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EIt appears that efforts to contain the 10-month Ebola epidemic in the Democratic Republic of Congo are bearing fruit, with a decrease in the number of cases in the past two weeks and a reduction in the number of cases. geographic footprint of the transmission areas, according to the World Health Organization said Thursday.
The notes of cautious optimism contrasted with early week messages from other partners in the response, including the Centers for Disease Control and Prevention.
Dr. Robert Redfield, director of the CDC, warned Tuesday that the world must prepare for the possibility that the epidemic will continue for another year or two. And Tariq Riebl, director of emergency interventions for the International Rescue Committee, said the sharp increase in the number of cases this spring, while the outbreak was to be contained, suggested radical changes. "This response requires a complete and complete reset," said Riebl.
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Dr. Mike Ryan of WHO, executive director of the World Health Agency's emergency program, said the Redfield estimate was the worst case scenario. But he added that other possibilities include stopping the spread in the Congolese provinces of North Kivu and Ituri much earlier than that.
"The result is related to the efforts," Ryan said. "Are we ready to make immediate, sustained and comprehensive efforts to control this disease? And if we do, I think the delays can be much shorter than those indicated. "
"But … I think Dr. Redfield is really trying to make the world understand that the situation is very complex and if we continue to operate with less than perfect efficiency, we may end up managing this epidemic for a while. long time."
Ryan rejected the call for a full reset, saying that this option was not available for the answer.
"S & # 39; adapt, yes. Learn, yes. Change things, yes, "said Ryan. "I have been the victim of many Ebola and other epidemics. There is no magic bullet. There are no unicorns. It's hard work and we learn from what we do. "
The epidemic, which broke through the 2,000 mark at the start of the week, is the second largest ever recorded. On Tuesday, there were 2,025 cases and 1,357 deaths.
Although the epidemic is still significantly less important than the 2014-2016 West Africa epidemic – which covered several countries and which recorded more than 28,000 cases and more than 11 000 deaths – the WHO claimed that it could be the hardest that the agency and its partners faced. .
The affected provinces are struggling with conflict for more than two decades, making travel and work in some communities difficult and dangerous. The years of fighting have left residents of the region extremely wary of their own government and anyone who is considered a stranger.
This has made the critical work of Ebola containment cases difficult – finding out who has been exposed to cases, persuading contacts to get vaccinated and persuading people with the virus to seek treatment at specially equipped health centers. Since the end of February, Ebola teams and facilities have been the target of multiple attacks, many of which have claimed the lives of the control personnel.
While intervention teams often need armed guards to move, locals move freely and often. Ryan noted that about one-fifth of the infected people went to another health zone from where they were living at the time of their first care – often starting to spread to new locations or reactivating transmission to a place where he had already been arrested.
This trend also complicates the work of determining who infected whom. Response agents need to determine where the virus is circulating and who is on its way, so that people at risk of contracting the Ebola virus can be offered an experimental vaccine used to help stop the epidemic.
Ryan acknowledged that officials believe they only detect about 75% of cases. Improving this figure will involve persuading affected communities to cooperate in containment efforts, he said.
Still, Ryan said that there were signs of progress. There have been 88 cases per week in the last two weeks, compared with an average of 126 cases per week in April. And the number of case contacts monitored daily to see if they have developed symptoms has gone from a peak of 20,000 a day to 15,000, he said.
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