‘First line of defence’ against rare Ebola outbreak ‘has collapsed’

The ‘first line of defence’ against a deadly strain of Ebola has collapsed, Oxfam has said.

The Democratic Republic of Congo (DRC) is facing its largest-ever outbreak of the virus, with nearly 781 infected and 181 dead.

But Oxfam has warned that the true toll is likely far higher as the country’s contact tracing programme and water infrastructure are at breaking point.

Only one in five health centres in the northeastern province of Ituri, the worst-affected region, has access to enough clean water.

In Mongbwalo, a town of 140,000 people, only two in 10 have access to clean water, and a quarter have access to working hygiene facilities.

Manel Rebordosa, Oxfam’s field response coordinator, said this is forcing families to use water contaminated with chemicals from local mines.

‘Water – the absolute first line of defence in any public health emergency is simply not available,’ he said.

‘Miners working in the surrounding areas have no toilets and handwashing stations. Then they return home to communities already battling the virus.

‘Clean water costs $2 (£1.50) for 20 litres. For most families here, that is far beyond what they can afford.’

Tibakanya Mireille, a mother of five in Ituri, said she is ‘worried’ her child has become infected with Ebola.

‘Here, two houses have been quarantined, and one family lost several relatives after caring for a sick relative, which caused others to be sick,’ she said.

‘The disease has already killed several people in our community of Shari, in Bunia.’

Why is this the largest Ebola outbreak on record?

The strain of Ebola virus behind this outbreak, known as Bundibugyo, is rare and has no vaccine or treatment.

The US Centers for Disease Control and Prevention (CDC) has confirmed this is the largest Bundibugyo outbreak on record.

North Kivu province is even seeing Ebola cases being identified after the patient has died, unaware they had the illness.

Contact tracing – seeing who an infected person has come into contact with – has just 43% coverage.

Oxfam fieldwork found that there are just 0.2 doctors per 1,000 people, and some 70 health facilities have been destroyed by conflict.

The years-long violence that has torn the DRC has displaced millions, including people in Ituri, complicating contact tracing efforts.

Aid workers have built isolation tents and disinfection stations near hospitals, only for locals to burn down the facilities when officials refused to hand over the bodies of the dead over fears of infection spread.

People can become infected with Ebola through contact with the bodily fluids of an infected, sick or dead person.

Locals see hospitals now as ‘death traps’, so are turning to traditional health methods, which Rebordosa says is hampering containment.

As well as some locals simply not knowing much about Ebola, Rebordosa said the US has played a role in the Ebola outbreak.

‘One month into the 2018 outbreak, healthcare workers achieved contact tracing rates where nearly eight in 10 known contacts were successfully monitored,’ he said.

‘Today, following the withdrawal of the US funding for disease surveillance and severe funding shortfalls, contact tracing is reaching fewer than half of the contacts.

‘That gap is not just a statistic; it is a painful reality that allows the virus to spread undetected through communities.’

What is Ebola?

Ebola is an illness caused by a group of related viruses, known as orthoebolaviruses.

Infections come in two parts – dry and wet.

Dry symptoms, which include fever, aches, pains and fatigue, can progress to ‘wet’ ones such as diarrhoea, vomiting and bleeding.

As the first round of symptoms, which show within 21 days, resemble the common cold or flu, many Ebola cases go undiagnosed.

The US withdrew from the World Health Organization in January after closing the US Agency for International Development.

There is some hope: About 25 people have recovered from the virus, the African CDC, a continental health group, said last Wednesday.

Dr Katherine O’Reilly, a medical director at International SOS, a leading health and security risk services company, told Metro that there is an ‘experimental’ Bundibugyo vaccine in the works.

‘The vaccine is being developed in the UK by the Oxford Vaccine Group using the same technology used to develop the COVID vaccine,’ she said.

‘Researchers are developing Bundibugyo Ebolavirus candidate vaccine, ChADOx1BDBV, looking at an accelerated schedule while adhering to established scientific, ethical and regulatory standards.’

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