Health officials in the Democratic Republic of the Congo (DRC) today confirmed a case of Ebola virus on the Ugandan border, about 200 kilometers (125 miles) from the nearest known case in the country's current outbreak in North Kivu province.
According to Reuters, the case was reported in Tchomia, on the shores of Lake Albert, the closest the disease has come to Uganda during the outbreak. Tchomia is in Djugu territory, where violent ethnic clashes have caused mass migration across the Ugandan border.
Yesterday, the World Health Organization (WHO) confirmed that no cases of Ebola have been detected in Uganda, despite more than 100 investigations of suspicious illnesses. But Uganda, with help from the WHO, is preparing to implement a ring vaccination strategy in the coming months in an effort to protect healthcare workers. About 3,000 doses of Merck's Ebola vaccine will be shipped in cold-chain compartments to Uganda, the WHO said in a news release.
"Ebola is a very aggressive and deadly disease. The opportunity that vaccinating frontline health workers and ring vaccination provides to contain the disease as soon as it is confirmed when the cause is Ebola Zaire in a country is one that must never be missed. That's why we are making all these costly but necessary preparations," said Yonas Tegegn Woldermariam, MD, WHO representative in Uganda.
The WHO said there are 22 high-risk border districts between DRC and Uganda, and ministry of health officials in each country have increased cross-border surveillance.
New case in Butembo
Yesterday DRC's ministry of health announced the eighth confirmed case of Ebola in Butembo, a large city in the eastern part of the country. The new case brings the total number of cases to 143 (112 confirmed), including 97 deaths.
Butembo, along with Beni, have become the new hot spots for disease activity, according to the latest WHO outbreak update.
"The situation in Mangina (Mabalako Health Zone) is stabilizing," the WHO said. Since Sep 12, all five new Ebola cases detected have been from active transmission chains in Butembo and Beni.
The DRC confirmed that 10,663 people have been vaccinated against Ebola, including 3,935 in Mabalako, 3,409 in Beni, 1,582 in Mandima, 814 in Butembo, 373 in Katwa, 270 in Masereka, 121 in Oicha, 94 in Komanda and 65 in Kinshasa, since vaccination began on Aug 8. The outbreak began on Aug 1 in Mangina. The WHO said 4,008 health workers and 2,362 children are included in the total vaccinated.
As of Sep 18, the WHO said nine suspected cases are awaiting laboratory testing. Currently, 8 vaccination rings have been identified, in addition to 24 rings of health workers and other frontline workers. These rings include the contacts (and their contacts) of all confirmed cases from the last 4 weeks, the WHO said.
"Significant risks for further spread of the disease remain," the WHO said. "Continued challenges include contacts lost to follow-up, delayed recognition of EVD in health centres, poor infection prevention and control (IPC) in health centres, and reluctance among some cases to be treatment in Ebola treatment centres."
Adults ages 35 to 44 account for 23% of cases in this outbreak (based on information from 135 patients. Most cases (56%) have been in women. Nineteen healthcare workers have been infected, three of whom have died.
The continued challenge is the turbulent location of the outbreak, health officials said. Some communities have rejected medical assistance and shown reluctance to implement prevention measures.
Sep 21 Reuters story
Sep 20 WHO press release
Sep 20 DRC update
Sep 20 WHO update