The Centers for Disease Control and Prevention (CDC) is mobilising a global response to an Ebola outbreak in Africa after a small number of Americans were exposed to the deadly virus. The agency confirmed on Sunday that an unspecified number of US citizens based in the Democratic Republic of the Congo (DRC) are believed to have been exposed to the Ebola virus during the country's latest outbreak.
The outbreak, caused by the rare Bundibugyo virus, has resulted in 10 confirmed cases, 336 suspected infections, and 88 deaths in the DRC. Additionally, there are two confirmed cases and one death in neighbouring Uganda.
In a news release on Sunday, the CDC stated: 'The Centers for Disease Control and Prevention (CDC) has mobilised response activities following confirmation of an Ebola outbreak in Ituri Province, Democratic Republic of the Congo (DRC) and cases in Uganda. Through existing relationships with the DRC and Uganda Ministries of Health, CDC was notified of the ongoing outbreak as soon as cases were confirmed and have been actively working to support needs.'
The agency emphasised that the risk to the American public remains low, with no confirmed or suspected cases of Ebola in the United States. 'Ebola virus spreads through direct contact with the bodily fluids of an infected person and does not spread through casual contact or air,' the CDC explained. 'CDC continues to closely monitor the situation and has systems in place to detect and respond rapidly to potential public health threats.'
On Monday, the agency announced enhanced screening and traveller monitoring for individuals arriving from areas affected by the Ebola outbreak. Non-US passport holders who have been in Uganda, the DRC, or South Sudan within the past 21 days will face restrictions. The CDC also plans to coordinate with airlines, international partners, and port-of-entry officials to identify and manage travellers who may have been exposed.
'CDC is also supporting interagency partners who are actively coordinating the safe withdrawal of a small number of Americans who are directly affected by this outbreak,' the agency added.
Travel Advisory and Precautions
The CDC has issued a Level 2 travel advisory for the DRC, urging travellers to 'practice enhanced precautions' while in the region. These measures include avoiding contact with individuals exhibiting symptoms such as fever, muscle pain, and rash, as well as steering clear of blood, other body fluids, or contaminated objects. Travellers should also avoid contact with bats, forest antelopes, primates, and their blood, fluids, or meat.
The agency advises travellers to monitor for Ebola symptoms for 21 days after leaving the DRC.
Historical Context and Current Strain
Ebola has been present in the DRC since 1976, with the current outbreak marking the country's 17th. Previous outbreaks in 2018 and 2020 in eastern Congo killed more than 1,000 people each. The largest Ebola outbreak occurred from 2014 to 2016 in West Africa, with over 28,600 cases reported.
The World Health Organization (WHO) has stated that the current outbreak does not meet the criteria for a pandemic emergency. However, countries sharing borders with the DRC, such as Uganda and Rwanda, face an increased risk of further spread.
The Bundibugyo virus strain responsible for this outbreak has no targeted treatments or vaccines. It has been implicated in only two previous outbreaks, in 2007 and 2012. The mortality rate for this strain ranges from 25 to 50 percent.
In contrast, the more common Zaire strain can be treated with the drugs Inmazeb and Ebanga, and prevented with the Ervebo vaccine, which is administered during outbreaks. 'Unfortunately, Bundibugyo has fewer proven countermeasures than Zaire ebolavirus, where vaccines have been highly effective in controlling outbreaks,' said Amanda Rojek, Associate Professor of Health Emergencies at the University of Oxford's Pandemic Sciences Institute.
Symptoms and Transmission
Ebola spreads through direct contact with the blood or body fluids of an infected person, as well as contact with contaminated objects or infected animals such as bats or primates. Symptoms include fever, headache, muscle pain and weakness, diarrhoea, vomiting, abdominal pain, and unexplained bleeding or bruising. Ebola can cause severe disease, with a mortality rate as high as 90 percent without treatment.
The WHO reported that the first known suspected case, a health worker in the DRC, developed symptoms on April 24. Two infected individuals from the DRC travelled separately to Kampala, Uganda's capital, where one died. The WHO indicated there is no evidence of ongoing transmission in Uganda.
