Isolating suspected Ebola patients is one of the strategies used to prevent the spread of the Ebola virus. With the current outbreak in the Democratic Republic of the Congo, "ring vaccination" could go a long way in stopping the spread of the disease.
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The Democratic Republic of the Congo (DRC) is again under threat of an Ebola outbreak. Can vaccines really help to thwart Ebola?
Ebola outbreak in the Democratic Republic of the Congo
According to the World Health Organization (WHO), the first deaths recorded in the current outbreak of Ebola virus disease (EVD) in the Democratic Republic of the Congo It happened in January. Since then, the most recent data reveal a cumulative total of 58 cases of EVD including 27 deaths in the three health zones. Of the cases, 28 have been confirmed, but 21 are still likely and nine are suspected.
This is the ninth outbreak of EVD in the Democratic Republic of the Congo in the last 40 years, with the last outbreak last May, 2017. Various organizations such as WHO, Ministry of Health, the Ministry of Health of Guinea, Gavi, the Alliance of Vaccines, UNICEF and Doctors Without Borders are working together to address the outbreak.
Some of the lines of action prioritized in addressing the outbreak include community commitment, surveillance and tracking of contacts, prevention and control of infections, case management, vaccination, and safe and dignified burials for the deceased.
Vaccine against Ebola virus
The rVSV-ZEBOV has been shown to be an effective protection against EBV. It was found to be safe and protective against EVD after successful clinical trials involving more than 16,000 volunteers in Africa, the United States and Europe.
The vaccine consists of the vesicular stomatitis virus that has been genetically altered to also contain an Ebola Zaire protein. The vesicular stomatitis virus is an animal virus that can cause flu-like symptoms in humans and with the Zaire Ebola protein it can provide an immune response to the Zaire strain of the Ebola virus.
However, despite being 100 percent effective Ebola, the vaccine is still not technically approved and its effects are limited to the Zaire Ebola strain. That said, the WHO Strategic Advisory Group on Immunization recommended earlier that in the event of an outbreak of the Zabo Ebola strain before the vaccine is approved, it should be deployed immediately with informed consent and in accordance with good clinical practices.
"Ring vaccination" strategy for the outbreak of the Democratic Republic of the Congo
Due to the threat of a large-scale outbreak, vaccination is expected for Bikoro, Iboko and Mbandaka, the three locations where Ebola was confirmed by laboratory. However, the vaccine will not be widely distributed immediately. Instead, it will be administered using the "ring vaccination" strategy, in which individuals at increased risk of infection due to close connections or interactions with a patient should first be tracked and administered with the vaccine.
This "ring" does not generally mean a geographical circle, but rather a social network of people potentially at risk. This may include family members, neighbors, visitors or anyone who has been in contact with a sick person in the last 21 days, even if they live in a fairly distant location. Generally, such "rings" can be composed of up to 150 individuals.
This strategy of "ring vaccination" is very similar to the strategy used to eradicate smallpox . Along with other courses of action to prevent the spread of disease, vaccination can help control the outbreak in affected communities.
Participation in vaccination is completely voluntary, but children, as well as pregnant and lactating women will not be administered with the vaccine. Health care providers and front-line workers in the affected areas will also be vaccinated.
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