Another Ebola case detected outside DRC's main hot spots

Signaling another extension of Ebola outside the main hot spots, a case has been detected in a village in Masereka health zone not far from the urban center of Butembo. The case involves a health worker from Beni who refused follow-up and vaccination after potential exposure, the Democratic Republic of the Congo (DRC) health ministry said yesterday.

The World Health Organization (WHO) said in its update today that the risk of spread is heightened by the movement of two cases from Beni, the one in Masereka Health Zone and a case confirmed earlier this week that marked the first spread to Butembo, home to nearly 1 million people.

The developments, however, aren't surprising, the WHO said. "Given the mobility of populations in the affected areas, these two cases were expected, rapidly detected, and additional response measures swiftly activated to interrupt further spread of the virus."

Overall, the WHO said transmission focus has shifted to Beni, but it warned that sporadic cases are still being reported in Mangina and Mandima health zones, the outbreak's earlier hot spots.

Health teams continue to face sporadic reluctance to response activities in the outbreak areas, the agency said. It added that insecurity and conflict activity is also closely being monitored in the affected areas, and, as in earlier outbreaks, officials are following the United Nations policy of using armed military escorts in separate vehicles when needed. The WHO said security personnel aren't directly involved in response operations.

Latest health ministry numbers

The latest confirmed cases include the one from Masereka Health Zone and another from Beni, the health ministry said yesterday. The developments push the outbreak total to 129, including 98 confirmed and 31 probable cases. Health officials are investigating 7 suspected cases.

Health ministry Oly Ilunga, MD, traveled to Beni yesterday and with other high-level health officials took part in a public information session in Ndindi district, where some residents have hid sick patients, obstructed response activities, and refused vaccination. The group also flew to Butembo to meet with response teams and deliver mobile lab equipment.

Vaccination teams continue to make headway in the area, and the WHO said 6,830 people have been immunized in 44 defined vaccination rings and in 10 rings of health workers.

Treatment facilities expand

Ebola treatment centers (ETCs) are fully operating in Beni and Mangina by the Alliance for International Medical Action (ALIMA) and Doctors Without Borders (MSF).

Over the next 2 weeks, ALIMA plans on expanding its "treatment cube" capacity. The treatment cubes, developed in the wake of West Africa's massive Ebola outbreak with input from an expert team brought together by ALIMA, have transparent walls that allow health workers to perform most patient care activities without having to wear personal protective equipment (PPE). The units are designed for quick assembly and to offer biosafety level 4 security

In another development, a new ETC in Ituri province staffed by the International Medical Corps is expected to begin operating the week of Sep 9.

MSF said in an update today that in its first month of responding to the DRC's latest Ebola outbreak it has treated 65 patients, more than 80% of the number of confirmed patients hospitalized in the region's ETCs.

Of those treated in MSF's Mangina ETC, 29 have recovered and returned to their families and 3 are still in treatment.

MSF warns epidemic at a crucial point

Berangere Guais, MSF's emergency coordinator in Beni, said the latest epidemic is at a crucial point.

"Yes the number of patients in the treatment center has reduced significantly, but new cases from a number of different chains of transmission have emerged in recent days," she said.

Response teams must continue to build trust with the community to ensure that those with symptoms are quickly isolated and tested. "We just cannot let down our guard until the epidemic is declared over."

See also:

Sep 6 DRC update

Sep 7 WHO situation report

Jun 10 ALIMA press release

Sep 7 MSF update

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