into contact with infected bodily fluids like vomit, blood, urine, saliva and sweat. Individuals can also pick up the virus by touching contaminated surfaces such as clothes, bedding and medical equipment. Already, the Ebola outbreak has spread beyond the country of Congo, with one death reported in the neighboring country of Uganda.
Public health is interconnected and imported cases can reach anywhere in the globe, including the United States, if proper containment policies and protocols are not implemented effectively.
A Problematic Strain
The strain of Ebola that is responsible for the current outbreak in Congo is known as the Bundibugyo strain, which is different from the more common Zaire strain, according to the World Health Organization. Unlike the Zaire strain, there are no currently approved treatments or vaccines that can help mitigate the spread of the virus. When doctors need to rely on supportive measures such as isolation and containment as opposed to treatments and vaccines, people can become sick very quickly and even die. The mortality rate of the Bundibugyo strain can reach up to 50%, according to statements provided by the DRC’s health minister.
Although containment strategies, infection control and contact tracing form the cornerstone of outbreak responses, a lack of proven therapies and vaccines makes controlling the outbreak much for difficult for public health officials.
Why Containment Could Be Difficult In Congo
Containing Ebola in Congo poses unique challenges. Although the DRC has experienced more than a dozen of Ebola outbreaks since 1976, the current political turmoil, violence and armed conflict make mitigating the spread of the virus exceptionally challenging. The current environment makes contact tracing of individuals extremely difficult. In addition, many infected individuals may not readily get tested or cooperate with isolation protocols if community violence precludes travel and safety. This could ultimately translate into more spread of virus, with the unfortunate outcome of increased cases and even deaths.
Decreased Funding For USAID
The U.S. has significantly decreased funding for important global health programs through the United States Agency for International Development. The Trump administration announced cuts last year of 83% of USAID’s activities, which translated to billions of dollars. This funding has allowed for the building of surveillance systems, laboratory networks, vaccination campaigns and frontline health worker training across many countries with limited resources, including Congo. These programs have functioned to help divert and control disease outbreaks for decades.
When outbreaks are stopped overseas, Americans are protected at home. With decreased funding for these critical programs, there are fewer trained epidemiologists handling outbreaks, weaker surveillance systems and delayed outbreak responses which allows more time for viruses to spread before the world notices. Health officials believe the Ebola outbreak in Congo likely started in April, although it was only confirmed this past Friday. This delay in detection indicates a weakened public health infrastructure in the ability to recognize and communicate disease to the general public.
The current Ebola outbreak matters because it sits at the intersection of biological risk, geopolitical instability and shifting global health priorities. A virus with a high mortality, limited treatment options and challenging containment conditions emerging at a time of reduced international health investment poses a serious risk to everyone globally. The world should take notice.