In the Democratic Republic of the Congo (Congo DR) in Western Kasai
Province, health officials are trying to contain an Ebola outbreak.
The World Health Organization (WHO) says that out of 42 patients, 5
cases of Ebola have been confirmed; 12 others are probable cases, and
25 more are suspected cases of Ebola [hemorrhagic fever].
Gregory Hertl, WHO spokesperson for epidemic and pandemic diseases,
spoke from Geneva to VOA News reporter Joe De Capua about how hard it
is to diagnose a case of Ebola. "Certainly, on the ground, when
you're there in the middle in the jungle or in a very isolated
location, there are many diseases which are endemic in that part of
the world. It is difficult to make a snap and accurate diagnosis of
something being Ebola. Certainly, also, in the early phases of the
disease, there are actually many diseases which have a similar
presentation, which is basically a spike in fever, plus vomiting and
diarrhea. It's only in the later stages of Ebola do you start to see
the tell-tale hemorrhagic symptoms," he says.
Hertl says that the 1st response when a suspected Ebola outbreak is
reported is to get health professionals "on the ground." But it's not
always easy to do that right away. He says: "Unfortunately, many of
these outbreaks occur in extremely remote locations where very few
people have access. So it takes a while to get people on the ground.
But if we had people on the ground at the start of this, we would
want to isolate suspected cases so that there was no possibility of
transmitting the disease onward. We would want to institute proper
infection control procedures in hospitals so that no hospital workers
[become] infected. We would want to do a laboratory testing to
confirm that this was indeed Ebola."
The WHO spokesperson says that the WHO and others would also work
with the communities to make sure they understand what Ebola is and
"what measures they need to take in order to not contract Ebola
themselves and to stop the disease from spreading further."
There's no treatment for Ebola. Hertl says: "There's no anti-viral
medication. There's no vaccine that one can be given beforehand. So,
all you can do is hope that the body's defenses will fight off the
virus. And we know that, unfortunately, the virus can kill up to 90
percent of the people it infects. It's not only deadly; it's easily
transmissible. They can't even touch someone else, because the virus
is transmissible even by the touch of the skin," he says.
It's been difficult to pinpoint the source of Ebola in the bush or
jungle. Hertl says: "It might come from contaminated bushmeat, but
we've also seen other routes of transmission, certainly, even more
so, more plainly, with Marburg (virus), because Marburg, which is a
very close cousin of Ebola, also can be transmitted by bats. If bats
urinate on fruit, which is then eaten, or you come in contact with
bat feces through one means or another, then the disease can also be
transmitted that way. But certainly, yes, one of the 1st ways that we
saw Ebola being transmitted was through bushmeat," he says [These are
presumed modes of transmission, not yet confirmed unequivocally. - Mod.CP].
It's difficult to educate communities in the bush to avoid the
disease, due to its very nature of transmission. "What you really
only can do is try to help them, often times after the fact, to
understand what can be done in order not to transmit it further, not
to endanger the family, loved ones, [and the] community," he says. In
areas where there have been previous outbreaks, communities often
know what Ebola is and what steps to take to prevent its spread. "But
in any time that Ebola 1st surfaces in an area which has never had it
before, that's a big issue," he says.
[Byline: Joe De Capua]
--
Communicated by:
ProMED-Mail Rapporteur: Susan Baekeland
[On 31 Dec 2008, the WHO reported that there has been a total of 3
laboratory-confirmed cases of Ebola hemorrhagic fever and that WHO
was aware of 36 additional suspected cases, including 12 deaths
associated with this outbreak. A further 184 contacts have been
identified and are being followed up upon. This interview with
Gregory Hertl of WHO adds little substance and possibly some
misinterpretation. The situation remains confused, and the number of
cases in the outbreak is now given as 42, comprising 5 confirmed
cases, 12 probable cases and 25 suspected cases. It is not clear how
these categories are defined.
A map of the Democratic Republic of the Congo can be accessed at
<http://www.lib.utexas.edu/maps/africa/congo_demrep_pol98.jpg>,
and the HealthMap/ProMED-mail interactive map is available at
<http://healthmap.org/promed/en?g=214139&v=-4.5,22,5>.
The location of Mweka District (the site of the outbreak) can be found at
<http://en.wikipedia.org/wiki/Mweka,_Democratic_Republic_of_the_Congo>.
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