Ur­ban cases spread worry of ‘ex­plo­sive’ Ebola dis­as­ter

National Post (National Edition) - - FRONT PAGE - Anne Gul­land

LON­DON • An Ebola out­break in the Demo­cratic Repub­lic of Congo has spread from the coun­try­side to a city of 1.2 mil­lion in­hab­i­tants, prompt­ing fears of a full-blown health emer­gency.

A rapid re­sponse team, com­pris­ing doc­tors, nurses and other pub­lic health ex­perts, is ex­pected to be sent from the U.K. to the re­gion in the next 48 hours by Pub­lic Health Eng­land as part of an in­ter­na­tional ef­fort to con­tain the deadly hem­or­rhagic dis­ease.

The lat­est out­break was first re­ported 10 days ago in the re­mote ru­ral area of Bikoro, in the north­west of the coun­try. Now three cases, one of which has been con­firmed by lab­o­ra­tory tests, have been re­ported in Mban­daka, a densely pop­u­lated city with poor san­i­ta­tion and thinly spread health care.

The lat­est of­fi­cial fig­ures sug­gest at least 44 peo­ple have been in­fected and 23 have died since the out­break started.

But ex­perts fear many more cases may have gone un­re­ported.

Peter Salama, a se­nior World Health Or­ga­ni­za­tion (WHO) of­fi­cial, said the spread to Mban­daka meant there was now the po­ten­tial for an “ex­plo­sive in­crease” in cases. “This is a ma­jor de­vel­op­ment in the out­break,” he said. “We have ur­ban Ebola, which is a very dif­fer­ent an­i­mal from ru­ral Ebola.”

Jose Bara­hona, Ox­fam’s DRC coun­try di­rec­tor, said it was likely the dis­ease had been car­ried from the coun­try­side down the river Congo to the city by an in­fected per­son.

“Boats move up and down the river, car­ry­ing peo­ple and goods,” he said. “One of the risks is that some­one with the virus could eas­ily ac­cess one of the boats and start mov­ing up and down.”

The river con­nects Mban­daka with the cap­i­tal of DRC, Kinshasa, as well as Braz­zav­ille, the cap­i­tal of neigh­bour­ing Congo-braz­zav­ille.

The au­thor­i­ties al­ways feared the spread of the dis­ease to the city, which is just 128 kilo­me­tres from Bikoro.

“If the num­ber in­creases in Bikoro it’s bad but it’s not a dis­as­ter. But if these three cases in Mban­daka be­come 10 or 12 then we have an ur­ban epi­demic,” Bara­hona said.

This is the ninth out­break of the dis­ease in DRC since it was first dis­cov­ered in what was then Zaire. But all pre­vi­ous out­breaks have been con­tained in ru­ral ar­eas.

Some 514 peo­ple who may have been in con­tact with in­fected peo­ple are be­ing mon­i­tored while the WHO is de­ploy­ing 30 ex­perts to con­duct sur­veil­lance in the city.

“The ar­rival of Ebola in an ur­ban area is very con­cern­ing and WHO and part­ners are work­ing to­gether to rapidly scale up the search for all con­tacts of the con­firmed case in the Mban­daka area,” said Mat­shidiso Moeti, WHO re­gional di­rec­tor for Africa.

Henry Gray, Medecins Sans Fron­tieres (MSF) emer­gency co­or­di­na­tor in DRC, said with the spread of the dis­ease to the city the sit­u­a­tion had be­come “most se­ri­ous and wor­ry­ing.”

“We’re cer­tainly not try­ing to cause any panic in the na­tional or in­ter­na­tional com­mu­nity,” Salama said. But “ur­ban Ebola can re­sult in an ex­po­nen­tial in­crease in cases in a way that ru­ral Ebola strug­gles to do.”

MSF teams have set up an iso­la­tion zone in the city’s main hos­pi­tal and are build­ing two Ebola treat­ment cen­tres in Mban­daka and Bikoro.

The first 4,000 batches of the VSV Ebola vac­cine have arrived in the coun­try and the WHO, in part­ner­ship with MSF and the Con­golese health min­istry will soon start a vac­ci­na­tion pro­gram .

The largest recorded Ebola out­break in 2014-16 oc­curred in West Africa and killed 11,300 peo­ple. It proved dif­fi­cult to con­trol af­ter it spread to the cap­i­tals of Guinea, Sierra Leone and Liberia.

Teams from the World Health Or­ga­ni­za­tion and all ma­jor agen­cies have been de­ployed quickly, with sig­nif­i­cant fund­ing from world gov­ern­ments and agen­cies.

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