How worried should we be about the spread of the Ebola virus?
The Ebola epidemic in the Democratic Republic of Congo is spreading unseen. How worried should we be?
Until a few days ago, the world's attention was focused on the Hantavirus . Now, the Ebola virus seems to be taking over , and in its worst form.
The World Health Organization has declared the Ebola epidemic caused by the Bundibugyo virus in the Democratic Republic of the Congo and Uganda a public health emergency of international concern .
However, he stresses that the criteria for a pandemic are not met, although it is a cause for serious concern. In the Democratic Republic of Congo, 336 suspected cases and 88 deaths have been recorded.
The Africa Centers for Disease Control and Prevention has convened an emergency meeting with authorities in the Democratic Republic of Congo, Uganda, South Sudan and international partners to step up cross-border surveillance and strengthen efforts to address the problem.
Before we panic, though, let's start things (coolly) from the beginning.
What is the Ebola virus?
Ebola remains frequently fatal, despite recently developed treatments and vaccines. Since 1976, when the first cases were identified in what was then Zaire, now the Democratic Republic of Congo, it has killed at least 15,000 people in Africa.
The virus is transmitted through bodily fluids and the main symptoms of the disease are fever, bleeding and diarrhea.
The virus has been spreading undetected for weeks in a region ravaged by civil war, making it difficult to contain. It is the rare form of Bundibugyo, which has a high mortality rate , between a third and a half of people infected.
According to the WHO, the risk to the rest of the world remains low. Even during the major outbreak of 2014-2016, there were only three cases in the UK, all of which were health workers who had volunteered to help.
"The situation is complex enough to require international coordination ," says Dr. Amanda Rozek from the Pandemic Sciences Institute at the University of Oxford.
The rare form of Bundibugyo and its challenges
The current outbreak is caused by the rare Bundibugyo strain , one of three known to cause epidemics, but relatively unknown. It had previously caused only two small outbreaks, in 2007 and 2012, killing 30%-50% of people infected.
Bundibugyo poses serious problems. There are no approved vaccines or drugs for this form , and diagnostic tests often fail to confirm infection.
Its treatment is based on supportive care, pain management, infection management, hydration, and nutrition. Early care significantly increases the chances of survival.
Symptoms appear two to 21 days after infection , initially similar to those of the flu, with fever, headache and fatigue, and progress to vomiting, diarrhea, organ dysfunction and bleeding.
Transmission occurs through contaminated bodily fluids, mainly blood and vomit, but usually only after symptoms appear.
The delay in detection and the difficulties of the area
The first known case was recorded on April 24, and it took three weeks for the outbreak to be confirmed . The delayed detection means health authorities are behind on the need to control the spread.
The WHO warns that this could lead to a “much larger epidemic than is currently being recorded.”
Rapid identification of those infected and their potential contacts is the key to the response, as is preventing the spread of the virus in hospitals and care facilities. Safe burial of the deceased is also critical, as the body remains infectious.
The situation is complicated by the large number of people already infected and the fact that the outbreak is taking place in areas affected by armed conflict, with over 250,000 displaced people. These areas include mines with mobile and transient populations, which increases the risk of spread.
Despite the difficulties, Congo has extensive experience in dealing with Ebola and the response today is "significantly stronger than a decade ago", according to Dr Daniela Mano from the London School of Hygiene & Tropical Medicine, who spoke to the BBC .
The outcome of the epidemic will be judged by the speed and effectiveness of the current intervention.
