The global risk of Ebola remains low as the number of confirmed cases in the outbreak’s epicentre, the Democratic Republic of the Congo, has been revised from more than 1,000 to 344.
Follow-up checks on people suspected of having the virus in the DRC confirmed fewer cases than first expected. One of those suspected cases recently travelled to neighbouring Uganda through the UAE.
The Ministry of Health and Prevention has said there are no cases in the UAE, but additional measures including contact-tracing are in place as a precaution.
Dr Tedros Adhanom Ghebreyesus, director general of the World Health Organisation, visited the centre of the Ebola outbreak in the DRC province of Ituri, to check on treatment and prevention efforts.
“I'm very encouraged by the level of commitment I saw everywhere I went,” he said. “What I saw gave me hope, although challenges remained.”
The DRC reported 60 deaths in 24 health zones, across three provinces – Ituri, North Kivu, and South Kivu. “As we work through the backlog, we can either confirm them or rule them out,” Dr Tedros said.
He added that the WHO was working Uganda and the UAE to gather additional information, assess the risk of exposure during travel, and to enable contact tracing.
“We thank both the UAE and Uganda for their collaboration to mitigate the risks related to this case,” Dr Tedros said.
Safety measures in place
The UAE has said it will bar entry to travellers from the DRC, Uganda and South Sudan from Saturday as a precautionary measure, owing to the outbreak in central Africa.
Ebola is a relatively rare but deadly disease caused by a group of viruses. It primarily affects animals, typically fruit bats. It can be transmitted to humans, with outbreaks often starting when people eat or handle infected animals.
Previous outbreaks of Ebola across Africa have helped shape how health systems and authorities respond, to contain further spread.
Sean Costello, head of business development for Aspen Medical in Middle East and Africa, who is a former nurse, said the UAE was well-placed to monitor the disease due to its role as a major international transit hub.
“There is a big focus on emergency preparedness and response in the UAE,” he said.
“The Unified Medical Operations Command [in Abu Dhabi] tracks and traces pretty much every piece of emergency response data, with infectious diseases a big part of that through contact-tracing.
“The UAE couldn't be in a better place with the amount of resources they've put into place between training, actual identification and clinical services.
“When you're looking at Ebola, there's a framework there, the model is to identify, isolate and inform.”
Containment operation
Aspen Medical were front and centre of the Ebola response in West Africa in 2014, working with the UK Department of Foreign Investment and Trade and USAID.
The lessons learnt have echoed through the current containment operations in the DRC, Mr Costello said.
The Fifa World Cup starting on June 11 could see thousands of supporters travel to the US, Mexico and Canada to watch matches.
However, the experience of hosting major sporting events during the Covid-19 pandemic has left authorities well prepared.
“Any delay gives the virus a head start, so it's about identifying and isolating early, and stopping the spread,” he said.
“Once you disregard symptoms, that leads to a spread and you're playing catch up. Community trust is almost as important as treatment. If you don't get people to come to the treatment centres, and if they don't trust you, you can't treat it.
“Fifa of all organisations know how to run a big event. They have run football tournaments through Covid, and there's a lot of lessons learnt, a lot of attention on it, but a lot of resources there as well.
“The right systems will be in place. The risk is low and the World Health Organisation is more than aware of the challenges around a World Cup event.”
How high is the risk of Ebola spreading outside Africa?
Although there is no vaccine to protect against the latest strain of Ebola, the risks remain low outside of central Africa.
The World Cup has focused attention on supporters looking to travel to North America in the coming weeks, as the DRC qualified for its first tournament since 1974.
That has intensified containment efforts, with any US medical staff working in the region expected to be sent to 50-bed Ebola quarantine centre in Kenya before flying home.
The proposed centre, at Laikipia Airbase in Nanyuki, has sparked protests in Nairobi, over concerns of transporting the virus into Kenya.
How does this Ebola outbreak compare with others?
The number of confirmed deaths related to the current outbreak vary from 60 to 240. By comparison, the largest outbreak since the virus was discovered in 1976 occurred in West Africa between 2014 and 2016.
The outbreak originated in Guinea, before spreading to neighbouring Sierra Leone and Liberia infecting more than 28,600 people and claiming 11,325 lives.
Malaria, however, remains the most deadly disease in Africa. The continent shoulders 94 per cent of the global burden of the disease carried by mosquitoes, causing about 600,000 deaths every year.
What are the signs and symptoms of Ebola?
Symptoms typically appear between two and 21 days after exposure, progressing from flu-like symptoms towards more serious gastro-intestinal complaints like vomiting and diarrhoea.
A skin rash with small bumps typically follows, then chest pain, confusion and aggression. In the most severe of cases, about 50 per cent of infections, the disease escalates to multiorgan failure and severe bleeding from the gums, nose and eyes.
Can it be treated?
Yes. Five patients with the virus in the DRC have already recovered and left hospital.
Ebolavirus is primarily treated with monoclonal antibody medications, such as Inmazeb and Ebanga, combined with supportive intensive care. Drugs neutralise the virus, while symptoms are managed with an IV drop to restore fluids, and oxygen therapy.
Is there a vaccine for Ebola?
Yes. There are FDA-approved and WHO pre-qualified vaccines to protect against some strains, but not the newly discovered Bundibugyo variant in the DRC.
Ervebo is manufactured by Merck, and is highly effective in a single dose against the Zaire Ebolavirus variant, which is responsible for the deadliest outbreaks.
Zabdeno/Mvabea is a two-dose vaccine regimen developed by Johnson & Johnson, approved for protection against the Zaire Ebolavirus in adults and children.
Research is under way at the University of Oxford to develop a vaccine suitable for the Bundibugyo strain, but that could take months or even years to develop.
