Aug 16, 2018

WHO official: Congo's Ebola on "precipice" to spread further

Data: Ministry of Health DRC; Chart: Andrew Witherspoon/Axios

Public health officials in the Democratic Republic of the Congo are scrambling to contain the Ebola outbreak, as neighboring countries of Burundi, Rwanda, South Sudan and Uganda bolster their readiness in case the hemorrhagic virus spreads past their border.

What's new: Xinhua reported there were 3 people suspected of being infected in Uganda, one of whom died — however, Uganda's health ministry and the World Health Organization say there are no confirmed Ebola cases there. Meanwhile, in DRC, the number of suspected deaths has crept up to 44 (as of Aug. 15) and the growing rate of suspected infections now includes 11 health care workers.

"We are on an epidemiological precipice. We have a critical, time-limited window of opportunity to prevent the #DRC #Ebola outbreak from taking hold in areas that are much more difficult to access because of insecurity. There is not a minute to lose."
— Peter Salama, deputy director-general for emergency preparedness and response, WHO, tweeted earlier this week

Concerns about conflict zones: One of the big concerns is that one of the affected areas is in a conflict region, which is dangerous for health care workers and is near the border of Uganda.

Peter Salama, a top World Health Organization official, told STAT News:

“That’s really the worst-case scenario: That we can’t get in quickly enough to an alert [of possible cases] or we just have a blind spot because of security. And then an outbreak really begins to take hold in those blind spots and becomes a multicountry regional outbreak."

However, a DRC Health Ministry spokesperson tells Axios that while this is definitely a concern...

"At the moment, health officials have been able to enter afflicted areas relatively freely as the the epicenter of the outbreak is not in an actual red zone. Most fightings happen outside the areas where our teams are deployed. However, we are closely working with the national army and MONUSCO to guarantee the security of our health workers and the affected population."

Meanwhile, the DRC is continuing its vaccination, treatment and education program. The spokesperson tells Axios:

  • They are distributing the experimental mAb114 Ebola treatment and are waiting for DRC's ethics committee to approve 5 other experimental treatments including ZMapp.
"All the treatments except ZMapp have already been sent to the affected area ready to be used as soon as the ethics committee gives its approval."
  • They also are administering the experimental rVSV-ZEBOV vaccine using the ring method (vaccinating the people who were thought to have been exposed to an infected person). There's no current plan to also offer any other experimental vaccine, such as the Ad26.ZEBOV vaccine with a MVA‐BN‐Filo boost.
"The vaccination was quickly accepted by the population. Everyone wants to be vaccinated. Our main challenge is to make people understand that this is not a mass vaccination campaign but a targeted, ring vaccination."
  • They are concerned about health care workers, and have deployed national teams in the field to train local health staff on all infection prevention and control measures.
"Beyond this outbreak, an important part of our resilience plan for all the regions where Ebola is a risk is to increase the sensitization and training of local health workers."

Go deeper:

  • The initial response to this Ebola outbreak.
  • A recent study on possible problems presented by people persistently infected with Ebola.
  • U.S. health officials' viewpoint on current experimental Ebola vaccines.

Editor's note: The chart and the number of suspected deaths and infected health care workers was updated since this story was first published today.

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