The new epidemic between the Democratic Republic of Congo and Uganda has prompted the WHO to intervene. Because there is no vaccine for the Ebola virus. Here are the possible scenarios
In recent days a word that seemed to belong to the archives of major global health emergencies has suddenly returned to the center of the news: ebola. THE’World Health Organization (WHO) one declaredinternational health emergency after a new resurgence of the virus among the Democratic Republic of Congo (DRC) and theUgandawhere confirmed cases, deaths and signs of cross-border transmission are being recorded. This is a very high alert level, the same used when an outbreak requires global coordination, although, it is worth clarifying immediately, it does not mean that we are faced with a new pandemic. Above all, what further reignited international attention was the case of an American doctor infected during field work in Congothen evacuated to Germany for specialist treatment. US health authorities confirmed the case, underlining however that the risk for the general population remains lowwhile strengthening controls and monitoring of travelers coming from the areas involved. The current outbreak concerns the Bundibugyo ebolavirusa rarer strain than the Zaire ebolavirusresponsible for the major epidemics of recent years. The difference is not just taxonomic: the problem is that There are currently no approved vaccines or specific authorized therapies for this variantan element that makes management more delicate. According to the most recent data available, there are Congo and Uganda hundreds of suspected cases and over one hundred suspected deathswhile the situation is made more complex by the fact that the outbreak affects areas marked by political instability, high mobility and fragile health infrastructures. Above all, WHO fears that there is a significant proportion of cases that are still unidentified. Yet, just while the term Ebola returns to evoke disaster movie scenariosthe first thing to do is to distinguish between perception and real risk.
Can Ebola reach Italy? The real risk explained without alarmism
The question that many are inevitably asking is simple: should we worry in Italy? The response of European bodies, at least at present, is relatively reassuring: the risk for the Italian and European population is considered very low. Also the European Center for Disease Prevention and Control (ECDC) clarified that, while carefully monitoring the evolution of the epidemic, the probability of infection for those living in the European Union remains minimal. The reason is simple and very different from the experience with Covid-19: Ebola is not a respiratory virus and is not transmitted through the air. It is not enough to be in the same environment as a sick person, share public transport or breathe the same air. Contagion occurs through direct contact with blood, vomit, saliva, urine, feces, sweat, or other body fluids of a symptomatic personor via contaminated materials such as needles or biologically exposed surfaces. Also, the virus it becomes contagious when symptoms appearand not before. It is precisely this characteristic that makes Ebola much more containable than respiratory viruses. Furthermore, Italy has highly structured hospital protocols for high-risk infectious diseasesrefined precisely after the great epidemics of recent years. From airports to infectious disease departments, there are established procedures for early identification, isolation and contact tracing. This does not mean that the risk is zero. Globalization, international flights and continuous mobility always make the importation of an isolated case possible. However, a possible introduction of the virus into our country does not automatically equate to uncontrolled spread. Epidemiological history shows that sporadic cases of Ebola imported into Europe or the United States have generally been contained quickly through immediate isolation, surveillance and personal protective equipment. More than the virus itself, therefore, what worries international experts today is the ability to contain the outbreak at its source, in the African regions where the health system is more fragile.
Symptoms, treatments and vaccines: what to really know today about Ebola
But How does Ebola manifest itself? Initial symptoms may seem surprisingly nonspecific: high fever, intense tiredness, muscle pain, headache, nausea, vomiting and diarrhea. In more serious cases they may appear internal or external bleedingmultiple organ failure and systemic shock. Progression can be rapid, which is why early diagnosis is crucial. One of the most delicate aspects of the current epidemic concerns the strain involved. For it Zaire ebolavirusresponsible for the most well-known epidemics, there are specific vaccines and treatments already used in Africa in recent years. But the Bundibugyo virusprotagonist of the current resurgence, represents a different problem: There is not yet an authorized targeted vaccine or a specific approved drug. This forces healthcare workers to focus above all on early diagnosis, isolation of cases, contact tracing and intensive supportive care. What does “supportive therapy” mean? Specifically: aggressive hydration, blood pressure stabilization, electrolyte management, respiratory support, and treatment of complications. It is precisely the timeliness of treatment that often makes the difference in survival. In the past, the mortality rate associated with the Bundibugyo strain has fluctuated between 30% and 50%lower than some historical variants of Ebola but still very high.
The real good news, however, is that the world today is no longer as unprepared as it was in the 1990s or during the devastating West African epidemic of 2014-2016. Accumulated experience, international surveillance networks and the speed of health communications allow for a much more timely response. For this reason, if on the one hand it is correct to carefully follow what is happening in Congo and Uganda, on the other There are no elements today that justify alarmism in Italy. The key word, if anything, is another: vigilance. Because Ebola remains a severe disease, but it is not an invisible enemy that spreads silently through the air. And knowing well how it is transmitted, how it is treated and how it is controlled is the best way to prevent fear from taking the place of correct information.
