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Experimental Ebola vaccinations begin in Congo

Health workers in Congo began administering an experimental Ebola vaccine to medical staff in the northwestern city of Mbandaka on Monday to tackle an outbreak of the virus believed to have killed 26 people since early April.

The World Health Organization (WHO) hailed the vaccinations as a "paradigm shift" in how to fight the disease, which killed more than 11,300 people in a West African epidemic between 2013 and 2016.

The WHO is sending over 7,540 doses to the central African country, 540 of which have been earmarked for Mbandaka, a city of about 1.5 million where four Ebola cases have been confirmed.

In a ceremony attended by Health Minister Oly Ilunga Kalenga, health workers in blue overalls and rubber gloves administered the vaccine developed by U.S. drug company Merck, marking the start of a complex effort to contain the virus before it gets out of control.

The other vaccines will be given to medical staff later on Monday at a nearby hospital. People who had contact with Ebola victims will come later.

"This is a new phase in our response, another pillar in the fight. We must continue the monitoring of contacts," Ilunga said.

The shot is designed for use in so-called ring vaccination plans. When a new Ebola case is diagnosed, all people who might have been in recent contact with the patient are traced and vaccinated to keep the disease from spreading.

"It's the first time in the midst of an outbreak … that we're using this as a way to stem transmission," WHO's Peter Salama said in a telephone interview. "It's an important moment that changes the way we've seen Ebola for 40 years."

Congolese Health Ministry officials arrange the first batch of experimental Ebola vaccines in Kinshasa. 'It's the first time in the midst of an outbreak … that we're using this as a way to stem transmission,' a WHO official said. (Kenny Katombe/Reuters)

The same strategy was used to test Merck's vaccine in Guinea in late 2015, toward the end of an Ebola outbreak in West Africa from 2013 to 2016. The trial results showed it was safe and gave very high levels of protection against Ebola.

Around 30 Guinean health workers who were directly involved in that 2015 vaccine trial have travelled to Congo and will help with the immunizations there, Salama said.

Ebola causes hemorrhagic fever, vomiting and diarrhea and spreads through contact with the bodily fluids of an infected person. More than 11,300 people died in the West Africa epidemic.

Stopping the outbreak

This latest outbreak has killed 26 people since early April, according to the WHO. It is Congo's ninth outbreak since the disease made its first known appearance near the country's Ebola river in the 1970s.

Cases in Mbandaka, a port city on the Congo River, have raised concern that the virus could spread downstream to the capital, Kinshasa, which has a population of 10 million.

Salama, who visited Congo after the Ebola outbreak was first reported on May 8, said up to 1,000 people — first in Mbandaka and then in Bikoro and other affected areas — could be vaccinated within the next week.

We're fine for vaccine supply; that's not an issue. The issue is going to be making sure we find every contact, track them down and get them vaccinated.- Peter Salama, WHO's head of emergency response

Some 7,300 doses are already in Congo, and hundreds of thousands more are available in a stockpile built up by Merck.

"If we need any more we can ship it within days," he said. "We're fine for vaccine supply; that's not an issue. The issue is going to be making sure we find every contact, track them down and get them vaccinated if they agree."

Congolese health ministry data show four cases of Ebola confirmed in Mbandaka's Wangata neighbourhood and two suspected cases. One patient has died. For every case, up to 150 contacts will be offered the vaccine.

Salama said he was particularly concerned about the "unknowns" of the outbreak — namely the potential numbers of cases in the village of Ikobo, where no roads go and even helicopters have trouble landing.

"I'm actually very worried about Ikobo because we have four new suspected cases there and it's very, very remote. We've tried to land helicopters there several times, but we need the community to clear the airstrip, and they haven't fully cleared it yet," Salama said.

"And when you haven't got people on the ground, it's very hard to assess the extent of the outbreak. I'm worried there are many more cases than we've been able to identify so far."

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