Health officials are worried about the latest Ebola outbreak

The world has never been so prepared for an Ebola outbreak, but the latest emergence of the virus in the conflict-stricken East of the Democratic Republic of Congo is the most dangerous in years.

Seventy-two out of 111 patients infected with haemorrhagic fever have died, making this outbreak the deadliest in more than a decade in Congo, where the disease was first diagnosed in 1976 and named after the nearby Ebola River.

While the current death toll is far away from the 11,300 people who died when Ebola spread through West Africa from 2014 to 2016, international health officials are worried about containing the virus in an area close to armed militias and close to the porous border with Uganda.

"This outbreak is still in the escalation phase," said

Robert Redfield,

Director of the US Centers for Disease Control and Prevention, which has staff working to counter the outbreak in Congo, the neighboring countries and the headquarters of the World Health Organization in Geneva. "The key is identifying (patient) contacts and getting people vaccinated."

Since 2014, international health groups, governments and pharmaceutical companies have been racing to strengthen their defense against Ebola. Congo has approved the use of an experimental vaccine made by the Americans


& Co., which helped a boom in Northwest Congo last month. It has also released five experimental treatments designed to reduce the mortality of the virus, which kills on average half of the infected people.

Two of the first 10 patients who received a drug containing an antibody isolated from a survivor of an Ebola outbreak in 1995 have recovered, said the Congo Department of Health Saturday. The eight others remain in treatment.

In a region that has seen a spike in violence in recent months, including beheadings, health professionals have struggled to reach patients and implement safe funeral protocols that were the key to controlling recent outbreaks. Ebola, which causes fever, diarrhea, vomiting and internal bleeding, is transmitted by body fluids, including from corpses.

On Friday, the WHO said that a doctor in the city of Oicha in the province of Ituri had become ill with Ebola and possibly infected his wife. The cases are the first in & # 39; an area with high insecurity & # 39 ;, said

Peter Salama,

the head of the emergency response. "It was really the problem we were expecting, and the problem at the same time we feared," he said.

Officials have identified 97 people in the city who may have been exposed and have to be vaccinated, but have not been able to reach them all because of safety considerations, Dr. Salama.

Although Oicha himself is not under rebel control, it is almost completely surrounded by the territory controlled by the allied democratic forces, Uganda's Islamic dissidents who are one of the dozens of foreign and local armed groups operating in the gold and tin mining countries of Congo.

Large numbers of civilians have been killed around Oicha and emergency workers, priests and government officials are being held hostage, said Dr. Salama. Health teams from the American and Congo governments managed to reach the city, accompanied by military escorts, but employees from non-governmental groups were excluded.

Dr. Salama said the WHO expected at least another wave of cases. "We are really at the crossroads," he said.

Officials are concerned that the outbreak in Ituri and North Kivu provinces may result in neighboring countries, including Uganda, Rwanda and South Sudan. The Ugandan government has a better screening of health at border crossings, where thousands of people travel daily. "It is very likely that cases will cross the border with Uganda, but it is also likely that they will be diagnosed quickly," said Dr. Redfield, who traveled to the east of Congo earlier this month.

The 1.3 million people, including thousands of refugees, living in the region have witnessed violent uprisings dating back to the 1990s. But it is the first time that they have experienced an Ebola outbreak, a beautiful rural population, many of whom believe that the virus is sent by evil spirits, say emergency officers.

"Many can not understand the idea of ​​not killing loved ones according to tradition," said

Hassan Coulibaly,

a field director in Eastern Congo for the International Rescue Committee. "We try to raise them, but the environment is hostile"

Last week, the residents were upset because health officials insisted on renegotiating traditional funeral practices, including washing bodies to prevent infections, wrecking a health center in Mangina, the epicenter of the outbreak, and expelling medical staff, according to the WHO. A local team that administers vaccinations was also beaten up in the village of Manbangu, about 10 kilometers west of Mangina, while the IRC was forced to close its health center in the village of Mabalako after an attack by the local population.

The threat of militias led Kinshasa to deploy more troops to protect health officials, said Congo's information minster, Lambert Mende.

"The state of insecurity means that we are dealing with a whole new experience," said Gwenola Seroux, head of emergency teams at medical charity experts Doctors Without Borders. "We would like to stay in close contact with all affected people, but the prevailing security situation dictates differently."

Write to Nicholas Bariyo on [email protected] and Betsy McKay on [email protected]

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