Ebola Outbreak Reaches a City, Prompting Use of an Experimental Vaccine

Although the World Health Organization (WHO) is not labeling the latest Ebola outbreak in the Democratic Republic of Congo an “international emergency” just yet, the agency raised concerns that because this outbreak has reached a city, it could be much more difficult to control. Responding to the “high risk” outbreak, the WHO plans to implement an experimental new vaccine.

The WHO called an emergency meeting on Friday after the outbreak was confirmed in the Democratic Republic of Congo ten days ago. DRC Health Minister Oly Ilunga Kalenga said the virus was discovered in Mbandaka, a city with a population of one million people. Whereas past outbreaks of the rare but deadly virus have mostly existed in remote areas in the countryside, Mbandaka is a major transportation hub with routes to Kinshasa, the capital city with a population of 10 million.

“This is a major development in the outbreak,” Senior WHO official Peter Salama told the BBC on Thursday. “We have urban Ebola, which is a very different animal from rural Ebola. The potential for an explosive increase in cases is now there.”

In an attempt to control the outbreak before it spreads further in metropolitan areas, the WHO is seeking government approval to inject people using the experimental vaccine ZMapp, which is comprised of three three chimeric monoclonal antibodies that are still under development. Officials have never attempted to use this vaccine to prevent an outbreak, but the WHO argues that implementing the vaccination is crucial if the virus has already reached a city.

Doses of the experimental drug first began to arrive in the country on Wednesday and vaccinations could begin as soon as Sunday. Pending government approval, the first phase of the vaccination program will include a range of 8,000 to 10,000 people in Mbandaka. The inoculation program will be complex since ZMapp is an infusion that takes several hours.

Responding to the potential crisis, the International Organization for Migration plans to deploy teams of medical staff on Saturday to report to 16 points of entry along the DRC’s borders. While not yet an “international emergency,” this robust border control strategy and WHO’s insistence on implementing an experimental vaccine right away suggests the agency is desperate to keep the unusual outbreak contained.