As a rare strain of the Ebola virus continues to spread in the Democratic Republic of Congo and Uganda, here’s what Canadians need to know.
Are there different types of Ebola?
Yes. There are several types of bacteria that cause Ebola. The most common are the Ebola virus, also called the Zaire strain, and the Sudan virus, said Dr. Isaac Bogoch, an infectious disease specialist at the University Health Network in Toronto.
I the type of Ebola causing the current outbreak is called the Bundibugyo virus.
“Most of the diseases associated with the Ebola virus have been the Zaire strain of the Ebola virus. And that’s where most of the research has focused on vaccines and treatments,” said Bogoch, noting that Canada’s National Microbiology Lab helped pioneer the first Ebola virus vaccine.
But one of the concerns about the Bundibugyo outbreak is that there are no proven treatments or vaccines for the strain, he said.
Symptoms are the same for all types of Ebola and can start with fever, fatigue, muscle pain, headache and sore throat, according to the World Health Organization.
That can progress to vomiting, diarrhea, abdominal pain, rashes and kidney and liver damage.
Internal and external bleeding, including blood in the gums or stool, can also occur, but not as often as other symptoms.
“There’s a perception, I think, that bleeding is a normal symptom, but that’s rare and it really happens in that late stage (of the disease),” said Meaghan Thumath, an assistant professor of public health and emergency medicine at the University of British Columbia who worked with the World Health Organization during the 2019 Ebola outbreak in the Democratic Republic of Congo.
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One of the challenges in diagnosing Ebola is that several symptoms occur with other infectious diseases such as malaria, typhoid fever and meningitis, so diagnostic tests are important.
The incubation period for Ebola is two to 21 days. People with Ebola are not contagious until they develop symptoms, said Trish Newport, a Canadian who works as an emergency manager at Doctors Without Borders.
The Ebola virus is spread through contact with bodily fluids.
“People with Ebola are very sick. So it can be in the vomit, in the diarrhea, in the blood (and) in the respiratory output,” said Bogoch.
“The people most commonly infected with the Ebola virus are unfortunately the family members of people with this virus who directly care for people who are close to them (or) health care providers who do not get the right PPE (protective equipment) or do not use their PPE properly if there is a violation of the law,” he said.
Ebola can also spread when people who have died from the virus are buried if loved ones touch the body without proper precautions.
Monoclonal antibodies that help the body fight infections can treat the Zaire strain, Bogoch said, but have not been proven to work in people infected with the Bundibugyo strain.
There are also vaccines that can be given to a person exposed to the Zaire strain to clear the infection or at least reduce the severity of the illness – but again, those have not been tested with Bundibugyo.
“The cornerstone of treatment is supportive care,” Bogoch said.
“That means you need a good hospital, you need good medical management, you need fluid and electrolyte replenishment because unfortunately, one of the symptoms of the Ebola virus is severe nausea, vomiting, diarrhea, organ failure, and occasional bleeding. And you just need to replace fluids and electrolytes very carefully … over a long period of time.”
Is there an effective vaccine for bundibugyo Ebola virus?
GAVI, the Vaccine Alliance and other partners are working to explore ways to speed up the development of vaccines in the research and development stage – but it could be months before doses are ready for clinical trials.
GAVI is funding a stockpile of Ebola vaccines approved for use against Zaire Ebola and said in a press release that “there are currently no approved vaccines for BVD (Bundibugyo virus disease).”
“Considering the limited evidence available for protection against non-Zairean strains, any decision to use this vaccine in the current outbreak of BVD will require further evaluation and will be done in accordance with WHO guidance,” said a press release issued Thursday.
“(It can be used) only with the informed consent and understanding of the affected communities that the benefit of the BVD vaccine is not yet known.”
If there was an Ebola case in Canada, would we be ready?
There has never been a case of Ebola in Canada.
On Wednesday, Ontario’s health department said it was testing a person who recently returned from East Africa “out of an abundance of caution.”
Officials did not disclose what type of Ebola the Ontario patient was tested for, or what state he had traveled to.
A spokesperson for the Public Health Agency of Canada said test samples are expected to arrive Thursday at the National Microbiology Laboratory in Winnipeg.
If there is an Ebola case in Canada, both Bogoch and Thumath say the country’s public health systems and hospitals will be well equipped to handle it.
But one of the most important ways Canadians can protect themselves from Ebola is to invest in stopping its spread elsewhere, they say.
“The longer and larger the outbreak, the more likely it is to spread globally,” Bogoch said.
“The risk is small. But it’s not zero percent and the longer this goes on and the bigger it is, the greater the risk.”
Thumath said the outbreak of global diseases is important, no matter where we live in the world.
“As we know, infectious diseases do not respect borders,” he said.
“In North America, I think there’s a perception that, ‘oh, this (outbreak) only happens over there,’ but rapid containment is very important for global health security. So the best thing we can do is share our expertise, share our resources, and make sure they’re contained.”
