A deadly Ebola outbreak in the Democratic Republic of Congo has killed a suspected 27 people, World Health Organization officials announced this week, upping the death toll for the second time in less than seven days.
On Wednesday, health workers also confirmed that two infected individuals had escaped a treatment facility in the populous Mbandaka, a busy port city of more than 1 million people that sits along the Congo River, a major economic channel for the region.
Médecins Sans Frontières (MSF), or Doctors Without Borders, confirmed the escape on Thursday. According to MSF spokeswoman Rosie Slater, the two slipped out of the facility on Monday night, with the help of family members. Both died within the day — one at his home and the other at the treatment facility — after returning on Tuesday. Family members later brought the body of the man who died at home to the facility for safe burial under MSF supervision.
A third patient left the facility early on Sunday, although MSF noted the patient was already set to be discharged within the week.
“In all three cases, every effort was made by staff at the hospital to convince the patients — and their families — not to leave and to continue their treatment,” Slater told CNN Thursday. “However, forced hospitalization is not the solution to this epidemic. Patient adherence is paramount.”
The escape has left health workers and regional officials scrambling, as they seek out anyone with whom the patients may have come into contact.
The WHO on Wednesday raised the suspected death toll linked to the Ebola outbreak to 27, up from 23 on May 18. The total number of suspected Ebola virus disease (EVD) cases could be as high as 44 so far, with figures likely to rise.
Mbandaka is one of the DRC’s most populated regions, and health officials have long been concerned that the recent outbreak, which was initially confined to the isolated Bikoro, Iboko, and Wangata health zones, may spill over into the city. On May 18, WHO spokespersons announced that workers had indeed identified five new EVD cases within Mbandaka, confirming officials’ worst fears.
“This is a major development in the outbreak,” said Peter Salama, deputy director general of emergency preparedness and response at the WHO, speaking with the Washington Post at the time. “We have urban Ebola, which is a very different animal from rural Ebola. The potential for an explosive increase in cases is now there.”
On Wednesday this week, WHO officials stated that information on the outbreak was still limited, but that the most recent developments were cause for concern.
The #Ebola response efforts in the Democratic Republic of the Congo (#DRC) continue. A new Ebola treatment center run by @MSF near #Mbandaka -an affected area- will open later this week. WHO has deployed clinical experts to support optimized supportive care. pic.twitter.com/LcgG5Mqmus
— World Health Organization (WHO) (@WHO) May 24, 2018
“The confirmed case in Mbandaka, a large urban centre located on major national and international river, road and domestic air routes increases the risk of spread within the Democratic Republic of the Congo and to neighbouring countries,” spokespersons noted in a statement. “WHO has therefore revised the assessment of public health risk to very high at the national level and high at the regional level.”
Ebola is a viral hemorrhagic disease that is typically found in animals like primates or fruit bats. Humans may contract with the virus after exposure to an infected animal or after handling tainted bushmeat. It is transmitted between humans through bodily fluids like blood, saliva, breast milk, sweat, urine, or semen and may produce flu-like symptoms, such as fever, muscle pain, weakness, diarrhea, and vomiting. Infected individuals may also experience sudden bruising or hemorrhaging.
The disease is not air- or water-borne. It typically carries a 50 percent case fatality rate, though young children are at higher risk of death after exposure.
The DRC Ebola outbreak calls back memories of the 2014 West Africa outbreak, which killed more than 11,000 people as it spread across Guinea, Sierra Leone, and Liberia. Nigeria and Mali also saw scattered cases, and four individuals in the United States who had recently traveled to the region were also diagnosed with the disease. Only one of the U.S. patients died.
Since that time, researchers have been working swiftly to develop a vaccine that can inoculate anyone potentially exposed to an Ebola patient against developing the viral disease themselves, debuting a final version of the rVSV-ZEBOV Ebola vaccine, also called V920, for human trials in late 2016. Those trials yielded promising results: Out of the nearly 6,000 patients vaccinated with Merck-manufactured V920, all were declared “free” of the disease after a period of 10 days.
The WHO has recently deployed approximately 8,640 doses of V920 to the DRC, where health workers plan to employ a ring-vaccination method to slow the outbreak. The first round of vaccinations began on May 21, and Merck says it will supply the WHO with an additional 8,000 doses in the coming weeks.
“Vaccination will be key to controlling this outbreak,” WHO Director-General Dr. Tedros Adhanom Ghebreyesus said on Monday.
On Thursday, addressing the World Health Assembly, he added, “The ongoing Ebola outbreak in the Democratic Republic of the Congo is a stark reminder that outbreaks can happen anywhere, at any time.”