Words by Waqar Ahmed
The ongoing COVID-19 pandemic has had a lot of media coverage over the last month, with several vaccines being rolled out across the world and easing of lockdown measures being discussed, but this widespread attention may be drawing away from another familiar infectious disease which has recently caused a rising number of cases in West Africa. On the 14th of February this year, authorities in Guinea confirmed an outbreak of Ebola Virus Disease (EVD), which had previously caused up to 28,652 suspected cases and 11,325 deaths worldwide in the 2014-2016 Ebola outbreak, according to the US Centers for Disease Control and Prevention.
By the start of March, the new outbreak in southern Guinea had caused 17 suspected EVD cases, leading political leaders and epidemiologists to suggest preventative steps such as screening of travellers and public health measures to stop the outbreak becoming an epidemic. Another outbreak in the Democratic Republic of the Congo (DRC) began when a case of EVD was reported on the 7th of February. Since then, rising cases in both countries led to the US government announcing that travellers from the two affected countries will be funnelled into six US airports to control the spread of the disease and monitor the situation more closely.
EVD outbreaks in the DRC are considered recurrent, possibly due to the presence of the virus in the animal reservoir in many parts of the country, though at the time of writing, a new case has not been reported in the country since the 22nd of February. As of yet, virus sources are not known and there is not enough information to comment on the extent of transmission, though advancements in the control of the disease, such as two licensed vaccines against Ebola virus, make the risk of infection significantly lower than in the 2014-2016 outbreak.
The humanitarian organisation Médecins Sans Frontières (MSF) has announced that a team of experienced Ebola specialists have arrived in Guinea to investigate the outbreak and its potential impacts, particularly in the atmosphere of an ongoing pandemic. In any case, there are certain steps that need to be taken to minimise the effects of the outbreak whilst epidemiological surveillance and genetic sequencing is carried out. These steps include effective contact tracing to monitor the health of people who may have been in touch with an infected person, ensuring safe funeral practices for people who are suspected to have died from Ebola and having facilities in place to isolate and treat Ebola patients with the good triage set-up to minimise the risk to other patients and healthcare workers.
Another hurdle in controlling this outbreak includes ensuring that there are enough vaccines available and that there is good uptake of these vaccines in the regions most affected by Ebola, which requires effective community engagement and public education. In addition to vaccines, there are now treatments for EVD which did not exist in the West Africa outbreak of 2014. Though it is not yet clear which treatments will be used in Guinea and the DRC, these therapeutic options substantially increase the chances of survival, especially if started early, and they may also encourage patients to come forward promptly if they suspect they may be infected. One of the key issues highlighted during the 2014-2016 outbreak was patient hesitation when it comes to isolation in Ebola treatment centres as there were few effective treatments available. Vedaste Ndahindwa, an epidemiologist working at the World Health Organization (WHO) has called for a mass rollout of vaccinations and has commented that the affected countries’ experience in combating COVID-19 may better equip them in controlling Ebola, through reinforcing familiar measures such as handwashing and contact tracing.