Like Nigeria
in 2014 DRCongo has successfully defeated its latest Ebola Virus epidemic,
swiftly:
Courtesy of
the Atlantic we share -
'The
Atlantic
How the
Democratic Republic of the Congo Beat Ebola in 42 Days
The latest
outbreak was swiftly contained by a fast, decisive response, acting as a model
for containing infectious diseases in remote places.
Children in
Guinea get their feet disinfected in the West African Ebola
JUL 3,
2017 The Atlantic.Bottom of Form
As
anti-climaxes go, it was a most welcome one. On May 11, the Ministry of Health
of the Democratic Republic of the Congo (DRC) notified the World Health
Organization that one of its citizens had been infected with the Ebola
virus. The announcement marked the start of the country’s first Ebola outbreak
since the historically unprecedented West African epidemic that infected 28,000
people between 2014 and 2016, and killed more than 11,000.
But after
just 42 days, it was all over.
With the
last confirmed patient having tested negative for the virus for the second time
in a row, the WHO declared an end to the outbreak on Sunday. Just four people had
died, and just four more had become infected.
This swift
resolution was partly a matter of luck. The virus hit the remote and sparsely
populated Likati region, which is 1,300 kilometers away from the capital city
of Kinshasa, and nestled deep in equatorial rainforest. “People weren’t moving
around in the way they were during the West African outbreak,” says Anne
Rimoin from the University of California Los Angeles, who has worked
in the DRC for 15 years. “So it was a very small outbreak in and of itself.”
But just as
importantly, once the first cases were confirmed, the response was fast,
decisive, and coordinated—all qualities that were initially missing in West
Africa. The DRC response shows that when everything goes right, Ebola can be
quickly brought to heel, even when it hits poor, remote places. “With the end
of this epidemic, DRC has once again proved to the world that we can control
the very deadly Ebola virus if we respond early in a coordinated and efficient
way,” said Dr Tedros Adhanom Ghebreyesus, the WHO’s new Director-General, in a statement.
“Within 24
hours, we could start airlifting.”
The DRC has
had eight run-ins with Ebola since 1976, and has proven to be remarkably
successful at controlling the virus. In 2014, for example, while West Africa
was struggling with its historically unprecedented epidemic, the DRC managed to
contain its own separate outbreak after just 66 cases and 49 deaths. “In the
West Africa outbreak, nobody was looking for Ebola. It wasn’t on a list of
things that people were worried about, or even among the top suspects at the
time,” says Rimoin. “But in the DRC, when you see something that resembles
Ebola, it’s one of the first things that come to mind.”
The symptoms
of Ebola are greatly exaggerated in the popular press. It’s not a disease of
apocalyptic hemorrhaging from every orifice, and symptoms can easily be
mistaken for other maladies. In this case, the first patient—a 45-year-old man
who contracted the virus on 22 April—initially went to see a traditional
healer. When that didn’t work, he took a taxi to a health center—and died on
the way. (Both the driver, and a third individual who cared for the man, also
eventually died.) The center quickly suspected Ebola and immediately sent
samples to a national laboratory in Kinshasa. The staff there had the right
knowledge, training, and connections—they ran some preliminary tests while also
calling international colleagues. Rimoin flew over with the latest diagnostics.
After the
first positive case was confirmed, the government immediately notified the WHO,
which activated their emergency protocols. That inaccessibility of Likati was
both a blessing and a curse—it made it harder for the virus to spread, but also
harder for health workers to reach the infected zone. Fortunately, after the
sluggish response to the West African Ebola epidemic, the WHO had set up a $41
million contingency fund to ensure that money would be readily
available for future emergencies. This fund allowed them and other
organizations to quickly rent helicopters for flying personnel, generators, and
supplies into Likati. “Within 24 hours, we could start airlifting,” says
Ibrahima-Soce Fall, director of the health security and emergencies cluster at
the WHO’s African office.
“This time
we did better. And every time, we do better.”
The team set
up a base camp and field lab in the grounds of a former convent. Health workers immediately
started tracking anyone who had contact with infected individuals, eventually
tracing 583 such contacts. There weren’t any good maps of the area, so the
volunteers used their cellphones to start charting the region. They spread out
through the region’s villages to improve accessibility by fixing bridges and
forest tracks. With training from UNICEF and the WHO, they taught local
communities how to stop Ebola from spreading, how to safely bury people who die
from the disease, and how to disinfect affected homes.
In the end,
the outbreak was so small that it’s unclear if this fast response made much of
a difference. But with diseases like Ebola, it’s far better to be accused of
overreacting than of being lax. “It’s a good sign of things to come,” says
Rimoin. “It wasn’t necessarily needed in this case, but it showed that the
world is much more capable of managing outbreaks.”
The response
was so effective that even though this was the first Ebola outbreak where a
potential vaccine was available, it wasn’t necessary. Around 300,000 doses had
been stockpiled. None were used. “This is a candidate vaccine, which still has
some steps before it is fully licensed,” says Fall. “The WHO expert committee
recommended to use it in the event of an outbreak, on health workers and
[people who had been in contact with cases.] But because the outbreak was
rapidly controlled, we didn’t need to use it.”
The outbreak
may be over, but the response continues. For the next 90 days, the WHO will
continue to strengthen health services in the region, to ensure that local
volunteers are trained to spot possible symptoms should the disease arise
again. That, after all, is what preparedness is all about. A country’s ability
to control diseases in a crisis depends on everything that it sets in place
during peace-time.
“This is
clearly not the last outbreak,” says Rimoin. “But this time we did better. And
every time, we do better.”
Africa Center for Clin Gov Research &
Patient Safety
@ HRI West Africa
Group - HRI WA
Consultants in
Clinical Governance Implementation
Publisher: Health and
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