[ad_1]
The Democratic Republic of Congo has confirmed its first Ebola death in the Butembo town in the east of the country, a trade hub with Uganda that is home to nearly a million people. This first urban death, coupled with persistent violence in the region of the epidemic in north-eastern DRC and some resistance from communities, worries experts: the slowing of the epidemic could be even worse .
Having already killed 87 people, this epidemic is fast becoming the eighth largest Ebola outbreak in history. Although officials welcomed the decreasing number of cases and a successful vaccination campaign and contact tracing, this new case in urban areas is worrisome, said Peter Hama, head of the World Health Organization. the health.
"When an Ebola case is confirmed in a city with 1 million residents, no one should sleep well tonight around the world, "Salama said.
The patient traveled from the hotspot of the current epidemic, the city of Beni, 35 miles southwest, to Butembo after ignoring medical advice, Salama said. The patient died in a health facility.
While members of the WHO team are on hand and are working to quickly find and vaccinate those with whom the patients have come into contact, the potential for spread could "change the trajectory of the patient." epidemic, "said Salama. Two other cases are suspected in the mall, reported Wednesday the DRC Ministry of Health. Butembo is known to be critical for import and export between the DRC and East Africa, Reuters reported.
And since the patient died in a health facility, the risk of spread among patients and health workers is of particular concern because health workers have been "the main driver of transmission," said Salama. So far, in this epidemic, which has already occurred in a region of northeastern DRC, 16 health workers have been infected and one has died.
For Salama, the biggest danger is that the 40 people identified as having been in contact with infected patients in the "red zones" – areas that health workers can not reach because of persistent violence. North Kivu is home to more than one million people displaced by the many armed rebel groups in the region. That is why the largest United Nations peacekeeping mission is based there. The United States considers the region a threat to Level 4 security in the United States, on a five-level scale.
"I think it's very unlikely that we're missing a lot of cases, but it's quite possible that we're running out of time," Salama said. The standby period of the day before would expire soon for most of the 40 contacts – which means they would be eliminated.
Whenever you have a simmering ember, you can always have a forest fire.
Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases
Jeremy Konyndyk, senior researcher at the Washington-based Center for Global Development, who previously led part of the 2014 Ebola response for the Obama administration, pointed out that these potential cases were a major concern.
"We had a phase in 2014 in West Africa where, likewise, the number of files dropped and it appeared that things had turned a corner. But, in fact, there was a significant spread that was simply not visible, and eventually allowed the subsequent blast. "
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told HuffPost Tuesday that one can never settle for Ebola.
"Whenever you have a simmering ember, you can still have a forest fire," Fauci warned.
An additional fight against insecurity and resistance of the community
In addition to the first case in an urban area, two major attacks by the Allied Democratic Forces (ADF), rebels who oppose the Congolese government, have complicated the response efforts.
On August 24, ADF invaded a DRC military base north of Beni, Salama said. On Monday, the group executed a series of ambushes against Congolese and US security forces. Both incidents took place near Beni airport, where the WHO embarked more than 200 people stationed in Congo. Indirect messages were sent to the ADF urging them to stop the violence in the region as the response to the Ebola outbreak continues, Salama said, while emphasizing that the violence had not hindered the response.
Hassan Coulibaly, field director of the International Rescue Committee, on the ground in Beni, told HuffPost that operations have not been hit hard by recent, often nocturnal, fighting when health workers are not allowed to travel.
Coulibaly told HuffPost that the biggest problem in fighting the spread of Ebola at this stage was community resistance.
He estimated that 8 to 10 families had refused offers of burial practices from WHO and the Red Cross. Traditional burials can put family members at risk of transmission. A local politician had also spread rumors that Ebola was not real, and some in the area had resisted vaccination and treatment, according to Coulibaly.
Salama said local religious leaders had repressed the politician's remarks and that health and community workers were working to fight misconceptions that the arrival of Ebola was linked to the upcoming elections in the DRC or to foreign organizations.
He emphasized, however, that, overall, vaccination rates were very high: more than 6,300 people were vaccinated and 98% of those who received the vaccine took it.
He attributed the high response rate to the new tools that health care workers can offer in the experimental vaccine and treatments. Health care workers are no longer just presumed in their forties, but they have tools to prevent and potentially save, which will change the game.
"The Ebola treatment units will no longer be considered an isolated place where you risk dying, but in fact a place where you could even possibly survive," he said.
Salama added that he is delighted to announce that the discussions for a multi-country and multi-epidemic randomized trial of the five experimental therapies are in the final stages and could be deployed as early as this outbreak.
While the Ministry of Health wrote Tuesday in its report that "several violent incidents against medical staff and health facilities were also reported," Salama said he could only think of one injured and one community health center. by a group of young people in Manbango, outside Beni, after learning of the death of a prominent villager.
Despite the measured warning from WHO, Ron Klain, who was President Barack Obama's Ebola tsar during the 2014 outbreak, told HuffPost that "many signs are now flashing yellow" after news from Butembo. While Klain congratulated the WHO for its prompt response and cited the new tools for transforming vaccines and experimental treatments, the "security risk, potential urban spread, community resistance" are as much of a problem. indications of the limitation of our current global system. It is quite possible that a broader response is needed, with more leadership and commitment from other countries – including the United States – that can and should do more to help. "
Another type of epidemic situation
For Salama, this outbreak is a prototype of the growing number of future outbreaks, which is spreading to more populated areas. As HuffPost has already reported, epidemics of the worst types of pathogens – those with the highest mortality rates and limited countermeasures – are on the rise because population increase, global displacements and the evolution of migratory and environmental patterns other populations. And with more people living closely, epidemics like this one will become even more common, Salama said, calling them a "very different paradigm."
"The norm will no longer be isolated rural communities that are at the center of these outbreaks, but very densely populated areas of the world.
Fauci also expressed how the growing number of emerging and re-emerging pathogens has led to increased response from WHO and other global health organizations – and required its maintenance.
"We need to continue to develop better and better methods for coping with epidemics – we tend to be reactive rather than proactive."
When a case of Ebola is confirmed in a city of 1 million inhabitants, no one should sleep well tonight in the world.
Peter Salama, Chief of Emergency Response for the WHO
A week ago, Salama declared that the the next 7 to 10 days would be critical to turn this Ebola outbreak around. As the world nears the end, he says, the promising data point to a slowing down of the epidemic – but this new Butembo affair, in addition to security concerns, is far from over.
"Because With regard to all the complicating factors, it is extremely important that we continue to make great efforts and to support the DRC and the neighboring countries so that they are up to the task and not to have a false sense of security. It's not over until the last case is really treated. "
[ad_2]
Source link
