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article imageStopping new outbreak of Ebola in Congo 'war zone' will be risky

By Karen Graham     Aug 4, 2018 in Health
The Ebola virus has popped up again in the Democratic Republic of Congo, days after another outbreak was declared over — but this time it may be harder to fight.
It's bad enough that the Ebola virus is one of the world’s deadliest pathogens. However, fighting an outbreak of the Ebola virus is dangerous and complicated in the best of circumstances, but trying to contain the virus and treat people who are infected while under threat of bodily harm has health officials worried.
Such is the case in the latest outbreak of the Ebola virus in a densely populated area of the DRC, 1,500 miles away from the last outbreak in Equateur Province in the northwest corner of the country. This region is fairly stable but it still took months, plus hundreds of international volunteers and tens of millions of dollars to contain the virus.
The latest outbreak is in North Kivu province and presents health-care workers with an unprecedented challenge because of the threat of violence between warring ethnic groups. Not only that, but the area is teeming with refugees who have been displaced internally by ethnic conflicts.
An attendant disinfects shoes outside the Wangata Reference Hospital in Mbandaka  northwestern Democ...
An attendant disinfects shoes outside the Wangata Reference Hospital in Mbandaka, northwestern Democratic Repubic of Congo in May 2018
JUNIOR KANNAH, AFP/File
“Here we are responding to an outbreak of a high-threat pathogen … in the context of a war zone,” Peter Salama, deputy director-general of emergency preparedness for the World Health Organization, said at a news conference in Geneva Friday. “In terms of difficulty scales, we are at the top of the difficulty scale.”
DRC officials say that at least four cases have been confirmed near the border with Uganda. At least 20 people have died and workers are trying to determine whether they died of Ebola. “Already one health worker has died. We know at least two have been infected,” Salama said.
Internal conflict a big concern
There are more than 100 separate armed groups involved in the two-decades-long conflict. Over one million of the province's eight million inhabitants have been displaced. Salama told VOA News there are additional fears that refugees who have been in contact with people infected with the Ebola virus will flee into neighboring Uganda, Tanzania and Burundi - taking the virus with them.
A UN report last month estimated that more than 260 people had been killed in recent intercommunal v...
A UN report last month estimated that more than 260 people had been killed in recent intercommunal violence in the Ituri region of the Democratic Republic of Congo
ALEX MCBRIDE, AFP/File
"So, not only do you have the problem of tracking that internal displacement but then you have the potential exportation of infection across borders," Salama said. "And, that is why we are already working with the government of Uganda particularly, but also Rwanda, which shares a border as well with northern Kivu to be fully prepared for any eventualities across the border."
UNHCR spokesman Andrej Mahecic says his agency's staff in Uganda, Rwanda, and Tanzania are on Ebola alert. "Specifically, in Uganda, we have a continuous influx from the DRC. Our operation has intensified the awareness-raising among the refugee and host communities. We have also increased the infection control and outbreak preparedness measures," Mahecic said. "And, we also are preparing for entry screening, that could be the temperature checks for arriving Congolese refugees at the borders."
Health workers don protective equipment at Bikoro Hospital in northwest DR Congo -- the epicentre of...
Health workers don protective equipment at Bikoro Hospital in northwest DR Congo -- the epicentre of the latest Ebola outbreak
MARK NAFTALIN, UNICEF/AFP
Contact tracing will be difficult
One of the keys to halting the spread of Ebola is contact tracing. Actually, this is a key objective in any disease outbreak. In other words, if one person has a disease that can be transmitted to others, health workers have to track down everyone the infected person has had any contact with.
Those contacts will have to be isolated and monitored for any signs of infection. “We don’t know to what extent we are going to have to rely on armed escorts for contact tracing,” Salama said.
Ebola kills anywhere between 20 percent and 70 percent of the people it infects. There are several experimental treatments, but no certain cure. The virus spreads via bodily fluids such as blood, sweat and diarrhea.
More about Ebola, Drc, North Kivu Province, warring ethnic groups, displaced internally