Localized surveillance systems
Measles cases remain underreported across the country. MSF has set up surveillance strategies to identify new areas affected by the epidemic, in order to start interventions as soon as possible. At the beginning of December, MSF sent a small team to Viadana—a town in the province of Bas-Uélé in the north of the country—following a rapid increase in the number of recorded measles cases. But the situation they found was far worse than what the recorded numbers represented. In a single school of about 300 children, more than 100 students had measles. MSF immediately provided medical care for the children and organized a vaccination campaign in the area.
In the four provinces of ex-Katanga, in the south-east of DRC, MSF created localized surveillance systems and set up a decentralized laboratory to quickly analyze suspected cases of measles and rubella. The system was set up in October, but prior to that, the samples had to be sent all the way to Kinshasa—the capital of DRC—for analysis, which took several months.
MSF is also works in the province of Kongo Central, supporting the Congolese health authorities. On December 13, MSF opened a treatment center for complicated measles cases in the general hospital in Matadi, the capital of the province and the country's main port. A week earlier, another team opened a similar facility a few hours drive west, in the coastal town of Muanda. These treatment centers reached capacity within a few days after opening, and we had to relocate to larger structures.
In these treatment centers, MSF teams treat other pathologies, such as malaria and malnutrition, which greatly increase the risk of mortality in measles patients if left untreated. We also support the treatment of simple measles cases in areas surrounding these health zones by distributing treatment kits, strengthening surveillance and detection of new cases, and providing free transport for patients who need to be transferred to healthcare facilities for further treatment.
“Too many children have died”
Between January 2018 and October 2019, MSF teams treated 46,870 measles patients and vaccinated 1,461,550 children against the disease across 54 health zones in various provinces around the country, including Ituri, Haut and Bas-Uélé, Tshopo, Kasai, Mai-Ndombe, Kwilu, and Sud Ubangi.
In collaboration with the Congolese Ministry of Health, MSF also helped to strengthen measles vaccination activities in areas where the Ebola outbreak continues to spread. “In July, we introduced the first measles vaccination in an Ebola context,” said Dr. Peyraud. “Everything went smoothly and children in several health zones including Bunia and Ituri were vaccinated.”
Unfortunately, many regions still have low vaccination coverage.
"Supplementary immunization activities have been launched by the Congolese Ministry of Health, but there are still many health zones where the outbreak continues,” says Wade. “It is essential that humanitarian organizations and other responders pool all possible efforts to help the Congolese Ministry of Public Health to overcome this measles outbreak. Too many children have died from this easily preventable disease.”
MSF has worked in the DRC since 1981. Our teams respond to the needs of communities during health and humanitarian emergencies, including epidemics, pandemics, displacement of people, and natural disasters, with the primary objective of reducing morbidity and mortality.
*These numbers were updated on January 7, 2020.
