Ebola virus outbreak: Why is WHO finding it hard to contain this wave?

The Ebola outbreak in Africa has not been a new phenomenon and the life-threatening virus strains have caused some outbreaks in the past — but this one hits differently.

Reportedly, there are over 1,000 suspected cases in the Democratic Republic of Congo and nearly 220 deaths. 

Also, the cross border contamination has resulted in Uganda confirming 7 cases and one death.

“We are urgently scaling up operations, but at the moment, the epidemic is outpacing us,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus.

On May 17, the WHO declared the current outbreak in Democratic Republic of Congo a public health emergency of international concern.

If Ebola is not entirely new to the African population — what has caused WHO to seek global support?

The answer lies in both the strain of the virus causing the disease and the unique challenges of its epicenter.

The newer strain

There are multiple strains of the Orthoebolavirus which cause Ebola sickness in the infected population.

As per the Centers for Disease Control and Prevention (CDC), Zaire or Ebola strain, Sudan strain and Bundibugyo virus have caused outbreaks in Africa.

The current outbreak of the infection has been driven by the Bundibugyo strain, a newly identified member of the virus family, causing sickness in western Uganda (2007).

As per the Harvard School of Public Health, the Zaire strain which has a high fatality range between 60 percent to 90 percent had caused an outbreak in 2014-16, with more than 28,600 cases reported. However, it has a viable vaccine to prevent its spread.

While Bundibugyo virus has a comparatively lesser mortality rate between 25 percent to 50 percent, it continues to worry the authorities because there is no vaccine or treatment for the infection caused by it apart from the supportive care. 

As per CDC, this is the third largest outbreak caused by this strain, earlier two were concentrated in the DRC region and the border regions between DRC and Uganda.

The problematic epicenter

The viral disease has its epicenter in Ituri province, the region located in the top-eastern corner of the DRC.

Immediately south to Ituri lies the North Kivu province, sharing an extensive border with Uganda and Rwanda.

And immediate south to North Kivu is the South Kivu, all three geographical regions having highly fertile volcanic soils, a massive pool of natural resources and serve as crucial trade routes.

While Ituri remains the primary hotspot for the current wave of Ebola outbreak, cases have reached up to North Kivu and South Kivu.

As per experts, population movement and trading have been the major cause of disease spread.

To add another layer, the outbreak sowed its seeds in a conflicted region threatened by cross border tensions, international interference and fast movement of people across the porous boundaries.

Multiple armed forces have constantly competed with the central authorities to have power over the region and to win an easy access to the rich mineral reserves.

As per WHO, the disease spillover from animal to human has been thought to first emerge in Mongbwalu, a prominent gold mining town in the Ituri province. Likewise, another town, Bunia, is also a major commercial hub and invites trading movements.

Reportedly, a combination of human, environmental and genetic forces have made this outbreak difficult to contain.

There are no specific diagnostic methods to detect the virus which can delay its diagnosis and also in absence of a treatment, supportive care is the only way out.

While earlier the outbreaks were limited to rural regions, the growing urbanisation is increasing interaction between the humans and the rich wildlife in the region.