The Ebola outbreak in the Democratic Republic of Congo (DRC) is now at 6,041 cases and 2,911 deaths, as the Bundibugyo strain has taken hold in North Kivu province. 

According to the most recent update from the World Health Organization (WHO), the outbreak now has a crude case fatality ratio (CFR) of 48.1%, or nearly half. 

“The crude case fatality ratio of 48% underscores the severity of the disease and ongoing challenges related to timely case detection, access to and quality of clinical care, and effective interruption of viral transmission,” the WHO said.  “Delays in recognizing cases increase the likelihood of onward transmission within households, communities and healthcare facilities.” 

New treatment center in North Kivu

In other developments, Doctors Without Borders (MSF) is opening a new Ebola Treatment Center in Beni to strengthen response in North Kivu. Though Ituri and North Kivu have the most cases, the outbreak is now in six provinces, including South Kivu, Haut-Uélé, Bas-Uélé and Tshopo.

“Eola disease is terrifying, and many people refrain from seeking healthcare out of fear to catch the virus in the health facilities or due to false rumours about the care that is provided there. This means that patients who have diseases like malaria, which is the leading cause of death in the country, or women and girls who are pregnant, might not get the care they need,” MSF said in a press release. 

“This risks causing more people getting sick or dying from other causes than Ebola disease. Therefore, working alongside local communities, MSF is also strengthening primary healthcare services in the affected areas.” 

A study published last week in Obstetrics & Gynecology found no significant link between long COVID and preterm birth or several other adverse pregnancy outcomes but did uncover an association with hypertensive disorders of pregnancy.

Researchers from University of Utah Heath led the analysis of data on female COVID-19 survivors enrolled in the Researching COVID to Enhance Recovery (RECOVER) study from October 2021 to January 2024. Participants had completed at least one symptom survey and were classified as having likely or suspected long COVID before or during pregnancy.

The primary outcome was preterm birth (before 37 weeks’ gestation), and secondary outcomes were hypertensive disorders of pregnancy, cesarean delivery, neonatal intensive care unit (NICU) admission, and small-for-gestational-age birth weight (below the 10th percentile). 

Long COVID and adverse social determinants of health 

Of 603 participants, 19.6% likely had long COVID before or during pregnancy. These women were more likely to have certain adverse social determinants of health (difficulty covering expenses and paying bills, food insecurity, cost-related missed care, medical discrimination) and higher pre-pregnancy body mass index (BMI) than those with suspected long COVID. 

The association with hypertensive disorders of pregnancy in the average treatment effect among the treated analysis highlights the need for further research.

The primary treatment-effect analysis identified no link between likely long COVID and preterm delivery (adjusted outcome rate, 8.1% exposed vs 9.6% unexposed; absolute risk reduction [ARR], 0.82) or secondary outcomes. 

In the treated sensitivity analyses, probable long COVID was similarly not tied to preterm delivery (ARR, 1.11) but was associated with an increased risk of hypertensive disorders of pregnancy (adjusted outcome rate, 39.0% exposed vs 25.9% unexposed; ARR, 1.51) but not with other secondary outcomes.

“A classification of likely Long COVID was not significantly associated with preterm birth or several other adverse pregnancy outcomes,” the study authors wrote. “However, the association with hypertensive disorders of pregnancy in the average treatment effect among the treated analysis highlights the need for further research.”

Japanese drugmaker Shionogi announced last week that the US government has ordered $37 million worth of the antibiotic ceferidocol to support national preparedness.

The Biomedical Advanced Research and Development Authority’s (BARDA’s) Project BioShield exercised the $36.9 million procurement option on the antibiotic as a critical countermeasure against difficult-to-treat gram-negative bacterial infections and pathogens that could pose a biosecurity threat. 

Marketed under the brand name Fetroja, cefiderocol is a siderophore cephalosporin antibiotic with a novel method of penetrating the tough outer membrane of gram-negative bacteria and an ability to overcome resistance mechanisms used by bacteria to evade antibiotics. 

Potential treatment for biothreats

Cefiderocol was approved by the US Food and Drug Administration for treating complicated urinary tract infections and hospital-acquired and ventilator-associated bacterial pneumonia in adults. It’s since become a valued option for difficult-to-treat multidrug-resistant infections.

The order is the first of several procurement options under a contract signed in April between BARDA and Shionogi that’s worth up to $482 million. The contract includes plans to develop a US manufacturing site for cefiderocol, expand its use in children with pneumonia, and study its potential to treat infections caused by Yersinia pestis, the bacterium that causes plague, and Burkholderia pseudomallei, which causes melioidosis. 

Both pathogens occur naturally in certain parts of the world and have the potential to be used as weapons in a biological attack.