Showing posts with label ebola virus disease. Show all posts
Showing posts with label ebola virus disease. Show all posts

Thursday, April 2, 2026

‘Our problem here is the #pig #Ebola’: local accounts of #epizootics preceding Ebola #outbreaks in north-eastern #DRC

 


Abstract

Introduction 

Despite their potential relevance for outbreak understanding, epizootic reports associated with Ebola scarcely appear in biomedical literature. This study examines local accounts of animal deaths preceding the 2012 and the 2017 Ebola outbreaks in the north-eastern Democratic Republic of the Congo (DRC).

Methods 

The analysis is based on retrospective interviews conducted with scientists deployed during these two Ebola outbreaks, as well as testimonies collected in 2022 and 2023 from local residents, clinicians and veterinarians. It also draws on local archives to examine how reports of animal deaths were framed and understood in light of a new epidemic situation.

Results 

Selective pressures that favour certain wild animal species, along with social practices such as bushmeat hunting, contribute to a narrowing of focus during outbreak investigations. This has contributed to overlooking some testimonies from marginalised local actors, which remain unpublished to this day. Animal death reports, however, need to be read in their social context. During the 2017 Ebola outbreak, local breeders framed their concerns about pig mortality into a question to be addressed by global health researchers—even though the deaths were not linked to Ebola but were likely caused by an unrelated pathogen, the African swine fever virus.

Conclusion 

Beyond their biological relevance, epizootics can offer insight into the social contexts in which epidemics are identified. These epizootics can shed light on local experiences of diseases, illustrating local priorities and sense-making processes.


Data availability statement

Data sharing is not applicable as no data sets were generated and/or analysed for this study.

DOI: https://doi.org/10.1136/medhum-2025-013586


Footnotes

Contributors: JV conceptualised the study, conducted the research and wrote the manuscript. JV is the guarantor.

Funding: The author received support from Sciences Po Medialab and IFAS (Institut Français d'Afrique du Sud) for fieldwork in the DRC in 2022 and 2023.

Competing interests: None declared.

Patient and public involvement: Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

Provenance and peer review: Not commissioned; externally peer reviewed.

Source: 


Link: https://mh.bmj.com/content/early/2026/04/01/medhum-2025-013586

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Tuesday, March 31, 2026

Confirming #ERVEBO #Vaccination to Support #Ebola Virus #Surveillance

 


Abstract

Accurate confirmation of Ebola vaccination (ERVEBO) is essential for interpreting serologic data and assessing vaccine coverage during Ebola virus (EBOV) outbreaks. Current GP1,2-based assays cannot reliably distinguish vaccine-induced immunity from responses generated by natural infection. We developed a multiplex Luminex assay incorporating EBOV GP1,2, secreted glycoprotein (sGP), and a modified vesicular stomatitis virus nucleoprotein (VSV-P-N), a vector antigen encoded by ERVEBO but absent from wild-type EBOV. By using samples from US vaccinees and controls and a small comparison set from the Democratic Republic of the Congo, we found sGP and VSV-P-N demonstrated 100% sensitivity and >97.6% specificity for identifying vaccinees. In samples collected after a ring vaccination campaign in Guinea, combined sGP and VSV-P-N positivity confirmed vaccination in 94.8% of persons with written and 90.8% of persons with verbal confirmation of vaccination history. Our findings show that sGP and VSV-P-N provide a reliable signature of ERVEBO vaccination and support improved Ebola surveillance.

Source: 


Link: https://wwwnc.cdc.gov/eid/article/32/4/25-1906_article

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Monday, March 23, 2026

Mapping #global emergence of #pathogens with #epidemic and #pandemic #potential to inform and accelerate pandemic #prevention, #preparedness, readiness and response

 


Abstract

Introduction 

Increasing occurrence of epidemics and pandemics and concurrent emergence of different pathogens calls for multi-sectoral, multi-pathogen preparedness actions. Data on various factors that drive emergence of diverse pathogens can inform evidence-based preparedness by identifying geographies at-risk. When leveraging evidence within a One Health approach, multiple pathogens can be addressed simultaneously, thereby strengthening countries pandemic preparedness efforts. 

Methods 

For seventeen priority pathogens (avian influenza viruses, zoonotic coronaviruses including COVID-19, hemorrhagic fever viruses including Ebola, Henipaviruses, and arboviruses including yellow fever and Zika), we identified global evidence on animal reservoirs, vectors, environmental suitability, and reported human cases. We discriminated geospatially recorded pathogen detections from a background sample and constructed maps using these datasets to generate an evidence-based assessment of emergence risk globally. 

Results 

Seventeen pathogen-specific assessments were combined into a global composite map. Sub-Saharan Africa and South Asia have evidence supporting emergence risk for the greatest number of pathogens (included areas at-risk of all pathogens) and scored highest when strength-of-evidence weightings were factored. The Americas had the lowest tally of considered pathogens. Environmental suitability analyses received the highest weights, reservoir ranges the lowest. 

Discussion 

Preparedness and readiness must consider the range of global biological threats. Our methodology is capable of incorporating changing evidence on emergence potential for multiple pathogens to identify geographies at higher risk with different pathogen combinations. Our maps can contribute to existing decision-support structures, guiding shared interventions and strategic allocation of resources for spillover prevention and pandemic preparedness, thereby enhancing local response capacities applying a multidisciplinary approach.


Competing Interest Statement

The authors have declared no competing interest.


Funding Statement

This work was concluded in 2024 and supported by the United States Agency for International Development (USAID) before January 22, 2025, the Germany Agency for International Cooperation (GIZ) and the Government of France.

Source: 


Link: https://www.medrxiv.org/content/10.64898/2026.03.20.26347940v1

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Wednesday, March 18, 2026

Limited durability of #improvements in #infection #prevention and control practices following reactive interventions leaves #healthcare facilities vulnerable to #Ebola virus transmission

 


Abstract

We assessed impact and durability of an infection prevention and control (IPC) bundle intervention during the Kivu/Ituri Ebolavirus outbreak (2018-2020). IPC scores increased initially, then declined 6 months post-intervention (median 19/36, 30/36, and 28/36, p<0.0001). Without sustained IPC practices, health facilities remain vulnerable to nosocomial transmission in future Ebolavirus outbreaks.

Source: 


Link: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciag192/8526630

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Friday, March 13, 2026

#Glycoprotein-specific transcriptional response contributes to differential #vaccine #protection against lethal #Ebola virus #infection

 


Abstract

Since the West African Ebola virus (EBOV) epidemic in 2014-2016, recurrent outbreaks of the EBOV-Makona variant have been driven by recrudescence and human-to-human transmission emphasizing the need for effective vaccination strategies. A live-attenuated recombinant vesicular stomatitis virus (VSV)-based vaccine expressing the EBOV-Kikwit variant glycoprotein (VSV-Kik) received FDA approval in December 2019 and provides complete, rapid protection against EBOV-Makona as early as 7 days post-vaccination (DPV). During the 2018-2020 Ebola outbreak, the VSV-Kik vaccine, known as ERVEBO, was administered to lower-risk individuals at a 5-fold dose reduction of the standard 2 × 107 PFU to provide broader population protection. Identification of a protective lower dose providing rapid protection would ease supply burdens during future outbreaks and enhance vaccine coverage. We previously generated a VSV-based vaccine expressing the glycoprotein of the Makona variant (VSV-Mak) which provided complete protection against homologous challenge 28 DPV at as low as 1 × 101 PFU. However, the transcriptional responses engendered by VSV-Mak and VSV-Kik vaccines in the context of early EBOV-Makona challenge have not yet been evaluated. In the current study, we compared transcriptional responses following a low dose (1 × 104 PFU) of lab-grade VSV-Mak or GMP-grade VSV-Kik and subsequent EBOV-Makona challenge 10 DPV. VSV-Kik provided complete protection against heterologous challenge and elicited rapid antiviral transcriptional changes followed by the activation of adaptive immunity. On the other hand, VSV-Mak only provided partial protection and induced minimal transcriptional response. These results highlight a glycoprotein-specific transcriptional response after vaccination despite the high EBOV variant homology.

Source: Vaccine, https://www.sciencedirect.com/journal/vaccine/vol/79/suppl/C

Link: https://www.sciencedirect.com/science/article/abs/pii/S0264410X26002185?via%3Dihub

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Wednesday, January 21, 2026

An #mRNA #vaccine encoding the #Ebola virus glycoprotein induces high neutralizing #antibody titers and provides strong protection against lethal infections in mouse models

 


Abstract

Ebola virus (EBOV) is the causative agent of Ebola disease (EBOD), a viral hemorrhagic fever with a notably high case fatality rate. Current treatments for EBOD are limited to monoclonal antibodies or two licensed viral vector vaccines, a recombinant vesicular stomatitis virus (rVSV)-vectored vaccine or an adenovirus and modified vaccinia Ankara regimen. However, comparisons of protection, efficacy, and durability with alternative nucleotide platforms remain understudied. Here, we evaluated the immunogenicity of an mRNA vaccine expressing the EBOV glycoprotein (GP) in parallel with rVSV- and DNA-based vaccine platforms. The mRNA EBOV-GP vaccine, formulated in lipid nanoparticles, elicited significantly higher levels of total IgG and neutralizing antibody titers compared to the rVSV-EBOV-GP vaccine. Linear antibody epitope analysis indicated a preference for targeting the mucin-like domain in EBOV-GP1 following rVSV-based vaccination, while the mRNA platform distinctly targeted the internal fusion loop of EBOV-GP2. After characterizing the immunogenicity of the mRNA vaccine, two models of EBOD were used to demonstrate its protective efficacy: a surrogate rVSV-based challenge model of EBOD using type-I interferon deficient C57BL/6 mice and infection of BALB/c mice with authentic mouse-adapted EBOV. In both studies, the EBOV mRNA vaccine fully protected the mouse cohorts against morbidity and mortality. Additionally, the EBOV mRNA vaccine produced greater neutralizing antibody titers compared to the DNA EBOV-GP vaccine. These results suggest that an mRNA vaccine expressing EBOV-GP can induce robust, functional humoral responses that are protective against EBOD, warranting further development as an alternative to, or as part of a vaccine strategy including, viral vectored vaccines.

Source: Frontiers in Immunology, https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2025.1682418/full

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Monday, December 1, 2025

#Ebola virus disease - #DRC: End of the Outbreak Declared (#WHO D.O.N., Dec. 1 '25)

 


{Summary}

Situation at a glance

On 1 December 2025, the Ministry of Health (MoH) of the Democratic Republic of the Congo (DRC) declared the end of the Ebola virus disease (EVD) outbreak which had been declared on 4 September 2025. 

The end was declared after two consecutive incubation periods (a total of 42 days) since the last person confirmed with EVD tested negative for the virus and was discharged on 19 October 2025. 

A total of 64 cases (53 confirmed, 11 probable), including 45 deaths (CFR 70.3%), were reported from six health areas in Bulape Health Zone, Kasai Province

WHO and partners provided technical, operational and financial support to the government to contain the outbreak. 

This is the country’s 16th outbreak of Ebola. 

Although the outbreak has been declared over, health authorities are maintaining surveillance to rapidly identify and respond to any re-emergence. 

Risk communication and community engagement activities will continue to provide accurate information, monitor and address community feedback and rumours, and support efforts to reduce stigma toward individuals affected by the outbreak.

(...)

Source: 


Link: https://www.who.int/emergencies/disease-outbreak-news/item/ebola-virus-disease---democratic-republic-of-the-congo

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Wednesday, November 26, 2025

Assessing #Ebola virus circulation in the Tshuapa province (#DRC): A #OneHealth #investigation of wildlife and #human interactions

 


Abstract

The wildlife reservoir and spillover mechanisms of Ebola virus remain elusive despite extensive research efforts in endemic areas. This study employed a One Health approach to examine the virus’ circulation in wildlife and the associated human exposure risks in the Tshuapa province of the Democratic Republic of the Congo. We screened 1049 samples from 919 animals, predominantly small mammals, collected in 2021, and 380 samples from inhabitants of Inkanamongo village, the site of an Ebola virus disease outbreak in 2014. These samples were screened for evidence of current (RNA) or past (IgG antibodies) Ebola virus infections. We also conducted interviews with 167 individuals in the surrounding districts to assess their interactions with wildlife. While no Ebola virus RNA was detected in the wildlife samples, anti-orthoebolavirus IgG antibodies were found in 13 bats and 38 rodents. Among the human participants, 120 individuals had IgG antibodies against at least 1 orthoebolavirus antigen, with 12 showing seropositivity for 2 antigens of the same orthoebolavirus, despite not having a prior Ebola disease diagnosis. Furthermore, the majority of respondents reported frequent visits to the forest to hunt a variety of wild animals, particularly ungulates and rodents, which could account for occasional viral spillovers. The absence of active Ebola virus circulation in wildlife may reflect seasonal patterns in reservoir ecology, as those observed in bats. Similarly, seasonal human activities, such as hunting and foraging, may result in periodic exposure risks. These findings highlight the importance of continuous, multidisciplinary surveillance to monitor changes in seasonal spillover risks.


Author summary

Since its discovery in 1976 in the Democratic Republic of Congo (DRC), Ebola virus (EBOV) has caused more than 20 outbreaks in humans, with fatality rates as high as 90%. While the virus is believed to have an animal origin, naturalist reservoir and the mechanisms of transmission to humans remain poorly understood. Gaining insight into which species may harbour the virus and how transmission occurs is essential to predict and prevent future outbreaks. In this study, we investigate EBOV exposure in wildlife and humans in a region of the DRC with a documented history of outbreaks. Although we did not detect active infection in animals, we found serological evidence of prior exposure in several bat and rodent species, as well as among local residents. Interviews with community members revealed frequent contact with wildlife through hunting and handling, practices that could elevate the risk of animal-to-human transmission. These findings offer new clues about possible EBOV reservoirs and highlight the role of human behaviours in facilitating facilitate spillover events. Our results underscore the need for continued, integrated surveillance to improve understanding of Ebola virus ecology and to help reduce the risk of future Ebola outbreaks in endemic regions.

Source: 


Link: https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1013628

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Friday, November 7, 2025

Simultaneous #outbreaks of #Ebola, #cholera, #mpox, and #measles in #DRC in 2025

 


{Excerpt}

On Sept 4, 2025, the DR Congo Government and Ministry of Health announced a new Ebola virus disease outbreak in the Bulape health zone (Kasai province), marking the end of over 15 years without any reported cases of Ebola virus disease in this region. As of Sept 14, 2025, there were 35 confirmed Ebola virus disease cases and 16 deaths, representing a case fatality rate of 45·7%.1,2 This unexpected resurgence in a region with insufficient preparedness capacity raises serious concerns about potential regional spread, including towards neighbouring Angola.

At the same time, DR Congo is experiencing one of the most severe cholera outbreaks of the past decade, with a total of 48 139 cases and 1443 deaths reported between Jan 1 and Aug 24, 2025, resulting in a case fatality rate of 3%.3 By epidemiological week 33, high case fatality rates were reported in the provinces of Kwilu (76 cases, 26 deaths; 44%), Sankuru (42 cases, 6 deaths; 14%), and Equateur (224 cases, 19 deaths; 8%).3

DR Congo also continues to be the global epicentre of mpox. Between Jan 1 and Sept 14, 2025, DR Congo has reported 16 879 confirmed mpox cases and 43 deaths.4 Response efforts have been challenged by factors such as persistent endemic conditions, gaps in surveillance, and poor access to vaccines.

(...)

Source: The Lancet, https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02100-2/fulltext?rss=yes

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Wednesday, October 1, 2025

#Ebola Virus Disease in the #DRC - External #Situation #Report 03 - September 28 '25 (#WHO, summary)

 


Date of issue: 30 September 2025

Data as reported by: 28 September 2025


{Summary}

The Ebola virus disease outbreak in the Democratic Republic of the Congo continues, with signs of a notable decline in transmission

Since our last update (Situation Report #2), a total of seven new cases have been reported, comprising six confirmed and one probable cases (retrospectively validated). 

The new cases were detected across three health areas within Bulape Health Zone, namely, Bulape (n=4), Mpianga (n=2), and Dikolo (n=1). 

During the same reporting period, seven deaths occurred among newly identified and previously hospitalized cases. The reported deaths were distributed across Dikolo (n=3), Bulape (n=2), Mpianga (n=1), and Bulape Communitaire (n=1) health areas.

As of 28 September 2025, a total of 64 cases (53 confirmed and 11 probable), including 42 deaths (31 confirmed, 11 probable), have been reported from Bulape Health Zone, Kasai Province, Democratic Republic of the Congo. 

The overall case fatality ratio (CFR) is 65.6%. 

Cumulatively, five confirmed cases have been reported among healthcare workers, including three deaths. 

The outbreak remains confined to six affected health areas out of the 21 that make up Bulape Health Zone.

Cases to date range in age from 0 (newborn) to 65 years

Since the onset of the outbreak, the majority of cases have been reported among females (57.8%, n=37), children aged 0–9 years (25.0%, n=16), and individuals aged 20–29 years (23.4%, n=15). 

Mortality has also been concentrated among these groups, with females accounting for over half of the reported deaths (57.1%, n=24) and children under 10 years representing 31.0% of deaths (n=13). 

The CFR is slightly higher among males (66.7%) compared to females (64.9%). 

In the past two weeks, fewer cases (n = 2) have been reported among children (0-9 years old). 

A decreasing CFR trend has been observed over time with improvement in surveillance (early case detection and isolation) and the quality of case management (prompt and high-quality treatment).

As of 28 September 2025, a total of 1 787 contacts were under follow-up, with 1 735 (97.1%) seen in the last 24 hours. 

Nine (9) cases were successfully treated and discharged following recovery while 13 are currently in treatment as of 28 September 2025.

(...)

Source: ReliefWeb, https://reliefweb.int/attachments/de19e29d-1f89-4ad2-a086-e9afcdce91cc/DRC_EVD_External_Sitrep_28Sept2025.pdf

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Friday, September 19, 2025

RAPID #RISK #ASSESSMENT: #EBOLA VIRUS DISEASE, DRC (#WHO, September 19 '25)

 


{Summary}

Overall risk and confidence

Overall risk

-- National: High 

-- Regional: Moderate   

-- Global: Low   

Confidence in available information 

-- National: Moderate

-- Regional: Moderate

-- Global: Moderate


Risk statement

On 1 September 2025, WHO received an alert from the Ministry of Health of the Democratic Republic of the Congo (DRC) regarding suspected cases of Ebola virus disease (EVD) in the Bulape Health Zone, Kasai Province, DRC. 

The first currently known suspected EVD case was admitted to the Bulape General Reference Hospital on 20 August 2025 and reported to have died five days later (25 August 2025).

This is a 34-year-old female patient with a 34-week gestational age who presented with fever, bloody diarrhoea, followed by anal, oral, and nasal haemorrhage, vomiting, and asthenia

She reportedly died on 25 August 2025, with a clinical picture of multiple organ failure. 

Two of the contacts of this first case (a midwife and a laboratory technician) also developed similar symptoms and died a few days later.  

As of 4 September 2025, a total of 28 suspected cases, including 15 deaths (case fatality ratio: 54 %) had been reported from the Bulape health zone (Bulape, Bulape COM and Dikolo) and Mweka health zone. 

Among deaths, four are health care workers.  

In addition, 20% of the suspected cases are aged under 15 years

Five blood samples and one swab were collected from six suspected cases from the three health areas and arrived today at the National Public Health Laboratory (INRB) in Kinshasa for confirmation testing.

A crisis committee has been activated at the local and provincial levels, risk communication and active surveillance activities are underway, all cases are isolated, Infection Prevention and Control (IPC) measures are being implemented, isolation and contact tracing are underway, and patients are receiving intravenous medications, including ceftriaxone and metronidazole

The INRB confirmed Ebola virus (EBOV), Orthoebolavirus zairense species was detected through RTPCR assays, including GeneXpert, on 3 September.    

At national level, the risk is considered high due to:  

Information gaps on the cases, including the first case, particularly: 

-- the date of symptom onset, 

-- their therapeutic itinerary, 

-- the potential number of contacts within the community, and 

-- epidemiological links between cases does not allow an assessment as to the extent of the outbreak. Similar alerts have been reported from this location/region in the past few months.  

Most of the cases recorded so far in this health zone live in the Health Areas with a high population density and mobility. This could accelerate disease transmission within the community.  

The last EVD outbreak in this health zone, Bulape, was in 2007, 18 years later, the capacities required for the response to a potential EVD outbreak may not exist.  

So far, in addition to Bulape health zone, the epicentre of the outbreak, suspected cases are being reported in the neighbouring district of Mweka showing a potential geographic extension of the outbreak.   

Bulape has a large market every Friday, attracting people from the surrounding villages. The city of Mweka borders a health district in the province of Kasai-Central (Bena Leka). Furthermore, population movements between Bulape and Tshikapa, the capital city of Kasai province, are frequent as part of trading activities.  Tshikapa city is considered as a regional market hub receiving populations from neighbouring provinces.  

At the regional level the risk is moderate due to the proximity of Bulape to Tshikapa city, the capital city of Kasai province and the Angolan border (approximately 100 to 200 kilometres depending on the nearest border crossing point) as well as population movement between Bulape and Tshikapa then Tshikapa and Angola.  

At the global level, the risk is low

(...)

Source: World Health Organization, https://www.who.int/publications/m/item/who-rapid-risk-assessment---ebola-virus-disease--democratic-republic-of-the-congo-v.1

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#Modeling and #Analysis of SIRR Model (#Ebola #Transmission Dynamics Model) with Delay Differential Equation

 


Abstract

Background

Ebola virus disease (EVD) is a severe and often fatal illness with high transmission potential and recurring outbreaks. Traditional compartmental models often neglect biologically important delays, such as the latent period before an infected individual becomes infectious, limiting their ability to capture real-world epidemic patterns. Including such delays can provide a more accurate understanding of outbreak persistence and control strategies.

Methods

In this study, we develop and analyze a novel deterministic SIRR model that captures the complex transmission dynamics of Ebola by explicitly combining nonlinear incidence rates with a delay differential equation framework. Unlike traditional models, this approach integrates a biologically motivated delay to represent the latent period before infectiousness, providing a more realistic depiction of disease spread. The basic reproduction number (R0) is derived using the next-generation matrix, and local stability for disease-free and endemic equilibria is established. Using center manifold theory, we investigate transcritical bifurcation at R0 = 1, while Hopf bifurcation analysis determines when delays trigger oscillatory epidemics. Sensitivity analysis identifies parameters most influencing R0, and numerical simulations are performed using the fourth-order Runge–Kutta method.

Results

The main novelty of this work lies in its detailed investigation of how delays influence outbreak persistence and can trigger oscillatory epidemics, patterns often observed in practice but rarely captured by classic models. For R0< 1, the disease-free equilibrium is locally asymptotically stable; for R0> 1, an endemic equilibrium emerges. Increasing delays destabilizes the system, amplifying peak infections, prolonging outbreaks, and producing sustained oscillations. Isolation of recovered individuals (c) significantly reduces R_0, while transmission rate (β), recruitment rate (Λ), and isolation transition rate (ρ) are identified as the most sensitive parameters.

Conclusions

Accounting for delayed recovery dynamics is crucial for accurately predicting outbreak patterns and designing effective interventions. This delay-based, nonlinear-incidence model offers a robust analytical and computational framework for guiding public health strategies, with direct implications for reducing transmission, shortening outbreak duration, and preventing epidemic resurgence.

Source: F1000 Research, https://f1000research.com/articles/14-857/v1

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Tuesday, September 16, 2025

#DRC: #Ebola #Outbreak, Kasai Province Situation #Report #2, September 15, 2025 (ReliefWeb)

 


FAST FACTS

On September 4, the DRC Ministry of Health officially declared an outbreak of Ebola virus disease (EVD) in the Bulape and Mweka health zones in Kasai province.

According the the World Health Organization (WHO), as of September 15 there are 81 suspected cases and 28 deaths, including four nurses. However, data reporting has been challenging, with conflicting statistics reports being circulated by various health authorities.

Kasai is extremely isolated, sometimes requiring multiple days of driving from Kinshasa to Tshikapa, the provincial capital, during the rainy season. Very few air routes reach the province, though an airstrip in Bulape is being established.

Significant gaps exist in the response to EVD, including adequate case management capacity, blood supplies, IPC/WASH support, and more.


OUR RESPONSE

International Medical Corps has been responding in the DRC since 1999, and currently has offices in Goma and Kinshasa.

Our Rapid Response Team (RRT) has deployed to Kasai, with staff on the ground assessing and planning our response.

Through our US government-funded LEARN project, we are preparing to conduct training covering topics including case management and IPC.

Procurement of medical supplies, including personal protective equipment, has begun and will be used both as training materials and in response to EVD.

International Medical Corps will lead working groups on case management at the national and provincial level.

Source: ReliefWeb, https://reliefweb.int/report/democratic-republic-congo/dr-congo-ebola-outbreak-kasai-province-situation-report-2-september-15-2025

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Friday, September 12, 2025

#Ebola virus’ hidden #target: virus #transmission to and infection of #skin

 


ABSTRACT

Ebola virus (EBOV), the causative agent of Ebola virus disease, remains one of the World Health Organization’s top 10 threats to global health. Infectious EBOV virions can be found on the surface of skin late in infection and may be transmitted to others through skin-to-skin contact. We investigate in vivo EBOV tropism and the kinetics of virus movement to and from the skin. Increasing viral loads were detected over time in the skin of EBOV-infected non-human primates and mice, with antigen detected in dermal stromal and immune cells. Epidermal cells within and surrounding hair follicles also harbored viral antigen, suggesting a novel mechanism of virus egress to the epidermal surface. During late infection, proinflammatory responses were elevated in infected visceral organs but minimal in the skin despite significant viral loads. We observed similar viral trafficking and cell tropism in the skin of mice intraperitoneally infected with a low containment EBOV model virus, rVSV/EBOV GP, allowing more detailed mechanistic studies. Sites of virus infection in the skin were patchy, with intense focal areas of infection surrounded by uninfected areas. To investigate virus entry into the body through skin, rVSV/EBOV GP was applied to the surface of gently abraded skin to remove the stratum corneum; epidermal keratinocytes were robustly infected with subsequent systemic viral dissemination observed in some mice. Optimal levels of infection within the skin required expression of the phosphatidylserine receptor, AXL. Collectively, our data demonstrate that skin serves as an important organ targeted by EBOV, facilitating virus entry into and egress from the body.

Source: Journal of Virology, https://journals.asm.org/doi/full/10.1128/jvi.01300-25?af=R

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Friday, September 5, 2025

#Ebola virus disease - #DRC (#WHO D.O.N., September 5 '25)

 


Situation at a glance

On 1 September 2025, WHO received an alert from the Ministry of Health of the Democratic Republic of the Congo (DRC) regarding suspected cases of Ebola virus disease (EVD) in the Bulape Health Zone, Kasai Province, DRC

The first known index case was a pregnant woman who presented at Bulape General Reference Hospital on 20 August 2025 with symptoms of high fever, bloody diarrhoea, haemorrhage and extreme weakness. She died on 25 August from multiple organ failure

On 4 September 2025, following confirmatory laboratory testing, the Ministry of Health declared an outbreak of EVD

Ebola virus disease is a serious, often fatal illness in humans. The virus is transmitted to humans through close contact with the blood or secretions of infected wildlife and then spreads through human-to-human transmission

As of 4 September 2025, 28 suspected cases, including 15 deaths (case fatality ratio (CFR): 54%), have been reported from three areas of the Bulape health zone (Bulape, Bulape Com and Dikolo) and Mweka health zone. 

Among the deaths, four are health-care workers

About 80% of the suspected cases are aged 15 years and older. Six samples were collected from five suspected cases and one probable death from Bulape health zone and arrived on 3 September at the National Public Health Laboratory (INRB) in Kinshasa for confirmation testing. All five samples tested positive for Ebola virus (EBOV) through GeneXpert and Polymerase Chain Reaction (PCR) assays on 3 September 2025. 

The Ministry of Health, with support from WHO and partners, is implementing public health response measures to contain the outbreak. WHO assesses the overall public health risk posed by the current EVD outbreak as high at the national level, moderate at the regional level and low at the global level.


Description of the situation

On 1 September 2025, WHO received an alert from the Ministry of Health of the Democratic Republic of the Congo (DRC) regarding suspected cases of EVD in the Bulape Health Zone, Kasai Province, DRC. 

The first known suspected index case was admitted to the Bulape General Reference Hospital on 20 August 2025. The patient was a pregnant woman at 34-weeks of gestation who presented with symptoms of fever, bloody diarrhoea,  haemorrhage, vomiting, asthenia, followed by multiple organ failure. She died on 25 August 2025. Two of the health-care workers that had initially been in contact with this first case also developed similar symptoms and died.

As of 4 September 2025, a total of 28 suspected cases, including 15 deaths, of which four are health-care workers (case fatality ratio (CFR): 54%) have been reported from three areas of the Bulape health zone (Bulape, Bulape Com and Dikolo) and Mweka health zone. 

About 80% of the suspected cases are aged 15 years and older. Five blood samples from five suspected cases and a  naso-pharyngeal swab from a probable death were collected from the three health areas and shipped to the National Public Health Laboratory (INRB) in Kinshasa for testing.

On 3 September 2025, the laboratory testing conducted at INRB confirmed Ebola virus (EBOV)[1] through GeneXpert and Polymerase Chain Reaction (PCR) assays.

The results obtained from whole genome sequencing suggest that the outbreak is a new zoonotic spillover event and is not directly linked to the 2007 Luebo or 2008/2009 Mweka EVD outbreaks.[2]

(...)


Epidemiology

Ebola virus disease is a severe disease caused by the Ebola virus (EBOV). The virus belongs to the species Orthoebolavirus Zairense. The virus is transmitted to humans through close contact with the blood or secretions of infected wildlife and then spreads through human-to-human transmission by direct contact with bodily fluids, organs, or contaminated surfaces and materials.

The incubation period, the time between infection with the virus and the onset of symptoms, ranges from 2 to 21 days, but typically is 7–11 days. People are not infectious during the incubation period; they become contagious with early symptoms, therefore, transmission risk begins at the onset of clinical signs and increases with disease severity.

The average case fatality ratio is 50%; case fatality ratios ranging from 25% to 90% have been reported in previous outbreaks. 

The disease is characterised by an acute onset of fever with non-specific symptoms/signs (e.g., abdominal pain, anorexia, fatigue, malaise, myalgia, sore throat) usually followed several days later by nausea, vomiting, diarrhoea, and occasionally a variable rash. 

Severe illness may include haemorrhagic manifestations (e.g., bleeding), encephalopathy, shock/hypotension, multi-organ failure, and spontaneous abortion in infected pregnant women. 

Individuals who recover may experience prolonged sequelae (e.g., arthralgia, neurocognitive dysfunction, uveitis, sometimes followed by cataract formation), and clinical and subclinical persistent infection may occur in immune-privileged compartments (e.g., central nervous system, eyes, testes). 

Family members, health and care providers, and participants in burial ceremonies with direct contact with the deceased are at particular risk. 


Public health response

Health authorities are implementing public health measures, including but not limited to the following:

-- A crisis committee was activated at both the local and provincial levels.

-- Risk communication and active surveillance activities are ongoing.

-- All cases are isolated, and Infection Prevention and Control (IPC) measures have been implemented.

-- Patients are receiving intravenous medication.

-- Contact isolation and tracing are continuing.

-- Investigations are ongoing. 

WHO is supporting the national authorities, including through:

-- Risk assessment and investigation.

-- Providing operational, financial and technical support to the Ministry of Health to ensure swift response.

-- Provision of essential supplies (Personal Protective Equipment (PPE), medical supplies and infrastructures support)

-- The approved Ervebo vaccine is available with a stock of 2000 doses located in Kinshasa expected to be shipped shortly to the affected area, to vaccinate contacts of confirmed or suspected cases,  frontline and health workers.


WHO risk assessment

This is the 16th EVD outbreak in the DRC since 1976. The current outbreak occurs after almost three years without a confirmed EVD outbreak in the country. The last EVD outbreak in the country was declared on 15 August 2022 in Beni city, North Kivu province, with one single case reported who later died, and the MoH declared the end of the outbreak on 27 September 2022. In the Bulape district, the epicentre of the current outbreak, the last EVD outbreak was recorded in 2007.  

This outbreak is occurring in a complex epidemiological and humanitarian context. The country is facing several outbreaks, including mpox, cholera, and measles. In addition, the country is experiencing a long-term economic and political crisis. The country's resources and capacity to effectively respond to the current outbreak are therefore limited. 

The epicentre of this outbreak is in the proximity of the Tshikapa city, the capital city of the Kasai province, and the Angolan border (approximately 100 to 200 kilometres, depending on the nearest border crossing point). 

Although the affected district is a hard-to-reach rural area relatively far from the two main urban centres of Mbuji Mayi and Kananga, population movements between different parts of the province are frequent, especially between Bulape and Tshikapa.

In addition, epidemiological investigations are ongoing with transmission chains, and the source of the outbreak has not yet been identified; therefore, additional infected people cannot be ruled out.  

The date of symptom onset for the first case is not yet known, as well as the therapeutic itinerary prior to health facility consultation, which further increases the likelihood of an ongoing community transmission with further risk of spread to other health districts.

WHO assesses the overall public health risk posed by the current EVD outbreak as high at the national level, moderate at the regional level and low at the global level. 


WHO advice

Effective outbreak control relies on the application of a set of interventions, namely clinical management, IPC & Water, sanitation and hygiene (WASH), surveillance and contact tracing, good laboratory service, safe and dignified burials, community engagement, and social mobilization. 

The Ebola virus can persist in some body fluids of people who have recovered from EVD. 

In a limited number of cases, secondary transmissions resulting from exposure to the body fluids of people who have recovered from EVD have been documented. Therefore, maintaining collaborative relationships with survivor associations while monitoring survivors is a priority to mitigate any potential risks.

Early diagnosis and initiation of optimized supportive clinical care can reduce mortality from EVD. 

In addition, monoclonal antibodies active against a 3-antibody combination of atoltivimab, maftivimab and odesivimab [Inmazeb®] or a single antibody ansuvimab [Ebanga®].  

Ebola treatment centres should be designed and managed to ensure safe care is provided with appropriate biosecurity and infection prevention and control intervention, and allow optimized care, allowing direct visualization of patients in the red zone as much as possible. WHO and partners have worked to develop these innovative solutions. 

There is a need to strengthen surveillance and other response activities, including at relevant points of entry and borders, to contain the possibility of exponential spread. 

Cases, contacts and individuals in affected areas who present signs and symptoms compatible with case definitions should be considered suspects and cared for and treated in designated treatment facilities with appropriate biosecurity, infection prevention and control and be offered testing in a timely fashion and advised not to travel. 

Collaboration with neighbouring countries should be enhanced to harmonize reporting mechanisms, conduct joint investigations, and share critical data in real time. 

Surrounding countries should enhance readiness activities to enable early case detection, isolation and treatment. 

Critical infection prevention and control measures should be implemented and/or strengthened in all health care facilities, per WHO's Infection prevention and control guideline for Ebola and Marburg disease.   

Health workers caring for patients with confirmed or suspected Ebola should apply transmission-based precautions in addition to standard precautions, including appropriate use of PPE and hand hygiene according to the WHO 5 moments to avoid contact with patients’ blood and other body fluids, and with contaminated surfaces and objects. 

Waste generated in health-care facilities must be safely segregated, safely collected, transported, stored, treated and finally disposed. National guidelines should be followed on rules and regulations for safe waste disposal or WHO’s guidelines on safe waste management.

Patient-care activities should be undertaken in a clean and hygienic environment that facilitates practices related to the prevention and control of health-care-associated infections, as outlined in Essential environmental health standards in health care. Safe water, adequate sanitation and hygiene infrastructure and services should be provided in healthcare facilities. For details on recommendations and improvement, follow the WASH FIT implementation Package.

In accordance with the recommendations of the Strategic Advisory Group of Experts on immunization, the Ervebo vaccine is recommended during an EVD outbreak due to EBOV for ring vaccination, for contacts and potential contacts of confirmed/suspected EVD cases, as well as for frontline workers. A global stockpile has been established and is being coordinated by the International Coordination Group for vaccine procurement.

WHO advises against any restrictions on travel and/or trade to the Democratic Republic of the Congo based on available information for the current outbreak.

(...)

Source: World Health Organization, https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON580

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Thursday, September 4, 2025

#DRC declares #Ebola virus disease #outbreak in #Kasai Province (#WHO AFRO, September 4 '25)

 


Kinshasa – Health authorities in the Democratic Republic of the Congo have declared an outbreak of Ebola virus disease in Kasai Province where 28 suspected cases and 15 deaths, including four health workers, have been reported as of 4 September 2025.

The outbreak has affected Bulape and Mweka health zones in Kasai Province where health officials have been carrying out investigations after the cases and the deaths reported presented with symptoms including fever, vomiting, diarrhoea and haemorrhage. Samples tested on 3 September at the country’s National Institute of Biomedical Research in the capital Kinshasa confirmed the cause of the outbreak as Ebola Zaire caused by Ebola virus disease.   

A national Rapid Response Team joined by World Health Organization (WHO) experts in epidemiology, infection prevention and control, laboratory and case management has been deployed to Kasai Province to rapidly strengthen disease surveillance, treatment and infection prevention and control in health facilities. Provincial risk communication experts have also been deployed to reach communities and help them understand how to protect themselves.

Additionally, WHO is delivering two tonnes of supplies including personal protective equipment, mobile laboratory equipment and medical supplies. The area is difficult to reach, taking at least one day of driving from Tshikapa (the provincial capital of Kasai), with few air links.   

“We’re acting with determination to rapidly halt the spread of the virus and protect communities,” said Dr Mohamed Janabi, WHO Regional Director for Africa. “Banking on the country’s long-standing expertise in controlling viral disease outbreaks, we’re working closely with the health authorities to quickly scale up key response measures to end the outbreak as soon as possible.”   

Case numbers are likely to increase as the transmission is ongoing. Response teams and local teams will work to find the people who may be infected and need to receive care, to ensure everyone is protected as quickly as possible.    

The country has a stockpile of treatments, as well as 2000 doses of the Ervebo Ebola vaccine, effective to protect against this type of Ebola, already prepositioned in Kinshasa that will be quickly moved to Kasai to vaccinate contacts and frontline health workers.   

The Democratic Republic of the Congo’s last outbreak of Ebola virus disease affected the north-western Equateur province in April 2022. It was brought under control in under three months thanks to the robust efforts of the health authorities. In Kasai province, previous outbreaks of Ebola virus disease were reported in 2007 and 2008. In the country overall, there have been 15 outbreaks since the disease was first identified in 1976.    

Ebola virus disease is a rare but severe, often fatal illness in humans. It is transmitted to people through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as fruit bats (thought to be the natural hosts). Human-to-human transmission is through direct contact with blood or body fluids of a person who is sick with or has died from Ebola, objects that have been contaminated with body fluids from a person sick with Ebola or the body of a person who died from Ebola.

Source: World Health Organization, Regional Office for Africa, https://www.afro.who.int/countries/democratic-republic-of-congo/news/democratic-republic-congo-declares-ebola-virus-disease-outbreak-kasai-province

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Tuesday, June 10, 2025

Monotherapy with #antibody 1C3 partially protects #Ebola virus-exposed #macaques

ABSTRACT

A cocktail of human monoclonal antibodies 1C3 and 1C11 previously protected macaques from a lethal exposure to either Ebola virus (EBOV) or Sudan virus (SUDV). 1C3 is of particular interest because its paratope strongly binds with unique stoichiometry to the glycoprotein head of several orthoebolaviruses, resulting in neutralization of EBOV and SUDV. Therefore, we evaluated the protective activity of 1C3 as a standalone therapeutic in macaques exposed to either EBOV or SUDV. Two doses of 1C3 monotherapy, administered 4 and 7 days post-exposure, did not protect SUDV-exposed macaques and partially protected EBOV-exposed macaques. Notably, in a macaque that succumbed to EBOV infection, we identified two mutually exclusive escape mutations that emerged immediately after the first dose and resulted in two amino acid changes at the 1C3 binding site. We also detected a subconsensus treatment-emergent mutation likely affecting the 1C3 binding site in all three deceased SUDV-exposed macaques. Our findings highlight combination treatment with 1C11 as critical for protection, particularly against SUDV, and in vivo activity of unpartnered 1C3 as susceptible to rapid EBOV and SUDV escape under therapeutic pressure.


IMPORTANCE

A cocktail of human monoclonal antibodies 1C3 and 1C11 previously protected macaques exposed to a lethal dose of either Ebola virus (EBOV) or Sudan virus (SUDV). Since the unique binding characteristics of 1C3 are of particular interest, we evaluated its protective activity as monotherapy in macaques exposed to either EBOV or SUDV. Two doses of 1C3 alone did not protect SUDV-exposed macaques and only partially protected EBOV-exposed macaques. Importantly, failure to protect was associated with the rapid emergence of previously in vitro-identified escape mutations at the 1C3 binding site, highlighting the importance of its use in combination with 1C11 for protection against fatal disease outcome and avoiding rapid EBOV and SUDV escape. Findings have broader implications for the wise use of combination-based monoclonal antibody therapeutics to improve outcomes and prevent resistance in filovirid diseases.

Source: Journal of Virology, https://journals.asm.org/doi/full/10.1128/jvi.00296-25?af=R

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Friday, May 23, 2025

#Epidemiology and Genetic Characterization of Distinct #Ebola #Sudan #Outbreaks in #Uganda

Abstract

Background

Sudan virus (SUDV) has caused multiple outbreaks in Uganda over the past two decades, leading to significant morbidity and mortality. The recent outbreaks in 2022 and 2025 highlight the ongoing threat posed by SUDV and the challenges in its containment. This study aims to characterize the epidemiological patterns and phylogenomic evolution of SUDV outbreaks in Uganda, identifying key factors influencing transmission and disease severity. 

Methods

We conducted a retrospective observational study analyzing epidemiological and genomic data from SUDV outbreaks in Uganda between 2000 and 2025. Epidemiological data were collected from official sources, including the Ugandan Ministry of Health and the World Health Organization, supplemented with reports from public health organizations. Genomic sequences of SUDV were analyzed to investigate viral evolution and identify genetic variations associated with pathogenicity and transmissibility. 

Results

The 2022 outbreak involved 164 confirmed cases and a case fatality rate (CFR) of 33.5%, with significant geographic variation in case distribution. The 2025 outbreak, still ongoing, was first detected in Kampala, with evidence of both nosocomial and community transmission. Phylogenomic analysis revealed the presence of two main genetic groups, representing Sudan and Uganda, respectively. The genetic variability of the Ugandan cluster is higher than that observed in Sudan, suggesting a greater expansion potential, which aligns with the current outbreak. Epidemiological findings indicate that human mobility, weaknesses in the health system, and delays in detection contribute to the amplification of the outbreak. 

Conclusions

Our findings underscore the importance of integrated genomic and epidemiological surveillance in understanding SUDV transmission dynamics. The recurrent emergence of SUDV highlights the need for improved outbreak preparedness, rapid response mechanisms, and international collaboration. Strengthening real-time surveillance and enhancing healthcare system resilience are critical to mitigating the impact of future outbreaks.

Source: Infectious Disease Reports, https://www.mdpi.com/2036-7449/17/3/44

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Thursday, April 24, 2025

#Remdesivir, mAb114, REGN-EB3, and #ZMapp partially rescue nonhuman #primates infected with a low passage #Kikwit variant of #Ebola virus

Abstract

In 2018, a clinical trial of four investigational therapies for Ebola virus disease (EVD), known as the PALM trial, was conducted in the Democratic Republic of Congo. All patients received either the antiviral remdesivir (RDV) or a monoclonal antibody product: ZMapp, mAb114 (Ebanga), or REGN-EB3 (Inmazeb). The study concluded that both mAb114 and REGN-EB3 were superior to ZMapp and RDV in reducing mortality from EVD. However, the data suggested that some patients in the RDV and ZMapp groups might have been sicker at the time of treatment initiation. Here, we assessed the efficacy of each of these therapies in a uniformly lethal rhesus monkey model of EVD when treatment was initiated 5 days after Ebola exposure. Treatment with RDV, mAb114, REGN-EB3, and ZMapp each resulted in similar survival (approximately 40%). Survival was associated with circulating viral load at treatment initiation. A trend of more escape mutants in the GP1 and GP2 domains was observed for the mAb114 group. Our data show similar suboptimal efficacy of individual therapeutics in the uniformly lethal NHP model of EVD, supporting further clinical investigation of therapeutic combinations to maximize the overall therapeutic effect and improve patient outcomes, particularly for the treatment of advanced stage EVD.

Source: Nature Communications, https://www.nature.com/articles/s41467-025-59168-5

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Tuesday, March 25, 2025

Jamaican fruit #bats’ competence for #Ebola but not #Marburg virus is driven by intrinsic differences

Abstract

Ebola virus (EBOV) and Marburg virus (MARV) are zoonotic filoviruses that cause hemorrhagic fever in humans. Correlative data implicate bats as natural EBOV hosts, but neither a full-length genome nor an EBOV isolate has been found in any bats sampled. Here, we model filovirus infection in the Jamaican fruit bat (JFB), Artibeus jamaicensis, by inoculation with either EBOV or MARV through a combination of oral, intranasal, and subcutaneous routes. Infection with EBOV results in systemic virus replication and oral shedding of infectious virus. MARV replication is transient and does not shed. In vitro, JFB cells replicate EBOV more efficiently than MARV, and MARV infection induces innate antiviral responses that EBOV efficiently suppresses. Experiments using VSV pseudoparticles or replicating VSV expressing the EBOV or MARV glycoprotein demonstrate an advantage for EBOV entry and replication early, respectively, in JFB cells. Overall, this study describes filovirus species-specific phenotypes for both JFB and their cells.

Source: Nature Communications, https://www.nature.com/articles/s41467-025-58305-4

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