January 13, 2009

Some 46 patients in total have shown symptoms of Ebola hemorrhagic fever in the province of Western Kasai, central Democratic Republic of Congo (DRC).

Seven patients have tested positive for the Ebola virus after sample analysis in laboratories. Of the seven confirmed, one has died. The 39 remaining patients are still suspected cases, of which 13 have died.

Currently, three patients suspected of having Ebola are in an isolation center built by Doctors Without Borders/Médecins Sans Frontières (MSF) in Kampungu, a village in the center of Western Kasai province. Two of them had contact with a woman confirmed as having Ebola who died earlier. One of the two is the woman's 3-year-old child; the other is her sister who has taken care of the child since the mother's death.

Monitoring "contact people" is key to breaking the line of contamination. The MSF team on the ground is currently following up daily with about 200 people.

“All three patients are doing fine”

The third patient in the isolation center comes from a village some 20 km (about 12 miles) away from Kampungu and has not been in contact with any previous patient.

"We were fearing the virus could also be located outside Kampungu and Kaluamba (the village thought to be the epicenter of the epidemic)," says Dr. Michel Van Herp, MSF epidemiologist. "However, until last night, his symptoms resembled those of typhoid fever. Nonetheless, as long as we don't have confirmation he is negative for the Ebola virus or he is not presenting any symptoms anymore, he will be staying in the isolation center.

"Our team took samples from all three patients to confirm the presence or absence of the virus. For the moment, all three patients are doing fine. They are eating, walking by themselves and do not require any rehydration,” adds Van Herp.

MSF takes measures to avoid contamination in the isolation center. The team is following strict protocols to make sure that the medical teams, the patients' families, and the patients themselves are protected against contamination.

Patients stay in the isolation center until their symptoms disappear. This means they survived a suspected Ebola infection or were not infected with the deadly virus. Indeed, an Ebola contamination can only be confirmed by analysis of samples done by a specialized laboratory.

A patient is a suspected case until samples sent to a laboratory confirm his infection or lack of infection with the Ebola virus. Ebola symptoms can resemble those of malaria or other diseases such as typhoid fever or shigellosis at the beginning. This is the reason why we also give medication against malaria and antibiotics when we suspect Ebola. MSF also provides psychological support.

Unidentified strain of Ebola

Until now, out of the seven confirmed Ebola patients, one person has died.

"It is true that we are not talking about the usual death rates that come along with Ebola outbreaks. The reason is that although it has been confirmed we are in the presence of an Ebola outbreak, it has not yet been confirmed which type of Ebola we are faced with," explains Van Herp. "The Zaire type of Ebola kills 70 to 90 percent of those infected, but we could actually be in the presence of a less lethal Ebola strain. Still, we cannot forget that 13 suspected patients also died, making the death toll 14 people."

Last year, an Ebola outbreak that occurred in the same area killed up to 186 people, but other deadly diseases are also thought to have been involved.

An MSF team of 18 is currently working in Western Kasai. The team consists of doctors, an epidemiologist, a psychologist, nurses, water and sanitation specialists, health promoters, and logisticians.