Ebola Outbreak in the Democratic Republic of Congo: What You Need to Know

The U.S. Centers for Disease Control and Prevention (CDC) has issued a health advisory regarding the recent outbreak of Ebola virus disease in the Democratic Republic of Congo. As of September 18, there are 37 confirmed cases and 19 deaths reported during this outbreak.

In addition, the CDC released a travel health notice on September 8 for those visiting Congo. Travelers are advised to steer clear of sick individuals and to keep an eye on themselves for any symptoms of Ebola while in the affected zones and for 21 days after leaving.

So, what exactly is Ebola? What causes it, and what symptoms should one watch for? How is the disease transmitted, and are there any treatments available? Is there any vaccine? These questions are critical, especially given the alerts from the CDC.

To dive deeper into these queries, I consulted with Dr. Leana Wen, a CNN wellness expert and clinical associate professor at George Washington University. Dr. Wen also brings experience as Baltimore’s former health commissioner.

CNN: What is Ebola, and what causes it?

Dr. Leana Wen: Ebola is a severe illness with a high mortality rate. The typical fatality rate is around 50%, which indicates that roughly one in two infected individuals may die, as per the World Health Organization.

Ebola is caused by a group of viruses belonging to the Orthoebolavirus family, first identified in 1976 in what is now the Democratic Republic of Congo. Alongside the Ebola virus itself, there are also the Sudan virus, Bundibugyo virus, and Taï Forest virus, all of which can lead to severe illness.

This particular outbreak is attributed to the Ebola virus, marking the 16th reported case of Ebola disease in Congo since 1976.

CNN: What symptoms should people be aware of, and how quickly do they manifest after exposure?

Wen: The incubation period for Ebola can range from two to 21 days, but the average window from exposure to the appearance of symptoms is about eight to 10 days. Initially, patients show “dry” symptoms — things like fever, joint and muscle pain, severe headaches, and fatigue. These nonspecific early signs often lead to misdiagnoses, causing confusion with illnesses like influenza or malaria.

After about four to five days, patients may start to exhibit “wet” symptoms, which are more definitive of Ebola. These can include gastrointestinal issues like abdominal pain, vomiting, and diarrhea, along with other serious symptoms such as chest pain and bleeding from various orifices like the eyes, mouth, and rectum. As the disease progresses, it can result in organ failure and ultimately, death.

CNN: How is Ebola transmitted?

Wen: The most common route of transmission is person-to-person contact. A person might contract the virus through exposure to blood or bodily fluids of someone who is infected or has died from Ebola. Contaminated objects can also pose a risk; these include bedding, utensils, clothes, and medical tools.

Transmission can occur through sexual contact as well, particularly through the semen of individuals who are infected or have recently recovered. Additionally, humans can contract Ebola through hunting or consuming infected animals like bats, monkeys, and antelopes.

CNN: What treatment options are available for Ebola patients?

Wen: Patients diagnosed with Ebola are immediately isolated to prevent further spread. Supportive care, which includes providing fluids and electrolytes, is crucial. If blood pressure or oxygen levels drop, intensive care may be necessary. Treatment for secondary infections or complications from preexisting conditions might also be needed.

Currently, two treatments have been approved by the U.S. Food and Drug Administration (FDA) for Ebola: a combination of three monoclonal antibodies and a single monoclonal antibody. Clinical trials have shown that these therapies can reduce mortality rates, though the death rate remains high even with treatment. Access to these medicines can be limited, particularly in sub-Saharan Africa where most outbreaks occur.

CNN: Is there a vaccine available?

Wen: Yes, there is. The FDA approved a vaccine called Ervebo for Ebola virus disease in 2019. A second vaccine is authorized in Europe, but it hasn’t been made available in the United States yet.

Ervebo is intended for use during outbreaks and involves a strategy known as “ring vaccination.” This means vaccinating people at the highest risk of infection — those in close contact with confirmed Ebola cases, their contacts, and frontline healthcare workers. The aim is to create a protection barrier around cases to limit the spread.

According to the WHO, an initial 400 doses of Ervebo have been sent to one of the hotspots in Congo, with more doses on the way shortly.

CNN: What else should the public know about this outbreak, and why is the CDC issuing alerts?

Wen: Although Ebola is indeed a grave public health issue and assistance is necessary in Congo, this outbreak has not yet affected the U.S. The CDC indicates that no suspected, probable, or confirmed Ebola cases from the outbreak have been reported in the U.S. As it stands, the risk of the virus spreading to the United States is low.

The CDC advises travelers to Congo to avoid contact with sick individuals and to observe for any symptoms for 21 days post-travel. Those who show any symptoms should immediately isolate and contact their healthcare provider or local health department.

The advisory effectively reminds healthcare professionals to consider Ebola in patients showing concerning symptoms who have recently traveled to affected areas. It also outlines resources for hospitals, labs, and public health departments that might deal with patient treatment or community inquiries about Ebola.

CNN: Are there any further recommendations for the public at this time?

Wen: For the general public outside affected regions, there are no specific recommendations. However, if you’re in or visiting areas with Ebola, it’s vital to be cautious. Avoid contact not just with sick people but also with anything that might be contaminated. Also, it’s best to refrain from visiting healthcare facilities unless absolutely necessary.

Additionally, traditional burial customs that involve touching the deceased should be avoided. Keep away from bats, monkeys, and forest-dwelling antelopes, and steer clear of caves or mines where bats could be present. Anyone developing symptoms should seek medical care immediately.