Sunday, January 20, 2019

Ebola Update: Concerns About Spread To Goma, A Major Population Center



DRC Ebola outbreak: The worrying new developments, explained


The Ebola outbreak in Eastern Congo is moving toward a major city. That’s not good.




At least 680 people have been infected with the Ebola virus in the Democratic Republic of Congo. It’s the second-largest Ebola outbreak in history, with 414 deaths so far, and the first Ebola outbreak in an active war zone, DRC’s eastern North Kivu and Ituri provinces. 
But it could get worse: Health officials this week are concerned that Ebola appears to be spreading in the direction of Goma, a major population center in DRC. 
Just this week, DRC’s health ministry confirmed four cases of the deadly virus in Kayina, a town in North Kivu, where fighting among rebel and militia groups has repeatedly interrupted the painstaking work of health workers who are responding to the outbreak. 
Kayina happens to be halfway between Butembo, currently one of the outbreak’s most worrisome hotspots, and Goma, where a million people live.

So far, the outbreak has not affected DRC’s biggest cities. But Ebola in Kayina “raises the alarm” for Ebola reaching Goma, Peter Salama, the head of the new Health Emergencies Program at the World Health Organization, told Vox on Friday. 
Goma is a major transportation hub, with roads and highways that lead to Rwanda. “These are crossroad cities and market towns,” Salama added. People there are constantly on the move doing business, and also because of the insecurity in North Kivu. Ebola in Goma is a nightmare scenario WHO and DRC’s health ministry are scrambling to prevent.

Together, they’ve deployed a rapid response team, including a vaccination team, to Kayina. And if the virus moves on to Goma, Salama says Ebola responders are ready. They’ve already mobilized teams there, set up a lab, and prepared health centers where sick people can be cared for in isolation. 
But as Ebola expert Laurie Garrett wrote in Foreign Policy this week, Ebola in Goma could also trigger a rare global public health emergency declaration by WHO, escalating the severity of an already dangerous outbreak.
Because we have no cure for Ebola, health workers use traditional public health measures: finding, treating, and isolating the sick, and breaking the chains of transmission so the virus stops spreading. 
They mount vigorous public health awareness campaigns to remind people to wash their hands; that touching and kissing friends and neighbors is a potential health risk; and that burial practices need to be modified to minimize the risk of Ebola spreading at funerals.
They also employ a strategy called “contact tracing”: finding all the contacts of people who are sick, and following up with them for 21 days — the period during which Ebola incubates.
In this outbreak, there’s also an additional tool: an effective experimental vaccine. Since the outbreak was declared in August, more than 61,000 people have been vaccinated. But while the vaccine has tempered Ebola’s spread, it hasn’t overcome the social and political chaos in DRC, which has been called the world’s most neglected crisis
As of Friday, the two biggest hotspots in the outbreak were Butembo, with 51 cases, and a neighboring city, Katwa, with 119 cases. But the outbreak is geographically dispersed. There are active Ebola cases in 12 of the country’s “health zones,” the districts around which the DRC’s health system is organized. Because of the insecurity and difficulty reaching people, only 30 to 40 percent are coming from known contact lists, Salama said. That means the virus might already be in places no one’s discovered yet.

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