New DRC Ebola outbreak poses high country-level, regional-level risks, WHO says

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“Tracking a deadly high threat pathogen across a war zone” puts response “at the top of the degree of difficulty scale”

Risk of global spread remains low

The context of the Ebola outbreak just announced in the Democratic Republic of Congo’s North Kivu province is “very different” from the context of the outbreak just declared ended in the country’s Equateur province, World Health Organization officials said today. While challenges pervasive in both include multiple sites, remote terrain, health worker infection, as well as risks that the outbreak would cross national borders, armed conflict in the North Kivu region, as well as the resulting displacement of more than one million people — more than 10 percent of the province’s population — puts the response to the new outbreak “at the top of the degree of difficulty scale,” Dr. Peter Salama of WHO said today.

The virus found in four samples from North Kivu this week “appears likely” to be the Zaire strain of Ebola virus  identified in the just ended Equateur outbreak, and that is both good news, and bad, Dr. Salama said. Bad, because it is the deadliest strain of Ebola, with an estimated 50 percent case fatality rate, and good because the vaccine found safe and effective in the control of the last outbreak could once again be deployed to control the new outbreak. About 3,300 vaccine doses were administered in the Equateur outbreak, and about 3,000 doses are immediately available, if needed for the new outbreak.

But that deployment, which would involve tracing contacts of Ebola patients, as well as contacts of those contacts, would be greatly complicated by the need for armed military escorts to traverse the areas that will need to be covered to track contacts. “Tracking a deadly high threat pathogen across a war zone,” Dr. Salama said, would be “a very complex operation.”

No evidence suggests that the current outbreak, near eastern DRC borders is linked to the previous outbreak, which took place near the country’s west, Congo River borders. The current outbreak however, is believed to have spread to 10 localities. The province borders Uganda and Rwanda, and health officials are working with the governments of both countries, Dr. Salama said.

The possibility that Ebola had once again broken out in the DRC was recognized after a 65-year-old woman who had been hospitalized was discharged and immediately fell ill again with fever, vomiting, bloody diarrhea, and bleeding from her nose. Following her July 25th death, and apparently unsafe burial, seven members of her family also fell ill and died, Dr. Salama said.

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