The Birth and Demise of Ebola?

Ebola Virus Disease (EVD) was first discovered in 1976 near the Ebola River in the Democratic Republic of Congo (DRC). Four decades later, the DRC grapples with the world’s second-largest Ebola epidemic in history.

The latest WHO report as of September 9, 2019, shows that 3084 Ebola cases, including 111 probable cases, have been identified since the outbreak was declared on August 1st, 2018. Sadly, 67% (2071 cases) of these patients succumbed to the deadly virus. To put the statistics in perspective, the number of reported Ebola cases in DRC over the past 40 years was 1097, and of these, 76% died. 

DRC which is located in Central Africa is the largest country in the Sub-Saharan region, second largest, and fourth most populous country in Africa. The country is surrounded by nine African countries. The Ebola outbreak is occurring in North Kivu, South Kivu and Ituri provinces of DRC, which are mainly bordered to Uganda, Burundi, Rwanda, and South Sudan. Due to proximity, these countries are at high risk of acquiring the epidemic.

Restraining the outbreak from spreading to the neighboring regions is a significant challenge in the fight. WHO reports that neighboring countries are taking necessary steps to contain the outbreak.

As of September 10, 2019, no confirmed EVD has been reported in neighboring countries except in Uganda. A 5-year-old child from DRC entered to Uganda with his family following a funeral of his grandfather who was a confirmed EVD case. The child died a day after EVD was confirmed in a hospital in Uganda, and two other members of the family died from EVD a day later. A month and a half later, another 9-year-old Congolese girl who entered Uganda seeking medical attention died from EVD.

Is EVD curable? Not yet. However, a multi-drug study for the treatment of EVD launched in November 2018 just a few months after Ebola outbreak in DRC shows promising efficacy.

The Pamoja Tulinde Maisha (PALM [together save lives]) study is a randomized, controlled trial of four experimental agents: ZMapp, remdesivir, mAb114, and REGN-EB3. The National Institute of Allergy and Infectious Diseases (NIAID), Co-sponsor of the PALM study, reported on August 12, 2019, that EVD patients who received either mAb114 or REGN-EB3 agents responded better compared to the rest in the study.

FDA has recently granted mAb114 a “Breakthrough Therapy” designation based on the interim results obtained from the PALM study.

If the study holds its promises, not only will DRC be the birthplace of Ebola but also the fortress of its demise.

Meanwhile, EVD cases are likely to rise in DRC and the risk of spread to neighboring regions remains high.

Mark Brown