FIU experts answer questions about the Ebola outbreak in the DRC

The quickly escalating Ebola outbreak in the Democratic Republic of the Congo (DRC) caused by a rare strain is raising global concern and renewing questions about public health preparedness, international travel and the risk of the contagion spreading widely. DRC health authorities have reported over 1000 suspected and confirmed cases and over 200 suspected and confirmed deaths.

FIU experts with Robert Stempel College of Public Health and Social Work say the risk of Ebola to the general U.S. public remains low, but the outbreak highlights the importance of global health preparedness and surveillance.

Dr. Mary Jo Trepka, a professor and the chair of the Department of Epidemiology, and Rajiv Chowdhury, a professor and the chair of the Department of Global Health, answer pressing questions and explain what South Florida residents should understand about the Ebola outbreak in the DRC.

What is Ebola and how does it spread?

Trepka: Ebola is a very severe infectious disease caused by a group of viruses called orthoebolaviruses. The current outbreak, which is primarily affecting the DRC and Uganda, is caused by the Bundibugyo virus, which is rare.

The natural hosts for Ebola are most likely fruit bats, and now and again there is what is called a spillover event, when the virus crosses into humans. This can happen if people have close contact with infected animals, for example through hunting, handling or eating. Once a human is infected, they can infect other humans.

Human-to-human Ebola transmission happens if a person has direct contact with the bodily fluids of people who have been sick or died from Ebola disease. The people who are at highest risk of infection are health care providers and family members who care for a person with Ebola. 

What are its symptoms?

Trepka: The time between when people are infected until they have symptoms is on average 8-10 days. The initial symptoms include fever, fatigue, muscle pains, headache and sore throat. These first symptoms are not unique and can be confused with other infections that are common in the areas where Ebola occurs. As the disease progresses a person can develop vomiting, diarrhea, abdominal pain, rash, problems with their kidneys and liver and unexplained bleeding. Ebola also affects the brain and can result in confusion and seizures.

We also don’t have a specific treatment for the current strain. It has a case fatality rate of 30-50%, meaning potentially two of four people who become ill with it have died although that information comes from outbreak settings where intensive medical care is not always readily available. Supportive intensive medical care does improve the prognosis. If people survive, they start to get better six days after the symptoms start.

Why are global health experts especially concerned about this outbreak right now?

Chowdhury: The current outbreak in DRC and Uganda is particularly concerning. It involves a rare strain that is spreading rapidly into urban and cross-border areas and, as mentioned, there is currently no licensed vaccine or approved treatment for it. Additionally, there are severe medical supply shortages, including basic pain medication, face masks, protective gloves and motorbikes needed for contact tracing in the remote and conflict-affected areas in DRC. 

Moreover, there is concern that the outbreak has already spread geographically to eastern DRC and Uganda, and that, given the scale and speed of the epidemic, suspected cases are rising quickly. The crisis has been further complicated by delayed detection.

Chowdhury: The CDC currently considers the risk of Ebola transmission to the United States low, though enhanced travel measures are in place for affected countries. Therefore, I would say that, for the public, international travel through major U.S. airports remains low risk. However, travelers should consult and follow CDC guidance before traveling to the DRC, Uganda or nearby areas.

Modern systems can help identify high-risk travelers, detect symptoms and quickly connect people to public health monitoring. However, screening is imperfect because Ebola can incubate for up to 21 days before symptoms appear. Therefore, stronger local health systems, rapid testing and contact tracing remain essential for limiting global spread.

What role do universities like FIU play in global health preparedness and infectious disease research?

Trepka: A key goal is that we have a trained workforce that has developed the competencies needed to investigate infectious disease outbreaks and control them. The Robert Stempel College of Public Health and Social Work has trained many of the disease control specialists in our community as well as professionals at the state and federal level. We cannot predict all the infectious diseases that may threaten our community, but if our students know how to go about investigating outbreaks and containing them, our community is safer.

Chowdhury: At FIU, we support that preparedness and health protection through global health research, training, surveillance, data analysis, community education and partnerships with local and regional health departments. So, FIU can contribute through our global health expertise, student training, and work with different communities closely connected to international travel.