The second-largest Ebola outbreak in history has spread to a major city in the east of the Democratic Republic of the Congo (DR Congo), as health experts worry whether the stock of an experimental vaccine can stand up to the demands of an epidemic with no end in sight.
Butembo, with more than 1 million residents, is reporting cases of the deadly hemorrhagic fever. That complicates Ebola containment work already challenged by rebel attacks elsewhere that have made tracking the virus almost impossible in some isolated villages.
“We are very concerned by the epidemiological situation in the Butembo area,” said John Johnson, project coordinator with Medecins Sans Frontieres in the city.
New cases are increasing quickly in the eastern suburbs and outlying, isolated districts, the medical charity said.
SHEER SIZE
The outbreak declared on Aug. 1 is now second only to the devastating West Africa outbreak that killed more than 11,300 people a few years ago.
There are 471 Ebola cases, of which 423 are confirmed, including 225 confirmed deaths, the DR Congo’s Ministry of Public Health said late on Thursday.
Without the teams that have vaccinated more than 41,000 people so far, this outbreak could have already seen more than 10,000 Ebola cases, the ministry said.
VACCINE STOCK
This is by far the largest deployment of the promising but still experimental Ebola vaccine, which is owned by Merck. The company keeps a stockpile of 300,000 doses, and preparing them takes months.
“We are extremely concerned about the size of the vaccine stockpile,” WHO Deputy Director-General of Emergency Preparedness and Response Peter Salama, told the STAT media outlet in an interview this week.
He said that 300,000 doses is not sufficient as urban Ebola outbreaks become more common.
Health workers, contacts of Ebola victims and their contacts have received the vaccine in a “ring vaccination” approach, but in some cases all residents of hard-to-reach communities have been offered it. The prospect of a mass vaccination in a major city such as Butembo has raised concerns.
Salama called the approach “extremely impractical.”
A WHO spokesman said shipments of doses arrive almost every week to ensure a sufficient supply for the ring vaccination.
“No interruptions of vaccine supply have occurred to date,” Tarik Jasarevic said in an e-mail. “Merck is actively working to ensure sufficient number of doses continue to be available to meet the potential demand.”
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