DRC Ebola outbreak 'way bigger that what we see now', virologist says • FRANCE 24 English

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[00:00:02]This is apppropo. Medical personnel are tonight rushing to the front lines of a fresh Ebola outbreak in Eastern Democratic Republic of Congo, where the late detection and quick spread of the virus are alarming health experts. At least 100 deaths have been reported with hundreds more cases suspected. An American missionary is among those who've tested positive for the virus.

[00:00:26]August Hackinson has the latest.

[00:00:30]The Democratic Republic of the Congo is sounding the alarm. The strain of the Ebola virus currently circulating has already caused nearly 100 deaths and health officials say there is currently no vaccine specifically targeting this strain.

[00:00:47]>> We know that hospitals are already under pressure due to the number of patients.

[00:00:51]I'd like to inform the public that we currently have 59 patients who are receiving active care. However, we're preparing to set up treatment centers of the three sites in order to expand our capacity.

[00:01:05]At Bunia Airport, the World Health Organization delivered emergency medical supplies and protective equipment.

[00:01:12]This equipment certainly won't be enough. What we've done is just the first step. We've depleted our stock in Kinshasa and brought it here.

[00:01:22]The resurgence of Ebola in the Ituri province which borders Uganda was one of the main topics at the 79th World Health Assembly in Geneva.

[00:01:33]>> Yesterday I declared a public health emergency of the international concern over over the Ebola outbreak in the Democratic Republic of the Congo that has already spread to Uganda. We live in difficult and dangerous and divisive times.

[00:01:51]>> Ebola causes a highly contagious hemorrhagic fever. The virus has killed more than 15,000 people across Africa over the past 50 years. Around 350 suspected cases have been reported in the DRC. Most patients are between 20 and 39 years old and 60% are women.

[00:02:13]The current strain of the virus is known as the bundio variant which has already caused two previous outbreaks in Uganda in 2007 and in the DRC in 2012.

[00:02:26]>> Well, for more we're joined now by Muhammad Munir, professor in verology at Lancaster University. Thanks so much for being with us on the program. Professor, firstly tell us a little bit more about this particular strain of Ebola. What are the symptoms? How contagious is it?

[00:02:45]>> Well, um if we look onto Ebola viruses, there are at least five different types of Ebola viruses. One of them is called bundio virus. This is relatively uncommon, rare. Only two times have caused outbreak before. But almost all of the Ebola viruses, they start with fever, um muscle ache, um vomiting, diarrhea, which are a very common symptom for many of the diseases. But in particular case of the Ebola virus when the disease progress um the end result is that majority of the openings of the body like ear nose mouth start bleeding and that is a very pthogonic which is a very characteristic uh feature of the Ebola viruses and that is the time when majority of the people who are either in the diseased uh person's funeral or in the healthcare setting uh of the dis of this diseased person or the sickened person treating them catch the infection. So mainly the virus spread through the bodily fluid such as uh semen uh saliva or the blood uh or the vomit when it comes out of the deceased or uh the sick person.

[00:03:54]>> And do we know if this strain of the disease is more dangerous and and how do you treat it if there's no vaccine and there isn't really any drug treatment specifically for it either?

[00:04:05]>> That's very important question. Um so basically if we look on to the previous outbreaks of this particular strain of the Ebola virus called bundi bongio there have been only two outbreaks and based on that one it is less pathogenic compared to the two most common Ebola strains which are zed and sudon ebola viruses around 27% people who have been infected with bundio they have died but bundugio uh strain of the ebola virus only share 60% of the genetics uh commonalities with the zire and the sudon ebola viruses which were very common. So majority of the vaccine the treatment and the test to detect the infection for common type of uh ebola viruses are unfortunately not sufficient to detect to treat to vaccinate against bundio viruses >> and why do you think there was this initial delay in detecting the presence of Ebola here? It's believed that the virus might have been circulating for weeks before it was first detected back in April.

[00:05:07]Absolutely. I think there are two main reasons. Number one reason is that the initial symptoms of the Ebola viruses are the same for any infection. So those can go unnoticed quite clearly and majority of the people in that part of the world they first go into the you know the witchcrafts or some of the prayer uh areas and get the treatment from there until they really notify to the uh health authorities when the situation is already very aggravated.

[00:05:31]And number two is that the tests that initially were deployed for this strain of the Ebola virus were not really meant for this strain of Ebola virus. So therefore those were tested negative which were actually positive. So it only came to know when they started sequencing the strain and then they identified that it is a bulbio virus. So therefore overall the delay had led to spruing of the infections uh under the carpet and now I think there are a lot more cases that have uh already been identified. Yeah, I was going to ask you as well if it took so long relatively speaking to detect the virus, can we be sure really how break the how big the current outbreak outbreak might actually be and how many contact cases there could be potentially as well.

[00:06:18]>> Absolutely. This is also a very important question and we don't really know yet what is the scale of the outbreak but we do know is that the scale of the outbreak is way bigger than and larger than what we are having now and that is the reason world health organization decided um as a public health emergency of international concern and you can imagine also by the fact that people who were traveling from DRC into Uganda Kala for example is around 1,200 kilometer away from uh Aishuri where the the hub of this outbreak has and and those people one of them has unfortunately died and then the spread is gone beyond uh Uganda in in in for example Rwanda is another target uh for this outbreak. So more of the uh uncontrolled and poorest border are open more chances for this virus to spread unfortunately.

[00:07:06]>> And another risk factor obviously the the violence in the region how hard do you think it's going to be to get help to where it's most needed armed conflict also general distrust are said to be hampering containment efforts generally.

[00:07:23]>> Absolutely. And I think this is probably the most important aspect for controlling Ebola virus. And as we all know that the Ebola virus uh outbreak in DRC and a broader context of the Africa is not a new thing. I mean we have had at least 40 different outbreaks of the Ebola viruses since its first identification back in 1976 and out of those 17 has been in DRC and there are several reasons for that. One of the major reason is that the bat population which is the reservoir which is the carrier of the Ebola viruses they are very common in the DRC and and part of the central Africa throughout the length of that as well and then other aspect is that the bo borders are porous overall health infrastructure is quite uh poor and other than that is the political instability um all of these factor are precipitating and unfortunately would have a negative impact onto the um outbreak moving forward And professor, as well, we're hearing that a funeral procession has been linked to the outbreak. Local authorities there are saying as well that people seemingly believed the disease was a mystical illness and that there had been rumors that the area that it was initially spreading in was cursed. So, what kind of a role do you think public health campaigns need to play here in providing information about how diseases as dangerous and potentially deadly as Ebola can spread?

[00:08:47]Absolutely. And not only in this particular outbreak, in the previous outbreaks as well, the majority of the cases are either in and around funeral um family contacts and in the ceremonies where you know body is either being prepared for the funeral and in the hospital setting where you know doctors are and healthcare professional are very close to the the infected person. And then this is the critical bit because for this particular strain of the um uh Ebola virus we don't have much options.

[00:09:18]We don't have treatments. We don't have vaccines and some of the tests are also not the perfect tests. So we only left with very few option and those are we call non-farmaceutical options by which I mean is that the contract tracing the isolation proper awareness with within the community who to report to at the first instance and making sure the people who are showing clinical sign even if those are early clinical sign they are properly documented and reported so that the spread within the community can be minimized >> and do you think the this outbreak will be quickly contained difficult to say of course when So many questions remain.

[00:09:55]But is it likely, professor, do you think that there is a chance that it might spiral into a a repeat of what we saw here just over a decade ago?

[00:10:05]>> Well, it is less likely that it would become a covid like pandemic for one particular reason is that the more deadlier the disease is, harder it is for to spread. For example, person who would be uh terminally infected with the uh covid uh sorry with the with the ebola virus is going to be complete contrast to the co person start showing so characteristic clinical sign like blood oozing out of all the opening of the person unfortunately that person is not going to make it longer but that also mean the spread would be relatively harder compared to covid or measles infection so I'm not seeing this one as it become a global pandemic but what I can see is that within the um DRC the neighboring countries and East Africa is going to certainly be a problem.

[00:10:49]>> Okay, we'll have to leave it there for now. Professor, thanks so much for being with us though on the program this evening. That is Muhammad Munir, professor in verology at the UK based Lancaster University.