Ebola Crisis - Continue!

Original: Update: Aug 20, 2019;

Adding to the arsenal of treatments "to end" Ebola is another vaccine to fight the outbreak that caused more than 1,800 casualties in a year. The World Health Organization is calling the use of another, though preventative," vaccine by Johnson & Johnson. Dr. Jean-Jacques Muyembe of Congo's National Institute for Biomedical Research projects the end of the Ebola outbreak within the next four months. With advancements in medicine and community development, the vaccination of "more than 197,000 individuals" will continue to promote the response efforts of health workers into the affected communities (AP, 2019b).

How Ebola attacks the body

https://www.msn.com/en-us/video/science/catch-the-perseid-meteor-shower-light-up-the-sky/vi-AAFHz9i?ocid=ientp

Duration: 01:14 20 hrs ago

Videographic on Ebola. Scientists were a step closer to an effective treatment for Ebola after two drugs in a clinical trial were found to significantly boost survival rates, the US health authority co-funding the research said. VIDEOGRAPHIC

Over the last two years, many medical advances were developed and effectively introduced to the fore of battling the deadly Ebola virus. A vaccine is now available for life-saving experimental treatments. And, with international support from WHO, the Congo was able to contain an earlier outbreak earlier this year at its Equateur Province.

Unfortunately, the local and international healthcare providers and scientists did vastly underestimate another enemy. More alarming than Ebola (sometimes) are the more than 100 military groups who are fighting against each other as well as the government troops. Health workers and doctors have been targeted at many treatment centers. Some have even lost their lives.

Needless to say, the mission of the Ebola response team has suddenly broke into two parallel tracks. One is to fight the biological Ebola virus. And, another is to workaround the political, cultural, and military landmines spiked along the desolate and impoverished Congo.  

Ebola Disease: Ebola virus - a viral disease - is most commonly transmitted to human from nonhuman primates like monkeys, gorillas, and chimpanzees. It then spreads within the populace through human-to-human transmission via body fluids. Spreading through bodily fluids of infected people, it causes internal bleeding. It is extremely contagious with half of those infected individuals (& become ill with Ebola) will die.

Ebola Endemic: This is the first outbreak of the Ebola virus to the Bikoro region, 400 kilometers (about 250 miles) from Mbandaka, the capital of the Equator province, part of the Central African Republic of Congo. Bikoro has a population of about 163,000 spread over an area of 1,075 square kilometers (415 square miles). The affected area in Bikoro is remote, with challenging transportation & communication infrastructures.

According to WHO, more than 27 cases of fever with hemorrhagic symptoms were recorded between April 4 and May 5, including 17 deaths. Of these cases, two tested positive for the Ebola virus disease, one death from the Ebola hemorrhagic fever, & 11 new cases were confirmed by the Congo Minister of Health. By now, the Ebola virus is considered endemic, as this is the 9th outbreak in the Congo since its discovery back in 1979. In this case, the WHO Ebola Expansion Risk Assessment was as follows - the risk to public health assessed as high at the local level, moderate at the regional level, & low at the global level.

Ebola First Line of Defense: Healthcare professionals are "the first actors" in the government's response to Ebola. Often, they are the first at the scene as part of the Ebola quarantine unit. Compounding their efforts to provide speedy and effective care are the logistic challenges in reaching the Ebola victims. Because of these high barriers, more cases are reported, either due to access challenges or due to human-to-human unknown infection.

Sometimes, healthcare professionals are among the deceased. For example, on June 13, 2017, three healthcare providers were reported as Ebola victims. In addition, one Ebola case was confirmed in the village, two cases in the laboratory while 18 others were suspected. This is why the Ebola outbreaks are of utmost concern, "requiring immediate & energetic response."

Ebola Treatments & Contingency Plans: Since its last outbreak from 2014 to 2016, the African Health Ministries in coordination with WHO & Doctors Without Borders have promulgated plans to strengthen the response to Ebola. Prior to the international support, the best description to the primitive treatments was that the Ebola victims don't flee a treatment center but rather "the Ebola victims walk out as "no one wants to touch them."

At the medical level, healthcare providers are now equipped with "an impressive array of new treatments to draw on." Four drugs are administered on experimental trials in the Congo. The French Alliance for International Medical Action has developed "bio-secure" plastic cubes for patients with intensive treatment. These cubes reduce the risk of contamination, and provide the medics with the proper protection while treating patients without confining themselves into protective equipment.

At the cultural level, healthcare providers are considering "local traditions" as the underpinning of an effective outreach. By incorporating local customs into their medical and health frameworks, they workaround challenging barriers to effective access and delivery of treatments. Simply, by convincing the locals to bury their deceased victims into body bags inside coffins would help in containing the spread of the Ebola virus, instead of placing the victims into body bags directly into the graves.

At the community level, Ebola survivors (considered immune to the virus) are being recruited "to care and nurture" orphans. This is essential when "the full extent of the outbreak is unknown," with location posing logistical challenges."

At the diplomacy level, Dr. Oly Ilunga of the Ebola Response team had learned to adopt diplomacy when dealing with militia leaders. Since his response team travel to many locations controlled by more than 100 military groups, he has to negotiate the safe passage of his team into the affected locations. Negotiating with militia leaders prove "to be trickier than treating" the Ebola virus. It is "a risky business" given the unpredictable hostility of military groups. A couple of weeks ago, one rebel group hacked to death a dozen civilians for "no apparent reason as well as killed additional 17 soldiers.

Miracles in Congo: Baby Sylvana was born healthy. It is a rare event when "born to Ebola survivors; her mother has recovered from the Ebola virus. She is considered "a bright spot in Congo's deadly Ebola outbreak." (AP, 2019)

Ebola Recurring Nightmares: West Africa has recently contained an Ebola epidemic back in January 2016. In the largest recorded outbreak of Ebola over a two-year period from March 2014 to January 2016, a total of 28,616 were confirmed as probable and suspected cases in Guinea, Liberia and Sierra Leone, with more than 11,310 confirmed deaths. In that case, the WHO Ebola Expansion Risk Assessment was as follows - the risk to public health assessed as extremely high at the local level, very high at the regional level, and high at the global level. The Congo outbreak now is the second deadliest on record, infecting more than 2,071 individuals, and causing at least 1,396 deaths as of June 10.

Widespread of Ebola beyond its epicenter: New reports depict a worsening condition as the year-old Ebola outbreak jumps the border from the Democratic Republic of Congo to Uganda. With one boy died and two relatives infected (confirmed to have tested positive for Ebola and treated in isolation), this is the first confirmed case of Ebola outside the highly infectious epicenter. More concerning is the spread of the Ebola virus to at least 8 other individuals, raising the risk of further infections (Gladstone, 2019).

WHO Actions: "Signaling his concern", the WHO Director-General called for an immediate assessment of whether the Ebola spread is now an international public health emergency. Infectious disease experts are alarmed at the rate of Ebola spilling over into Uganda - whose health workers are now vaccinated with promising new vaccine. The confirmation of new Ebola cases in Uganda raises the threat index - "the epidemic is in a truly frightening phase with no sign of stopping anytime soon." Governments, donors and agencies all are concerned about the prevalence and incidence rate of those with Ebola infections - from 1,000 cases to 2,000 cases. With its spread across borders, the outbreak is becoming a global health threat of un-fathomed implications. The outcome might be no less than a declaration of the outbreak as a health threat known as "Public Health Emergency for International Concern" (Gladstone, 2019)

References:

AP. (2019a, Jan. 11). Congo: Mom who had Ebola has healthy baby. The State, p. 4A

AP. (2019b, Aug 20). News: Congo to use second vaccine on Ebola. The State, p. 5A

Gladstone, Rick. (2019a, June 13). Ebola Fears Grow as Boy In Uganda Succumbs. NY Times, p. A10

Gladstone, Rick. (2019b, June 13). Ebola kills child; Uganda confirms two more cases. The State.com, p. A10

Scutti, Susan. (2018, May 11). Ebola outbreak: First death, 11 additional cases confirmed in Congo. CNN, https://www.msn.com/en-us/news/world/ebola-outbreak-first-death-11-additional-cases-confirmed-in-congo/ar-AAx6u0s?ocid=ientp