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The World Health Organization announced Wednesday whether the latest outbreak of the Ebola epidemic in Congo should be declared a global health emergency. Some support groups expressed concern that the number of new cases has more than doubled this month. As the area is compared to a war zone, resistance to health workers sometimes becoming violent and confirmed cases discovered near the busy Ugandan border, the risk of regional spread is "very high".
Here is an overview of the outbreak that has had 181 confirmed cases, including 104 deaths, since its declaration on August 1st.
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WHAT IS EBOLA?
Ebola is a virus that, without preventive measures, can spread quickly and is deadly in 90% of cases. Symptoms include fever, vomiting, diarrhea, muscle aches and sometimes internal and external bleeding. According to the WHO, symptoms can begin to manifest between two and 21 days after infection.
The virus is transmitted through close contact with the body fluids of people with symptoms and with objects such as contaminated leaves. Health care workers are often infected and burial practices that require close contact with Ebola victims can spread the disease.
Dozens of people in this epidemic have received one of the many experimental treatments for Ebola, but their effect has not yet been fully investigated.
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WHY REGION ABOUT A WAR ZONE?
Several rebel groups are active in the far northeastern Congo and have killed hundreds of people in recent years. Attacks in Beni, the center of the fight against the Ebola virus, have resulted in a traumatized population that may be suspicious of foreigners. A strike in the "dead city" in Beni to protest an attack forced the work on Ebola to be suspended for a few days, with disturbing results. The Congolese Ministry of Health said the crucial work of research and monitoring of suspected contacts of Ebola victims is less important in Beni than elsewhere, which increases the risk of invisible spread of the virus.
Health workers describe being accompanied by armed guards from the United Nations peacekeeping mission or Congolese security forces, having heard gunshots every day and being forced to finish before sunset not get caught by the rebels.
"When we arrived at the airport, we found that the area was heavily militarized," says Dr. Marie Claire Kolie, of ALIMA (Alliance for International Medical Action). "Personally, it's a little scary, I have to say, but … we can not leave these people."
The Congo Ministry of Health announced this week a "remarkable breakthrough". After a confirmed Ebola victim fled into a "red zone" deemed inaccessible to health workers – one of the biggest fears of this epidemic – long negotiations with the US government, he said. One of the most feared armed groups, the Mai Mai, allowed a vaccination team to enter.
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WHY IS COMMUNITY RESISTANCE?
This is the first time that an Ebola outbreak is occurring in this part of Congo, and health workers need to explain the importance of safe burials and other preventive measures. . Yet some residents rejected the Ebola vaccines and fled or attacked health teams or, in one case, left with the body of an Ebola victim. Red Cross volunteers were seriously injured during a confrontation.
This has hindered containment efforts. On Saturday, Congo's health minister said that the majority of confirmed Ebola cases reported this month were not on the list of known contacts and that epidemiological links "have been identified only in the past. After a thorough investigation ".
After "numerous attacks" against health workers, the ministry announced new measures in Beni this month. They allow health teams to call security forces during safe burials. They also threaten criminal sanctions against those who hide suspected cases of Ebola or do not send them to treatment centers.
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IS THERE A NEW EBOLA VACCINE?
Yes, and it has been very effective. The Congolese Ministry of Health announced on Wednesday that more than 18,000 people had been vaccinated. The vaccine must be kept very cold, minus 60 degrees Celsius, which poses a logistical problem in the tropical Congo that does not have reliable electricity.
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