If you’ve ever played Pandemic, (acclaimed board game) or Plague Inc. (acclaimed mobile game) you’ve likely also grappled with the same nightmare that keeps the United Nations World Health Organisation from sleeping soundly. Deadly infectious diseases are capable of posing significant threats, particularly to residents of third-world countries, where health infrastructure may be poor to begin with.

The Democratic Republic of the Congo is currently experiencing an outbreak of Ebola. This is the second time Ebola’s broken the world headlines in four years. So let’s take a look.

What is Ebola?

Ebola is regarded as highly infectious. Up until very recently, it hasn’t had a vaccine (and the one they’ve got at the moment is ‘experimental’, we’ll get to that in a tick). That makes it one of the most feared contemporary illnesses. While it’s not the most contagious, its symptoms can take days or weeks to appear – meaning an infected person can travel long distances while carrying the virus.

It’s posed a considerable threat in some parts of Africa. It spreads to humans through contact with infected animal’s blood, secretions or other bodily fluids. Fruit bats and the bush meat trade have shouldered the blame for past outbreaks.

Once in the human population, the disease spreads through direct contact with blood or other body secretions. Ebola doesn’t spread through the air or through water, and you apparently can’t spread it if you don’t already feel sick.

Symptoms begin with a high fever, general weakness and muscle pain. Then your blood slows down as it gets thicker. Clots form. From there it gets real bad real quick. It attacks organs and the tissue that holds muscles together. Inevitably, there’s external bleeding, which raises the chance of infecting others.

What happened in 2014?

You may remember this: there was a big-ass outbreak back in 2014 that continued until 2016. More than 11,000 people died. West Africa was hit the hardest, with Guinea, Liberia and Sierra Leone making up most of those infected. Cases were also reported in the United States, Germany, Spain, Norway, France and the UK.

In this case, patient zero was a two-year-old child in Guinea. And make no mistake: this was a big deal. The World Health Organisation said the rate of infection was unprecedented. Health officials in the United States warned that the virus would be the next HIV. The United States (this was under Obama) invested a heavy dose of cash into clinics and measures to stop the virus. Dozens of health care workers from around the world were also infected, and many died.

Australia remained free of infection, but instituted special security policies for any travellers from infected areas.

Eventually, it got under control. That is, until a few weeks ago.

The 2018 Outbreak

It’s in the Democratic Republic of Congo, and it’s at an important hinge point. A visitor to the village of Ikoko-Impenge was given a ritual burial when he suddenly passed away. The priest gave the corpse its last food and drink. A few days later, the priest and most of his family were dead.

The virus spread within the rain forest to bigger towns, eventually finding its way to Mbandaka – a regional hub of over a million people at the confluence of two rivers. It’s only a couple of hours away from an airport. That’s where it is now. As of Friday, there’s been 37 cases confirmed. Around 25 have died.

The Congolese government and the World Health Organisation have launched a gargantuan effort to contain the outbreak. They’ve launched the use of an experimental vaccine. At the moment, the vaccine is only going out to those who have come into contact with a sick person. But there are basic logistic problems. Congo is a country that has been largely ravaged by violence and problems since it gained independence from Belgium in 1960. Electricity is an issue in remote areas. The vaccine needs to be kept cold.

The World Health Organisation hasn’t called it an emergency…yet. There are no restrictions on trade or travel. But the list of precautions is long, including issuing  Congolese airport security staff with thermometers guns to take travellers temperatures from a safe distance.

Administering the vaccine is also tricky. Because it is unlicensed, recipients must sign a consent form before they are vaccinated. This can require persuasion. From The Washington Post: 

“The lesson from West Africa is this: The concept of a vaccine is not something that someone in rural Guinea or Congo will understand in just two minutes,” said Fatoumata Battouly Diallo, 31, the team leader of the Guinean vaccinators.

The outbreak made headlines last week when it was reported that two infected patients had broken out of a hospital and run free. They were found dead a day later.

Those in charge of containing the outbreak are still living with the memory of the 2014 disaster fresh in their minds. They point to Mbandaka’s relative poverty as a potential advantage. Where response to the outbreak in 2014 was too slow, it also found a grip in more urban, wealthier cities with greater speed. In this part of the Congo, travel is infrequent and difficult – the residents are generally unable to travel because of lack of funds, and navigating the African rainforest is no easy task. Overall, commentary is very cautiously optimistic.

Slow News Weekly is taking a very rare break next week, but we’ll keep you up to date with the Ebola outbreak as it progresses (or, hopefully, doesn’t).

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Photo at the top thanks to the New York Times. It shows health workers praying before the start of their shift in the last Ebola outbreak. It is taken by Daniel Berehulak who won a Pulitzer for his work. You can see more of his harrowing photos here.

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