Ebola responses gain steam in Guinea, DRC

Vaccine cooler
Vaccine cooler

UNICEF Guinea / Flickr cc

With both Guinea and the Democratic Republic of the Congo (DRC) reporting Ebola recurrences just a week apart, the World Health Organization (WHO) today said it is deploying 100 staff and, for Guinea specifically, has released $1.25 million to support local control efforts and prepare neighboring countries for possible spread.

The WHO's African regional office also shared more details about the cluster in Guinea, where the total currently stands at seven cases, three of them confirmed and four listed as probable. (Two days ago the Africa Centres for Disease Control and Prevention listed the totals at 17 cases and 5 deaths.)

In an update late yesterday, the WHO said two patients with confirmed infections are hospitalized in isolation, one in Conakry, the country's capital, and one Gouecke in N'Zerekore prefecture. Five have died, including the index patient, a nurse from N'Zerekore prefecture in the southeast, the same area where West Africa's massive 2014-16 outbreak began.

Guinea cases include family members, healer

The nurse first sought care for her symptoms, including nausea and fever, on Jan 18, when she was initially diagnosed as having typhoid fever. Five days later after her condition worsened, she sought care again and was diagnosed with malaria; the next day she visited a traditional healer. She died on Jan 28 and was buried without safety protocols in Gouecke.

The other six patients include five of her family members and the traditional healer.

Earlier this week, health officials said initial analysis showed the virus involved in the cluster is from the Zaire subtype, the same one involved in the country's earlier outbreak. However, genetic analysis is underway to shed more light on the source, such as another introduction from an animal source.

So far, no cases have been detected in other countries, but the WHO said the outbreak area is located at a travel crossroads, so the risk of the virus spreading to countries such as Liberia and Ivory Coast is high.

Ebola vaccine deliveries, increased surveillance

At a WHO African regional office briefing today, Matshidiso Moeti, MBBS, the group's director, said more than 11,000 vaccine doses in Geneva are being prepared to ship to Guinea, with more to be shipped from the United States. Dr. Mohamed Lamine Yansane, senior advisor to Guinea's health ministry, said samples are leaving Conakry today for further sequences in Senegal. He said the first vaccine doses are due in Guinea on Feb 21, with immunization to start the following day.

Also, today at a WHO briefing in Geneva, Mike Ryan, MD, who leads its health emergencies program, said that work is under way to form a coordinated vaccination strategy in African countries, which includes the Merck vaccine that has been used successfully in ring vaccination activities. He also said it's possible that the strategy could include the Johnson & Johnson vaccine for related efforts, such as vaccinating healthcare workers in the region.

In the DRC, where the number of cases remains at four, vaccination began earlier this week in Butembo.

So far, one symptomatic person traveled by taxi to Conakry, where 290 contacts have been identified, of which 94% have been evaluated, according to Moeti. Ryan added that no cases have been detected outside of Guinea, and officials are on heightened alert.

Scale-up includes experts, aid deployment

In a separate statement, the WHO detailed plans to scale up the response to the Guinea and DRC outbreaks. It will have more than 100 staff on the ground by the end of February, starting with a team of 8 from the WHO African regional office who are leaving soon.

"Our collective, quick action is crucial to averting an uncontrolled spread of Ebola amid the COVID-19 pandemic which has already pushed health workers and health facilities to the edge," Moeti said.

In other developments:

  • A humanitarian flight arrived on N'Zerekore on Feb 15, carrying medical equipment donated by the WHO and its partners.

  • In the DRC, 20 WHO experts are already on the ground, and nearly 70 people have already been vaccinated.

  • Along with the $1.25 million from the WHO for response efforts in Guinea and neighboring countries, the United Nations has disbursed $15 million for responses in the Guinea and the DRC, which covers preparedness steps in neighboring countries.

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