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World Health Organization (WHO) leaders today said that the Ebola epidemic in the Democratic Republic of Congo (DRC) remained contained in a small geographical area, but it did not mean the virus was backing away.
"At any time, it could burst within an area," said Mike Ryan, MD, assistant director general of the WHO. Ryan, citing information contained in the report on the Ebola situation released yesterday by the WHO, said there were encouraging signs, including lower transmission rates in known hotspots and increased surveillance.
"Surveillance has intensified to 1,300 alerts per day, of which 200 to 300 have been validated and tested," Ryan said. The number of contacts monitored is 15,000.
Ryan said the reproductive rate of the outbreak is 1.04, which means that each case of Ebola begets an extra case. This means that the transmission is flat, does not increase, but does not decrease significantly.
Up to 25% of missed cases
During the entire press conference, Ryan called the epidemic complex. In addition to security concerns in the area, he said that some health-promoting behaviors and death practices in the community had contributed to the longevity of the epidemic.
About 20% of Ebola patients initially seek health care in a health zone far from their place of residence, making it difficult to link the chains of transmission. In addition, several deaths still occur in the community. Every death in the community, Ryan added, increases the risk of spreading the disease.
Ryan also said that the WHO estimates to be in the process of detecting 75% of cases, with up to 25% missed or taken care of "too late".
He also responded to recent criticisms by various non-governmental organizations that WHO should "reset" the response to the epidemic.
"It's not an iPhone, we're not just pressing a reset button," Ryan said. "We have to adapt … and make sure the answer is the best we can."
He also reminded journalists in the room that 80% of vaccinators in the region were Congolese and that most of the doctors and nurses responsible for the epidemic were Congolese.
"It is the Congolese who put an end to this epidemic," he said.
Today, the DRC Ministry of Health has confirmed 6 new cases of Ebola and 10 deaths, bringing the total epidemics to 2,031 cases and 1,367 deaths. Three of the 10 deaths occurred in the community, which is a lower than normal percentage.
A total of 293 suspected cases are still under investigation and 130,711 have been vaccinated. The number of infected health workers remained at 110.
The vaccine should run out
Yesterday, Robert Redfield, MD, director of the US Centers for Disease Control and Prevention (CDC), told Congress that the world needed to prepare for the outbreak to spread internationally and vaccine stocks are going down, according to an article by Devex.
Ryan, questioned about Redfield's comments, turned away. "Dr. Redfield is trying to draw attention to the epidemic, which is a good thing," he said.
Redfield said that vaccine production is delayed by the validation of the plant. Merck had manufactured the rVSV-ZEBOV vaccine in Pennsylvania until recently, transferring the operation to Germany.
There are currently about 145,000 doses of vaccine, which is insufficient for a larger vaccination campaign, which would aim to vaccinate geographic areas instead of contact rings.
See also:
June 6 conference call from the WHO
DRC Report of 6 June
June 6th article on Devex
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