Health officials' longstanding fears about the potent mix of armed conflict in weak states — combined with a highly infectious disease outbreak — are being realized. In the Democratic Republic of the Congo (DRC), an Ebola virus outbreak is now at a tipping point and threatens to expand.
Background: The current outbreak began on Aug. 1 and appeared to be slowing down, as most of the new cases were contacts of known infected people. However, as security deteriorated, other cases emerged.
The latest: The World Health Organization met on Wednesday and decided not to declare the outbreak a "Public Health Emergency of International Concern," which could've triggered international travel restrictions. They determined such a step could actually hinder the international response to the outbreak.
But the security situation in DRC keeps getting worse — there were 8 major security incidents in north Kivu in the last 8 weeks, per WHO.
- The violence has led to an interruption in public health initiatives — including efforts to quarantine those who may be infected, to vaccinate all "contacts" of people who were infected, and to educate pockets of people who are suspicious of health care workers.
- There's been a spike in new cases — with special concern that roughly half of them are in people who are not on contact lists of previously known patients, meaning the outbreak is spreading.
- As security deteriorates, cases of the disease are surging — 25% of all suspected and confirmed cases were recorded in the first 2 weeks of this month alone.
Details: The violence has been serious enough to cause the CDC to withdraw its Ebola experts from field work in that area.
- The CDC says it moved an Ebola expert adviser, a vaccine expert and a border health expert to Kinshasa, which is more than 1,500 kilometers from the emerging epicenter of the outbreak in Beni.
- Since the start of the outbreak, the U.S. has deployed more than two-dozen experts from USAID and the CDC to support preparedness and response in the DRC and neighboring countries.
- CDC's experts "are still very involved in the response even from Kinshasa and the Ministry of Health has regular videoconferences with the CDC team in Atlanta. So no we do not believe this will hamper our efforts to contain the outbreak as many local and international experts continue their work in the field," DRC Health Ministry spokesperson Jessica Ilunga tells Axios.
Vaccination impact: The DRC's Health Ministry mobilized an experimental ring vaccination campaign a week after the first case was reported. Between Aug. 8 and Oct. 17, nearly 19,000 people were vaccinated, the DRC Health Ministry says.
- Still, Julie Fischer, co-director of the Center for Global Health Science and Security at Georgetown University, tells Axios there's a "real risk this outbreak is ready to explode locally."
The bottom line: This outbreak is nowhere near over. The longer it lasts, the greater the chances of it spreading. However, the WHO says it has confidence that at-risk neighboring countries are prepared.
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