The new Ebola outbreak could take ‘three, maybe four’ months to control

May 15, 2018

The Democratic Republic of Congo is currently fighting its ninth Ebola outbreak—and Jean-Jacques Muyembe Tamfum is as calm as ever. Muyembe was the first scientist to encounter Ebola during the first-ever outbreak in 1976, and he has been involved in studying and fighting the disease ever since.

“I think we will need three months to control [this new] outbreak. Maybe four,” he said.

There are currently 32 suspected cases, dating back to April 4; of those cases, 18 have died. This suspected-case count has risen by 11 since the ministry of health first reported the outbreak, but it’s still unclear how many of them actually have Ebola. (For comparison, during a similar Ebola outbreak last year, the DRC reported 37 suspected cases, of whom only 8 were eventually lab-confirmed.) To date, only five blood samples have been sent to the national lab in Kinshasa for testing, and only two of them were confirmed to have Ebola. Neither of those confirmed cases has died.

Further samples are on the way, but as is often the case in the DRC, shipping is complicated by the lack of good roads and the remoteness of the affected region—a northwestern town called Bikoro and a nearby village called Ikoko-Impenge, 30 kilometers away.

Even in these early stages of the outbreak, confusion is brewing. Reuters reported that cases of hemorrhagic fever were reported in the outbreak area “as far back as December,” and the first deaths “were reported in January.” That’s true, insomuch as health authorities did examine a group of 15 suspected cases and 8 deaths in the same region in January and February. But their investigations weren’t conclusive. “There was no proof that it was Ebola,” said Tarik Jašarević, a World Health Organization spokesperson. It’s anyone’s guess when the outbreak actually began, although it seems likely that it was underway by April.

But there were problems in the flow of information. The investigators filed a report on March 1, but the ministry of health for the province didn’t channel that report onward, as they were meant to, according to Muyembe. It was May 8 when the national ministry of health notified the WHO of the two lab-confirmed cases. That delay is a blow for a country that prides itself on its ability to detect new cases of problematic diseases like Ebola. This time, the fringes of the surveillance web worked as intended, but the threads leading to the center had been severed. “It’s not usual,” Muyembe says. “We have to seriously discuss why the information was not used properly by the provincial level.”

Nonetheless, Congolese health workers, along with the WHO and international partners, are already mobilizing to address the outbreak. They are working to find people who may be infected, track down everyone they had come into contact with, and isolate and treat patients. They are also distributing thousands of leaflets and posters to ensure that local communities practice safe burials. In Congolese funerals, families and friends will dress, clean, hug, caress, and kiss the bodies of the deceased—a loving ritual that tragically allows Ebola to spread.

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