The Democratic Republic of the Congo (DRC) health ministry reported four more Ebola cases Sep 29 and yesterday, three of them confirmed, and noted that two involved circumstances known to spread the disease: delayed treatment and unsafe burial.
All of the cases are from the most recent disease hot spots, Beni, which has experienced civil unrest and community resistance, and Butembo, a large city near the Uganda border.
Political overtones in Butembo
In its Sep 29 report, the DRC health ministry reported two new cases, one in Beni and one in Butembo.
The case-patient from Butembo is a woman whose symptoms began on Sep 20, but her family members initially refused to transfer her to an Ebola treatment center and instead hid her. They refused to meet with Ebola responders without the presence of members of the "Standing Parliament," a district political pressure group that they support.
When the woman's condition worsened, the pressure group, which had been in negotiations with responders in Butembo, called on emergency teams to transfer her to the treatment center.
The woman tested positive for Ebola upon her arrival, and health officials registered her family, members of the lobby group, and the aligned member of parliament, Crispin Mbindule Mitono, as at-risk contacts, and all agreed to be vaccinated.
According to the health ministry, Mitono had been quoted in the media in August as saying he believed Ebola was created in laboratories and moved from Equateur province to Beni to exterminate the population, and he had pushed his supporters to resist vaccination.
Getting Mitono and the pressure group on board with response steps is an important breakthrough, the health ministry said, according to a machine translation of its update. "Thus, the involvement of [Mitono] and the pressure group is a major step forward in social mobilization and the lifting of the last Butembo resistance wall," it added.
Unsafe burial in probable case
Yesterday, the health ministry reported two more cases in Beni, one of them a confirmed infection involving a patient who died shortly after arriving at the Ebola treatment center.
The other is classified as a new probable case, a contact of the last confirmed case-patient who died a day earlier and was buried by his family without safety precautions. In Ebola outbreaks, unsafe burials have been known to pose a high risk of virus spread.
The latest developments push the outbreak total to 159 cases, 127 of them confirmed. The two deaths put the fatality count at 104.
Call to end Beni stigmatization
In another development yesterday, the DRC outbreak coordinator held a press conference in Beni to detail the impact the recent community protests had on the outbreak response.
He said contact tracing dipped from 98% to 50% during the protest days, held in the wake of deadly violence between rebels and DRC armed forces, and that the actions slowed active case finding and port-of-entry monitoring.
Ndjoloko Tambwe Bathe, MD, said the protest sidelined vaccination activities for 3 days and brought sample testing to a halt on Sep 25. Also, he said the actions hurt disinfection efforts and impeded the supply of personal protective equipment for health providers.
He also urged the media to stop stigmatizing the Beni population, noting that the city's population has been very cooperative with response teams and that cases of resistance in Beni have been limited to one or two families that are linked to the spread of the virus to Butembo and Tchomia.
Overall, the number of people vaccinated has reached 12,940, including 3,958 in Beni.
See also:
Sep 29 DRC health ministry report
Sep 30 DRC health ministry report
