In Africa, the number of patients with Ebola hemorrhagic fever is steadily increasing, but medical staff are not responding properly. Experts worry that the local civil war and the United States' withdrawal from the World Health Organization (WHO) have weakened the disease control network. Because a virus species different from the Ebola outbreaks to date is the cause, there is no treatment or vaccine, let alone a diagnostic kit. With patients emerging only in underdeveloped African countries, there is also a lack of economic incentive for global pharmaceutical companies to step in. The medical crisis is being further exacerbated by political and economic factors.
On the 17th (local time), the World Health Organization (WHO) declared a Public Health Emergency of International Concern (PHEIC) in connection with the spread of Ebola virus infections in and around the Democratic Republic of the Congo and Uganda. As a vaccine- and treatment-less virus showed signs of spreading across borders, the organization issued the highest-level alert to urge a joint international response.
Ebola hemorrhagic fever is a severe infectious disease caused by the Ebola virus. It begins with headache, muscle pain, fever, and general fatigue, later progressing to systemic bleeding, and has a fatality rate of 60%. The virus was first discovered near the Ebola River in the Democratic Republic of the Congo in 1976, giving the disease its name. It spreads from wild animals such as fruit bats and chimpanzees to humans, and can also be transmitted between people through contact with an infected person's blood or bodily fluids. This is why there are many cases of infection among medical staff.
◇No treatments, vaccines, or diagnostic kits
The WHO was notified on the 5th that Ebola had occurred in the Democratic Republic of the Congo. A health care worker showed Ebola infection symptoms such as fever and bleeding on Apr. 24. After that, two confirmed Ebola patients from the Democratic Republic of the Congo entered neighboring Uganda, where cases were also reported. Both countries officially declared outbreaks last week.
There are broadly six species in the genus Ebolavirus. Of these, four cause hemorrhagic fever in humans. The U.S. Centers for Disease Control and Prevention (CDC) said as of the 17th there were 336 suspected cases infected with the Ebola virus species called Bundibugyo, with 88 related deaths. Infections with the Bundibugyo species show a case fatality rate of 20% to 50%.
In particular, four medical staff died at the same hospital, suggesting the virus spread in clinical settings as before. According to the WHO, during the worst Ebola outbreak that killed more than 11,300 people in 2014, 10% of all infections were medical personnel. More than 500 medical workers died at that time.
The problem is that while there are already two vaccines for the Zaire species, which caused the massive 2014 outbreak, there is no vaccine or treatment for the Bundibugyo species. The rapid diagnostic kits used in clinical settings were also designed to detect the more common Zaire species.
Raina MacIntyre, an epidemiologist at the University of New South Wales in Australia, said in the international journal Nature on the 18th, "Because the incubation period of the Ebola virus can be as short as two days and as long as 21 days, considering the number of cases reported so far, it is highly likely the virus has been spreading for several months already."
◇Political circumstances weaken disease control
Ironically, local medical staff were unable to focus on finding Ebola patients. In the areas where Ebola is spreading, medical workers are already tied up responding to other infectious diseases such as measles, mpox, and malaria. Political circumstances also contributed to the spread of Ebola. Siouxsie Wiles, a microbiologist at the University of Auckland in New Zealand, said that because many people are fleeing civil war locally, the virus likely spread undetected for a long time. Experts also believe the United States' withdrawal from the WHO earlier this year has dampened the WHO's capacity to respond to infectious diseases. After the United States halted funding, the WHO has made sharp budget cuts this year and is restructuring to reduce a quarter of its total staff.
For now, the likelihood of Ebola spreading worldwide is slim. Because it does not spread through the respiratory tract like COVID-19, its spread can be contained if infected people are properly identified and isolated. Pharmaceutical companies have not actively pursued vaccine development because Ebola patients appear mainly in Africa.
But the situation changes if people who traveled to infected areas or animal hosts move to other continents. The 1995 film "Outbreak" depicted a U.S. San Francisco quarantine officer diverting a monkey smuggled from Africa, after which people in various places coughed up blood and died. Experts note there is a nonzero chance the virus could spread to developed countries, and that technologies exist to enable rapid development, as with the COVID-19 mRNA (messenger ribonucleic acid) vaccines, so vaccine development for the Bundibugyo species of Ebola virus should be accelerated.
Fortunately, in Jan., the University of Oxford in the United Kingdom announced it had begun, with U.S. drugmaker Moderna that developed an mRNA COVID vaccine, to develop a vaccine candidate that simultaneously targets multiple filoviruses capable of causing deadly hemorrhagic fevers, including the Ebola virus and Marburg virus. Experts said development funding should be rapidly increased and clinical trial regulations eased to further speed up vaccine development.