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Why Ebola Is Proving Hard To Beat In The DRC

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Why Ebola Is Proving Hard To Beat In The DRC

 

Connor Bamford, University of Glasgow

Nearly this time exactly two years ago I wrote about the latest positive results showing – for the first time – that a vaccine against one of the world’s scariest viruses, Ebola, could work. I was writing after the epidemic that hit Guinea, Liberia and Sierra Leone from 2013 until 2016. Since then, there have been three more outbreaks of the disease: all in the Democratic Republic of Congo (DRC).

The first two outbreaks (in 2017 and 2018) were extinguished quickly as the DRC is experienced in stopping Ebola. When a new outbreak happened earlier this year, I also said that it would be quickly brought under control especially with use of the vaccine. But that is not the case: the latest outbreak has been going on for months, infecting 505 people and killing 296 by the middle of December 2018.

Why is Ebola proving so recalcitrant to our best efforts at stopping it? The answer lies partly with the inherently deadly properties of the Ebola virus; the DRC’s instability is another element of the problem.

Ebola: one of the worst viruses

Ebola is a dreadful disease. It causes fever, vomiting and diarrhoea and bleeding, and is one of the deadliest infections known to medical science. At least half of the people who get the disease will die – even with the best medical care.

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The spread of the virus is closely linked to human behaviour. It’s transmitted via contact with the bodily secretions from someone who is already sick with Ebola. This means that those who are caring for the sick and dying, such as close family members or healthcare workers, are more likely to get infected.

These close ties to basic human social biology can result in a dramatic disruption to family community and regional life. This is only compounded by the trade and travel restrictions that are often applied by surrounding nations.

No cure

There is now a safe and effective Ebola vaccine, rVSV-ZEBOV. But one of the reasons that Ebola is so deadly and frightening is that there is no cure. There are medical treatments for some of the symptoms, such as fluid loss, pain and fever – but nothing that can eradicate the disease entirely.

This lack of a cure shouldn’t suggest that researchers and doctors aren’t trying. Since Ebola was discovered in the late 1970s, scientists across the world have been studying the virus and have identified a number of ways of preventing infection and disease. But testing new potential drugs for a virus that’s as unpredictable as Ebola in humans is nearly impossible.

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That being said, some experimental drugs are being used under compassionate usage rules, giving an unapproved medicine to someone who is very near to death. And there are plans in place to conduct a number of rigorous trials in the DRC, during the current outbreak.

Finding a safe and effective cure for the disease will go a long way in stemming future outbreaks.

Controlling the virus

For now, the best way to control the Ebola outbreak is to ensure that an infected person does not pass the infection on to more than one other person.

A “straightforward” way to do this would be to find, treat and isolate every infected person then track down all the people they could have spread the virus to and make sure they don’t get sick and then isolate them, and so on. This is aided in Ebola as it has a relatively long incubation period of at most three weeks and it is typically pretty obvious that you are sick allowing you to find sick people and their exposed contacts before it’s too late.

The existence of rVSV-ZEBOV makes this process much more efficient. It can make treating Ebola safer and less open to disruption. Vaccination can be used to immunise and block infection in contacts of identified sick people.

The vaccination approach appeared to work well at the end of the West African outbreak and this time it may in fact be the reason that this DRC outbreak is not infinitely larger than it could be. However, the vaccination process requires a lot of effort and resources on the ground. Working in larger, more-complex, densely-populated regions – and especially in the case of an extended outbreak – makes this much more challenging. This is what’s happened in the DRC. And why predictions about getting the latest outbreak under control have been so wrong. What I, and others, hoped would not be an insurmountable issue, is that a great deal of the East of the DRC is essentially war zones. This has meant that contact tracing and vaccination efforts are easily disrupted.

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Ebola in the future

As the DRC outbreak shows no sign of ending, and grows in complexity near cities and war zones, the world must not get complacent. Global efforts must be redoubled. If they are not, there’s the risk that we will have to somehow learn to live with an Ebola that never goes away.The Conversation

Connor Bamford, Virologist, University of Glasgow

This article is republished from The Conversation under a Creative Commons license. Read the original article.

African News

MSF Raises Alarm Over Malnutrition In Southern Ethiopia

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MSF Raises Alarm Over Malnutrition In Southern Ethiopia

Medical charity, Doctors Without Borders, MSF has raised the alarm over malnutrition rates in Southern Ethiopia amongst tens of thousands of Internally Displaced People (IDPs).

MSF says, its teams saw rates of malnutrition amongst children to be well above the emergency threshold in one local government area, last month. They also saw a high number of malnourished pregnant women.

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MSF field coordinator in the area, Markus Boening said, the camps are overcrowded and in extremely poor conditions. Markus added that, the people living there are at risk from outbreaks of epidemics and their health is very vulnerable after being forced to move so many times.

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At least a million people were forced from their homes by ethnic clashes last year. Some have returned, but many still live in IDP camps. MSF is now working with local authorities focusing on improving nutrition.

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Egypt Parliament Votes To Extend Sisi Rule Until 2030

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Egypt Parliament Votes To Extend Sisi Rule Until 2030

Egypt’s capital Cairo is full of banners encouraging Egyptians to participate in a referendum after parliament approved amendments to the constitution that could keep President Abdel Fattah Al-Sisi in power until 2030. The 596-member parliament, dominated by Sisi supporters, voted 531 to 22 in favor of the amendments, though they still have to be endorsed in a referendum before it takes effect.

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The changes would extend Sisi’s current term to six years from four and then allow him to run again for a third term, which would last six years.

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Sisi’s supporters say the changes are necessary to give him more time to complete major development projects and economic reforms.

Critics of the changes say, the amendments would encourage the role of the military in political life and increase the president’s power over the judiciary.

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Libya Death Toll Rises To 205 Amid Clashes In Tripoli says W.H.O

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Libya Death Toll Rises To 205 Amid Clashes In Tripoli says W.H.O

World Health Organization (WHO) has said on Thursday, at least, 205 persons have been killed in Libya, including 18 civilians, and more than 900 wounded in two weeks of fighting near the capital, Tripoli.

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It says, shells slammed, into a densely-populated district of the area on Tuesday, piling misery on civilians, from a two-week assault by commander Khalifa Haftar’s forces, to take Libya’s capital from an internationally-backed government.

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The UN refugee agency says it has now evacuated nearly 180 migrants from a detention centre close to the area of fighting. It says, people relocated from the Abu Salim centre were among its most vulnerable detainees – including women and children.  U.N said, there’s grave concern for those still in the facility.

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