The Ebola outbreak in the province of North Kivu in the Democratic Republic of Congo (DRC) shows no signs of delay, as health officials approved the use of four extra Ebola treatments in ebola treatment centers in the eastern part of the country.
As of yesterday, the health ministry of the DRC reported a total of 102 cases (6 new), of which 75 confirmed; 59 people have died and 9 additional cases are suspected.
The DRC has also updated information on immunization: since the vaccination began on 8 August, 1,693 people have been vaccinated: 903 in Mabalako, 471 in Beni and 319 in Mandima health zones.
Four new treatments approved for use
Last week DRC officials began using the experimental monoclonal antibody treatment mAb114 in Beni in 10 patients. Now ZMapp, remdesivir, favipiravir and Regn 3450-3471-3479 are also approved for use in ETCs, the health ministry said.
"The protocols for administering these molecules meet strict conditions with regard to the patient's condition, the ease of use of the treatment and the capacity of the medical team of the patient. [ETC]"said the Ministry of Health in a translated update." On Tuesday, August 21, 2018, the Remdesivir, produced by Gilead Sciences, was administered to a patient [ETC] Beni, it's going well. As a reminder, the mAb114 has been used since Saturday 11 August 2018. It was administered to 10 patients who experienced a positive evolution. "
In the last weekly outburst newsletter, the regional office of the World Health Organization (WHO) of Africa shared new details on the response measures taken in North Kivu.
The WHO said that as of August 18, only 59% of the contacts had been successfully followed, but contacts in Mandima's health zone were not followed up for "an apparent resistance from the community".
That resistance comes in a region divided over 130 rebel groups. The area is also home to more than 1 million refugees, making it one of the most dangerous places of the DRC.
"The coming days will be crucial in the evolution of the outbreak because the people who had previously been exposed to infections continue to develop the disease," the WHO said. "It is also a decisive moment in the race to control the outbreak, where new exposure to infections must be prevented, thereby distorting further transmission.
"This can only be achieved by carrying out rigorous field work to identify each individual contact and transmission chain. There is an urgent need to continue scaling up and improve the effectiveness and efficiency of all aspects of the response."
Role of population growth
Today thenNew England Journal of Medicine published a commentary on recent Ebola outbreaks, highlighting the link between population growth in Central Africa and an increased risk of the disease.
Before 2013, the authors write that Ebola outbreaks were mostly limited to small rural clusters of cases that had limited opportunities to spread over large geographical areas.
But as the population grows and roads expand across the continent to provide a growing economic infrastructure, the region is at greater risk of spreading diseases that need to be tackled with preventive public health expenditures, write the authors under guidance by Vincent J. Munster, PhD. Munster is the leader of the virus ecology unit at the US National Institute of Allergy and Infectious Diseases.
"Instead of using exorbitant quantities of reactive for control activities, international donors could invest in long-term infrastructure for public health and prevention," they write. Part of that investment should come in the form of human capital – more rural health workers trained to identify Ebola, and more African scientists to strengthen research infrastructure.
August 21 DRC update
August 22, WHO weekly
August 22 N Engl J Med comment