Thurs­day's new

Orlando Sentinel - - FRONT PAGE - By Max Bearak The Wash­ing­ton Post

con­firmed case of Ebola in Mban­daka, Congo, a city of 1.2 mil­lion, is called “a game changer” be­cause of it mark­ing the first ur­ban case in the lat­est out­break of the dis­ease.

NAIROBI, Kenya — Congo has con­firmed a case of Ebola in Mban­daka, a city of 1.2 mil­lion, mark­ing the first ur­ban case in the lat­est out­break of the dis­ease. The World Health Or­ga­ni­za­tion’s lead re­sponse of­fi­cial called Thurs­day’s new con­firmed case “a game-changer.”

Ebola is much harder to con­tain in ur­ban ar­eas, so this de­vel­op­ment com­pounds the risk of con­ta­gion and el­e­vates the out­break to the most se­ri­ous since an Ebola epi­demic that raged across West Africa from 2014 to 2016.

Pre­vi­ously, con­firmed cases had been lim­ited to an ex­tremely re­mote area more than 100 miles south of Mban­daka, in the rain for­est of Congo’s Eu­a­teur prov­ince.

The case in Mban­daka is only the third con­firmed case of the cur­rent out­break; 20 oth­ers are prob­a­ble, and 21 are sus­pected, bring­ing the to­tal of po­ten­tial cases to 44. The death toll is now 23.

“This is a ma­jor de­vel­op­ment in the out­break,” said Peter Salama, the WHO’s deputy di­rec­tor gen­eral of emer­gency pre­pared­ness and re­sponse. “We have ur­ban Ebola, which is a very dif­fer­ent an­i­mal from ru­ral Ebola. The po­ten­tial for an ex­plo­sive in­crease in cases is now there.”

The port city of Mban­daka lies on the east­ern bank of the Congo River, Africa’s sec­ond long­est af­ter the Nile. Tens of mil­lions of peo­ple live along the river, and the cap­i­tals of Congo, the Cen­tral African Repub­lic and Congo Repub­lic lie along it and its trib­u­taries.

Ebola is no­to­ri­ously hard to con­tain, though re­cent out­breaks in Congo have been man­aged swiftly by the World Health Or­ga­ni­za­tion and Con­golese health of­fi­cials, gain­ing the gov­ern­ment there a rep­u­ta­tion as one of the con­ti­nent’s most pre­pared. Ebola is en­demic in Congo, and this is the ninth out­break of the dis­ease there since the 1970s.

Last May, a small out­break re­sulted in five con­firmed cases and four deaths in a prov­ince neigh­bor­ing Equa­teur.

The out­break in West Africa that started in 2014 reached epi­demic pro­por­tions and was the worst ever recorded, in­fect­ing more than 28,000 and killing more than 11,000. A con­cur­rent but much smaller and un­re­lated Ebola out­break took place in Congo in 2014 as well. The WHO was ac­cused of re­spond­ing slowly in 2014, and the or­ga­ni­za­tion has taken pains to en­sure it is both act­ing more quickly and be­ing seen as do­ing so this time around. The or­ga­ni­za­tion’s head, Te­dros Ghe­breye­sus, vis­ited the af­fected area him­self ear­lier this week.

The dis­ease causes in­ter­nal bleed­ing and spreads rapidly through con­tact with small amounts of bod­ily fluid. Its early symp­toms are not ob­vi­ous, and the worst ef­fects may take weeks to show. It is of­ten transmitted to hu­mans through the con­sump­tion of con­tam­i­nated meat, but it can also be ac­quired through any kind of close con­tact with an in­fected an­i­mal.

MARK NAFTALIN/UNICEF

Health work­ers pre­pare to di­ag­nose and treat sus­pected Ebola pa­tients in Bikoro Hos­pi­tal in Congo.

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