The Bundibugyo Ebola outbreak, first detected in early May, has spread across the eastern provinces of Ituri, North Kivu and South Kivu in the Democratic Republic of Congo and crossed into Uganda. There are concerns it could extend into South Sudan. By 25 June the DRC had recorded more than 1,200 confirmed cases and 321 deaths; Uganda had 20 confirmed cases and two deaths. Bundibugyo was first identified in 2007 in Uganda and produced a major outbreak in the DRC in 2012 in Isiro. The strain typically causes a less severe illness than the Zaire strain and often shows more subtle bleeding, which delayed detection; its fatality rate is around 30–40 per cent.
There is currently no licensed vaccine or specific cure for Bundibugyo. The World Health Organization has formed a group to test existing molecules in the field. The DRC’s National Institute of Biomedical Research (INRB), whose director Jean-Jacques Muyembe co-discovered Ebola in 1976, helped develop the monoclonal antibody Ebanga (mAb114) for Ebola Zaire and will work with an American team to try to develop a monoclonal antibody against Bundibugyo. Such research may aid future epidemics even if it does not halt the present one.
Immediate control relies on proven public health measures: rapid case identification, isolation of the sick, active community case-finding, protection of healthcare workers with gloves and protective clothing, and dignified safe burials. Teams also face major security and logistical problems when they travel from Kinshasa to remote villages such as Mongbwalu; in 2018 the WHO rented more than 500 vehicles and used armoured cars at very high cost. Funding is tighter now, with the government providing significant sums while some US funding was cut; WHO, Africa CDC, UNICEF, MSF and ALIMA are active partners. Muyembe has urged careful use of funds and better organisation and has called for using outbreaks to strengthen surveillance and health systems so future epidemics are detected and controlled more quickly. The Merck vaccine proved effective for Ebola Zaire in 2018, but its effect on Bundibugyo is unknown.
Difficult words
- outbreak — sudden increase of disease cases
- strain — a subtype of a virus or bacteria
- fatality rate — percentage of infected people who die
- monoclonal antibody — laboratory-made protein that targets a virus
- surveillance — ongoing monitoring to detect disease spread
- logistical — related to transport and practical organisation
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- How should limited funds be prioritised between immediate outbreak response and long-term health system strengthening? Give reasons.
- What are the benefits and limits of developing treatments like monoclonal antibodies during an outbreak?
- How could improved surveillance change the detection and control of future epidemics in remote areas?
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