Ebola pres­ence in Congo city sparks worry

The Globe and Mail (Prairie Edition) - - NEWS - GE­OF­FREY YORK JO­HAN­NES­BURG

Cana­dian vac­cine will be put to test against new out­break as Mban­daka records con­firmed case

As it pre­pares to de­ploy an ex­per­i­men­tal Cana­dian-de­vel­oped vac­cine to bat­tle the world’s lat­est Ebola out­break, the World Health Or­ga­ni­za­tion says it is deeply con­cerned by the spread of the virus into a Con­golese city of 1.2 mil­lion peo­ple.

Thou­sands of doses of the vac­cine arrived in the Demo­cratic Repub­lic of the Congo this week. This is the first time the ex­per­i­men­tal vac­cine, de­vel­oped in Winnipeg’s mi­cro­bi­ol­ogy lab­o­ra­tory, will be used to fight a new Ebola out­break, although it was shown to be ef­fec­tive dur­ing the fi­nal days of the pre­vi­ous ma­jor out­break in 2015.

The WHO is con­ven­ing a meet­ing of its emer­gency com­mit­tee on Fri­day. Border-screen­ing mea­sures have al­ready been boosted in 13 coun­tries near Congo.

So far, there have been 44 sus­pected, prob­a­ble or con­firmed Ebola cases, in­clud­ing 23 deaths, in the out­break that be­gan in a re­mote re­gion of Congo. But the dis­clo­sure of a con­firmed case in the city of Mban­daka, the pro­vin­cial cap­i­tal of Équa­teur, is a dan­ger­ous new de­vel­op­ment that will greatly com­pli­cate the fight against the virus.

“The chal­lenge just got much, much tougher,” said Peter Salama, the WHO deputy di­rec­tor­gen­eral for emer­gency pre­pared­ness and re­sponse, in a tweet on Thurs­day.

“Con­fir­ma­tion of ur­ban Ebola in the Demo­cratic Repub­lic of the Congo is a game-changer in this out­break,” he said.

Mban­daka is a port city on the Congo River, a ma­jor trans­port route that flows down­stream to Congo’s cap­i­tal, Kinshasa. River­boats travel reg­u­larly be­tween the two cities and the city of Braz­zav­ille, cap­i­tal of the Repub­lic of Congo.

In a state­ment on Thurs­day, the WHO said the ur­ban Ebola case is “very con­cern­ing.”

Until now, the Ebola cases had been con­fined to for­est vil­lages in the iso­lated ru­ral area of Bikoro, about 150 kilo­me­tres from the pro­vin­cial cap­i­tal. The area is so re­mote that the WHO had to use he­li­copters to fly its ex­perts into the main sites af­ter the out­break was con­firmed on May 8.

The out­break will be a ma­jor test for the ex­per­i­men­tal vac­cine, which was de­vel­oped by sci­en­tists at the Na­tional Mi­cro­bi­ol­ogy Lab­o­ra­tory in Winnipeg over a 15year pe­riod. The vac­cine has been li­censed to Merck and Co., although reg­u­la­tors have not yet given ap­proval for it to be mar­keted.

The vac­cine was shown to be highly ef­fec­tive in 2015, when it was given to about 5,800 peo­ple who had con­tact with Ebola pa­tients in the West African coun­try of Guinea dur­ing the wan­ing days of the pre­vi­ous ma­jor Ebola out­break, which killed about 11,300 peo­ple in three coun­tries. But this will be the first time the vac­cine has been used to tackle a new out­break.

The first batch of more than 4,000 doses arrived on Wed­nes­day in Kinshasa and vac­ci­na­tions are ex­pected to be­gin early next week.

The vac­cine is de­signed to “ring-fence” the Ebola out­break by pro­tect­ing health-care work­ers and fam­ily mem­bers who are in con­tact with those who have the virus.

But the vac­cine can be dif­fi­cult to de­ploy, since it must be stored at a tem­per­a­ture of be­tween -60 C and -80 C. This is a ma­jor chal­lenge in re­mote re­gions with un­re­li­able elec­tric­ity ser­vices.

So far, health work­ers have iden­ti­fied about 430 peo­ple who may have been in con­tact with sus­pected Ebola cases and they were try­ing to trace thou­sands of oth­ers. But that was be­fore the new ur­ban case, which makes the task much more dif­fi­cult.

The WHO is de­ploy­ing about 30 ex­perts to con­duct sur­veil­lance in Mban­daka, while more than 110 Red Cross vol­un­teers in Bikoro and Mban­daka are alert­ing com­mu­ni­ties and dis­in­fect­ing houses where Ebola cases have been sus­pected.

An­other agency, Médecins sans fron­tières (Doc­tors With­out Borders), has set up iso­la­tion zones in the main hos­pi­tals of Mban­daka and Bikoro. It is also set­ting up two Ebola treat­ment cen­tres in the city and the ru­ral re­gion. Sev­eral tonnes of med­i­cal sup­plies will ar­rive in the next few days.

Con­golese Health Min­is­ter Oly Ilunga Kalenga said the spread of the virus to Mban­daka is a “new phase” for the out­break. He said the au­thor­i­ties will in­ten­sify their trac­ing of all air, river and road routes out of the city.

Last week, U.S. Pres­i­dent Don­ald Trump asked Congress to cut US$252-mil­lion in gov­ern­ment funds that had been set aside to deal with Ebola out­breaks, but health ex­perts crit­i­cized the sug­ges­tion.

MARK NAFTALIN/UNICEF VIA AP

Health work­ers don pro­tec­tive cloth­ing on Satur­day as they pre­pare to at­tend to pa­tients sus­pected of con­tract­ing Ebola at Bikoro Hos­pi­tal in Bikoro, Demo­cratic Repub­lic of the Congo, where the out­break was con­fined until it spread to Mban­daka.

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