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5 Reasons Ebola Was Contained in the Congo

Oct 16, 2014
TIME Health
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While the world rightly focused on the growing number of Ebola cases emerging from Africa’s west coast this summer, the virus made another appearance in the heart of the continent: in the Democratic Republic of Congo (DRC), where Ebola was first identified in the 1970s. That outbreak—which was of another strain of Ebola Zaire—spread to just 69 people, however, and a report in the New England Journal of Medicine, has some answers as to why.

The DRC outbreak began with a pregnant woman who butchered and ate a dead monkey her husband had found in the Inkanamongo village, near a remote, forested area in the equatorial province. Presumably, the monkey was infected with Ebola; the woman became ill on July 26 and died on August 11. A local doctor and three health workers who performed a Cesarean section to remove the fetus before burial were also infected and died of Ebola.

Nearly two dozen others who were infected had direct contact with the woman, and most of them had helped care for her after she became sick. Forty nine of the 69 people who either had confirmed or suspected infection died. The number of cases was kept to a minimum, say the study authors, for five reasons, which could help inform how to contain the epidemic in the west.

PHOTOS: See How a Photographer is Covering Ebola’s Deadly Spread

Members of a Liberian Red Cross burial team, under contract from the Liberian Ministry of Health, remove the body of suspected Ebola victim Lorpu David, 30, on Sept. 18, 2014, in the Gurley street community in central Monrovia, Liberia.
Members of a Liberian Red Cross burial team, under contract from the Liberian Ministry of Health, remove the body of suspected Ebola victim Lorpu David, 30, on Sept. 18, 2014, in the Gurley street community in central Monrovia, Liberia.Daniel Berehulak—The New York Times/Redux
Members of a Liberian Red Cross burial team, under contract from the Liberian Ministry of Health, remove the body of suspected Ebola victim Lorpu David, 30, on Sept. 18, 2014, in the Gurley street community in central Monrovia, Liberia.
EBOLA OUTBREAK IN LIBERIA
A burial team collects the body of a 75-year-old woman in a neighborhood called PHP in Monrovia, Liberia.
A resident of the West Point neighborhood covers his nose as a burial team departed with a body in Monrovia, Liberia.
Members of a burial team from the Liberian Red Cross remove the body of a man, a suspected Ebola victim, from a home in Matadi on Sept. 17, 2014 in Monrovia, Liberia.
EBOLA OUTBREAK IN LIBERIA
Residents look on as the body of a man suspected of dying from Ebola lies in a busy street, after it was reportedly dragged there to draw attention to burial teams following days of failed attempts by his family to have his body picked up, in Monrovia, Li
Friends and relatives weep as a burial team removes the body of a 75-year-old woman who neighbors insisted died of a stroke, in a neighborhood called PHP in Monrovia, Liberia.
Eric Gweah, 25, grieves as he watches members of a Red Cross burial team carry the body his father, Ofori Gweah, 62, a suspected Ebola victim, in a riverside area called Rock Spring Valley in central Monrovia, Liberia.
Residents discuss an Ebola awareness campaign in Monrovia, Liberia.
Residents of the West Point neighborhood attend church after a 10-day quarantine was lifted in Monrovia, Liberia.
EBOLA OUTBREAK IN LIBERIA
EBOLA OUTBREAK IN LIBERIA
Medical staff carry James Dorbor, 8, suspected of having Ebola, into a treatment facility in Monrovia, Liberia.
EBOLA OUTBREAK IN LIBERIA
EBOLA OUTBREAK IN LIBERIA
EBOLA OUTBREAK IN LIBERIA
Members of a Liberian Red Cross burial team, under contract from the Liberian Ministry of Health, remove the body of sus
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Daniel Berehulak—The New York Times/Redux
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1. While both regions practice similar cultural rituals surrounding burial, including touching the bodies of the dead, some behaviors in the equatorial DRC differ from those in West Africa, and thus help to limit spread of the virus from person to person.

2. The strain circulating in DRC is also genetically different from that in Guinea, Sierra Leone and Liberia, and may have a different disease trajectory.

3. The remote and relatively isolated locations of villages in DRC helped to contain the virus and prevent it from spreading as quickly as it does in large, mobile populations.

4. The DRC may have a stronger health response to Ebola given its longer history with the virus. Since it first appeared there in 1976, the Congo has weathered six outbreaks and may have more experience in responding quickly and educating its citizens about how to control infection.

5. Finally, because the virus has circulated among the people in DRC, they may have more immunity to it, and could be in a better position to fight off infection.

The DRC outbreak provides a stark contrast to the way Ebola has erupted in West Africa; it shows how an experienced and prepared community might be one of the most important ways to help stop spread of a deadly disease. Similar strategies have helped to contain the epidemic in Nigeria and Senegal, which neighbor the most heavily affected countries in West Africa but are close to declaring their outbreaks over.

Read next: Lawmakers Grill Obama Administration Over Ebola Outbreak

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