New Ebola outbreak spreads to large urban area in DRC
Thursday, May 17, 2018
On May 8, the Ministry of Health and Population of the Democratic Republic of Congo (DRC) announced a new Ebola outbreak had begun after two cases were confirmed by laboratory test.
By May 13, there were already 41 cases, including 20 deaths and three healthcare workers affected. Considering the high contagiousness of Ebola, a total of 432 contacts are being monitored.
Despite earlier identification and attempts at containment, one new case of Ebola has been confirmed in Wangata, one of the three health zones of Mbandaka, a city of nearly 1.2 million people on a major river.
"This is a concerning development, but we now have better tools than ever before to combat Ebola," said Dr. Tedros Adhanom Ghebreyesus, World Health Organization (WHO) director-general. "WHO and our partners are taking decisive action to stop further spread of the virus."
Dr. Peter Salama, the WHO’s deputy director general for emergency preparedness and response on May 11 commented that the new outbreak was a "dire scene in regards to the lack of infrastructure of the remote area — especially the roads and poor hygiene." After the news of the confirmed urban case on May 17, he stated, "The challenge just got much, much tougher."
WHO was strongly criticized for the slow and timid response to the 2014 epidemic in West Africa. In the 2014 outbreak, WHO waited months before it convened an Emergency Committee to garner international aid.
Those tactical delays contributed to the largest outbreak that affected three countries, infected 28,000 and killed 11,000 of them. Having admitted their previous slow response, they have acted swiftly to mobilize resources.
As soon as May 5, teams from the Ministry of Health, with support from the World Health Organization (WHO), Médecins Sans Frontières (Doctors Without Borders) and had mobilized to attempt monitor and contain the spread of the disease. Now, in light of the new urban case, an emergency meeting is being called for May 18 to decide whether to declare a "public health emergency of international concern," which could trigger more international involvement and resources.
Ebola virus disease is a rare and deadly disease. There are five known virus species that can cause disease in people. First discovered in 1976 near the Ebola River in the DRC, there have been sporadic outbreaks, mostly contained due being in remote areas.
The Ebola virus spreads through direct contact with bodily fluids of a sick person or someone who has died, hence the public health focuses on hygiene and safe burial practices. Signs and symptoms are very similar to many other diseases — fever, muscle pain, weakness, vomiting — therefore it is of high importance to screen all patients of recent travel.
There is no cure for Ebola, just supportive care such as providing fluids and electrolytes through infusions, maintaining oxygen levels and other symptom management. Despite all efforts, the mortality rate remains high at about 50 percent.
A vaccine was created by the Public Health Agency of Canada in 2003. It showed 100 percent effectiveness in monkeys, but due to lack of pharmaceutical company interest it sat on a shelf.
However, during the 2014 outbreak, it was licensed to Merck and used as clinical trials with preliminary results showing everyone who got the vaccine immediately after contact with an Ebola victim did not get the virus. The results, later published in The Lancet, demonstrated substantial protection against the Ebola virus.
After the approval of the local government, the first batch of 4,000 vaccines has arrived in the DRC capital for distribution. Aid workers and researchers will be using the same process employed in the 1970s to eradicate small poxes. Essentially, they will vaccinate people who have been in contact with the affect patients and the contacts of contacts. This strategy is known as ring vaccination and hopes to contain the spread.
Although hopeful, there are logistical issues with the vaccine. Unlike more stable vaccines, such as oral polio, this particular vaccine needs to kept be kept between -60 to -80 Celsius (-76 to -112 F) making it particularly difficult for transporting to remote areas.
As with the last outbreak, it will need to be a global collaborative effort to contain the potentially disastrous public health outbreak.
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