Ebola

Abstract

Ebolavirus is known for its deadly viral hemorrhagic fever outbreaks in tropical sub-Saharan Africa. Safety and efficacy data of an Ebolavirus vaccine first tested during the 2014–2016 outbreak in West Africa were instrumental in gaining necessary regulatory approval for use in future outbreaks. In August 2018, the Ministry of Health of the Democratic Republic of the Congo declared the nation’s tenth outbreak of Ebolavirus disease. While this country has experienced and controlled more Ebolavirus outbreaks than any other place in the world, efforts to contain this particular outbreak have been thwarted by war-like conditions. The nation’s longstanding civil unrest, combined with a pervasive mistrust in the government, has allowed conspiracy theories about Ebola to flourish. Many patients and families have become reluctant to seek medical care, some have forcefully removed loved ones from hospitals, and others have launched attacks on Ebola treatment centers. On April 19, 2019, during an attack on Butembo University Hospital, WHO epidemiologist Dr. Richard Valery Mouzoko Kiboung was shot and killed. The US Centers for Disease Control and Prevention withdrew operations and Doctors Without Borders closed humanitarian-run Ebola treatment centers. Conditions were ripe for the Ebolavirus outbreak to explode, perhaps even superseding the more than 28,000 cases seen during the 2014–2016 epidemic in West Africa. Quick implementation of the newly available Ebolavirus vaccine soon after the outbreak started was instrumental in preventing a massive, catastrophic crisis on the African continent. As of March 2020, nearly 3500 cases and 2264 deaths had been reported, making it the world’s second largest and the country’s single largest epidemic ever recorded. To date, more than 290,000 individuals have been vaccinated. Interim analyses estimate that, during these outbreak conditions, vaccine efficacy exceeds 95%.