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Alarming number of Ebola deaths in DRC a ‘rallying cry’ to scale up treatment

As part of the response to the outbreak of Ebola, the Red Cross has been working with the World Health Organization (WHO) and the Ministry of Health of the Democratic Republic of the Congo (DRC) ensure safe burials to help stop the spread of the deadly di
UN Photo/Martine Perret
As part of the response to the outbreak of Ebola, the Red Cross has been working with the World Health Organization (WHO) and the Ministry of Health of the Democratic Republic of the Congo (DRC) ensure safe burials to help stop the spread of the deadly disease. (August 2019)

Alarming number of Ebola deaths in DRC a ‘rallying cry’ to scale up treatment

Humanitarian Aid

Since the Ebola epidemic struck in the north-east of the Democratic Republic of the Congo (DRC) one year ago, almost 600 of around 850 children who have caught the virus have now died, the UN Children’s Fund (UNICEF) reported on Friday.

“The news that the total number of deaths has now passed 2,000, out of more than 3,000 cases, should act as a rallying cry for us all to step up our efforts to defeat this terrible disease and end this outbreak,” the Agency’s statement said.

“As the numbers continue to grow, it is vital to remember that each one of these cases is somebody’s child, a son or daughter; a mother, father brother or sister,” the announcement read. “Each of these deaths leaves a family not only in mourning but also scared and worried about their own exposure to the disease.”

UNICEF noted recent breakthroughs in finding successful treatments highlight that “for the first time, we now have the means to both prevent and treat Ebola.” Recent media reports show the disease is no longer incurable, with scientific advancements promising to tame outbreaks and boost survival rates.

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Medical advances however, “mean little” if infection goes undetected, or “if individuals are too scared to seek treatment.”

The DRC’s northeast region has seen several attacks on Ebola treatment centres by armed groups, and in some cases, strikes specifically targeting people working to counter the virus. A deadly environment with added social and political crises could reverse progress made in treatment and prevention.

This Ebola epidemic, categorized by the World Health Organization (WHO) as International Public Health Emergency in July, has affected more children than in any other previous outbreak, and the virus “ravages children in ways that are very different from adults,” UNICEF said.

As such, treatments for young persons are specialized. “UNICEF is working with partners to meet children’s immediate and longer-terms needs, accompanying them and their families every step of the way,” the Agency said.

These efforts include risk communication and engagement, infection prevention and control, psychosocial support, deployments of child nutritionists and building protective school environments.

Ebola outbreaks are unique in the “exceptional level of investment” needed to combat them, UNICEF explained. “They require 100 per cent of cases to be treated, and 100 per cent of contacts to be traced and managed.”

UN Secretary-General António Guterres will travel to impacted areas on Saturday in an expression of solidarity with victims and families fighting the epidemic.

Of the 126 million dollars needed meet the needs of children and communities, UNICEF has so far funded 31 per cent of its appeal.

“The reality is that we need far more international support now.”

WHO confirms new Ebola case in Uganda

As the number of infected continue to climb in the DR Congo, a new case of the disease was identified in nieghbouring Uganda, WHO revealed on Friday. The child, a nine-year-old Congolese girl, tested positive in Uganda and traveled to the DRC for treatment.

Briefing journalists in Geneva, WHO spokesperson Fadela Chaib confirmed the child, had been stopped in a routine border check at Mpondwe in western Uganda, reportedly on Wednesday. 

Amid reports that she had died, the WHO spokesperson explained that the girl was clearly extremely poorly when health officers stopped her.  

In June, two other individuals died from Ebola in Uganda after crossing the border from DRC. A third individual from the same family died after being he was sent back to DRC. 

Asked about the dangers of transmission within Uganda, Ms. Chaib emphasized that Ugandan officials had acted quickly to limit the risks of the disease spreading and had the expertise to minimize contact with the infected patient. 

According to WHO’s 27 August update on the latest Ebola outbreak in DRC, which was declared on 1 August 2018, “there have been …almost 3,000 cases of Ebola with 1,998 deaths and 893 survivors,” Ms. Chaib said. “Most of the cases are in Nord Kivu province.” 

Ebola virus disease: WHO

 

Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness affecting humans and other primates.

The virus is transmitted to people from wild animals (such as fruit bats, porcupines and non-human primates) and then spreads in the human population through direct contact with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids.

The average EVD case fatality rate is around 50%. Case fatality rates have varied from 25% to 90% in past outbreaks.

The first EVD outbreaks occurred in remote villages in Central Africa, near tropical rainforests. The 2014–2016 outbreak in West Africa was the largest and most complex Ebola outbreak since the virus was first discovered in 1976. There were more cases and deaths in this outbreak than all others combined. It also spread between countries, starting in Guinea then moving across land borders to Sierra Leone and Liberia.

It is thought that fruit bats of the Pteropodidae family are natural Ebola virus hosts.

 

The incubation period, that is, the time interval from infection with the virus to onset of symptoms, is from 2 to 21 days. A person infected with Ebola cannot spread the disease until they develop symptoms.

Symptoms of EVD can be sudden and include: fever, fatigue, muscle, pain, headache, and sore throat. This is followed by vomiting, diarrhea, rash, symptoms of impaired kidney and liver function, and in some cases internal and external bleeding (e.g. oozing from the gums, blood in the stools). Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.

It can be difficult to clinically distinguish EVD from other infectious diseases such as malaria, typhoid fever and meningitis. A range of diagnostic tests have been developed to confirm the presence of the virus.

 

There is no proven treatment for Ebola but simple interventions early on can significantly improve chances of survival. This includes rehydration with fluids and body salts (given orally or intravenously), and treatment of specific symptoms such as low blood pressure, vomiting, diarrhea and infections.

A range of potential treatments including blood products, immune therapies and drug therapies are currently being evaluated.

Hand hygiene is the most effective way to prevent the spread of the Ebola virus.

An experimental Ebola vaccine known as rVSV-ZEBOV proved highly protective against the deadly virus in a major trial in Guinea in 2015. It is being used in response to the current outbreak in the Democratic Republic of the Congo using a ring vaccination protocol.

During an outbreak, health partners apply a package of interventions including case management, surveillance, contact tracing, laboratory testing, safe burials and community engagement.

Working with communities to reduce risk factors for Ebola transmission is critical to controlling outbreaks.