Feb 18, 2019 - Health

New Congo Ebola cases locations spur concern

Data: DRC Ministry of Health. Get the data. Chart: Andrew Witherspoon and Harry Stevens/Axios

Data: DRC Ministry of Health. Get the data. Chart: Andrew Witherspoon and Harry Stevens/Axios

The number of new Ebola cases has dropped slightly in the Democratic Republic of the Congo, according to the World Health Organization. However, some experts warn that doesn't mean the world's second-largest Ebola outbreak on record is yet under control, and in fact it could simply be moving to new areas of the sprawling country.

The big picture: There are 33% fewer cases to date in February compared with the same time period in December per STAT's Helen Branswell, but some experts warn Axios that there remain signs that this outbreak is far from over.

Between the lines: Johns Hopkins' public health expert Jennifer Nuzzo points to several reasons people should continue to view this outbreak as a cause for concern.

  • There appears to be a "shifting geography" of cases with small groups in different locations, Nuzzo says.
  • "It almost feels like we're playing whack-a-mole where we concentrate [resources] in one area, but take our eyes away from another area" where the disease then spreads, Nuzzo says.
  • There continues to be a number of community deaths, which means the government hadn't been aware of the infected person and therefore the disease is more likely to have spread.
  • And, transparency hasn't been great, she adds, as officials haven't made known how many of those confirmed and suspected cases were known contacts of sick individuals.

Meanwhile, DRC Ministry of Health spokesperson Jessica Ilunga tells Axios that violence and community mistrust continue to hamper their efforts to control and end the outbreak, which started Aug. 1.

  • "Any violent incident with the population slowed down the response as it prevents response teams from doing their job freely. Laboratories remain closed, surveillance teams can’t track alerts in the community, safe and dignified burials can’t proceed, vaccination activities are temporarily suspended, etc.," Ilunga says.
  • "Unfortunately, we had to step up the protection of our team with additional local police agents. It is not ideal but it is the only way to protect health agents from being beaten up by the population," she adds.
  • Last week, MOH launched their third "strategic response plan" for the next 6 months to stop Ebola in the North Kivu and Ituri provinces as well as neighboring countries. To reach this goal, DRC, WHO and its partners are asking the international community for $148 million.

Yes, but: Congo needs more than money from the international community and the U.S. in particular, Nuzzo says. Safety concerns have largely caused the CDC to limit its Ebola experts to the capital city of Kinshasa, where some have returned after being evacuated during an uptick in election-related violence. Now is the time for the U.S. to send them into the field, she says.

  • "The WHO is doing a heroic job, but the CDC is unparalleled in its expertise" from working prior outbreaks over the past 40 years, she says.

The bottom line: Ilunga agrees they need to remain vigilant against the outbreak. "The strategies put in place have proved effective to contain the outbreak in the main hotspots like Mangina and Beni. However, it remains a very challenging response and outbreak. We will continue adapt our strategies until we manage to completely stop it," she says.

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