Winning the War Against Ebola

For a long time, the mere mention of the word Ebola has been enough to evoke terror. That’s because Ebola is a deadly, contagious disease that has killed—in a particularly gruesome fashion—many of those it’s infected.

But now scientists could be on the cusp of beating Ebola, which has caused more than 12,000 deaths since its discovery in 1976 near the Ebola River in what is now the Democratic Republic of the Congo (DRC).

In August, scientists announced that a new experimental treatment seems to work so well—curing 90 percent of those treated—that it will be offered 
to all Ebola patients in the DRC (see map), where an outbreak has been spreading for more than a year. At the same time, a new vaccine to prevent people from becoming infected—which appears to work 98 percent of the time—is holding out the hope of preventing future Ebola epidemics altogether.

“This totally changes the face of the disease,” says Ashish Jha, who heads the Harvard Global Health Institute. “It’s a reminder that when the world focuses in a certain area, like Ebola, and puts a lot of science and effort into it, we can make amazing progress in very short order.”

For a long time, even the mention of the word Ebola has been enough to evoke terror. That’s because Ebola is a deadly, contagious disease that has killed many of those it’s infected. And it’s done so in a particularly gruesome fashion.

The Ebola virus was discovered in 1976 near the Ebola River in what is now the Democratic Republic of the Congo (DRC). It has caused more than 12,000 deaths since then. But now scientists could be on the cusp of beating the deadly disease.

In August, scientists announced that a new experimental treatment seems be working well. It has cured 90 percent of those treated. Now, the treatment will be offered to all Ebola patients in the DRC (see map), where an outbreak has been spreading for more than a year. At the same time, a new vaccine offers the potential to prevent people from becoming infected. It appears to work 98 percent of the time. The vaccine’s success is fueling the hope of preventing future Ebola epidemics altogether.

“This totally changes the face of the disease,” says Ashish Jha, who heads the Harvard Global Health Institute. “It’s a reminder that when the world focuses in a certain area, like Ebola, and puts a lot of science and effort into it, we can make amazing progress in very short order.”

The current outbreak, which began more than a year ago and was declared a global health emergency in July, is now the second biggest in history. More than 3,100 cases have been diagnosed, and more than 2,100 people have died. The only larger Ebola epidemic was the one that raged in West Africa from 2014 to 2016, infecting more than 28,000 people and killing more than 11,000.

Ebola victims first show signs of a fever, but before long, they have terrible stomach pains and start vomiting. They begin bleeding internally, as the virus attacks vital organs. The skin erupts in bruises and large blisters. In some cases, blood pours from the nose and eyes. Without treatment, about 60 percent of victims die, usually within a week.

Because the bodies of those who die are highly contagious, they need to be handled as little as possible and burials need to be conducted only by trained people wearing protective gear.

Until now, the only way to stop an outbreak has been to isolate infected patients, trace everyone they’ve been in contact with, quarantine every person on that list who gets sick, and then keep repeating the process until, finally, there are no more cases. But now, officials hope that by giving the new vaccine to as many people as possible in the areas surrounding the outbreak, they can stop the disease from spreading.

The current outbreak began more than a year ago. It was declared a global health emergency in July. More than 3,100 cases have been diagnosed, and more than 2,100 people have died. That makes it the second biggest Ebola outbreak in history. The only larger Ebola epidemic was the one that raged in West Africa from 2014 to 2016. That outbreak infected more than 28,000 people and killed more than 11,000.

Ebola victims first show signs of a fever. It doesn’t take long for them to have terrible stomach pains and start vomiting. They begin bleeding internally, as the virus attacks vital organs. The skin erupts in bruises and large blisters. In some cases, blood pours from the nose and eyes. Without treatment, about 60 percent of victims die, usually within a week.

The bodies of those who die are highly contagious. That’s why they need to be handled as little as possible. And burials must be conducted only by trained people wearing protective gear.

Until now, the only way to stop an outbreak has been to isolate infected patients. A list of everyone they’ve been in contact with is developed. Every person on that list who gets sick then gets quarantined. Then, the process gets repeated until, finally, there are no more cases. But now, officials hope that by giving the new vaccine to as many people as possible in the areas surrounding the outbreak, they can stop the disease from spreading.

News of these successes has been particularly welcome since there have been so many setbacks in tackling this latest epidemic.

Initially, health workers were hampered by the fact that the first cases were diagnosed in a remote region where health-care services are limited, and there’s a history of ethnic violence that dates back to the aftermath of the 1994 genocide in neighboring Rwanda. That turbulent history has made people suspicious of the aid groups that came to fight the disease. Afraid of being confined in isolation units, people have avoided getting tested or treated. People also don’t want authorities to interfere in their local rituals related to death and burial.

All this hostility led to the murder of health workers and the burning of Ebola treatment centers last February. The attacks forced aid groups to suspend their work and gave the virus time to spread.

The story of how Ebola spread to Goma, a city of nearly 2 million people, illustrates the challenge officials have been up against: A visiting pastor had preached in seven different churches in the epidemic zone, laying hands on the sick. He became ill and was treated by a nurse but got on a bus to Goma anyway. The bus stopped at three checkpoints meant to halt the spread of the disease by screening passengers for symptoms, but his illness was not detected. He gave a different name at each checkpoint, apparently hoping to avoid being detained, local health authorities said. Sick and feverish by the time he arrived in Goma, he went to a clinic there, where the disease was diagnosed.

There have been so many setbacks in tackling this latest epidemic. That’s why news of these successes has been particularly welcome.

The first cases were diagnosed in a remote region where health-care services are limited. And there’s a history of ethnic violence there. It dates back to the aftermath of the 1994 genocide in neighboring Rwanda. That turbulent history has made people suspicious of the aid groups that came to fight the disease. People have avoided getting tested or treated. Many of them are afraid of being confined in isolation units. People also don’t want authorities to interfere in their local rituals related to death and burial.

All this hostility led to the murder of health workers and the burning of Ebola treatment centers last February. The attacks forced aid groups to suspend their work and gave the virus time to spread.

The story of how Ebola spread to Goma, a city of nearly 2 million people, highlights the challenge officials have been up against. A visiting pastor had preached in seven different churches in the epidemic zone. During his journey, he laid hands on the sick. He became ill and was treated by a nurse but got on a bus to Goma anyway. The bus stopped at three checkpoints. These stops are meant to curb the spread of the disease by screening passengers for symptoms. The pastor’s illness was not detected. He gave a different name at each checkpoint, apparently hoping to avoid being detained, local health authorities said. He was sick and feverish by the time he arrived in Goma and went to a clinic there, where the disease was diagnosed.

Public health experts are heartened by the effective new treatments and by the vaccine, but many people in the infected areas still don’t trust health-care workers, and that’s stopping some people from getting treated.

“The vaccine is extremely effective,” says Trish Newport, who has directed the Ebola response for Doctors Without Borders. “But if people don’t trust you, they won’t get vaccinated.”

“What’s frustrating,” she adds, “is that we have the tools” to treat and stop Ebola. “But it goes to show that without the trust of the population, having effective treatments doesn’t matter.”

Public health experts are encouraged by the effective new treatments and by the vaccine. But the lack of trust between the people in the infected areas and the health-care workers still poses a challenge. It’s stopping some people from being treated.

“The vaccine is extremely effective,” says Trish Newport, who has directed the Ebola response for Doctors Without Borders. “But if people don’t trust you, they won’t get vaccinated.”

“What’s frustrating,” she adds, “is that we have the tools” to treat and stop Ebola. “But it goes to show that without the trust of the population, having effective treatments doesn’t matter.”

With reporting by Donald G. McNeil Jr. and Denise Grady of The New York Times.

With reporting by Donald G. McNeil Jr. and Denise Grady of The New York Times.