adminTWO outbreaks, two entirely different outcomes. The World Health Organisation has declared an outbreak of Ebola over in the Democratic Republic of Congo after just 66 cases and 49 deaths. It lasted three months. Yet the epidemic in Liberia, Sierra Leone and Guinea has been going for nine months, with more than 15 000 cases, 5 000 deaths and no end in sight.
What’s the difference? Experts say experience matters – it was the seventh outbreak in the former Zaire. But equally important is the fact that the village where it started was extremely remote, and the country has a rudimentary system of healthcare workers who know how to look out for Ebola.
The latest outbreak started when a pregnant woman was preparing game meat her husband had brought home for the family in Ikanamongo, a village in north-western Democratic Republic of Congo (DRC).
After she died of an unknown illness, healthcare workers performed a caesarian section to remove her foetus.
“It’s local custom – you can’t be buried with a foetus inside,” said Ben Monroe, a Centres for Disease Control and Prevention epidemiologist who has worked in both the DRC and Liberia.
“All the health care workers involved fell ill.” Within a week of the unfortunate woman’s death on August 11, there were 23 other cases and 13 of them had died.
“That raised a lot of alarm in the system. Someone in the health authority there recognised what was going on,” said Monroe.
“Congolese people have been hearing about Ebola for years and years and years,” Monroe added. “They put a fair amount of effort into preparing for situations like this.”
Not too far away, the Ebola River flows. Dr Peter Piot, who discovered the Ebola virus in 1976, named it after this river.
It also didn’t hurt that the CDC had been studying monkey-pox in the same forests since 2010. “We go every year, and train health care workers on infection control and disease surveillance,” Monroe said. “There’s been a lot of public education in this particular region in addition to training health care workers.”
Local health experts knew how to quickly identify potential cases and isolate them. It doesn’t help the patients much – the death rate is still very high – but it keeps the virus from spreading. Isolation is also not difficult. The area is very heavily forested and most people live along the rivers. There’s not much travel or trade.
Compare that to the area where Guinea, Liberia and Sierra Leone come together in West Africa. The current boundaries cross over ancient kingdoms, and people travel freely across the borders in trucks, by canoe, on motorcycles and on foot. There’s a lot of informal trade and commerce.
Years of civil war have left little infrastructure and even less trust in government, especially in Liberia.
Ebola had never been seen there. When someone shows up with fever at a clinic, health workers usually assume it’s malaria, and if there are more severe symptoms they might suspect another viral haemorrhagic fever, Lassa fever, or yellow fever. Ebola didn’t enter anyone’s minds for months as the virus was carried across borders and finally into crowded cities like Monrovia. — NBCNews.
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