[hlth] Ebola outbreak 'may spread' in Congo

HeliumAvid

Too Tired to ReTire
http://news.bbc.co.uk/1/hi/world/africa/2750017.stm

Ebola is highly contagious and deadly



By Pascale Harter
BBC, Brazzaville



Thirty-eight people have died in a suspected outbreak of the Ebola virus in the north of Congo-Brazzaville, near the border with Gabon.


The Congolese authorities say they are concerned that the virus might spread.

Ebola is spread through contact with small amounts of body fluids.

Little more is known about the virus, which causes its victims to die from internal bleeding.

Bush meat

The Congolese Ministry of Health says the people died in the villages of Kelle and Mbou, about 800 kilometres north of Brazzaville, in the Region known as Cuvette West.

The authorities were first alerted to a possible outbreak of Ebola when a clan of gorillas in the region began to die in December.

Tests carried out on the bodies confirmed that the gorillas had died from the Ebola virus, which has now claimed more than 80% of that gorilla clan.


Doctors say the virus can spread through infected bush meat

For the authorities, the Ebola virus is the stuff of nightmares.

Spread almost as easily as the flu but far more deadly, Ebola can result in the death of 95% of its victims.

The Congolese practice of washing the body before burial is just one of the factors that makes the virus so difficult to contain.

The Ministry of Health suspects that the current outbreak was caused by villagers eating primates in the area who were already infected with Ebola.

Hostile

But confirmation that the virus is responsible for the recent human deaths has not yet been possible.

This is because local inhabitants are refusing to co-operate with teams of Ministry of Health workers and World Health Organisation specialists who have gone to the region to study and contain the outbreak.

The villagers of Kelle and Mbou have so far refused to give blood samples needed to test for the virus, and have become hostile towards the visiting medical teams.


Medical professionals are at great risk of contracting Ebola

They claim it is the medical workers who bring the virus to the region.

The local inhabitants, who are mostly Pygmies, were badly mistreated by Gabonese troops who came to the area to contain an Ebola outbreak in 1996 and 97.

And this may be the reason why the local population is fearful.

Since an outbreak in the same area in June last year, the Congolese ministries of Forestry and the Environment have had teams of workers in the region trying to raise the awareness of the local population to the dangers of eating gorillas and chimps, particularly those which they find already ill or dead.

But they admit it is an uphill struggle in a region where bush meat has been a staple part of the local diet for centuries.
 

CanadaSue

Membership Revoked
Nice catch HA...

Last time I caught an update on this one the 'official' death toll stood at 6, clincially confirmed as opposed to confirmed through lab tests.

I do have abone to pick with the BBC whso surprised me as they usually get their facts straight. Ebola is not 'nearly as contagious as the flu'. It is spread only through direct contact with bodies of those who have it or have died from it.

Barrier techniques - mask, gloves & gown as well as rinsing off with a water/bleach spray mix prevent this puppy from spreading. It is passed on by medical persons yes, when they do NOT have the proper equipment or are forced to reuse syringes & needles. Also many cultures living in Ebola endemic areas, prepare the dead themselves; that is, the family does it & without the benefit of gloves. Bodies are washed, orifices emptied out... etc. Mourning practices include touching the body; hugging & kissing it.

That is what leads to its spread & typical pattern of spread. A person brings it home & spouse or other caretaker then contracts it, followed by kids & so on.

Our standard of medical practice, barrier techniques, UV & chlorine disinfection - more than enough to kill it.


A scary side note. These practices must be OBSERVED. We had a scary case in Canada 2 winters ago; a woman brought home what appeared to be a hemmorhagic fever. It was but was never identified & we tried, your CDC tried- nada! The woman recovered but before she was diagnosed, some lab techs drew blood without gloves or masks & some were pregnant. The 2 ambulances used for her transport were not taken out of service & disinfected until they'd transported a total of 7 further patients.

Nuts.

But as horrible as the filoviruses & other hemmorhgaic fevers are, they're no major concern here.

What is of concern in this outbreak is that it appears to be wiping out a substantial part of the lowland gorilla population in that part of the world. This puppy is yearly being seen more & more among other primates & yes, you can catch it eating bush meat.
 

CanadaSue

Membership Revoked
More on this story...

Death toll now up to 48 & fears among villagers as to the real cause of the illness continue. Artile from BBC:




Wednesday, 12 February, 2003, 15:07 GMT
Congo gets 'Ebola' samples


Ebola has killed hundreds of people in central Africa

At least 48 people are now known to have died in a suspected outbreak of Ebola in the north of Congo-Brazzaville, near the border with Gabon.
There is no cure for Ebola, which causes up to 95% of its victims to bleed to death.


The authorities in Brazzaville have not yet been unable to confirm the virus is the cause of the deaths.

But the ministry of health says it has now obtained blood samples from five of the deceased.

At first inhabitants of the villages of Kelle and Mbomo where people have been dying daily in recent weeks, refused to co-operate with emergency teams from the ministry of health and the World Health Organisation (WHO), sent to investigate a possible Ebola outbreak.


Instead they accused the health teams of bringing the virus to the area themselves, and refused to give blood samples from their dead.

Wild game

The samples have been sent from Kelle and Mbomo, 800 kilometres north of the capital, Brazzaville, to a laboratory in Libreville, Gabon, and results of the Ebola tests are expected within the next five days.


Doctors say the virus can spread through infected bush meat

In the meantime, the ministry of health and the WHO are treating the deaths as a confirmed Ebola outbreak and taking measures to contain the spread of the virus, which is easily passed by contact with body fluids and between humans and animals.

The ministry says its emergency teams have now succeeded in convincing inhabitants of the area to stay away from church and not to travel.

The teams are also trying to stop people in the region from eating wild game such as gorilla, gazelle and antelope.

These are among the animals which have been dying off in the surrounding forest and have already tested positive for Ebola.

Ebola killed 43 people in Congo and 53 others in neighbouring Gabon between October 2001 and February 2002.

The WHO says more than 1,000 people have died of Ebola since the virus was first identified in 1976 in western Sudan and in a nearby region of Congo.
 

offline

Membership Revoked
HeliumAvid said:
The authorities were first alerted to a possible outbreak of Ebola when a clan of gorillas in the region began to die in December.

Tests carried out on the bodies confirmed that the gorillas had died from the Ebola virus, which has now claimed more than 80% of that gorilla clan.
...

The Ministry of Health suspects that the current outbreak was caused by villagers eating primates in the area who were already infected with Ebola.
Time to print up some brochures to hand out in that region.

"If you encounter a dead gorilla that appears to be diseased, wear rubber gloves and facemask before touching it, and make sure you cook the meat thoroughly before consuming it."
 

CanadaSue

Membership Revoked
That's what surprised me Offline...

Congo is the " 'hood" where Ebola originally came from. They've had an extensive campaign including posters & pamphlets for years now, including travelling public health wrokers. This HAS brought down the infection rate from Ebola when outbreaks begin.

From the sounds of it, this may involve tribes or groups far removed from normal channels of communication. Their suspicions that health care workers may have brought the virus with them is unhappily, partly based on fact. The original outbreaks were not caused by health care workers, but certainly spread by health care workers unabl;e to sterilize syringes, not having masks, gloves & other basics, etc.

Now their fears may be more "primal" than that. They may actually feel the health care workers have deliberately infected them. I'll see what else I can find...
 

CanadaSue

Membership Revoked
What you don't want to happen...

From CNN, the region with the suspected Ebola outbreak now is reporting 51 deaths from 61 cases - all suspected, no lab confirmation yet. That's running at 84% fatality - ick!

The scary thing is, as reported, people are fleeing into the bush. The more movement of people, the wider the potential range of spread. Ideally, you want zero movement of folks in affected areas:

Story Tools

--------------------------------------------------------------------------------

BRAZZAVILLE, Congo (Reuters) - The death toll from a suspected outbreak of the deadly Ebola virus in Congo Republic has crept up to 51 and people have begun fleeing into dense forest to escape what some believe to be an evil spell.

Authorities have tried to impose tight restrictions on movement in the hope of preventing the spread of the outbreak, the second reported in little over a year in the remote northwest. It is thought to have been caused by the consumption of infected monkey meat.

Health Minister Alain Moka said late Thursday that 46 people had died in the Kelle region, and five in the nearby Mbomo region. Health officials on Wednesday had put the death toll at 48.

The area is 440 miles from the capital Brazzaville, near the border with Gabon. It has been placed under quarantine and no one is allowed in or out without authorization.

Ebola, transmitted via infected body fluids, kills 50 to 90 percent of its victims by causing massive internal bleeding, depending on the strain. There is no known cure.

Moka said the government had allocated about $66,000 to fighting the highly contagious disease and sending medical teams to the affected area.

Mobile radio stations and loudspeakers were to be used to advise inhabitants. Movement between villages was forbidden and sports competitions and cultural events banned, Moka said.

But locals, many of whom believe Ebola is the result of a witch doctors' spell, began fleeing as the disease spread.

Congo's top official in the fight against Ebola, Joseph Mboussa, said Wednesday that authorities were still trying to determine whether the outbreak was Ebola but suspicions were strong because of the high number of deaths in a short time.

Mboussa said the Ebola virus had been confirmed in tests on the bodies of animals from surrounding forests, where gorillas, chimpanzees, monkeys and antelopes started dying in large numbers late last year.

The meat of wild animals has long been a staple in central Africa's forests and a popular delicacy in its cities.

Ebola killed at least 73 people in Congo and Gabon in an outbreak from October 2001 to February 2002. That epidemic was also linked to the consumption of infected primates.

The disease was named after a river in the neighboring Democratic Republic of Congo, where Ebola was discovered in 1976. The worst outbreak was in that country in 1995 when over 250 people died.
 

CanadaSue

Membership Revoked
Case count ramping up...

The WHO team requested has finally arrived in the affected districts. Lab confirmation of Ebola has now been recieved, but no word on what strain/substrain. 59 deaths from 71 cases now, a case fatality rate of almost 81%. Here's the ProMed report:

Ebola Hemorrhagic Fever in The Republic of the Congo - Who Update 4
--------------------------------------------------
As of Tue 18 Feb 2003, a total of 73 suspected cases and 59 deaths of Ebola
hemorrhagic fever has been reported in the districts of Mbomo and Kelle in
Cuvette Ouest Region [see: Ebola hemorrhagic fever - Congo Rep. (06):
suspected 20030215.0398].

The Government of the Republic of the Congo has officially declared the
epidemic as due to Ebola hemorrhagic fever. Laboratory testing carried out
at the Centre International de Recherches Medicales de Franceville (CIRMF),
Gabon has confirmed the diagnosis of Ebola virus in clinical samples.

The government has requested the assistance of WHO in controlling the
outbreak. A team including epidemiologists and social mobilization experts
from WHO and the Global Outbreak Alert and Response Network have arrived in
the Cuvette Ouest Region. Experts in clinical management will be joining
them in the area shortly.

--
ProMED-mail
<promed@promedmail.org>

[This report is the first official confirmation of diagnosis of the disease
as Ebola hemorrhagic fever by laboratory testing. Since the previous WHO
update dated Thu 13 Feb 2003, the number of cases has increased by 12 and
the number of deaths by 9. - Mod.CP]
 

CanadaSue

Membership Revoked
Latest update...

Sounds like the gvt. & health types have an uphill battle on their hands...


Congo Ebola outbreak confirmed


By Pascale Harter
BBC, Brazzaville


The government of Congo-Brazzaville has now confirmed that it is the deadly Ebola virus which has claimed the lives of 64 people, in the north of the country near the border with Gabon.

The World Health Organisation in Congo says it is hopeful that international aid to fight the spread of the virus will now be forthcoming.

For the past four weeks the number of dead in the districts of Kelle and Mbomo has continued to climb daily, as the Ministry of Health and World Health Organisation have struggled to contain what they suspected was an outbreak of Ebola.

Confirmation came late last night, after blood samples from residents of Kelle were analysed in a Libreville laboratory, one of less than 10 in the world able to test for Ebola.

Appeal

Emergency teams of medical workers and Ebola experts from the WHO are already in place in the outbreak zone.

The government closed down the region to travel on Thursday and Gabon has shut its nearby border.


Locals are not co-operating with medical experts
But Dr Lamine Sarr, country director of the WHO says the official confirmation means appeals for international aid to deal with the outbreak should now be answered.

The WHO and Congolese government desperately need funds and food to help the people of Kelle and Mbomo.

The isolation techniques used in containing the Ebola virus are expensive and with the border to Gabon closed, the local population has nowhere to buy food.

The Congolese Government has already appealed to the United Nations World Food Programme for help.

But only last month, the WFP warned that it was already hopelessly overstretched in providing food aid for 60,000 people who have fled ongoing fighting in the Pool Region of Congo.

Sorcery

But money and food are not the only problems WHO and Congolese government face in containing the Ebola outbreak.

Dr Sarr of WHO told the BBC that residents in the outbreak zone are still unwilling to co-operate with the medical teams.

Only one person with Ebola out of 16 confirmed cases, has agreed to be hospitalised.

There is little understanding of the virus among the local population, who believe the recent deaths are a result of sorcery or something brought in to the area by the medical teams.
 

CanadaSue

Membership Revoked
checked with WHO...

The 64 deaths are from 80 cases, a case rate fatality of %80. Sounds like one of the Ebola Zaire strains...
 

ainitfunny

Saved, to glorify God.
They have shut off these peoples access to their normal food sources because of fear of epidemic, they cannot travel to the nearby cross border stores because the border is closed. They have coerced them with starvation, withholding food aid unless the people agree to let the health teams (which the residents suspect of spreading disease) inject them. The health teams warn the starving people Not to eat "bush meat" but like anyone here, the people, cut off from ordinary food sources will go hunting for game to eat rather than starve.

I see real problems both for the native population and the possibility of containing the epidemic.
 

CanadaSue

Membership Revoked
amen, ain't...

Ebola has been in that nation long enough for people to know the first 2 outbreaks were horrificly amplified by p*ss poor hygiene technique. Mixed feelings about that. Those nursing sisters were doing the best they could with next to nothing & had certainly never run into filoviruses before. Probably little AIDS either. The locals know that people who recieved injections got sick. They did, from Ebola in the syringes used & improperly cleaned from one or more patients who were already infected.

Another tragedy in this is that often, the disease is really only starting to spread quickly just as Health Teams arrive. They see a) medical types appear & b) more people get sick & conclude c) the medical types or their "treatments" make people get sick. Poor logic, but who the heck is thinking straight when faced with someone crashing with Ebola?

Yeah, Gabon closed the border; they've had enough experience with Ebola, thanx muchly. And how do you realistically tell people who've been doing it for umpteen years not to eat bushmeat? The "no food aid" unless you agree to have blood drawn is completely reprehensible imo. They NEED to evaluate all cases. They may be able to clear someone from an Ebola diagnosis by finding a less nasty bug. Many mimic Ebola's early symptoms.

Another Congo Cluster you-know-what.

Watch case numbers really ramp now & I'll betcha five that we're still updating this 4 months from now.
 
Top