Ebola/EVD :: At one-month mark in Ebola outbreak, the focus shifts to remote areas of DRC

Milestones :: Perspectives

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Ebola/EVD
 
At one-month mark in Ebola outbreak, the focus shifts to remote areas
WHO Statement,  Geneva
9 June 2018
[Editor’s text bolding]
One month into the response to an Ebola outbreak in the Democratic Republic of the Congo, the focus has moved from urban areas to some of the most remote places on earth.
The shift comes after a series of unprecedented actions that have led to cautious optimism about the effectiveness of the response.
A series of firsts
On 9 May, the day after country declared an outbreak of Ebola virus disease in Bikoro, the first WHO and Ministry of Health response team arrived in the provincial capital Mbandaka to begin setting up the specialized cold chain needed to store a vaccine.
By 11 May, teams had started to trace contacts of all active cases and WHO partners were setting up treatment centres in Bikoro. The next day, an air bridge was established to Bikoro and a mobile lab deployed to speed up testing for infection.
And then, just 6 days after the alert, the first batch of more than 4000 doses of vaccine was on its way from Geneva to Kinshasa. This marked the first time vaccines were available so early in a response.
Ring vaccination of contacts began on 21 May.
   On 4 June, an ethics committee in the country approved the use of 5 investigational therapeutics under the framework of compassionate use, following recommendations from a group of experts convened by WHO. This is the first time such treatments were available in the midst of a response.
“It’s far too early to declare victory, but the signals are positive and we are cautiously optimistic,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “We have new weapons and together with the government and our partners, we have acted with urgency to save lives. We will remain vigilant until this outbreak is over.”
As of 7 June, there were a total of 59 confirmed, probable and suspected Ebola cases, of which 27 people had died.  A new case was confirmed on 6 June…

Ebola response – building trust and engaging with affected communities
13 June 2018 – The following resources can be used to guide RCCE work which is central to stopping the outbreak and preventing its further amplification. Unlike other areas of response, RCCE draws heavily on volunteers, frontline personnel and on people without prior training in this area. As such, these resources provide basic background information, scopes the socio-economic and cultural aspects, and provides the latest evidence-based advice and approaches.
:: Risk communication and community engagement considerations for Ebola outbreak in DRC
:: ePROTECT occupational health and safety briefing
:: Ebola: Knowledge resources for responders

Ebola virus disease – Operational readiness and preparedness in nine countries neighbouring the Democratic Republic of the Congo
11 June 2018
Following the notification of an Ebola virus disease (EVD) outbreak in Equateur Province in the Democratic Republic of the Congo on 5 May 2018, WHO conducted a formal rapid risk assessment which determined that the public risk is high at the regional level.

On the basis of the rapid risk assessment, the WHO Regional Office for Africa identified nine countries neighbouring the Democratic Republic of the Congo to support them with preparedness and readiness activities: Angola, Burundi, Central African Republic, Republic of Congo, Rwanda, South Sudan, Tanzania, Uganda and Zambia. During the past month, WHO deployed teams of experts known as Preparation Support Teams (PST) to eight of the countries. The aim of these missions was to assess countries’ readiness using the WHO standardized checklist, and to provide technical support to countries to develop and initiate national contingency plans in collaboration with partners.

Risk in the nine neighbouring countries
There is a significant risk of spread of the ongoing EVD outbreak in the Democratic Republic of the Congo to neighbouring countries because of the geographic proximity, high volume of movement of people and goods across borders and along the Congo River, insufficient national capacities to prevent, detect and respond to EVD cases, and other factors which may enable transmission. The nine neighbouring countries were categorized into three priority levels based on their capacity to manage EVD and viral haemorrhagic fever (VHF) outbreaks and proximity to the affected areas (Figure 1).

The nine countries were categorized as follows, with priority 1 being the highest:
:: Priority 1: Central Africa Republic and Republic of Congo due to their proximity to the current event. These two countries share borders with the epicentre of the outbreak in Equateur Province and there is continuous population movement through the porous land borders and by the Congo and Oubangui rivers.
:: Priority 2: Angola, Burundi, Rwanda, South Sudan, Tanzania and Zambia which neighbour the Democratic Republic of the Congo but are not directly linked with Equateur Province.
:: Priority 3: Uganda because although it borders the Democratic Republic of the Congo, Uganda has regularly demonstrated the capacity to respond to recent previous VHF outbreaks…