After the crisis that we have experienced in Spain as a result of a strain of hantavirusthe news has spread to Africa and more specifically to the Democratic Republic of the Congo due to the Ebola virus outbreak in its strain known as Bundibugyo and that, unlike recent epidemics, it has neither a vaccine nor an approved treatment.
An answer. The WHO itself has declared the outbreak in Central Africa as a public health emergency of international importance, and no wonder, since in the latest reports there are more than 800 suspected and confirmed cases. But also, in the Democratic Republic of the Congo has been settled with 180 deaths and the problem is that this virus has passed to Uganda.
What makes this outbreak described by experts as a true “logistical nightmare” is not only the number of infections, but the nature of the enemy.
The Achilles heel. When we think about Ebola and the medical advances made after the devastating 2014-2016 epidemic, we often refer to the Zaire ebolavirus. For that strain, science managed to develop highly effective vaccines at the time, but the new outbreak is being driven by the Bundibugyo strain, for which we do not have any pharmacological arsenal, since both viruses share only between 60-70% of their genetic material. That is, current vaccines are useless.
In this way, without the possibility of vaccinating all people who have been in contact with a person who is infected to nip transmission in the bud, medical teams have been left without their most powerful containment tool. And although there are experimental vaccine candidates, WHO experts estimate that their production at scale for clinical trials could take between six and nine months.
Its complexity. Added to the lack of medical arsenal is an extremely complex operational context, since the origin of the outbreak in the Ituri region was complicated by an alleged “super-spreader” event and by initial failures in diagnosis. And it is not because there is a lack of knowledge, but because the initial symptoms of Ebola are very non-specific, being fever, fatigue or muscle pain, so it can literally be anything.
It is when the most serious symptoms of Ebola develop that this diagnosis is already considered, but sometimes it is too late. Furthermore, one of the diagnostic methods, such as the PCR test, is not widely available in the field as they are very expensive and complex techniques.
We don’t see everything. Although we are informed that we are facing a major public health problem, it is possible that we are only facing the ‘tip of the iceberg’. Here, some experts point out that the underreporting of cases, added to the violence of armed groups in the region that prevents access for health workers, paints a scenario where isolation and contact tracing border on the impossible.
We must keep in mind that access to the health system in these regions is quite limited, and that is why there may have been some deaths in the home environment without being reported because it has been confused with another endemic disease. And although the risk at a global level is low, the truth is that an immediate response is needed before the crisis takes on irreversible dimensions.
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