August 24, 2018

Earlier this year, Ebola struck again. This time, public health officials were ready.

Daily Briefing
    By Ashley Fuoco Antonelli, Contributing Editor

    Public health officials from the United States and abroad scored a significant victory in the global fight against Ebola last month, stopping an outbreak in the Democratic Republic of Congo (DRC) in less than three months.

    Your top resources for safely managing and preventing the spread of Ebola

    Officials used lessons learned from the 2014-2016 Ebola outbreak in West Africa, which infected more than 28,000 and killed more than 11,000 individuals, and deployed a multifaceted plan to stop the virus' spread.

    But Ebola in DRC is cyclical, and the country already is facing another outbreak. Public health officials warn the fight to contain this outbreak might prove to be much harder. Let's take a closer look.

    How officials beat the May Ebola outbreak in DRC

    The DRC government on May 8 declared an Ebola outbreak, and officials feared the worst as the outbreak quickly reached the river port city of Mbandaka, which has over one million residents. According to the New York Times' Donald McNeil, "At one point, experts had feared the virus might spread throughout Central Africa."

    But Ranu Dhillon, and an instructor at Harvard Medical School and a physician at Brigham and Women's Hospital, and Devabhaktuni Srikrishna, who founded Patient Knowhow, in the Harvard Business Review write that "[g]lobal agencies, on high alert after the West African epidemic, leveraged lessons learned from the West African epidemic and efforts made since then to respond differently in several important ways."

    The World Health Organization's (WHO) response to DRC's outbreak was immediate and well-coordinated, Dhillon and Srikrishna write. WHO partnered with CDC and others to deploy experienced personnel and top executives to the field, and equipped them with thousands of doses of an experimental Ebola vaccine developed and donated by Merck. Merck developed the vaccine, which is not yet licensed, in response to the 2014-2016 Ebola outbreak, which had infected several U.S. residents who had treated individuals with Ebola both abroad and in the United States.

    WHO spokesperson Tarik Jasarevic explained health care workers on the ground in DRC administered the vaccine in "rings," which involved vaccinating any individuals who were in close proximity to a confirmed case of Ebola, as well as any individuals who came in contact with those who were in close proximity to the confirmed case. Overall, more than 3,300 people were vaccinated.

    WHO also sent hundreds of body bags to DRC to ensure safe burials in communities affected by the outbreak, as well as at least 1,500 sets of personal protective equipment and emergency sanitary kits. Likewise, the U.S. Agency for International Development sent thousands of personal protective equipment kits, materials for diagnostic testing, and other technical support to DRC.

    The United States also provided several million dollars to help fund efforts to combat the outbreak. In total, WHO received $63 million from various donors to fight the outbreak, according to the United Nations Office of the Coordination of Humanitarian Affairs.

    By July, the outbreak was officially over. In all, about 50 individuals had been infected, leading to 33 deaths.

    Tedros Adhanom Ghebreyesus, WHO's director-general, credited the outbreak's quick containment to "the tireless efforts of local teams, the support of partners, the generosity of donors, and the effective leadership of [DRC's] Ministry of Health."

    He added that the response's success "should make the government and partners confident that other major outbreaks affecting the country, such as cholera and polio, can also be tackled."

    DRC faces another Ebola outbreak—and new challenges

    But officials are learning just how hard Ebola is to contain: DRC already is facing another Ebola outbreak—and this time, it's in a war-torn part of the country where the disease is proving harder to contain.

    As of Wednesday, WHO reported that there were 51 confirmed and 27 probable cases of Ebola, and at least 44 deaths, associated with the outbreak so far. Possible cases have been reported in Beni, which is about 18 miles southwest of Mangina, as well as Butembo, Oicha, and Musienene.

    Workers from WHO and DRC's health ministry already have mobilized to contain the latest outbreak. But Reuters' Fiston Mahamba writes that security challenges in the area are complicating their efforts. According to Mahamba, roughly "1,000 civilians have been killed by armed groups and government soldiers around Beni since 2014, and the wider region of North Kivu holds over one million displaced people." As such, Julie Hall, chief of staff at the International Federation of the Red Cross, told Mahamba that the response to this Ebola outbreak would require a "highly complex" operation.

    Peter Salama, who heads WHO's Health Emergencies Program in Geneva, has noted that vaccination teams might have to travel with armed escorts. "On the scale of degree of difficulty, trying to extinguish an outbreak of a deadly, high-threat pathogen in a war zone reaches the top of any of our scales," he said.

    Still, Tedros said he is confident officials will be able to contain the outbreak. "Ebola is a constant threat in DRC. What adds to our confidence in the country's ability to respond is the transparency they have displayed," he said, "adding, "We will fight this one as we did the last."

    From outbreaks to hurricanes: How can hospitals prepare for disasters?

    Hospitals must be prepared for myriad disasters that can stress health care systems to the breaking point and disrupt delivery of vital health care services.

    Advisory Board has compiled step-by-step procedures for various threats your facility may encounter—though we hope you'll never need to use them.

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