Officials rush to vaccinate 2,000 health workers in South Sudan amid fears killer Ebola outbreak in the Democratic Republic of Congo will spread

Health workers in South Sudan are being vaccinated against Ebola amid fears the deadly virus will spread from the Democratic Republic of Congo (DRC).

Front-line responders in high-risk areas of South Sudan - including the capital Juba - started receiving the jab yesterday. 

Merck - the pharma giant behind the vaccine - delivered 2,160 doses to the African nation.

No countries neighbouring the DRC have yet been affected by the ongoing outbreak, which has killed hundreds.

As of last Sunday, there were 682 confirmed Ebola cases and 54 probable incidences across the DRC, according to its Ministry of Public Health.

Some 459 people have died from the virus, of which 405 fatalities are confirmed. 

'It is absolutely vital we are prepared for any potential case of Ebola spreading beyond the Democratic Republic of the Congo,' said Dr Matshidiso Moeti, the World Health Orgnization's (WHO) regional director for Africa. 

'WHO is investing a huge amount of resources into preventing Ebola from spreading outside DRC and helping governments ramp up their readiness to respond should any country have a positive case of Ebola.'  

Vaccination began in Yambio, but health workers in Tombura, Yei, Nimule and Juba will be offered the jab.

The vaccine protects against the Zaire strain of the virus. Zaire is behind the DRC's ongoing tenth outbreak, which began on August 1 last year. 

As well as the WHO, the Ministry of Health of South Sudan; Gavi, the Vaccine Alliance; UNICEF; and the US Center for Disease Control and Prevention are also supporting the vaccination programme. 

On top of the vaccinations, the WHO has also deployed more than 30 staff to these high-risk areas and has helped train 60 health workers to administer the jab - which is yet to be licensed.

'Although research is ongoing, the evidence so far suggests the Ebola vaccine is a highly effective tool to help stop epidemics and can be used to prevent this national outbreak from becoming a regional one,' Dr Seth Berkley, CEO of Gavi, said. 

'Vaccinating front-line workers and health workers in South Sudan border regions will be crucial. An outbreak in South Sudan would be deeply concerning.' 

Gavi - which has donated $2million (around £1,518,090) to support the vaccination efforts - is offering the jab under 'compassionate use' as part of recommendations from the Strategic Advisory Group of Experts on Immunization.

The same jab was used in the Equateur province of the DRC last May and June to combat another outbreak.

The Ministry of Health has also set up 17 screening points to assess travellers entering South Sudan who may be infected with Ebola. 

Nearly one million people have been screened so far. 

Protective gear for responders is also being stockpiled in a specialist warehouse.

Uganda began vaccinating its front-line workers last November, with more than 2,600 medics across eight high-risk areas receiving the jab.

In the DRC, over 66,000 people have been vaccinated, of which more than 21,000 are health or front-line workers. 

Rwanda is also planning to vaccinate its first-line responders. 

Ebola is spreading within the DRC, with nine new cases being reported in Katwa - a city of several hundred thousand people just outside Butembo - earlier this week.

The ongoing outbreak's death count is second only to the 2013-to-2016 epidemic that decimated West Africa. 

The health ministry said in a daily bulletin that the area near the Ugandan border has emerged as the outbreak's new epicentre.

Health officials have already expressed concern about Ebola travelling south and reaching the DRC city of Goma, which sits on the border with Rwanda.

Goma has almost double the population of Butembo, meaning there is a much higher potential for the virus to spread quickly.

If Ebola does make it to the major city of Goma then 'all bets are off' for the bid to control the outbreak, one health official said earlier this month. 

In preparation, the WHO and the DRC's health ministry have already sent rapid response and vaccination teams to Kayina.   

Health officials have described the DRC as 'one of the most complex settings possible', largely due to widespread militia violence in eastern Congo, which experts claim has hampered the response from aid workers.

First-line workers have been kidnapped, had to dodge bullets, been confronted by armed groups and seen treatment centres ransacked.

Mistrust among the locals to comply with health officials has also been a challenge.

Experts have said people's unwillingness to come forward and be screened leads them to believe the number of cases could be even higher. 

Laurie Garrett, former senior fellow of global health at think-tank Council on Foreign Relations, said cases keep 'popping up unexpectedly out of thin air' in a piece for Foreign Policy^[1]. 

Ebola can be transmitted between humans via blood and the other bodily fluids of patients, as well as contaminated surfaces.

With women at the forefront of care in communities in the DRC, gender disparities have meant two-thirds of Ebola patients have been women. 

The country is predicted to have at least six more months of suffering ahead before the outbreak comes to an end.

But if the disease spreads out of the north-east region, where it has so far been contained, it could rage on for even longer. 

References

1. ^{^} Foreign Policy (foreignpolicy.com)