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 a few strains of viruses that cause Ebola. The most common viruses 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.
the The type of Ebola causing the outbreak happening now is called Bundibugyo virus.
“Most Ebola outbreaks have been caused by the Zaire strain of the Ebola virus. This is where most of the research has focused on vaccines and treatments,” Bogoch said, noting that Canada’s National Microbiology Laboratory helped pioneer the first Ebola vaccine.
He said one of the worrying things about the Bundibugyo outbreak is that there are no treatments or vaccines proven effective on this strain.
Symptoms are similar for all strains of Ebola and can begin with fever, fatigue, muscle pain, headache and sore throat, according to the World Health Organization.
It can progress to vomiting, diarrhea, abdominal pain, rash, and poor kidney and liver function.
Internal and external bleeding, including blood in the gums or in the stool, can also occur, but not as frequently as other symptoms.
“I think there’s a perception that bleeding is a common symptom, but it’s actually less frequent and really occurs at that late stage (of the disease),” said Megan Thomath, an assistant professor of public health and emergencies at the University of British Columbia who worked with the World Health Organization during another Ebola outbreak in the Democratic Republic of Congo in 2019.
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One challenge in diagnosing Ebola is that many of the symptoms also occur in other infectious diseases such as malaria, typhoid fever and meningitis, so diagnostic testing is vital.
The incubation period for Ebola virus ranges from 2 to 21 days. Trish Newport, a Canadian who works as an emergency director for Doctors Without Borders, said people infected with Ebola are not contagious until they show symptoms.
The Ebola virus is spread through contact with bodily fluids.
“People infected with Ebola become very ill. So it can be vomiting, diarrhea, blood and respiratory secretions,” Bogoch said.
“The people who tend to become infected with Ebola are unfortunately family members of infected individuals who are directly caring for a close contact (or) health care providers who either do not have access to appropriate personal protective equipment or do not use their PPE appropriately if there is a breach,” he said.
Ebola can also spread when people who have died from the virus are buried if their loved ones touch their bodies without taking proper precautions.
Monoclonal antibodies that help the body fight the disease can treat the Zaire strain, but their effectiveness has not been proven in people infected with the Bundibugyo strain, Bogoch said.
There are also vaccines that can be given to someone exposed to the Zaire variant to either avoid infection or at least reduce the severity of the disease, but again, these have not been tested with Bundibugyo.
“The mainstay of treatment is supportive care,” Bogoch said.
“That means you need a good hospital, you need good medical management, you need to replenish fluids and electrolytes, because unfortunately one of the features of the Ebola virus is severe nausea, vomiting, diarrhea, organ dysfunction, and sometimes bleeding. And you just need to meticulously replace fluids and electrolytes … over a long period of time.”
Is there a vaccine in the pipeline for Bundibugyo Ebola virus?
The Global Alliance for Vaccines and Immunization (GAVI), the Vaccine Alliance and other partners are evaluating ways to accelerate the development of vaccine candidates that are in the research and development stage – but it could be months before the doses are ready for clinical trials.
GAVI is funding the stockpile of Ebola vaccines currently licensed for use against Ebola in Zaire, and said in a press release that “there are currently no licensed vaccines for Bundibugyo virus disease.”
“Given the very limited evidence available on cross-protection against non-Zairean species, any decision to use this vaccine in the current BVD outbreak will require further evaluation and will be implemented in accordance with WHO guidance,” Thursday’s press release said.
“(It can be used) only with explicit informed consent and the understanding of affected communities that the benefit of the vaccine against RA is currently unknown.”
If there was an Ebola case in Canada, would we be prepared?
There has never been a case of Ebola in Canada.
Ontario’s Ministry of Health said Wednesday it was testing someone who had recently returned from East Africa “out of an abundance of caution.”
Officials did not reveal the type of Ebola the patient tested positive for in Ontario or the region he traveled to.
A Public Health Agency of Canada spokesperson said test samples are expected to arrive Thursday at the National Microbiology Laboratory in Winnipeg.
If there were an Ebola case in Canada, both Bogoch and Thomath said the country’s public health and hospital systems would be well-equipped to handle it.
But they said one of the most important ways Canadians can protect themselves from Ebola is to invest in stopping its spread elsewhere.
“The longer the outbreak lasts and the larger its size, the greater the potential for international spread,” Bogoch said.
“The risk is small. But it’s not zero percent, and the longer it goes on and the bigger it is, the higher the risk.”
Thomath said the global outbreak is important, no matter where we live in the world.
“As we know, infectious diseases do not respect borders,” she said.
“In North America, I think there’s a perception of, ‘Oh, these (outbreaks) only happen there,’ but rapid containment is critical to global health security. And so the best thing we can do is share our experts, share our resources, and make sure it’s contained.”
