Zoe trains the team's new staff
http://news.bbc.co.uk/2/hi/africa/7001506.stm
Posted on 09/20/2007 8:04:03 AM PDT by Mother Abigail
Congo's Ebola Outbreak Could Be Worst in Years
By Craig Timberg Washington Post Foreign Service Wednesday, September 19, 2007; Page A19
JOHANNESBURG, Sept. 18 -- International medical personnel and supplies are being airlifted to a remote region of central Congo to combat what threatens to become the world's most serious outbreak of the deadly Ebola virus in years.
(Excerpt) Read more at washingtonpost.com ...
THE OVERALL SITUATION
Where: The Democratic Republic of Congo, with the epicenter in the Western Kasai region.
Cases: 381 suspected cases with reports of widespread outbreaks in the 100km radius of Kampungu
Deaths: 172 with, again, reports of more deaths in remote regions of the area
THE SITUATION ON THE GROUND
The problem started round about April or May when there were some isolated cases where people had been hunting in the forest, and shortly after that there were reports of funeral ceremonies where quite a lot of people were buried at the same time.
So far they’ve found out that up to now there have been more than 170 deaths, which means it’s a real epidemic in a region where about 10 to 15 thousand people live. Later there was some spreading because sick people left the area, going to other towns and villages. This means it’s a real threat to the area.
CONTAINMENT
There are restrictions in place for the movement of sick people. And movement of the healthy population is controlled, not forbidden. The people who are clearly sick are being taken care of, but they have to be quarantined. Wards are being set up in the region and surrounding towns. And even in the provincial capital Kalanga there are now isolation wards.
There are ten new cases per day. Most of the people infected quickly die. But because people have been traveling to surrounding towns, they could be spreading the disease. There are several suspected cases in nearby villages, but they still have to be confirmed. The WHO is flying in a mobile laboratory, which will test and confirm whether all of the victims are dying of ebola.
COMPLICATIONS
1. The World Health Organization (WHO) on Thursday said it had confirmed typhoid in the area of Democratic Republic of Congo where health experts are working to fight an outbreak of deadly Ebola hemorrhagic fever.
“We now have five confirmed cases of typhoid among the suspect cases in Kampungu,” WHO spokesman Gregory Hartl said.
“One of the typhoid cases also tested positive for Ebola. This is proof that a lot of different disease events are going on, making it more complicated,” he added.
2. Laboratory analysis conducted in Gabon and the United States on samples taken from cases in the outbreak have confirmed the presence of the Ebola virus, which causes death in 50 to 90 per cent of cases.
WHO said some of the samples also show the presence of Shigella dysentery, which is complicating the treatment of victims, who are concentrated in the Mweka and Lwebo areas of DRC’s Kasai Occidental province. It is not clear yet how many deaths were caused by Ebola given the apparent simultaneous outbreak of the diseases.
Situation report: DR Congo - Ebola virus outbreak
PDA has provided funds from One Great Hour of Sharing to respond to an outbreak of the Ebola virus, possibly the largest yet, that has occurred in the Democratic Republic of the Congo.
186 deaths have been registered in hospitals or clinics, but it is possible that many are dying without being counted.
Ebola — known as Ebola hemorrhagic fever — is a severe, often-fatal disease in humans that has appeared sporadically since its initial recognition in 1976, according to the Center for Disease Control (CDC). The disease is caused by infection with Ebola virus, named after a river in the Democratic Republic of the Congo, where it was first recognized.
PC(USA) Mission worker Larry Sthreshley and Bill Clemmer, an American Baptist Churches mission worker who is head of SANRU (the Programme de Santé Rurale, or Rural Health Program), are working closing with the CDC in an effort to confront this recent Ebola outbreak.
The Atlanta-based CDC has been asked to establish a central lab and base to set up a diagnostic test for Ebola. This is essential, as everyone with a fever will not have Ebola; yet those who are positive need to be isolated.
Ebola is extremely contagious. An MSF (Doctors without Borders) nurse was tearfully recounting the story of a Congolese nurse she worked with for the past two weeks; the nurse, a health care worker who took basic precautions, is now in active stages of the disease (and dying). The nurse decided to stay in her home rather than go to the clinic, and MSF had to send a jeep to her house to take her away, knowing that many of her family members had cared for her. [I][U]
The CDC asked for SANRU’s assistance because the three epicenters of the outbreak are located around health districts where SANRU is involved and because of SANRU’s relationship with church structures that are co-managing the hospitals and health centers in the affected health districts.
Luebo Presbyterian Hospital has been chosen as the site where a team of 10-12 scientists will set up the lab and do the testing. Protection material is being provided to the hospital. Medical Benevolence Foundation is also assisting with vehicles needed to move around the area.
http://www.reliefweb.int/rw/RWB.NSF/db900SID/EMAE-776R2A?OpenDocument
http://www.christiantoday.com/artic...ctims/13265.htm
Mission Aviation Fellowship is transporting doctors to remote clinics in Congo to halt the spread of a deadly ebola epidemic.
Tuesday, September 18, 2007, 12:53 (BST)
Mission Aviation Fellowship(MAF) is working with the Center for Disease Control in Atlanta, US, to fight a deadly ebola epidemic that has killed at least 150 people in the Democratic Republic of Congo (DRC), MAF officials said today.
The World Health Organisation (WHO) has confirmed the outbreak and said measures are being taken to contain the spread of the deadly virus, which causes internal and external bleeding, as well as vomiting and diarrhoea. The deaths occurred in the central province of Kasai Occidental, WHO said.
MAF is transporting doctors into extremely remote jungle clinics, where they can treat patients and assess the severity and extent of the crisis.
“The thought at the moment is there are many, many more in the remote villages that are not making it to a hospital or a clinic and are simply dying in remote villages,” said John Boyd, MAF vice president for ministry advancement. “At the end of this week, we should have a better idea of the size and scope of the situation, and how we need to mobilize more resources.”
Ebola is one of the deadliest pathogens, killing 50 to 80 per cent of the people it infects. Because it is highly contagious, health officials in Congo are trying to quarantine anyone with symptoms. There is also an ongoing media campaign to educate villagers about the crisis.
Congo’s last major Ebola outbreak in Kikwit was in 1995, when 250 people in an area about 250 miles west of the current outbreak died.
The movement of the people in the bush is complicating efforts to quarantine the infected and is causing alarm with medical authorities. The virus is transmitted by direct contact with the body fluids of an infected person or carrier - sometimes infected chimpanzees, gorillas and forest antelopes.
While blood tests are analysed, the government in the DRC is asking for more help in dealing with an outbreak that may rival the outbreak of 1995. Part of that help is coming in the form of determining how large the problem is.
The current Ebola crisis, Boyd said, “dovetails very closely with who we are as a Christian ministry. We’re prepared to go into this stricken area. The ministry side of it is simply being there to help the ‘least of these’ and then taking the opportunity to share the gospel when that arises.”
MAF fills a strategic role in ministry by supporting Congolese churches, missionaries and an increasing number of short-term mission teams. The MAF team is committed to supporting the emerging intertribal Christian movement that is moving toward healing and reconciliation, Boyd said.
Other mission groups and humanitarian agencies utilise MAF services to help alleviate the suffering of those displaced by the instability of the DRC. To that end, MAF has earned a reputation of compassionate, evangelistic outreach, according to Boyd.
Founded in 1945, MAF serves more than 600 Christian and humanitarian agencies worldwide. It stations some 200 missionary families in the remotest regions of 26 countries on five continents. MAF pilots fly approximately 40,000 flights a year, transporting missionaries, medical personnel, medicines and relief supplies, as well as conducting thousands of emergency medical evacuations.
Revelation 12:12
Therefore rejoice, you heavens
and you who dwell in them!
But woe to the earth and the sea,
because the devil has gone down to you!
He is filled with fury,
because he knows that his time is short.”
Shakes of “The Hot Zone,” one of the most terrifying books ever written.
so true.
World’s Creepiest Disease.
This would of course prove that hell is actually above the earth...which brings up the conundrum that if the earth spins (has this been proven??), then where actually does hell exist? Does it hang over one spot in earth (sort of like a satellite) or move??
Yikes!
fyi
Ping!
Small comfort to the afflicted.
Uh ... "ascend" means "to rise." Hell RISES to earth. You're confusing it with "DEscend."
I agree. Ebola Zaire is the deadliest strain of Ebola. I wonder if this outbreak occurred in the same jungle cave area where it was originally thought to have materialized.
Ugh, what a dummy.
Try not to get bent and go on a personal religious tangient.
Ebola, Africa...
Stay focused.
Yes,
If this virus were not so hot we would be in deep kimchi.
Es Salaam
Tanzanian health authorities have cautioned people living in regions neighbouring the Democratic Republic of Congo (DRC) following the outbreak of Ebola haemorrhagic fever in the central African country.
Western Tanzanian regions bordering DRC include Mbeya, Rukwa, Kigoma and Kagera.
“All regional medical officers have been instructed to keep on alert because people from eastern parts of DRC enter into Tanzania through the four regions,” Wilson Mukama, Permanent Secretary in the Ministry of Health and Social Welfare, said in a statement.
Meanwhile the UN World Health Organization (WHO) clarified that while the latest figures released by various sources mention 375 cases and 167 deaths in western Kasai Province of DRC, the cause of death cannot be confirmed yet.
http://allafrica.com/stories/200709190780.html
Source: International Federation of Red Cross And Red Crescent Societies (IFRC)
Date: 20 Sep 2007
Democratic Republic of the Congo: Ebola Haemorrhagic Fever in Western Kasai DREF Bulletin No. MDRCD001
The situation
On Monday, 10 September 2007, the Ministry of Health of the Democratic Republic of the Congo (DRC) officially declared an Ebola Haemorrhagic Fever (EHF) (1) epidemic in the country. The confirmation followed laboratory tests conducted at the Centre International de Recherches Médicales de Franceville (CIRMF) in Gabon and the Centers for Disease Control (CDC) in Atlanta, USA. Laboratory analyses of samples from eleven patients with suspected EHF cases and four people they had come into contact with revealed that six tested positive.
The area most affected by the epidemic extends 70 km from Makonoku – in radius – reaching Kampungu, Kaluamba and the surrounding villages of Mweka (2) and Luebo, all in Western Kasaï Province. In early June 2007, several people fell ill in Bena Ndongo (one of the seven villages surrounding Makonoku); they displayed symptoms such as fever, headaches, diarrhoea, colic and vomiting. They all died within one week; deaths were also recorded in Kampungu and Kaluamba. Additionally, some suspected cases have been reported in Kananga, the capital of the province, approximately 170 km from the most affected areas. The epidemic can potentially spread to other bordering zones and provinces.
On 18 August 2007, the central office of the health zone was informed of the situation by the nurse in charge of the Makonoku health post. The central office then dispatched two supervisors to assess the situation. Their report confirmed that 46 deaths had occurred (14 in Kampungu and 32 in Kaluamba). The deaths were reported in communities where health centres recorded the least attendance by patients.
From 20 to 25 August, 300 cases, with 82 deaths, had been registered. According to medical records, as at 11 September 2007, a total of 372 cases, with 166 deaths, had been reported; translating to a fatality rate of 44.6 per cent. One hundred and seven people were confirmed to have come into contact with the patients and these were followed up. Thirteen patients were admitted to hospital; four of them are recovering.
Notes
(1) Ebola haemorrhagic fever (EHF) is one of the most virulent viral diseases known to humankind, causing death in 50-90% of all clinically ill cases. Several different species of Ebola virus have been identified. The Ebola virus is transmitted by direct contact with the blood, body fluids and tissues of infected persons. Source: WHO – http://www.who.int/csr/disease/ebola/en/
(2) The population of Mweka is 140,000 people while Kananga, where a few suspected cases have been registered, has a population of 1 million people.
Diary from DR Congo’s Ebola frontline
Zoe Young of the medical NGO, Medecins Sans Frontieres (MSF), shares her diary with the BBC News Website from the Democratic Republic of Congo where she is dealing with an outbreak of the deadly Ebola virus.
Since the first MSF team arrived in Kampungu at the beginning of September, 25 severe cases suspected to be Ebola haemorrhagic fever have been hospitalised at Kampungu’s health centre. Of these, eight patients have already died.
When I got back into the MSF office last week after a holiday everyone was talking about a mystery disease in the Congo.
Apparently there had been lots of deaths, but it wasn’t at all clear what it was.
Zoe is a water and sanitation specialist with MSF
There were different theories in the office, and we had to wait for the results of tests on samples that were sent to three different labs for analysis.
In the meantime, we sent our DRC emergency team to Kampungu, one of the affected areas, to set up the temporary isolation ward.
The first result that came through was a positive for Shigella. Then, late last Monday, the results came through from the Centre for Disease Control in Atlanta: some of the samples had tested positive for Ebola.
Everything changed straight away.
Exciting landing
MSF’s Emergency Unit coordinated a meeting with our water and sanitation experts, epidemiologists, public health specialists and HR people to decide what equipment and staff to send.
I boarded a plane to Kinshasa, the capital of DRC, two days later.
Patients have to be treated very carefully and kept very separate from the community
The seven of us travelled from Kinshasa to Kampungu on a 10-seater plane with a pilot who had a huge handlebar moustache.
The scenery was lovely: mile after mile of jungly forest which looked like tightly packed broccoli with the odd dead white tree reaching up above the canopy.
I didn’t see the airstrip until the pilot lined the plane up: it just looked like a footpath on a bumpy field. It was quite an exciting landing.
As we got out of the plane crowds of children and interested adults pushed forward to see us and then followed us shouting, “Comment ca va? Comment tu t’appelles? Comment ca va?”... on and on.
The din was amazing, piercing.
‘My job’
Then an hour’s drive to Kampungu on roads that forced the car to tip right over on its side.
The overall effect on the outside is rather like a spacesuit - on the inside it’s like a sauna
So, my job. Ebola is transmitted by contact with bodily fluids so patients have to be treated very carefully and kept very separate from the community.
We have set up a small isolation unit which is made up of a low risk part where we can change into protective clothing and then a high risk part which is where the patients are.
The building was part of the health centre before and has been surrounded by a low fence made of orange netting to keep people out (and to stop patients wandering off accidentally).
Four of us work in the isolation unit: a logistics expert who is responsible for building any new structures, beds, tables, fencing etc that we need; a nurse; a doctor and me, responsible for water and sanitation.
Marshmallows
We are slowly improving the wards for the patients, but everything takes ages since we have to dress up in full protective clothing before we can go in.
The Ebola virus is deadly
We have head covers, enormous white overalls with elasticated wrists and ankles so that they puff out making us look like little marshmallows.
Two pairs of latex gloves, ski-type goggles, a duck beak mask and an apron. The overall effect on the outside is rather like a spacesuit.
On the inside it’s like a sauna. Pouring with sweat takes on a new meaning.
The tiniest activity, like moving a patient or carrying a bed, causes sweat to cascade down my face.
Of course, I can’t wipe it off as I am all covered and have no access to my skin until I disinfect and leave the high-risk part of the centre.
Brave and determined
We have some nursing staff that have been trained to work in the high-risk area and some Red Cross volunteers who disinfect and help move patients around.
One of the patients died today
We are slowly increasing the numbers of staff but it takes time because we first have to find people who want to work with us and then we have to train them very carefully to make sure that they are safe inside the high-risk area and don’t make mistakes that would put others in danger.
One of the patients died today.
He had been a nurse in the health centre. He was an inpatient for a few days and was very brave and determined to get better. Every morning he sat on a wicker chair on the balcony to see what was happening and once or twice did a runner to go home.
That was OK.
When he came back we went back to disinfect the hut that he had been in.
Wailing and crying
Anyway, today he died and so I went into his ward with two of the disinfectors to tidy him up and put him in a body bag.
Special head-to-toe suits are worn to prevent contamination
This is important because it is possible to get infected even when people have died.
I was trying out a new kind of very waterproof body bag so I had a few teething problems trying to put him in but soon it was done and I left him on a bed while we waited for a coffin to be brought (I could see it being made through the window).
I could hear his family wailing and crying: they live in a house about 200m from the centre. I could see them from the window of the ward.
When the coffin was ready we brought out the patient and the intensity of the wailing increased.
We put the body bag into the coffin and then we put it on the back of the pick-up truck, which set off for the cemetery accompanied by the burial team.
I disinfected myself rapidly and ran to catch them up at the graveyard.
Hot work
There was a big patch of cleared ground with sticks lying on it. They told me that this was where all the other recent corpses had been put.
But there were no markers.
The grave was ready but there was no path alongside so that the coffin carriers couldn’t get the coffin next to the grave without falling in.
More than 200 people died in a previous Ebola outbreak in Kikwit
I shovelled along the grave to make it easier and then they inched forward.
The coffin started to fall so I wedged the shovel under it to hold it while they organised themselves and then they carefully lowered the coffin in.
I looked around expectantly for someone to shovel the earth back in.
Nobody around.
So, digging with our hands like badgers and with the single shovel, we backfilled the grave. Very hot work.
Some improvements to the burial procedures are definitely needed, I think, not least reassuring family members that it is perfectly safe once the person is in the coffin.
Long list
We are living in a large field that has been divided up with a campsite at one corner.
Zoe trains the team’s new staff
Five of us are sleeping in one big tent on inch-thick mattresses, under mosquito nets suspended from strings stretched from one side of the tent to another.
I seem to have a small hill under my bed which is not disguised by my rather thin mattress so I sleep curled around it like a snake.
Every night we have a meeting after dinner, which is how I find out what is going on outside the isolation unit.
The teams are working out where there might be more patients and visiting neighbouring health centres, talking to the communities and authorities and gathering information.
It is becoming clearer where cases have come from in the past few months and they are trying to work out what is going to happen next.
Some samples have also tested positive for typhoid, so we now have three epidemics at the same time.
Tomorrow I need to make changes in the wards to try and get more water in there.
I need to train a new cleaning lady and some more Red Cross volunteers.
I need to disinfect the deceased person’s house.
I might try cementing up some holes in the ward floors to make cleaning better.
Hmmmm - long list!
Very brave and selfless.
“This would of course prove that hell is actually above the earth”
Ascends would imply the opposite. I almost tripped on this too. It’s actually a pretty evocative metaphor.
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