A French doctor who had been working in the Democratic Republic of Congo (DRC) has tested positive for Ebola after returning home, marking the first case of the virus confirmed in France and in Europe since the current outbreak began. The doctor was immediately admitted to a specialised facility and is in a stable condition, according to the French health ministry, which stressed that the risk to the population was “very low”. But the case has drawn attention back to one of the world’s deadliest viruses and the ongoing epidemic in central Africa.
Ebola is a rare but severe haemorrhagic fever that spreads through direct contact with the bodily fluids of infected people or animals. Symptoms can appear suddenly between two and 21 days after infection, starting with flu-like signs such as a high temperature, extreme tiredness and headache. The virus is highly infectious and can be fatal in a high proportion of cases. Healthcare workers are especially at risk: in the current outbreak, 17 of the 75 health workers who caught Ebola in the DRC have died.
“An explainer on Ebola, the current outbreak, and why a case in France matters.”
The current outbreak is caused by the Bundibugyo species of the virus, for which there is currently no approved vaccine or specific treatment. According to both Africa’s Centres for Disease Control and Prevention (Africa CDC) and US public health authorities, this outbreak has the potential to be one of the largest ever. More than 1,000 people have been infected and more than 260 have died in the DRC, where cases are concentrated in the eastern provinces of Ituri, South Kivu and North Kivu. Ituri accounts for more than 90% of confirmed infections. Uganda, a neighbour of the DRC, has also confirmed Ebola cases – 20 people infected and two deaths, according to the World Health Organization (WHO). The WHO has warned that conflict in eastern DRC, where the M23 rebel group controls large parts of North and South Kivu, is making it more difficult to tackle the outbreak. Contact tracing – identifying everyone an infected person has come into contact with – has only 43% coverage in the DRC, and Oxfam has warned that the true toll is likely far higher because the country’s water infrastructure and health system are at breaking point. Only one in five health centres in Ituri has access to enough clean water.
For UK readers, the case in France is a reminder that infectious diseases can travel quickly in an interconnected world, even if the direct risk to the UK remains low. The WHO’s chief, Tedros Adhanom Ghebreyesus, said “the risk to the rest of the world is low” and that there was “no need to panic”. France has set up a dedicated monitoring system for aid workers returning from the DRC, and similar systems could be activated in other European countries if needed. The absence of an approved vaccine for the Bundibugyo strain means that, unlike the 2014-2016 West Africa outbreak, there is no prophylactic tool for healthcare workers or contacts. Four experimental vaccine candidates are being developed, but clinical trials have not yet started. This gap leaves the world reliant on rapid detection, isolation, and contact tracing – measures that are severely hampered by conflict and weak health infrastructure in the DRC.
Q: What is Ebola? Ebola is a rare but severe viral haemorrhagic fever that causes symptoms such as fever, fatigue, headache, vomiting, diarrhoea, and in some cases internal and external bleeding. It spreads through direct contact with the bodily fluids of infected people or animals, and can be fatal.
Q: How is Ebola spread? The virus spreads through direct contact with blood, saliva, sweat, vomit, urine, faeces, or other bodily fluids of an infected person or someone who has died from Ebola. It can also spread through contaminated objects like needles. It is not airborne.
Q: Why is there no vaccine for this outbreak? The current outbreak is caused by the Bundibugyo species of Ebola, for which there is currently no approved vaccine or treatment. Vaccines exist for the Zaire strain, but they do not work against Bundibugyo. Experimental vaccine candidates are being developed but have not yet started clinical trials.
What happens next will depend on the effectiveness of containment efforts in the DRC and Uganda, and on the speed of contact tracing around the French case. The WHO has declared a public health emergency, and work on experimental vaccines continues. The outbreak in the DRC shows no sign of abating, and conflict remains a major barrier to stopping the spread.