Ebola outbreak in DRC: disturbing new developments, explained

At least 680 people have been infected with the Ebola virus in the Democratic Republic of Congo. This is the second most important Ebola outbreak in its history, with 414 deaths to date, and the first Ebola outbreak in an active war zone, the eastern provinces of North America. Kivu and Ituri in the DRC.

But this could worsen: this week's health officials fear that the Ebola virus will spread to Goma, a major population center in the DRC.

This week again, the DRC Ministry of Health confirmed four cases of the deadly virus in Kayina, a town in North Kivu, where clashes between rebels and militias regularly interrupted the hard work of health workers who responded to the epidemic.

Kayina is halfway between Butembo, currently one of the most disturbing hot spots in the home, and Goma, home to a million people.

Until now, the epidemic has not affected the largest cities of the DRC. But Ebola in Kayina "pulls the alarm bell" for the Ebola virus to reach Goma, said Peter Salama, head of the new program on health emergencies at the World Health Organization, Friday at Vox .

Goma is a transportation hub, with roads and highways leading to Rwanda. "These are crossroads and towns," added Salama. The people there are constantly on the move to do business, but also because of insecurity in North Kivu. Ebola virus in Goma is a nightmare scenario WHO and the DRC Ministry of Health fight for prevention.

Together, they deployed a rapid response team, including a vaccination team, to Kayina. And if the virus spreads to Goma, Salama says Ebola workers are ready. They have already mobilized teams, set up a laboratory and prepared health centers where patients can be treated in isolation.

But as Laurie Garrett, an Ebola expert, wrote in Foreign Policy This week, the Ebola virus in Goma could also trigger a rare public emergency declaration of global public health by the WHO, thus compounding the seriousness of an already dangerous epidemic.

Ebola vaccine fails social and political chaos in DRC

WHO

When Ebola breaks out, it's the most serious and humiliating flu you can imagine. People suffer from sweats, body aches and pains. Then they start to vomit and have uncontrollable diarrhea. They suffer from dehydration. These symptoms can appear anywhere between two and 21 days after exposure to the virus. Sometimes patients are in shock. In rare cases, they bleed.

The virus is spread through direct contact with bodily fluids, such as vomit, urine or blood, from an already sick person with symptoms. The sicker people get closer and the closer they are to death, the more they become contagious. (This is why it is particularly dangerous to take care of the very sick and attend the funeral.)

As we can not cure Ebola, health workers use traditional public health measures: to seek out, treat and isolate the sick and break down the chains of transmission so that the virus stops spreading.

They organize vigorous public health awareness campaigns to remind people to wash their hands; touching and kissing friends and neighbors is a potential health risk; and that burial practices should be modified to minimize the risk of spreading Ebola at funerals.

They also use a strategy called "contact research": find all the contacts of sick people and follow them for 21 days – the period during which Ebola is incubated.

In this epidemic, there is also an additional tool: an effective experimental vaccine. Since the declaration of the epidemic in August, more than 61,000 people have been vaccinated. Although the vaccine has moderated the spread of the Ebola virus, it has not overcome the social and political chaos in the DRC, which has been called the most neglected crisis in the world.

"The brutality of the conflict is shocking," said Jan Egeland, head of the Norwegian Refugee Council, at the Thomson Reuters Foundation, "Scandalous National and International Negligence".

Presidential elections "intensified" tension in already tense situation

On December 30, after years of delay, voters went to the polls to elect a new president. In the days leading up to the elections, tensions in North Kivu "increased," said Salama. The protesters stormed the treatment centers of Doctors Without Borders in Beni, a hot spot recently appeared during an outbreak, closing them for several days.

In January, the country's electoral commission announced the results of the provisional elections, suggesting that opposition leader Felix Tshisekedi had probably won the elections. But the disclosed data and external badyzes show that there are irregularities in the count of voters that suggest electoral fraud.

"All the outside observers – the African Union, the European Union, the Catholic Church – say that the results of the election have been rigged", and that the people have indeed voted for the presidency of Martin Fayalu, said Séverine Autesserre, professor of Political Science at Barnard College and author of the book The problem with Congo. When the final results are announced in the coming days, new demonstrations and riots will probably follow.

Although political instability does not facilitate the response to Ebola, the war in the eastern provinces of Congo is a much bigger challenge. The conflict, which has lasted for 25 years, has displaced more than a million people and has made the already dangerous work of an Ebola response even more deadly, said Autesserre.

Between August and November, Beni had more than 20 violent attacks, which paused the reaction of the epidemic for several days. This meant that cases had not been counted and that Ebola was still spreading.

According to Salama, there is also more encouraging news: the outbreak of more than 200 people in Beni, a town in North Kivu marked by decades of violence, has been brought under control.

"Many people would have been extremely skeptical about the fact that the Beni epidemic can be controlled as quickly as possible due to the strength of infection observed in November and December, and the fact that we are not safe. "It has been volatile and insecure since," Salama said. "But the fact that Beni only had one confirmed case in two weeks gives us a lot of hope and optimism."

On Friday, the two biggest hot spots of the outbreak were Butembo (51 cases) and a nearby town, Katwa (119 cases). But the epidemic is geographically dispersed. Ebola cases are active in 12 of the country's "health zones", districts around which the DRC's health system is organized. Due to the insecurity and difficulty of reaching people, only 30 to 40% of them come from known contact lists, Salama said. This means that the virus may already be in places where no one has yet been discovered.