No 'reset' with Ebola outbreak, WHO official says

Ebola treatment tents
Ebola treatment tents

World Bank, Vincent Tremeau / Flickr cc

Today leaders from the World Health Organization (WHO) said the Ebola outbreak in the Democratic Republic of the Congo (DRC) remains contained to a small geographic area, but that does not mean the virus is retreating.

"At any point it could flare up within a zone," said Mike Ryan, MD, a WHO assistant director-general. Ryan, citing information contained in yesterday's WHO Ebola situation report, said there are some encouraging signs, including lower transmission rates in known hot spots and more surveillance.

"Surveillance has intensified to 1,300 alerts per day, of which between 200 and 300 are validated and tested,” Ryan said. "The number of contacts being followed is 15,000."

Ryan said the outbreak's reproduction rate is 1.04, meaning that every Ebola case begets one additional case. That means transmission is flat, not increasing, but also not decreasing significantly.

As many as 25% of cases missed

Throughout the press conference, Ryan called the outbreak complex. In addition to the security challenges in the region, he said certain health-seeking behavior and community death practices have contributed to the outbreak's longevity.

About 20% of Ebola case-patients first seek healthcare in a health zone far away from where they live, which makes it hard to make connections between transmission chains. Additionally, several deaths are still occurring in the community. Each community death, Ryan said, raises the risk of further disease spread.

Ryan also said the WHO estimates it is detecting 75% of cases, with as many as 25% missed or being picked up "too late."

He also responded to recent criticism from various non-governmental organizations that the WHO needs to "reset" the outbreak response.

"This is not an iPhone. We don't just hit a reset button," Ryan said. "We get to adapt… and make the response the best we can make it."

He also reminded the reporters in the room that 80% of vaccinators in the region are Congolese, and most doctors and nurses working the outbreak are Congolese.

"It's Congolese people ending this outbreak," he said.

Today the DRC ministry of health confirmed 6 new cases of Ebola and 10 deaths, raising outbreak totals to 2,031 cases and 1,367 deaths. Three of the 10 deaths occurred in the community, which is a lower percentage than usual.

A total of 293 suspected cases are still under investigation, and 130,711 have been vaccinated. The number of infected healthcare workers remained at 110.

Vaccine predicted to run out

Yesterday Robert Redfield, MD, the director of the US Centers for Disease Control and Prevention (CDC), told Congress that the world must be prepared for this outbreak to spread internationally, and for vaccine supplies to dwindle, according to a Devex story.

Ryan, when asked about Redfield's comments, deflected. "Dr. Redfield is trying to bring attention to the outbreak; that's a good thing," he said.

Redfield said vaccine production is being held up by plant validation. Merck had manufactured the vaccine, rVSV-ZEBOV in Pennsylvania until recently moving the operation to Germany.

There are currently about 145,000 doses of the vaccine, too few for a planned broader vaccination campaign that would look toward vaccinating geographic regions instead of contact rings.

See also:

Jun 6 WHO teleconference stream

Jun 6 DRC report

Jun 6 Devex article

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