The isolation of suspected Ebola patients is one of the strategies to prevent the spread of the Ebola virus. Given the current outbreak in the Democratic Republic of the Congo, "ring vaccination" could severely hamper the spread of disease.
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The Democratic Republic of the Congo (DR Congo) is again threatened by an Ebola outbreak. Can vaccinations really help to thwart Ebola?
Ebola outbreak in the DRC
According to the World Health Organization (WHO), the first deaths from the ongoing Ebola virus epidemic in the DRC happened in January. Since then, the most recent data show a cumulative total of 58 EVD cases, including 27 deaths from the three health zones. Of the cases, 28 were confirmed, but 21
This is the ninth EVD outbreak in the DRC over the last 40 years, with the last outbreak last May 2017. Several organizations, including the WHO, the Ministry of Health, the Ministry of Health of Guinea, Gavi The Vaccine Alliance, UNICEF and Médecins Sans Frontières are working together to fight the outbreak.
Some of the prioritized options for action in the fight against the outbreak include community engagement, surveillance and contact tracking, infection prevention and control, case management, vaccination and provision of safe and dignified burials for the deceased.
Ebola Virus Vaccine
The rVSV-ZEBOV has proven to be an effective protection against EBV. It has been found safe and protective against EVD following successful clinical trials involving more than 16,000 volunteers in Africa, the United States and Europe.
The vaccine consists of vesicular stomatitis virus that has been genetically modified to also contain a Zaire-Ebola protein. Vesicular stomatitis virus is an animal virus that can cause flu-like symptoms in humans, and with the Zaire-Ebola protein, it can provide an immune response against the Zaire strain of the Ebola virus.
Although it is effective against 100% Ebola, the vaccine is technically not approved yet and its effects are limited to the Zaire Ebola strain. Against this background, the WHO Advisory Group on Immunization Strategists has already recommended that an outbreak of the Zaire-Ebola strain occur before the vaccine has been approved, to be used immediately following patient consent and in accordance with good clinical practice
] Ring vaccine strategy for the outbreak of DRC
Due to the risk of a major outbreak, the administration of vaccines for Bikoro, Iboko and Mbandaka is expected, the three sites where laboratory-confirmed Ebola have been registered. However, the vaccine will not be distributed immediately. Instead, it is administered using the "ring vaccine" strategy whereby individuals with higher risk of infection are first detected and administered with the vaccine because of intimate connections or interactions with a patient.
This "ring" does this Mean it is generally not a geographical circle, but rather a social network of potentially vulnerable people. This may include family members, neighbors, visitors, or individuals who have had contact with the sick for the last 21 days, even if they live in a fairly remote area. In general, such "rings" can consist of up to 150 individuals.
This "ring vaccine" strategy is very similar to the strategy used to eradicate smallpox . Together with other measures to prevent the spread of disease, vaccination can help fight the outbreak in the affected communities.
Participation in the vaccination is completely voluntary, but children, as well as pregnant and nursing women, are not given the vaccine. Healthcare providers and frontline workers in affected areas are also vaccinated.
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