Health officials are on red alert after suspected cases of Ebola were found in Brazil and Italy, as experts warn that they have never seen 'so many cases' of the virus recorded this quickly. The outbreak, caused by the rare Bundibugyo strain — which can kill up to 50 per cent of those infected — has led to more than 1,000 suspected cases and 250 deaths since it emerged in the Democratic Republic of Congo (DRC).
However, the World Health Organisation (WHO) has warned that the true reach of the outbreak may be much greater. Neighbouring Uganda has seen several infections and one death, and now officials in Brazil and Italy are investigating suspected cases.
Suspected Cases in Brazil
In Brazil, two patients began showing symptoms linked to the virus — including a flu-like fever, headache, muscle pain, vomiting and diarrhoea — in Sao Paulo and Rio de Janeiro. One of them, a 37-year-old man, had recently travelled to the DRC and was placed into isolation at the Emilio Ribas Institute of Infectious Diseases upon his return. He has since been diagnosed with a severe form of meningitis on Sunday, but officials have not ruled out Ebola and are still monitoring him for the virus. The other patient, a man whose age is unknown, is currently in isolation in Rio after displaying symptoms such as a cough, chills and diarrhoea. He has tested positive for malaria and returned a negative Ebola test, but also remains in isolation and under investigation over concerns he may still have the virus.
Suspected Case in Italy
Elsewhere, in Cagliari, the capital city of the Italian island of Sardinia, protocols for a suspected case of Ebola were triggered after a man displayed symptoms upon returning home from the DRC. The health ministry in the region has since confirmed he has returned a negative test, and that the risk of Ebola in Italy 'remains very low'. The government in Sao Paulo also said the risk to Brazil and South America was 'very low'.
Concerns Over International Spread
However, concerns are growing that the outbreak could spread further internationally, after humanitarian aid charity Doctors Without Borders warned that the spread was 'deeply alarming'. The charity's deputy director Dr Alan Gonzales said on Saturday that 'so many cases' of the virus had never before been recorded so quickly. He continued: 'Two weeks after the declaration of the Ebola disease outbreak in Ituri Province, the situation is deeply alarming. Never before has an Ebola outbreak recorded so many cases so soon after its declaration.' He said that his teams were 'witnessing a response that has not yet caught up to the rapid spread of the epidemic' and warned that 'the reality today is that nobody knows the true scale and severity of this outbreak.' He added: 'New suspected cases are being reported daily, yet hundreds of samples remain untested.'
WHO Response and Vaccine Efforts
Gonzalez's comments came after WHO director-general Tedros Adhanom Ghebreyesus visited Bunia — the eastern DRC city where most cases and deaths have occurred. Ghebreyesus said that, although there is no vaccine for the Bundibugyo strain, there is hope that the virus could be treated with good medical care. The WHO also announced that four nurses treated for Ebola in Bunia had recovered and been discharged from hospital. Ghebreyesus also called on countries that have imposed travel bans on patients from infected regions to reconsider, adding: 'These measures make the response harder, and they discourage transparency and trust that saves lives.'
DRC Health Minister Roger Kamba said the country aims to contain and end the outbreak within 'four to six months' in the 'best case scenario'. Scientists from the University of Oxford are racing to create a vaccine for the Bundibugyo strain, which has the same symptoms as other Ebola variants including a flu-like fever, headache, muscle pain, vomiting and diarrhoea. In many cases, this progresses to internal bleeding, organ failure and death. Patients can carry the virus for up to 21 days before symptoms begin, which is when experts believe they become infectious. A successful vaccine would likely protect patients from severe illness and death as well as limit the spread of the virus, but there is no guarantee it will be effective. Oxford Uni scientists warned that it may take two-to-three months before their vaccine can be tested on humans, meaning it is unlikely patients in Africa will get the drug within the next six months.
Historical Context and Local Unrest
The present epidemic is one of the fastest spreading since the 2014 outbreak which was linked to more than 28,000 cases and 11,000 deaths across West Africa. There has been widespread disarray in affected nations in recent weeks, with locals protesting against the way the outbreak is being handled. Mongbwalu General Referral Hospital in the DRC has come under attack from people seeking to bury the bodies of friends and family members who have died from Ebola, according to the hospital's medical director, Dr Richard Lokodu. But as burials are highly contagious, they are being conducted by medical teams in the area. Some factions in the region are rebelling in the belief that Ebola is a hoax, and confronting Red Cross volunteers. Meanwhile others in local communities have taken to villages with megaphones to encourage residents to follow official health guidance.
All flights to and from Bunia have been grounded, but experts believe the virus may have already spread to other nearby nations, such as South Sudan. In previous Ebola outbreaks the virus has killed more than half of those infected, many of whom died due to internal bleeding and organ failure.
UK Preparedness
British health officials have also activated a Returning Workers Scheme — where healthcare workers returning from Ebola outbreak regions are monitored for signs of the disease once back in the UK. However, experts have warned that the UK is unprepared for the Ebola outbreak, and argue that the population may be at risk. Dr Derek Sloan, an expert in infectious diseases at St Andrew's University, said the recent outbreak shows we must remain 'vigilant' and 'preserve funding'. 'This outbreak, along with the recent Hantavirus cases on a cruise ship and meningitis infections in the UK shows how important it is that we stay vigilant and use effective public health tools to protect our populations,' Dr Sloan, also a spokesman for UK-Med and Healthy World, Secure Britain, said. 'Infectious disease outbreaks such as these in our interconnected world cannot be dismissed as someone else's problem. These examples show how important it is to maintain this expertise and underline the need to preserve funding for global health and international aid.'
