Ebola outbreak confirmed in Congo

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Sep 11, 2007 (CIDRAP News) – Five cases of the deadly Ebola hemorrhagic fever have been confirmed in a 3-month-old disease outbreak in the Democratic Republic of the Congo (DRC), but another disease may account for some cases in the outbreak, according to news services.

Congolese Health Minister Makwenge Kaput said yesterday that tests in Franceville, Gabon, and at the US Centers for Disease Control and Prevention (CDC) had confirmed the Ebola diagnosis, according to a report from the United Nations Integrated Regional Information Networks (IRIN).

The World Health Organization (WHO) said five samples tested positive and tests on 40 more samples were pending, according to an Associated Press (AP) report published today.

At least 395 cases and 167 deaths have been reported in the outbreak in Kasai Occidental province, provincial health inspector Jean-Constantin Kanow reported in the IRIN story.

WHO spokesman Gregory Hartl said some patients in the outbreak have reported cholera-like symptoms and responded well to ciprofloxacin, an antibiotic, which would not work against a viral disease like Ebola, according to a New York Times story today. He said those patients may have contracted Shigella (bacterial) infections.

"There's no way we can be sure at this point how many cases are Shigella and how many are Ebola," Hartl told the AP.

The WHO issued an alert today urging more doctors to travel to the country to fight the outbreak, according to the AP. Hartl told the Times that the first WHO teams involved in the effort arrived Sep 9 with protective equipment.

Kanow said most of the cases were in the Mweka and Luebo districts and that most of the deaths occurred early in the outbreak, according to the AP. The affected area is about 430 miles southeast of Kinshasa, the Congolese capital.

The outbreak was first recognized on Jun 8 after two village chiefs died, according to the IRIN report. All those who assisted in burying the chiefs died, said Kanow.

According to the Times report, CDC officials said six or seven villages were affected by the outbreak, and about 120 of 300 affected people died. Most of those who died were between the ages of 18 and 45 and survived only 4 or 5 days after the first symptoms, the story said.

The WHO had posted an online notice about the Congo outbreak on Aug 31, calling it an unknown illness with high mortality. The statement said more than 50% of the patients were children younger than 10.

Ebola was first recognized in the DRC (then known as Zaire) in 1976, with an outbreak in Yambuku, Orientale province. Since then, the country has had outbreaks in Kikwit, Bandundu province, in 1995, and in Watsa, Orientale province, in 1999, according to the IRIN report.

Ebola outbreaks occurred in the fall of 2003 and in the spring of 2005 in the DRC's immediate western neighbor, the Republic of the Congo.

Ebola is a highly contagious virus that is lethal in about 50% to 90% of cases. Initial symptoms include fever, headache, joint and muscle aches, sore throat, and weakness, followed by diarrhea, vomiting, and stomach pain, according to the CDC. Some patients have both internal and external bleeding. There is no vaccine or specific treatment for the disease.

See also:

Aug 31 WHO statement on Congo outbreak
http://www.who.int/csr/don/2007_08_31a/en/index.html

CDC fact sheet on Ebola
http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/Fact_Sheets/Ebola_Fact_Booklet.pdf

CIDRAP overview of viral hemorrhagic fevers, including Ebola
http://www.cidrap.umn.edu/cidrap/content/bt/vhf/biofacts/index.html

May 18, 2005, CIDRAP News story "Ebola found in Congo Republic outbreak"

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