Ebola outbreak grows as DRC issues alerts in Goma

The Democratic Republic of the Congo's (DRC's) health ministry today in its daily Ebola update reported 5 new cases and 9 new deaths and added that 100 suspected cases are under investigation.

Outbreak totals now stand at 505 cases, including 298 deaths. The new cases include two in Katwa and one each in Komanda, Musienene, and Mabalako. At least one of the newly recorded deaths occurred in the community, in Katwa, an event that heightens the risk of virus spread, the DRC said.

Sick patient, traveling contacts trigger alerts

Officials also issued two health alerts about possible disease spread in Goma, the capital and largest city in North Kivu province. For weeks, officials have warned that Ebola could spread in the city.

The first alert came after a bleeding patient died at the Rutshuru General Referral Hospital in Goma, but subsequent tests showed the patient did not have Ebola.

The second alert came after six family members (three adults, three children) of a case contact in Beni left that city for Goma, avoiding the 21-day surveillance period for case contacts. Yesterday, all six people had been found and accounted for, and all have returned to Beni for the remainder of their surveillance period.

The DRC issued a warning to the citizens of Goma, highlighting the need for safe and dignified burials and best hygiene practices.

"If all the inhabitants of these cities respect the sanitary measures recommended by the Ministry of Health, it is possible to ensure that, even if an Ebola case arrives in the city, it would be a sporadic case [and] would not lead to a new outbreak," the DRC said.

Concern over many pediatric cases

In other news, UNICEF today raised concerns about the high number of children infected in the outbreak, the world's second largest.

According to UNICEF, one of every third person diagnosed in the current Ebola outbreak is a child, a uniquely high number.  One in 10 children diagnosed with the virus are under the age of 5, and children are more likely to die from their infections than adults.

"We are deeply concerned by the growing number of children confirmed to have contracted Ebola," said UNICEF's Regional Director for West and Central Africa, Marie-Pierre Poirier, in a press release.

"The earlier children infected with Ebola receive treatment in a specialized health facility, the greater their chances of survival. Community mobilization and public awareness activities are also crucial to ensuring early detection and quick referral of suspected cases to Ebola treatment centres."

Point-of-care test shows promise

Today in Science Translational Medicine, researchers published promising data on a new point-of-care test that can detect Ebola with 90.0% sensitivity and 97.9% specificity and malaria with 100.0% sensitivity and 99.6% specificity within 30 minutes.

The test uses surface-enhanced Raman scattering (SERS) tags to simultaneously detect antigens from Ebola, Lassa, and malaria within a single blood sample, the study authors said, and could theoretically help clinicians differentiate between those viruses at the onset of a patient's symptoms. This is the first test to simultaneously detect these co-infections.

The test was assessed on 190 clinical samples collected from the 2014 West African Ebola outbreak, along with 163 malaria positives and 233 negative controls.

The authors of the study said the new test, if developed, is preferable to current Ebola tests for outbreak use.

"Considering that diagnosis of infections such as Ebola come with heightened biosafety concerns, it is beneficial that the SERS assay requires only the addition of blood to a tube that is then closed and tested directly, with no need to reopen the test vial," they said. "Its portability can enable near-patient testing, simplifying the logistics and biosecurity concerns associated with transporting samples for analysis."

WHO official addresses vaccine supply

Finally today, Peter Salama, MD, the World Health Organization's (WHO's) deputy director-general for emergency preparedness and response, said the organization was working with Merck to identify any possible supply chain gaps.

"WHO is working with the supplier of the investigational Ebola vaccine to address potential supply issues in DRC & elsewhere," Salama said on Twitter. "We have not experienced a gap in the vaccine doses required. Supplier is actively working to increase availability of doses to meet evolving needs."

Salama said 48,000 people have received the vaccine in response to the outbreak, including 2,000 healthcare workers in the DRC and Uganda. Health workers in South Sudan will also be vaccinated in the coming weeks, he added.

See also:

Dec 12 DRC update

Dec 11 UNICEF press release

Dec 12 Sci Transl Med study

Peter Salama Twitter feed

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