Eleventh outbreak declared in
Équateur province
On 1 June 2020, Democratic Republic of
Congo (DRC) declared its eleventh Ebola outbreak since records began,
following the revelation of new cases of Ebola in Équateur province,
northwestern DRC.
Less than two years since the last
outbreak of the disease ended in Équateur province - and just weeks
before the country declared over its long-running tenth tenth outbreak, in
North Kivu and Ituri provinces - authorities reported over a dozen people with
either confirmed or suspected cases in the city of Mbandaka and surrounding
area.
On 9 June, WHO announced that there is no link between the
tenth outbreak and the eleventh outbreak; they also established that the virus
in the new outbreak is distinct from that which circulated in Équateur province
during the country's ninth outbreak in 2018.
Current situation
The response to this eleventh Ebola epidemic does not face
the kind of security challenges that affected the response to the tenth Ebola outbreak.
The outbreak has progressed slowly, and -- as of 31 October
-- the province has gone 33 consecutive days without a case being recorded; the
outbreak would be declared over after 42 days since the last negative test of
the last known patient (as of the same date, this is 25 days).
Nevertheless, we know from previous experience -- including
during the tenth epidemic -- that new clusters of cases can still occur, even
after long periods of no new cases being reported.
Despite that this eleventh outbreak seems to be under
control, 13 out of Équateur province's 18 health zones have recorded cases,
with patients scattered over a vast area.\ However, compared to the North
Kivu/Ituri epidemic -- which saw a case mortality rate of 67 per cent -- the
outbreak in Équateur province is recording mortality levels of 43 per cent;
still high, but significantly lower than in the tenth outbreak.
Patients in this eleventh outbreak are benefitting from the
scientific progress that's been made in recent years, with a vaccine, and
curative treatments now available. According to WHO, 40,000 people have been
vaccinated using the rVSV-ZEBOV vaccine. However, these possible explanations
are based on observations; more analysis is needed.
Area
The area poses significant logistical challenges. Équateur
province is the same size as Iceland (nearly 104,000 km2), with some health
areas only accessible by river using canoes or after hours of difficult
transport by rough roads through the forest. Only one helicopter is available
to humanitarian organisations to move around the region.
Villages are scattered in the area, with often large
distances between them, and many are extremely remote. MSF teams, with
equipment, often need to reach these places by traversing lakes or navigating
rivers.
The province mostly lacks major long-distance roads, so
communities move along the meandering waterways of the area as they go from one
small village to another; therefore, we see sporadic cases that don’t appear to
spread in a linear way, as we saw during the North Kivu/Ituri outbreak.
MSF response to eleventh
outbreak
Following the declaration of the eleventh Ebola virus
outbreak in DRC by the Ministry of Health (MoH) on 1 June, MSF teams decided on
a decentralised, community-focused approach.
It is based on empowering decentralised micro-structures for
Ebola care in local healthcare facilities, close to patients and communities.
The approach is instead to engage mostly local health workers, supporting
people at the community level to conduct local case surveillance, and limit the
use of large, centralised facilities and personnel from outside the community.
We are supporting the healthcare system in Équateur province
to identify, isolate and treat patients with Ebola, minimising the need for a
parallel system.
At the height of our response, MSF teams were working in six
health zones: Bolomba, Bikoro, Monieka, Ingende, Lolanga Mampoko, and Lotumbe.
In total, we provided care to patients in across nine treatment and isolations
centres.
CURRENT ACTIVITIES
With no new cases reported for over a month, MSF teams are
now scaling down our response. However, we currently have an emergency team in
the province, based in Bolomba and Mbandaka, who are continuing to monitor the
situation until mid-November. They will be able to rapidly respond if and when
needed, and their mission can be extended, depending on how the situation
evolves.
PREVIOUS ACTIVITIES
Bolomba health zone
provided support to the Ebola treatment centre at the
general hospital
set up two small treatment and isolation centres in the
remote health areas of Boso Mondomba and Yuli.
Monieka and Bikoro health
zones
provided support to four small care and isolation structures
in difficult-to-access health areas.
Lotumbe and Ingende health
zones
Working with the MoH and WHO, investigated whenever a new
case was reported for contact tracing
Vaccinated the patient and their contact
Established -- in cooperation with the community -- health
zone alerts to potential cases
Lolanga Mampoko health zone
Short-term support was provided to health facilities through
medical and water and sanitation briefings,
Supported with triage and health promotion activities
Donated medicines and medical items
Across the six zones
our teams are supporting community surveillance
providing rapid treatment to patients living in
hard-to-reach areas
Our health promotion teams are also supporting those of the
Ministry of Health
An MSF epidemiologist worked alongside MoH, WHO and MSF
health promotion teams
Developed a triage algorithm, in collaboration with MSF's
epidemiological arm, Epicentre, to reduce people with suspected Ebola being
admitted to ETCs or isolation units, preventing cross-contamination
We are also supporting health centres in the hotspots and on
the major axes of Bolomba and Bikoro, with non-Ebola health needs.
Summary - tenth outbreak
Democratic
Republic of Congo (DRC) declared their tenth outbreak of Ebola in 40 years on 1 August 2018.
The outbreak was centred in the northeast of the country, in North Kivu and
Ituri provinces; cases had also been reported in South Kivu, and some across
the border in Uganda.
During the tenth outbreak, 3,470 cases were recorded; 2,287
people sadly lost their lives. It is by far the country's largest-ever Ebola
outbreak, and is also the second-biggest Ebola epidemic ever recorded, behind
the West Africa outbreak of 2014-2016.
The last Ebola patient was discharged from the Beni ETC on
14 May 2020; after recording no new cases for 42 consecutive days - twice the
length of the disease's incubation period of 21 days - the DRC Minister of
Health declared the outbreak in the northeast over on 25 June 2020.
Posts
No comments:
Post a Comment