- The Washington Times - Thursday, May 17, 2018

Officials have discovered a case of the deadly Ebola virus in a port city of 1 million people in the Democratic Republic of Congo, sparking fears Thursday the latest outbreak has broken out of the remote rural areas where it started and could spiral out of control.

The World Health Organization said it was alarmed by the spread of the disease from territory around Bikoro, a remote area that’s difficult to reach, to the urban center of Mbandaka — roughly 80 miles away. It dispatched 30 experts to the city to assist local officials in tracking cases and trying to prevent transmission.

“This is a major, major game-changer in the outbreak,” Dr. Peter Salama, the WHO’s deputy director-general of emergency preparedness and response, warned. “…We have urban Ebola, which is a very different animal from rural Ebola. The potential for an explosive increase in cases is now there.”

Officials’ fears are based on recent memory.

The West African outbreak that killed more than 11,000 people from 2013 to 2016 was so severe because it swept through major cities in Guinea, Liberia and Sierra Leone.

The disease started out in rural Guinea, but its jump to urban areas was followed by a “cascade of new cases,” according to David Wohl, a professor at the Institute of Global Health and Infectious Diseases within the University of North Carolina, Chapel Hill.

“Hopefully, in the coming days and weeks, history will not repeat itself,” he said. “But we will see.”

Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, said the risk is heightened in cities for two reasons — contagious persons will have far more human contacts, allowing the disease to spread, and it is more difficult to identify and isolate infected persons in crowded areas.

Mbandaka is located at the confluence of the Congo and Ruki rivers, raising fears that Ebola will spread further along trade routes.

“One can imagine that the spread of Ebola in the DRC from the fairly remote area in which it was first detected to this larger city may have been facilitated by the river. The Congo River runs right past both,” Dr. Wohl said.

Ebola is a serious illness that is transmitted to people from wild animals and spreads from human to human through the bodily fluids of people who exhibit symptoms. About half of those who contract Ebola die from it. This is the ninth Ebola outbreak recorded in the Congo since 1976, when the disease was discovered there.

So far, 44 confirmed or suspected cases have been reported in the latest outbreak — only three have been verified in a lab — and more than 20 people have died.

The outbreak comes as the Trump administration has proposed clawing back about $250 million in leftover Ebola money from a multi-billion-dollar package that Congress approved during the height of the West African outbreak in 2015. The request is part of a sweeping “rescission” package that would cut $15 billion in overall spending.

Democrats say it would be foolish to swipe Ebola dollars in light of the most recent outbreak.

“Cutting these vital funds — especially with a new Ebola outbreak on the horizon — is shortsighted and puts American lives in danger,” said Rep. Ami Bera, California Democrat and member of the House Foreign Affairs Committee.

WHO Director-General Tedros Adhanom Ghebreyesus said while the expanding Congo outbreak is concerning, “we now have better tools than ever before to combat Ebola.”

About 4,300 doses of a trial Ebola vaccine arrived in the capital city of Kinshasa on Wednesday.

The vaccine, known as rVSV-ZEBOV and developed by Merck, proved effective in Guinea during the West African outbreak.

“The use of the vaccine has the ability to impact the trajectory of cases and could be a powerful tool,” Dr. Adalja said. “Also, public health authorities are much more attuned to the need to extinguish Ebola outbreaks than pre-2014.”


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