Congo health teams struggle to track, vaccinate Ebola contacts

Health officials are struggling to identify possible Ebola patients and track the virus’ spread in the Congo, according to STAT.

Here are three things to know:

1. Public health officials maintain a list of individuals who’ve had contact with Ebola patients to identify individuals who should receive Merck’s experimental vaccine. However, it’s becoming increasingly difficult to identify people at risk of contracting Ebola. More than half of the newly identified Ebola cases in the city of Beni have not been on this list. Since recent violence in the city, health workers’ contact tracing performance dipped to 30 to 40 percent. This figure should sit above 90 percent, according to STAT.

“We have a number of indicators right now showing that our ability to quickly detect cases and follow up on their contacts has been seriously challenged by the safety issues,” Michael Osterholm, PhD, director of the Center for Infectious Disease Research and Policy at the University of Minnesota in Minneapolis who is tracking the virus’ spread, told STAT. “[Vaccines] can’t be given to people you don’t know exist.”

2. Response teams’ knowledge gaps regarding who is infected and where makes containments efforts difficult. If health workers cannot adequately vaccinate at-risk populations, the virus will circulate to new people and contribute to the outbreak’s spread.

3. The World Health Organization aims to maintain a supply of 300,000 doses of the Ebola vaccine at all times, according to Peter Salama, MD, WHO’s deputy director-general of emergency preparedness and response. While this amount may seem substantial, Dr. Salama said the stockpile could quickly deplete if the vaccines are applied geographically. This vaccination effort also poses its own set of challenges.  

“If your high-risk contacts are actively avoiding follow-up or vaccination or care, they’re going to avoid vaccination or geographic targeting strategy presumably as well,” he told STAT. “So you might end up thinking you’ve got great coverage geographically, but you’ve missed the same high-risk contacts that we’re unable to follow up on now. So it will have very limited impact in that sense.”

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