NAIROBI, 17 October 2012 (IRIN) - An Ebola outbreak that has killed several people in the Democratic Republic of Congo (DRC) appears to be slowing down, but health workers say there is a need for continued vigilance in order to contain the virus.
"Their last confirmed case was admitted in the MSF [Médecins Sans Frontières]/Ministry of Health Ebola ward on October 10, after two weeks with no confirmed cases," Olimpia de la Rosa, MSF medical emergency coordinator, told IRIN in an email. "The decrease in the number of admissions in our facility makes us think that we are on the way to contain the outbreak, but containment efforts must continue until no cases are confirmed for at least 21 days."
According to the UN World Health Organization's (WHO) 8 October update [ http://www.who.int/csr/don/2012_10_08a/en/index.html ], the disease had claimed 24 lives by 7 October, while 31 cases had been confirmed and 18 were suspected. The outbreak, first reported [ http://www.irinnews.org/Report/96160/DRC-Bushmeat-blamed-for-Ebola-outbreak ] on 17 August, is in Isiro and Viadana health zones in the country's north-eastern Orientale Province.
The Ministry of Health is working with a task force that includes, among others, MSF, the International Federation of Red Cross and Red Crescent Societies, the US Centers for Disease Control and Prevention, the UN Children's Fund (UNICEF) and WHO. Its activities involve surveillance, health worker training, community education and the implementation of biosafety measures. MSF has also set up a centre for supportive treatment of Ebola patients.
Ebola, which causes fever and bleeding from orifices, can cause death within days. There is no cure or vaccine for it, so efforts are concentrated on stopping its spread. The current strain in DRC has been identified as Ebola-Bundibugyo - named for a Ugandan district that borders the DRC. The fatality rate [ http://wwwnc.cdc.gov/eid/article/16/12/10-0627_article.htm ] rate for this strain is estimated at about 40 percent.
Medical situation delicate
According to MSF's de la Rosa, there is "a need to reinforce health staff knowledge about the ways of transmission of the disease and about the ways to protect patients and themselves from contagion".
Ebola is new to the area, and few local health workers had been trained to deal with it when the outbreak began. Several health workers have succumbed to the outbreak. Maintaining empathy for severely ill patients while ensuring health workers remain disease-free is a challenge.
"For the health staff providing care in the treatment centre, it is a big challenge to make compatible biosafety measures and establish[ing] an empathic patient-care giver relationship. Gloves, goggles, masks, gowns. pose a barrier to transmission but also to human contact and communication," she said.
"Physical contact through the protection material, words [of support] and provision of good medical care in the most friendly facility that biosafety allows can help to overcome this challenge and ensure the providing of quality medical treatment and patients' well-being."
Prevention a problem
According to WHO [ http://www.who.int/mediacentre/factsheets/fs103/en ], "Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals." Fruit bats are considered to be the natural host of the virus.
Preventing future outbreaks will remain difficult as long as the response is reactionary, de la Rosa noted. "It is very difficult to prevent an Ebola outbreak from appearing because we still ignore [the virus] in non-epidemic periods, making impossible to stop the appearance of the first cases," she said. "We can just detect outbreaks when some patients become infected, usually when they die of unknown causes."
Meanwhile, neighbouring Uganda, which experienced a fatal Ebola outbreak [ http://www.irinnews.org/Report/96010/UGANDA-Containment-worries-as-Ebola-numbers-rise ] in the western district of Kibaale in July, was declared Ebola-free by the country's Ministry of Health on 4 October.