By Peter Yeung
The Democratic Republic of the Congo (DRC) has declared an official end to its 11th Ebola outbreak nearly six months after it began, marking the first time in years the vast central African country has been free of the deadly hemorrhagic fever.
Eteni Longondo, the DRC’s minister of health, and the World Health Organization (WHO) made the announcement on 18 November after no new cases had been recorded in the country’s western Équateur province for more than 48 days. In this outbreak, there were 55 deaths and 75 people who had recovered out of 119 confirmed and 11 probable cases.
Announced on 1 June, the latest outbreak surfaced shortly before the DRC called an end to a separate Ebola epidemic – hundreds of miles away in the east of the country – that killed 2,280 people over nearly two years. The two virus strains were not related, according to genetic sequencing analysis.
Stretching vast distances across dense rainforests and remote waterways as well as busy urban areas, the latest outbreak was halted thanks to “cold chain” vaccine storage technology and community-based health workers who vaccinated 40,000 people who were deemed at high risk of contracting the disease, experts say.
“The geography was very difficult in terms of accessibility,” says Ngoy Nsenga at the WHO. “It required serious logistics, and so this ultracold-chain technology was very important.”
Known as the Arktek and originally developed by Global Good, a US-based technology company, the cylinder-shaped “super thermos” devices are capable of storing 500 vaccine doses at -80°C for up to a week with no external power source. This meets the cold temperature requirements of the Merck Ebola vaccine and Pfizer’s new covid-19 vaccine, which bodes well for vaccination in lower-income countries with less-developed infrastructure.
“But there were so many factors in the management of the outbreak,” says Nsenga. “The DRC is gaining experience in stopping epidemics and the WHO has learned to react as quickly as we can.”
Bob Ghosn at the International Federation of Red Cross’ (IFRC) says working with local communities was crucial to the success.
“Community engagement is key to stopping any outbreak,” says Ghosn, who helped deploy a team of 1000 IFRC community workers in Équateur. “We’ve got much better at it. Top-down messaging doesn’t work on its own – covid-19 has proved that.”
However, experts warn that the risk remains of another Ebola outbreak in the DRC – adding to the 11 since 1976. The disease, which can cause uncontrollable internal bleeding, is zoonotic and believed to derive from a species of bat.
Natalie Roberts at Doctors Without Borders in France says future efforts are likely to improve with the use of monoclonal antibodies – laboratory-made molecules that can enhance the immune system.
“Due to the remote nature of this outbreak and other constraints we weren’t able to use them as much as we wanted,” she says. “But they are very effective in the early stages of the disease.”
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