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World Ebola outbreak in Congolese war zone is proving hard to fight

A health worker sprays disinfectant on his colleague after working at an Ebola treatment centre in Beni, Eastern Congo, Sept. 9, 2018.

Al-hadji Kudra Maliro/The Associated Press

When a confirmed Ebola victim fled into the territory of the feared Mai Mai guerrillas in eastern Congo, beyond the reach of health workers, it was a sharp reminder of the unusual risks associated with the latest Ebola outbreak.

The outbreak, which has caused 142 confirmed or suspected deaths so far, is the first Ebola crisis ever to occur in an active war zone – an added layer of danger that has created extraordinary challenges. Long negotiations were needed before the Mai Mai finally agreed to allow health workers into their region to do vaccinations after the Ebola victim arrived, according to a report this week by Congo’s Health Ministry.

The World Health Organization, after a meeting of an expert committee on Wednesday, said it is “deeply concerned” by the latest Ebola outbreak in the Democratic Republic of the Congo. But the expert committee decided that the crisis does not require the declaration of a global emergency so far.

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In total, 220 confirmed and suspected Ebola cases have been reported in the latest outbreak, the Congolese health ministry reported on Wednesday. It’s the worst outbreak of the viral illness since the epidemic in West Africa that killed more than 11,000 people from 2014 to 2016.

In the latest crisis, many of the signs have been alarming. The number of daily new Ebola cases this month is twice as high as the daily rate last month. The conflict zone, with more than 20 armed groups in it, has made the health response far more complicated. And there is still a “very high” risk of Ebola spreading across borders to neighbouring countries such as Uganda or Rwanda, the WHO said on Wednesday.

Among the confirmed Ebola cases, the death rate has been 57 per cent so far, the WHO said. The response to the outbreak “needs to be intensified,” it said. “Ongoing vigilance is critical.”

Another problem is community mistrust – partly due to the armed groups and the years of fighting in the area. In several cases, angry villagers have attacked Red Cross volunteers, sometimes preventing the volunteers from conducting a safe burial of an Ebola victim. While most Ebola victims are getting a safe burial, the mistrust has meant that a minority of victims are not being safely buried, according to Peter Salama, the WHO deputy director-general for emergency preparedness and response. Burials were temporarily suspended at one point this month because of the attacks.

The local resistance has contributed to a spread of the outbreak to a new area, around the city of Beni, where rebel attacks have killed more than 20 people in recent weeks.

Because of the dangers of violence, it has been difficult for health workers to trace the contacts of those who were infected with the virus. “The frequency and intensity of the attacks have increased in the past month,” said Robert Steffen, head of the WHO emergency committee.

The violence has also sparked community protests in which people stayed at home in a “dead city” demonstration – making it difficult for health workers to trace those who may have come into contact with Ebola-infected people. And because of the risks of violence, some U.S. health workers have been instructed to stay away from the outbreak area.

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Another complicating factor is the fast-rising rate of hunger and malnutrition in many parts of Congo, including the area of the Ebola outbreak. This week, a new report by the United Nations and the Congolese government found that 15 million people across the country are unable to get enough food to eat, compared with 7.7 million people last year.

But the presence of a new Canadian-developed vaccine has helped fight the Ebola outbreak. So far, more than 18,000 people around the latest outbreak have received the vaccine, which was developed in Winnipeg’s microbiology laboratory.

“We believe the vaccine is working,” said Tedros Adhanom Ghebreyesus, the director-general of WHO, at a news conference in Geneva on Wednesday.

He said the vaccine is helping to slow the spread of the Ebola virus. The vaccine was used in another Ebola outbreak in a different region of Congo earlier this year, and it clearly had a positive effect, he said. “It was because of the vaccine that we were able to contain it quickly.”

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