By Sylvia Chebet
In the shadow of the vicious Ebola virus that perennially looms over parts of Africa, newly corroborated information about the power of vaccination holds out hope.
A recent study by Médecins Sans Frontières (MSF) revealed a significant reduction in mortality rates even among those vaccinated after exposure to the virus, debunking the perception that getting jabbed after being infected serves little or no purpose.
The study, published in The Lancet Infectious Diseases, analysed data from the 10th Ebola epidemic in the Democratic Republic of Congo (DRC) from 2018 to 2020.
The research data showed mortality risk reducing from 56% among unvaccinated patients to 25% for those who had received the vaccine.
The reduction in risk of death through vaccination applied to all ages and genders, irrespective of whether they got a shot before or after exposure.
MSF's East and Southern Africa programme manager, Dr Christopher Mambula, who was in DRC during the last epidemic, sees this as nothing short of a breakthrough.
He tells TRT Afrika that the findings are reassuring in the face of the prospect of battling yet another outbreak of such a "scary disease."
Misleading symptoms
What makes Ebola dangerous is that someone who has contracted the virus could easily be misled into thinking it is the flu until the infection progresses to an advanced stage of disease.
"The symptoms — fever, aches, sore throat, lack of appetite, weakness, and muscle and joint pains — mimic common ailments during the incubation period of two to 21 days," explains Dr Mambula.
"For those who end up having severe forms of the disease, the liver and the kidneys are affected. What then happens is there is dysfunction in both of those organs, which can lead to bleeding.”
Dr Mambula believes that without vaccination, anyone in an Ebola-affected zone is at high risk of death. "Once people contract the virus, it's almost like you are flipping a coin," he says.
During the largest Ebola outbreak in history (2014-2016), the disease spread beyond Africa to Europe and the US, where 28,000-odd cases were recorded.
More than 11,000 infected people died in Guinea, Sierra Leone and Liberia, the epicentre of the outbreak.
Emerging options
Against this backdrop, the new study opens up new possibilities for the treatment and management of ebola.
"Our results allow us to consider combining vaccination and treatment. No antagonistic effect between vaccination and treatment against Ebola was observed in this study," says Etienne Gignoux, MSF’s director of epidemiology.
But as Dr Mambula points out, there are multiple hurdles. For one, vaccine availability is still problematic.
"It's not like you can just click your finger, and you are producing a lot of it," he says, explaining that the vaccine is not commercially viable for manufacturers to produce in large quantities.
Furthermore, the vaccine that was the subject of MSF's study is only effective against the Zaire Ebolavirus strain, not against the other three types (Sudan, Bundibugyo and Tai Forest) that also cause illness in people.
The good news is that should there be a future outbreak, doctors know they can successfully treat vaccinated and unvaccinated patients.
Experts note that this would also give confidence to health workers deployed during Ebola outbreaks.
Production challenges
Designed to be administered in a single dose, the ERVEBO or rVSVΔG-ZEBOV-GP vaccine is recommended primarily for "ring vaccination" of people at high risk of exposure during Ebola outbreaks.
"You find a case, and then all contacts and the latter's contacts would be vaccinated," says Dr Mambula.
While the findings of the MSF study reveal that the world has found the strongest bulwark yet against the dangerous hemorrhagic fever, Dr Mambula flags some difficulties in scaling up vaccine production.
"Ebola is not something that occurs often. That means from a business perspective, it's not the vaccine that would make them tonnes of money. So, production of those vaccines is still fairly limited."
The same applies to the production of Ebola medicines.
"A few hundred treatments are available. I mean, if you have an outbreak of the scale of what happened in West Africa, your available treatments aren't going to cut it. At the end of the day, the tools to fight Ebola are fairly limited," explains Dr Mambula.
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