Scientists are confident future outbreaks of Ebola will have less impact because vaccines will be readily available.
Their comments came amid the outbreak in the Democratic Republic of the Congo, where there have been 344 cases and 60 deaths, along with 15 cases and one death in nearby Uganda.
Earlier this week, The National reported that the Coalition for Epidemic Preparedness Innovations has committed up to $50 million to support development and early testing of Moderna's vaccine candidate.
A second potential shot is being developed by the International Aids Vaccine Initiative and a third by the University of Oxford, with production by the Serum Institute of India.
“I’m really hoping the next [outbreak] will be thwarted by the mRNA vaccines, I really do hope it will,” said Prof John Oxford, co-author of the textbook Human Virology.
Ian Jones, a professor of virology at the University of Reading in the UK, said mRNA technology could be adapted quickly to develop new vaccines.
“For the RNA technology you can do it in two weeks,” he said. “Then you have to do preclinical tests to make sure it’s safe, but there’s no reason why it shouldn’t be safe.”
Tackling the outbreak
The outbreak was identified last month, but this week Dr Tedros Adhanom Ghebreyesus, director general of the World Health Organisation, said it could have originated in January.
However, on a more optimistic note, the WHO reported this week that the number of suspected cases of the disease has fallen from more than 1,000 last week to just 116 this week, with many people thought to have been infected having tested negative.
At the same time, efforts to develop a vaccine to the Bundibugyo strain, which is responsible for the current cases, are increasing.
A vaccine could, scientists say, mean that further outbreaks - each of which begins when the Ebola virus transfers from a wild animal to a person – are likely to have a more limited impact.
Given that trials could start within months, a new vaccine may even play a part in curtailing the current outbreak.
In comments reported this week by the Coalition for Epidemic Preparedness Initiatives (Cepi), which along with its partners has reportedly invested more than $60 million in the three Bundibugyo vaccine candidates, Dr Tedros said that a successful vaccine “could help to control this epidemic and strengthen preparedness for future outbreaks”.
As of now, the only approved Ebola vaccine is against the Zaire strain, which was behind a major outbreak of the disease in West Africa from 2014 to 2016.
A third form of Ebola, known as Sudan, has also caused large-scale outbreaks in people, but no vaccine for this is available.
Prof Paul Hunter, a professor in medicine at the University of East Anglia in the UK, who sat on a WHO/Unicef/Red Cross expert working group on Ebola at the time of the West Africa outbreak, said the Bundibugyo strain had “not been high up on the list of priorities before” because it caused only two outbreaks.
“I don’t think it’s going to be that difficult to get a good vaccine for it in the coming months,” he said.
Funding challenge
Efforts to develop vaccines against Ebola have in the past struggled because of a lack of funding, something blamed on the disease largely affecting people in poorer nations.
Margaret Chan, a former WHO director general, previously said that because Ebola was “historically, geographically confined to poor African nations, the R&D [research and development] incentive is virtually non-existent”.
“A profit-driven industry does not invest in products for markets that cannot pay,” she said.
Prof Jones said the financial support of Cepi was important in the current efforts to develop vaccines, although he cautioned that another problem would be gaining access to distribute any shots, as Ebola mostly affected “relatively rural, poor communities”.
“I fully support the vaccine development [but] it’s not a magic cure because you still have got to go into the area to vaccinate people,” he said.
Poor levels of contact tracing and mistrust of the authorities, with some residents believing that Ebola is not real or that patients are not being treated properly, have hampered efforts to control the outbreak and resulted in attacks on clinics.
Concerns over misinformation were also rife during the 2014 to 2016 West Africa outbreak, according to Prof Hunter.
“There was a lot of fake news and conspiracy theories – ‘It’s the government, they’re doing it for ethnic cleansing’ – that sort of thing,” he said.
“People are not necessarily behaving in their best interests and not in their community’s interests because of that.”
That outbreak saw more than 28,000 cases and more than 11,000 deaths, the overwhelming majority in Guinea, Liberia and Sierra Leone.
Another problem during the current outbreak is military conflict in the DRC’s Ituri province, an epicentre for the outbreak.
“In the past combatants have targeted and murdered healthcare workers and vaccine operatives,” Prof Hunter said.
“Trying to bring an epidemic under control where the staff have a very real risk of being murdered by armed combatants is not easy.”
Dr Bharat Pankhania, an independent public health doctor and former senior clinical lecturer at the University of Exeter Medical School in the UK, said the outbreak was “picked up late” and covered a large and unstable region.
Making people understand the importance of good hygiene and of limiting contact with other people was difficult, according to Dr Pankhania, especially as it was a poor region where people had to go out and work to survive.
“It takes a lot of effort to get that message across,” he said. “It’s significantly more [challenging] because it’s in a hard-to-manage geographical area which has its problems.”
Changes needed
Ebola is a viral disease that initially causes flu-like symptoms. It damages blood vessels and impairs clotting, with patients often suffering severe bleeding, internally and externally, and organ damage.
Mortality rates vary according to the exact type of virus causing the disease, but across previous outbreaks they have averaged around 50 per cent.
The virus, initially picked up from animals, does not spread easily between people, typically requiring exposure to infected bodily fluids.
Prof Oxford said that changes to funeral practices, which traditionally involve touching and washing the deceased ahead of the ceremony, were “the single biggest thing” needed to prevent spread.
Efforts to improve hygiene and reduce contact between people would, he forecast, eventually cause the outbreak to “die out”.
During the current outbreak there have been suspected cases of Ebola outside Africa, including in Brazil and Italy, leading to concerns about widespread global outbreaks, but the individuals involved have subsequently tested negative.
Prof Hunter said that, based on events in West Africa, cases in other parts of the world were “sort of expected”.
“There was a small number of cases that became ill elsewhere in the world and an even smaller number of people who acquired their infection from people returning,” Prof Hunter said, referring to the 2014-2016 outbreak.
“My feeling is that Ituri province, being such a big conflict area, there won’t be that many people, that many tourists or people visiting their family and then going back [to their home outside Africa],” he added.
Preventing future transmissions from wild animals, notably fruit bats, which are the “reservoir” of the virus, is difficult, Prof Oxford said, because of the dependence of communities on bushmeat.
