Ebola vaccination effort begins in DR Congo

The first doses of the Ervebo vaccine have been administered in the Democratic Republic of Congo (DRC) as health officials try another strategy to help bring the country’s raging Ebola epidemic under control.

The Associated Press (AP) reports that health and other frontline workers are being prioritized to receive the vaccine, which targets the Zaire Ebola strain but may offer some protection against the Bundibugyo virus. Roughly 50,000 doses of the vaccine have been approved for use in health and frontline workers in DRC, while 20,000 more will be used in a clinical trial. 

The vaccination campaign was launched in Tshopo province, one of six eastern DRC provinces affected in the outbreak. 

“We have started the compassionate use of the Ervebo vaccine among frontline workers and healthcare workers,” Placide Mbala-Kingebeni, MD, PhD, of the DRC’s National Institute of Biomedical Research, said yesterday at an Africa Centres for Disease Control and Prevention (Africa CDC) press briefing. “Then, we will conduct a follow-up to evaluate the impact of this vaccine.”

Mbala-Kingebeni said data from animal studies have indicated Ervebo might provide some cross-protection against Bundibugyo, which has no licensed vaccines or treatments. He also cited anecdotal reports that some health workers in DRC who received the Ervebo vaccine during a 2018 Ebola outbreak and have been infected in the current outbreak aren’t getting as sick as colleagues who weren’t vaccinated.

“This is why the government of DRC, together with Africa CDC, decided to see how we can use the Ervebo vaccine for compassionate use,” he said. 

Compassionate use programs allow vaccines and other medical products to be used in outbreaks and other serious medical situations even when they haven’t been approved for the specific disease being targeted.

Bundibugyo spreads farther into DRC

To date, there have been 5,794 confirmed cases and 2,786 deaths in the outbreak, though DRC officials have said the actual numbers could be much higher. The overall case fatality ratio is 48% but is higher in some of the affected areas. The outbreak hit a new high for weekly deaths last week, with 300.

The AP also reports that the outbreak has now spread to more health zones in the DRC, bring the total number affected to 60. 

We have started the compassionate use of the Ervebo vaccine among frontline workers and healthcare workers.

The outbreak is growing much faster than previous Ebola outbreaks. Through week 15, there have been nearly seven times the number of cases, and more than five times the number of deaths, as were recorded at the same time point in the 2014-2016 West Africa outbreak, which is the largest and deadliest on record, killing more than 11,000 people.

“Without a rapid change in the trajectory of transmission, the epidemic risks reaching a scale with profound national and regional consequences,” the World Health Organization’s International Health Regulations (IHR) Emergency Committee said in a statement released today. “The Committee therefore emphasizes the need for urgent, decisive and coordinated action to control BVD [Bundibugyo virus disease] transmission in the DRC.”

The IHR Emergency Committee called for drastic scale-ups of Ebola isolation and treatment centers, infection prevention and control measures, and trust-building and community engagement. 

“The response must be built with affected communities and supported by trusted local leaders and organizations, with transparent communication, meaningful participation and mechanisms through which community concerns rapidly influence response operations,” the committee said.