Critical issues and trends africa

 

An Ebola outbreak in the Congo is currently threatening to spread beyond control. It is the second-largest Ebola virus outbreak in history.

[UPDATED September 2, 2019, originally published March 5]

In a highly conflicted region of the DRC an Ebola outbreak has been fought since August of 2018. Currently, there are more than 3,000 confirmed Ebola cases in the DRC and over 2,000 deaths. Recently cases of Ebola have also been confirmed in the neighboring countries of Uganda and near the border of South Sudan.

On August 16, the government of Congo alerted the world that the virus spread to a third province. Two new cases were detected in South Kivu province, 430 miles south of the original outbreak.

In mid-July an Ebola victim died in the city of Goma, near the borders of Rwanda and Uganda. Goma hosts a population of 2 million people. This event triggered a significant shift in the scale and scope of the crisis as the potential for the Ebola outbreak spreading internationally was seen to be increasing. Meanwhile, in areas of the country where the outbreak was believed to be contained, it has flared back to life.

According to a New York Times article: “The man who brought the disease to Goma was a pastor who had preached in seven churches in the epidemic zone, laying hands on the sick. He became ill and was treated by a nurse, but got on a bus to Goma anyway. The bus stopped at three checkpoints meant to halt the spread of the disease by screening passengers for symptoms, but his illness was not detected. He gave a different name at each checkpoint, apparently hoping to avoid being detained, local health authorities said. Sick and feverish by the time he arrived in Goma, he went to a clinic there, where the disease was diagnosed.”

After the death of the victim in Goma the World Health Organization (WHO) declared the Ebola outbreak as a Global Health Emergency. Prior to this, the organization declined to make this declaration three times since the outbreak in 2018. The WHO has used the “Global Health Emergency” tool only four times before:

      • 2009 pandemic influenza
      • 2014 polio resurgence in several countries
      • 2014 ebola outbreak in West Africa
      • 2016 Zika virus epidemic

In communities where the danger of Ebola is the highest many Congolese do not trust the health providers. Some victims of Ebola have died in their homes, raising the risks of contagion.

ebola in the congo

Violence against the treatment facilities has raised the risk of the Ebola outbreak in Congo spreading. That violence worsened this spring. In April attackers killed an epidemiologist with the World Health Organization (WHO) in Congo. There is a belief thathealth workers actually started the epidemic. In the first week of May, a WHO team was attacked after burying an Ebola victim. Five days later gunmen stormed the neighborhood where they were working and a gunfire exchange was had between them and security forces. Today, many of the health workers are wearing disguises and lying about their identity among the locals so they can continue distributing care and vaccines. There have been 174 attacks on health workers between January and May of 2019.

 

Ebola outbreak in Congo

Ebola is a rare and extremely deadly virus that damages the immune system and organs. By causing the levels of blood clotting cells to drop, uncontrollable bleeding results. In extreme cases, as organs shut down victims of Ebola will bleed out of their eyes. Ebola kills up to 90% of those who are infected unless treated. Even when treated, the rate of death among those infected with Ebola is incredibly high.

According to The New Humanitarian, more than 147,000 people in the DRC have received an experimental Ebola vaccination which has proven effective in 97.5% of the cases where it has been tested.

 

 

Ebola was discovered in 1976. It was originally called Ebola hemorrhagic fever. The largest Ebola outbreak occurred in 2014-16 when the virus spread among many countries in Western Africa and killed more than 11,300 people before it was contained.

The current outbreak is taking shape in a highly unstable and conflicted region of the DRC. Multiple armed groups vying for control of the area have hindered the effectiveness of treatment efforts from organizations like Doctors Without Borders.

 

World Health Organization Director-General Tedros Adhanom Ghebreyesus says, “There has never been an Ebola outbreak in these conditions, with such a highly mobile population and with many gaps in the health system. The security context is another major concern.” The WHO has called the current Ebola outbreak in DRC an “extraordinary event” but so far has not officially classified it as a Public Health Emergency of International Concern. The organization added that it may take another two years before the outbreak is contained.

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In March Doctors Without Borders had to stop treatment in several areas after their treatment facilities came under attack. At one location a group of people began to throw rocks at the treatment facility and then set it on fire. A caregiver from one of the patients was killed. Four days later at another location, the treatment facility and vehicles were set on fire. As a result of this unrest Doctors Without Borders has been forced to suspend treatment in the area where 85% of all new confirmed cases in Congo have been diagnosed.

 

This unrest occurred among a growing concern that newly confirmed cases occurred among people who were already dead. This means it cannot be known for sure who all they spread the virus to before they died. The risks for the spread of the virus are spreading both through the unstable situation in the region where it is being found and the unknown factors of contagion among those within which it is found. ‘

 

The World Health Organization has stated that a high proportion of people with Ebola were dying within their community. This means carriers of the disease might be avoiding the health clinics. It is also becoming increasingly more difficult to track where the disease is spreading within the region.

The Ebola outbreak has interrupted responses to other significant health threats in the area. Health workers focusing on the administration of Ebola vaccines in North Kivu were interrupted from distributing measles vaccines. In the first six months of 2019 more than 1,800 people in the DRC died from a measles outbreak of more than 107,000 confirmed cases. In addition, a growing cholera epidemic resulted in more than 12,000 cases and 276 deaths in that same time period.

The pharmaceutical giant Merch has donated 195,000 doses of a vaccine that is believed to be effective against Ebola. More is needed. Johnson & Johnson have pledged donations of a second vaccine which the WHO wants to use but this has not been approved by the Congolese government, so far. Their delay in approval is largely based upon concerns regarding the public distrust in the pharmaceutical companies. The vaccine takes a year to make.

In a lightly covered news event, researchers announced in recent weeks, that a cure for Ebola has been discovered. The new drugs have undergone a clinical trial and demonstrated a 94% effectiveness in recovery from Ebola.

Dr. Jean-Jacques Muyembe the lead doctor of the research team behind the discovery explained, “I have spent four decades of my life thinking how to treat patients with the Ebola virus. So this is the achievement of my life.” This discovery does not end the crisis but does provide great hope.

Additional Reading on Ebola Outbreak in Congo:

 

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