DR Congo Ebola Outbreak Poses High Regional Risk, WHO Says

by Kim Boateng Posted on August 4th, 2018

Geneva, Switzerland : The latest outbreak of the Ebola virus in the Democratic Republic of Congo (DR Congo) poses a high risk to the region, though the danger of the disease spreading worldwide was described as low, the World Health Organization (WHO) said in Geneva, on Friday.

33 people are believed to have died in the latest outbreak, which the Congo government said on Wednesday had affected North Kivu Province, where conflict between armed groups has displaced more than a million people. North Kivu, in northeastern Congo, has borders with Rwanda and Uganda.

The outbreak is “at the top of the scale” in terms of the difficulty of responding, Dr. Peter Salama, head of the World Health Organization’s emergency response unit, told reporters in Geneva.

Suspected cases are under investigation across an area of more than 150 square miles, Dr. Salama added, citing the challenges of operating over large distances in a conflict zone.

The results of government laboratory tests make it “extremely likely” that the outbreak was the “Zaire” strain of the Ebola virus, Dr. Salama said.

The authorities in Congo declared 10 days ago that an outbreak of the same strain of Ebola in the northwestern province of Équateur had ended. That outbreak caused 33 deaths but was contained with the help of vaccines in storage in the capital, Kinshasa. Those vaccines should also be available to tackle the latest cases.

The Zaire strain is, however, the deadliest form of Ebola, a highly infectious disease that causes hemorrhaging, fever, bloody vomiting and diarrhea. The virus can often spread out of control, as it did during a 2015 outbreak in West Africa.

The Health Ministry in Congo confirmed on Wednesday that four people had contracted the disease in the remote town of Mangina in North Kivu, about 100 miles from the border with Uganda, where the latest outbreak is believed to have started.

The first case to raise alarm was a 65-year-old woman who had been hospitalized with fever and later discharged, but who then died in late July, Dr. Salama said. She was buried in a manner that health officials said was unsafe, and seven members of her immediate family have also died.

Dr. Salama said suspected cases had been identified in the city of Beni, in North Kivu, and in neighboring Ituri Province, to the north. He said the authorities were trying to track down contacts in 10 locations across an area of about 150 square miles.

One nurse has also died, and two others are believed to be infected, Dr. Salama said.

An outbreak of the Ebola virus declared this week in eastern Congo is believed to have killed 33 people, the health ministry said on Saturday.

Thirteen cases of the haemorrhagic fever have been confirmed, including three deaths, the ministry said in a statement, adding that suspected cases had been detected in both North Kivu and neighbouring Ituri province.

Three cases have been confirmed in Beni, a regional trading hub of several hundred thousand people about 30 kilometres from the centre of the outbreak in the town of Mabalako, and some 70 kilometres from the Ugandan border.

The latest flare-up was announced one week after Congo’s government declared the end of another outbreak in northwestern Congo that is believed to have killed 33 people as well. Health authorities say they have no evidence the two are connected.

So far, 879 people who came into contact with Ebola patients have been identified, the ministry said. Tracking those contacts, however, could be difficult in this part of the country, given its dense population and the presence of dozens of militia groups.

As with the outbreak in western Congo, health officials plan to deploy a vaccine manufactured by Merck that they have credited with helping disrupt the spread of the virus after it reached a river port city with transport links to the capital Kinshasa.

A so-called cold chain, the series of measures needed to keep the vaccine well below zero in a tropical climate without reliable power supplies, will be set up in Beni this weekend, the statement said.

For health officials, the lack of security in the region adds a daunting hazard to the already formidable challenges of operating in remote locations spread across huge distances and in dense forest with poor roads and communications.

Meanwhile, Uganda has set up screening at the land border it shares with Congo and at its Entebbe international airport.

“Ebola is highly infectious so we have put in place measures,” Uganda’s Junior Health Minister Sarah Achieng Opendi told reporters.

An international delegation including officials from the United Nations, the World Bank and the WHO is in Beni, 30 km from Mangina.

EARLIER : Ebola Resurfaces in DR Congo

Kinshasa, DR Congo: A new outbreak of Ebola virus has hit the Democratic Republic of Congo, just days after the last outbreak was  declared over. Four cases have been positively identified and more are likely, Congo’s health minister, Dr. Oly Ilunga Kalenga, said in a statement Wednesday.

“Just a week after announcing the end of the ninth epidemic of Ebola virus disease in the Equator Province, the Democratic Republic of Congo is facing a new epidemic,” Kalenga said. He added that there was no indication that the two most recent outbreaks, separated by more than 1,500 miles, are related.

More than 50 people were infected in the most recent outbreak and 33 died, according to Congolese officials.

The health ministry has been checking into reports of viral hemorrhagic fever in North Kivu Province, in the northeastern part of the vast Central African nation, since last weekend. Twenty people have died and 26 people have symptoms that could indicate any number of viral infections, including Ebola.

“Of the six samples analyzed, four were positive for Ebola virus,” Kalenga said.

It’s the third outbreak in just over a year in Congo. This time, the country could be ahead of the game. Thousands of doses of vaccine were shipped to the country during the last outbreak and the health ministry geared up to test samples, educate people about the spread of the virus and get experts to the site of the outbreak quickly.

“Although we did not expect to face a 10th epidemic so early, the detection of the virus is an indicator of the proper functioning of the surveillance system put in place by the General Directorate for Disease Control,” Kalenga said.

Outbreaks of Ebola have occurred regularly in Central Africa since the virus was first identified in 1976, but none has ever been as serious as the 2014-2016 epidemic, which killed 11,000 people in Liberia, Sierra Leone and Guinea in West Africa.

“Since we are coming out of another Ebola outbreak, we have kept staff and equipment in place,” Dr. Matshidiso Moeti, WHO Regional Director for Africa, said in a statement.

“This allows us to have a head start in response to this cluster.”

The area affected is on a lake and near the borders of Uganda and Rwanda, which raises the possibility of international spread. WHO says more than 1 million displaced people, who have fled war and unrest, live in the region.

North Kivu Province, the volatile region in the Democratic Republic of Congo where the new outbreak is centered, creates security complications that health officials did not confront in the outbreak they just defeated in northwest Équateur Province, 1,550 miles away. The World Health Organization is worried about the safety of medical workers in North Kivu and their access to areas controlled by militants.

“This new cluster is occurring in an environment which is very different from where we were operating in the northwest,” said Dr. Peter Salama, the deputy director general of the health agency and the head of its emergency response unit. “This is an active conflict zone. The major barrier will be safely accessing the affected population.”

The new cases are in and around the remote village of Mangina, near the city of Beni and the border with Uganda. The area has been chronically plagued by fighting between government forces and armed rebel groups. Last year, 15 United Nations peacekeepers were killed in an attack on a compound in North Kivu.

The region also hosts more than one million people displaced by conflict throughout the country and shares porous borders with Rwanda and Uganda.

The World Health Organization said it was working with those neighboring nations to ensure that they were prepared to respond to the disease.

But aid groups fear that the fighting and humanitarian crisis in North Kivu will only compound the difficulties of defeating Ebola. People on the move can frustrate the critical need to determine chains of infection.

“People are hungry and at risk of disease, and many have had to flee their homes,” said Jose Barahona, Oxfam’s country director for the Democratic Republic of Congo. “Ebola poses a serious risk to communities already on the edge and threatens our ability to help them.”

Michelle Gayer, the director of emergency health for the International Rescue Committee, said the new outbreak’s location made it unlike what she saw in Équateur and West Africa.

“We are in a different context again in the sense that, yes, it’s actually in small rural areas that we know of to date, however it’s in a zone where there has been a lot of insecurity and a lot of armed groups and a large amount of displacement,” Ms. Gayer said.

Simply getting to an affected community, she said, would be challenging.

“It is already hard because of geography,” Ms. Gayer explained. “And we can only go where we can go if there is this insecurity.”

Lack of basic resources after years of war, including limited health care, puts North Kivu residents further at risk. Ebola can often spread through community gatherings or funerals, or though contamination at health clinics.

The Health Ministry said a team of 12 experts arrived in the affected area on Thursday, with a mobile laboratory and protective equipment to begin a coordinated response.

The ministry also said additional security measures were in place to ensure the protection of health care workers. The World Health Organization also began sending experts to the area.

“Since we are coming out of another Ebola outbreak, we have kept staff and equipment in place,” said Dr. Matshidiso Moeti, the organization’s regional director for Africa. “This allows us to have a head start in response to this cluster.”

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Kim Boateng

Kim Boateng

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