September 12, 2007
Democratic Republic of Congo: MSF Responds to Ebola Outbreak in Kasai
An outbreak of Ebola hemorrhagic fever has been confirmed in West Kasai province, in the Democratic Republic of Congo. Doctors Without Borders/Médecins Sans Frontières (MSF) is reinforcing its emergency team already working on the ground. A team of specialists has been dispatched as well.
What is Ebola?
Dr. Armand Sprecher
Dr. Armand Sprecher is an MSF physician specialized in hemorrhagic fevers like Ebola and Marburg. He is currently advising MSF in the fight against the Ebola epidemic in the province of West Kasai, Democratic Republic of Congo. In this interview, he describes Ebola hemorrhagic fever and the measures that are taken to control the outbreak.
Read the blog of Zoe Young, a water & sanitation expert, currently stationed in the DRC working on the outbreak of Ebola in West Kasai province.
Late on Monday, September 10, the Congolese Ministry of Health officially declared an outbreak of Ebola haemorrhagic fever in the province of West Kasai. Laboratories in Atlanta, USA, and in Franceville, Gabon, have confirmed the presence of Ebola virus in samples. According to the World Health Organization (WHO), a total of 372 suspected cases have been reported and 166 people have died — a mortality rate of approximately 45 percent. Not all these deaths are necessarily due to Ebola, however. The presence of other diseases is also suspected, such as Shigella dysentery.
Since the end of April, cases of an unknown illness started to be reported in the region of Mweka, a town of 9,000 inhabitants in West Kasai, about two days drive from Kananga, the provincial capital. Over the last two weeks, more suspected cases were reported in the health zones of Mweka, Kampungu, Luebo, and even one in Kananga. MSF is working in the health center of Kampungu, the most affected health zone. There are 12 patients currently hospitalized, of whom three are in severe condition.
Patients present with high fever, headaches, vomiting, diarrhea, and, in some cases, external or internal bleeding. Case fatality rates have ranged from 50 to 90 percent Typically, by the end of the second week of illness, patients succumb to multiple organ failure. No vaccine or treatment exists for this type of infection, so MSF isolates suspected cases to prevent spread of the disease to other patients, health care workers, and families, treats the symptoms and reduces the suffering of patients. While waiting for the results of specialized testing for the organism, patients have been isolated, treated with antibiotics and given supportive therapy for low blood pressure and breathing difficulties.
Since September 2, a team from MSF's DRC-based emergency team has been working in Kampungu. The team consists of a physician, a nurse and a logistician, and has already been reinforced by a choordinator from the Emergency Unit from Brussels, Belgium, two water-and-sanitation specialists, and a social worker. Additional physicians, nurses, logisticians, water-and-sanitation specialists, an epidemiologist, and an expert in Ebola fever, will arrive in West Kasai in the coming days, bringing the MSF team to a total of 15 people.
MSF has responded to previous outbreaks of hemorrhagic fever, of Ebola or Marburg types: in Angola (2005), Gabon (1997 and 2002), Uganda (2001), Congo-Brazzaville (2003/2004), southern Sudan (2004). In DRC, MSF responded to a major Ebola outbreak in Kikwit, capital of the neighboring province of Bandundu, in 1995. This epidemic killed 244 people between May and August 1995.
"Ebola medical kits" will be sent by plane from Lubumbashi and from Kinshasa. These kits are made up of protection kits for the team—surgeon and plastic gloves, boots, glasses, masks, protection uniforms, apron and hoods—for single use. The disease is highly contagious and protective clothing can only be used once and then must be carefully destroyed.
Additional material designed to take samples from sick patients and to transport them will reach Kananga on Thursday. Medical supplies, such as perfusions, antibiotics, anti-malaria drugs, as well as food rations, are being prepared in the DRC capital, Kinshasa, and are scheduled to arrive in West Kasai province on Wednesday. Water-and-sanitation material, such as water tanks and chlorine for disinfection will also be sent.
The MSF team will continue to isolate infected persons in the health center of Kampungu; trace actively the people who have been in contact with sick patients; and raise awareness among the population about the basic rules to prevent the transmission of the disease.
