Congo's Ebola Outbreak Could Be Worst in Years

Ebola outbreak area
By Craig Timberg
Washington Post Foreign Service
Wednesday, September 19, 2007

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.

Only nine cases of the disease have been confirmed by laboratory tests. But medical authorities suspect the virus has killed 168 people and sickened 375 others across a heavily forested region where villages are linked only by deeply rutted dirt roads. Health officials said it is possible that new cases will continue to emerge over the coming months.

"It's a serious outbreak," said Peter H. Kilmarx, an official with the U.S. Centers for Disease Control and Prevention who toured the area last weekend. "Every day there is a new town with a reported suspect case."

The outbreak's epicenter, which is serviced by a dirt-and-grass airstrip, consists of three towns in Congo's Kasai Occidental province, but the affected area appears to stretch for more than 100 miles.

Kilmarx, speaking from the Congolese capital of Kinshasa, said that one village market he visited had been abandoned and that many Congolese in the area appeared reluctant to shake hands for fear of contracting the highly contagious disease.

Efforts to control Ebola depend on identifying and isolating those who are infected. There is no cure, and many who contract the virus die, typically from acute flu-like symptoms such as high fever, headaches and diarrhea. Hemorrhaging also is common, and bodily fluids containing the virus are the main source of transmission. In previous outbreaks, caretakers and those involved in burying victims were particularly susceptible.

"The only thing you can do is isolate the patient and avoid other infections," said Josep Prior, the top official with Doctors Without Borders in Congo, speaking from Kinshasa. "It's quite shocking. It's not easy to endure such a thing."

The international medical aid group has taken the lead in a global response that also includes the World Health Organization and the CDC team. These groups are assisting Congolese medical authorities in tracking the disease, alerting the public and caring for the ill.

Doctors Without Borders has converted a mud-walled building with a tin roof into a 15-bed isolation ward. To prevent infection, members of medical teams wear protective suits along with surgical masks, gloves and boots. Orange plastic fencing, stretched between tree branches pounded into the ground, keeps potential onlookers away.

As doctors across the region report suspected new cases, medical teams are preparing to visit villages by truck and motorbike in search of people with symptoms. That process may yield many more cases, and two mobile laboratories being flown to the area will speed the process of confirming cases.

Anyone who had contact with an infected person is supposed to be identified, but the logistics are daunting in an area where roadways are so damaged by war and neglect that a trip of only several miles can take an hour.

Doctors Without Borders also is assisting Congolese authorities in attempting to keep medical facilities open. Without proper training and protective clothing, some medical personnel are reluctant to treat patients with Ebola.

Gregory Hartl, a spokesman for the World Health Organization, said other diseases, including typhoid, malaria and shigellosis, may be responsible for some of the deaths now attributed to Ebola. Reports of suspicious deaths date to April. WHO also has called for international help to control the outbreak.

Cases of Ebola have been reported over the past decade in Congo, Sudan, Uganda, Gabon and South Africa. An outbreak in Congo in 2003 killed 128 people; an outbreak there in 1995 killed 250.

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